Figure 1

Before and after the first tumor resection. A. MRI shows an enhanced mass in the sphenoid sinus. The tumor extends into both cavernous sinuses surrounding internal carotid arteries. The pituitary gland and stalk are clearly identified (white arrow), and there is no tumor invasion in the sellaturcica. B. The photo shows a trans-nasal endoscopic view of the tumor. The anterior wall of sphenoid sinus is absent, and a whitish tumor (black arrow) is seen through the nasal cavity. The tumor was elastic and bled easily. There is no tumor invasion in the dura mater in the sellaturcica (black arrowhead). C. The tumor in the sphenoid sinus was totally removed; however, residual tumor is noted in cavernous sinuses (white arrowheads).