Longitudinal splitting of optic pathways by non-functioning pituitary macroadenoma: Report of two cases

Purpose Pituitary macroadenomas with suprasellar extension present tight relationships with optic pathways; only one case of optic nerve penetration by a pituitary adenoma has been reported previously. Methods We report two cases of patients suffering from non-functioning pituitary macroadenomas with intraoperative findings of longitudinal splitting of the optic pathways. Results In both cases the patients were first operated on by a trans-sphenoidal route and the residual suprasellar tumour was resected by a transcranial surgery. Conclusion The patients presented a good visual recovery, suggesting that the splitting of the optic pathways has not jeopardised the functional and anatomical integrity of the optic fibres in the reported cases.