Pituitary Adenoma Complicated by Multifocal Fibrosclerosis Involving Sella and Retroperitoneum

Multifocal fibrosclerosis (MFS) is a rare syndrome characterized by the co-occurrence of two or more fibrosing diseases thought to be of similar pathogenesis.Rarely, central nervous system manifestations of pachymeningitis or sellar/suprasellar fibrosis have been described.We report a patient with a pituitary adenoma with extensive fibrosclerotic stroma and idiopathic retroperitoneal fibrosis who initially presented with retroperitoneal fibrosis and obstructive renal failure. One day after transsphenoidal removal of the adenoma, he developed worsening vision, confirmed as hemorrhage into the residual tumor by imaging studies, and required craniotomy.The association of MFS with pituitary adenoma has not been previously reported.Such patients may be at greater risk for hemorrhagic complications due to the consistency of the tumor and its adherence to nearby normal anatomy.