Simin Soltaninejad and Maryam Bahador
It is the first time to report a coincidence of nasopharyngeal carcinoma and pituitary adenoma in a 36-year-old female with a history of chronic nocturnal headaches in the temporal region. The nasopharyngeal mass was missed during the initial visits as the patient was evaluated due to the secreting pituitary adenoma. Her initial symptoms were six months of amenorrhea, massive bilateral galactorrhea and typical clinical signs of acromegaly. It was just during the rhinoplasty that the nasopharyngeal mass was detected for the first time, using the endoscope. Histopathology reported non-keratinizing nasopharyngeal carcinoma (differentiated) and also pituitary adenoma. During the radiotherapy for the nasopharyngeal carcinoma, the patient showed visual symptoms including ptosis and outward deviation of the eye. Since the patient did not consent to the excision of the pituitary adenoma, the field of radiotherapy was increased to include the pituitary adenoma as well. As a result, after three months, all the patient's symptoms, including headache and vision problems, were completely resolved. There was no evidence of recurrence or disease progression on follow-up after 14 months.