Pituitary Adenoma and Meningioma Collision Tumor: An Additional Case and Systematic Review of the Literature

Background: The coexistence of pituitary adenoma with meningioma is very rare, especially without previous irradiation to a pituitary adenoma. Given variability of presentation, the difficulty with identying 2 separate tumors on imaging, and the potential overlap of local mass effect and hormone effects, determining the extent of resection and goals of surgery can be challenging. Methods: We present an additional case of a pituitary adenoma/meningioma collision tumor in a 61-year-old male patient without previous irradiation who presented with 3 months of progressively worsening peripheral vision. The mass was resected via single approach endoscopic/endonasal for transsphenoidal resection of sellar mass with transtuberculum/transplanum extension. We performed a systematic literature review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines in order to identify published cases of collision tumors in adult population. Results: Including the present case, 22 cases of pituitary adenoma/meningioma collision tumors are present in literature. The average age of presentation is 55 years, and 82% of cases are female. Fifty-nine percent of cases were non-functioning tumors. These cases demonstrated a wide variety of growth patterns including ventral, lateral and retrosellar growth, and it was frequently unclear if 2 separate tumors were present on imaging. Treatment strategy was also variable as 50% were treated surgically via transsphenoidal approach alone, 18% were treated with craniotomy alone, and 32% were treated with combined transsphenoidal and craniotomy. Conclusion: Pituitary adenoma/meningioma collision tumors present a wide range of presentations and growth patterns which strongly affects the surgical decision making. It is not always readily evident on imaging that 2 distinct tumors are present, so surgeons must have a high level of suspicion for this entity to guide surgical planning. Publication History Article published online: 27 February 2026 © 2026. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany