DIFFICULTIES IN THE MANAGEMENT OF LARGE ASYMPTOMATIC PITUITARY ADENOMA, DETECTED DURING DIAGNOSTIC OF THE CENTRAL GYRUS REGION MENINGIOMA

Multiple intracranial tumors with different histological types diagnosed in the same patient are rare. The combination of meningiomas and pituitary adenomas in most cases concerns patients who received radiation therapy for pituitary adenomas. In our observation, the giant meningioma of the central gyrus area and large asymptomatic pituitary adenoma were diagnosed. As a result of surgical treatment performed in 2 stages, the total removal of the large pituitary adenoma was not achieved, which raised the question of finding alternative non-surgical methods of patient management. According to the results of an additional immunohistochemical study, the presence of somatostatin receptors 2a (SSTR2a) was revealed both in the pituitary adenoma and in the meningioma, which makes it possible to consider the issue of further treatment of pituitary adenoma with somatostatin receptor agonists and might reduce the risk of relapse and meningioma in the patient. Keywords: Meningioma, pituitary adenoma , multiple intracranial tumors, asymptomatic macroadenoma, somatostatin receptors.