• Makoto Murase, Masahiro Toda, Kentarou Ohara, Eriko Ishihara, and Kazunari Yoshida.
• Department of Neurosurgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan. Electronic address: m.murase.ns@gmail.com.
• World Neurosurg. 2019 Mar 1; 123: 239-243.

BackgroundLarge calcified intrasellar masses, called pituitary stones, have been reported as calcified pituitary adenomas in the literature. Although relatively rare, calcified pituitary adenomas appear in various formations. Thus, whether the lesion is removable-and, if so, which approach is appropriate-mainly depends on its formation and quality.Case DescriptionA 46-year-old woman presented with visual loss and amenorrhea. Although computed tomography showed a uniformly calcified sellar tumor, magnetic resonance imaging displayed heterogenous intensity on T2-weighted images and mild gadolinium enhancement, suggesting that the lesion was a mixture of pituitary adenoma and fine calcification. Thus, we undertook tumor resection via an endoscopic endonasal approach, which resulted in total removal. The pathological diagnosis was a pituitary adenoma with rich calcification.ConclusionsWe report a rare case of a large pituitary stone that was successfully removed via an endoscopic endonasal approach. This could therefore be a feasible, effective technique for the removal of pituitary stones, although careful analysis of preoperative magnetic resonance imaging is required.Copyright © 2018 Elsevier Inc. All rights reserved.

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