• Ricardo H Menéndez, Patricio Thompson, Horacio Barea, Ana P Lisdero, Javier Lew, Jaqueline Elvira, Pablo E Lehrner, and Horacio A Sole.
• Department of Neurosciences, Hospital Aleman, Buenos Aires, Argentina; Division of Neurosurgery, Department of Surgery, Sanatorio Julio Mendez, Buenos Aires, Argentina. Electronic address: rmenendez24@yahoo.com.ar.
• World Neurosurg. 2020 Jan 1; 133: 260-265.

BackgroundCoexistence of sinonasal and skull base tumors is uncommon but possible, and the endonasal route seems to be the best option to manage both lesions simultaneously. We report the first case in the English literature of concomitant sphenoid sinus inverted papilloma and pituitary macroadenoma treated through an endoscopic endonasal approach.Case DescriptionA 68-year-old man presented with a history of progressive visual loss and nasal obstruction. Clinical examination disclosed bitemporal hemianopsia. Computed tomography scan and magnetic resonance imaging obtained on admission showed a large sellar/suprasellar enhancing lesion with a marked mass effect on the optic chiasm. Imaging also showed a second mass extending from the sphenoid sinus to the left nasal cavity with obstruction of the maxillary sinus ostium and development of maxillary sinus mucocele. Both tumors were entirely resected by an endoscopic endonasal approach. Additionally, middle meatal antrostomy and marsupialization with drainage of the maxillary mucocele was performed. Biopsy confirmed the coexistence of a pituitary macroadenoma and sphenoid sinus inverted papilloma.ConclusionsThis case and the literature suggest that patients with concomitant nasal and skull base pathologies can be simultaneously managed. The otolaryngologist plays an essential role in removing the sinonasal lesion to ensure a safe surgical corridor before entering the intracranial cavity and for planning for the skull base reconstruction.Copyright © 2019 Elsevier Inc. All rights reserved.

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