Pituitary Macroadenoma Presenting as Odontogenic Pain and Trigeminal Neuralgia: Diagnostic Delay
DOI:
https://doi.org/10.32776/revbiomed.v37.i2.1360Keywords:
Pituitary neoplasms, diagnostic delay, facial pain, pituitary surgery, hemianopsiaAbstract
Introduction: Pituitary macroadenomas may cause progressive neurological deficits due to compression of adjacent structures. Delayed diagnosis increases the risk of visual and endocrine complications.
Case presentation: A 64-year-old male presented with a one-year history of right-sided headache, facial pain, and progressive visual field impairment. Initial evaluations attributed symptoms to dental pathology and later to trigeminal neuralgia. Neuroimaging performed more than one year after symptom onset revealed a 27× 35 × 31 mm parasellar pituitary macroadenoma. The patient underwent transcranial surgical resection, achieving subtotal tumor removal without postoperative neurological or endocrine deficits. Adjuvant radiotherapy was administered due to residual tumor. Histopathological examination confirmed a pituitary neuroendocrine tumor without atypia.
Discussion: This case illustrates how delayed imaging assessment in patients with persistent unilateral headache and visual symptoms may postpone the diagnosis of intracranial tumors, leading to potentially preventable morbidity. Early neuroimaging should be considered when neurological warning signs are present.
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