COEXISTING PRIMARY EMPTY SELLA SYNDROME AND ACROMEGALY

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Abstract
The empty sella syndrome is now a more frequent diagnosis due to the increased use of pneumoencephalography in the evaluation of the enlarged pituitary fossa. This syndrome has also been classified into a primary form in which there has been no prior pituitary irradiation or surgery, and a secondary form in which the empty sella is found after such procedures. Most patients with the primary empty sella syndrome are found to have normal pituitary function while about 30% have varying degrees of hypopituitarism. It is not widely appreciated that the primary empty sella may harbor a pituitary tumor with resultant acromegaly. In this report 2 such patients are described who presented with active acromegaly. This entity of pituitary tumor in a primary empty sella merits careful consideration since the coexistence of these 2 findings may influence the therapeutic approach that might otherwise be appropriate for the pituitary tumor.

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