Endoscopic Endonasal Resection of a GH and Prolactin-Secreting PIT-1 Positive Pituitary Adenoma Invading the Carotico-Clinoid Ligament

PIT-1 expressing pituitary adenomas have higher predilection for invasion of the cavernous sinus medial wall. We present the case of an incidentally diagnosed PIT-1 positive pituitary adenoma with invasion of the carotico-clinoid ligament (CCL) in a 42-year-old woman with headaches and elevated IGF-1/prolactin levels. Radiographically, the sellar mass appeared to abut the left cavernous ICA. Intraoperative inspection demonstrated infiltration of the CCL which was carefully dissected and removed with normalization of IGF-1/prolactin levels postoperatively.