Giant Prolactinoma and Concomitant Internal Carotid Artery Pseudo-Aneurysm: All Stages of the Decision-Making Process

We report a case of right internal carotid artery pseudo-an-eurysm, arising in the aspects of a giant macroadenoma in a 57-years-old man, presented with right severe temporal orbital headache and vomiting.Computed tomography scan (CT) revealed a destructive skull base mass extended from sellar region to clivus. Pre and post-gadolinium brain magnetic resonance (MRI) con-rmed the lesion, characterized by an encasement of optic nerves and carotid siphons bilaterally, with a pseudo-an-eurysm of cavernous segment of the right internal carotid artery (ICA).The patient underwent endoscopic biopsy of the endonasal portion of the lesion with a subsequent diagnosis of prol-actinoma. Endovascular therapy using Derivo® 5 × 25 mm, Acandis® ow diversion embolization device was performed. After subsequent hormonal therapy with Cabergoline, a six months follow-up MRI and digital subtractions angiography (DSA) demonstrated reduction of both tumour and pseu-do-aneurysm volume