Meningioma or Pituitary Adenoma?

The diagnosis of meningioma is easy when the tumor is associated with dural or bony changes, such as at the tuberculum sellae, anterior clinoid process, or dorsum sellae. Blistering of the planum sphenoidale is characteristic of this location. The sella is usually not enlarged in menigiomas at the difference with what is observed in PitNETs. The diagnosis of meningioma could be less easy at the sellar diaphragm level and in the cavernous sinus and mimic pituitary adenoma. The pituitary gland is almost never located below a pituitary macroadenoma, at the difference of what is observed in meningiomas or in RCCs. Meningiomas of the cavernous sinus frequently invade the sella, mimicking an adenoma, but meningiomas frequently exhibit a T2W hyperintensity if compared with PitNET. Stenosis of the intracavernous internal carotid artery seen in meningiomas is inconstant and not specific.