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Reminder of important clinical lesson
Planum sphenoidale meningioma leading to visual disturbance
  1. Nancy Lutwak1,
  2. Curt Dill2,
  3. Rosemary Wieczorek3
  1. 1Department of Emergency Services, VA New York Harbor Healthcare Center, New York, United States
  2. 2Department of Emergency Medicine, VA New York Harbor Healthcare Center, NYU School of Medicine, New York, United States
  3. 3Department of Pathology, VA New York Harbor Healthcare Center, New York, United States
  1. Correspondence to Dr Nancy Lutwak, nancy.lutwak{at}


A 60-year-old male presented with complaints of dizziness, which worsened with fatigue and a sense his balance was ‘off’. Initial physical examination was negative and the laboratory testing was unremarkable. Within weeks, the patient developed bilateral visual field deficits. MRI revealed an extra-axial mass which extended into the pituitary fossa and caused compression of the pituitary gland. The pituitary stalk was displaced posteriorly and the optic chiasm was compressed with displacement superiorly and posteriorly. The patient underwent a surgical resection. Diabetes insipidus developed postoperatively requiring a vasopressin drip. He also developed hypopituitarism after the resection with hypothyroidism, hypoadrenalism and hypogonadism. The patient requires testosterone, levothyroxine and hydrocortisone replacement and has mild residual bitemporal hemianopsia.

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  • Competing interests None.

  • Patient consent Obtained.

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