Introduction. About 25% of all somatotropic pituitary adenomas are combined somatotropic-lactotropic adenomas, which are characterised by large size (over 40 mm), aggressive growth, increased secretion of prolactin and growth hormone into the blood, which determines the clinical picture of the disease.

Materials and Methods. Patient Z., 51 y.o., with complaints of nasal breathing disorder, moderate headache, mucopurulent nasal discharge, double vision. External signs of acromegaly, curvature of the nasal septum, and a neoplasm in the nasopharynx were detected. According to the results of CT scan of the PNS and MRI of the brain with additional contrast, a tissue mass was detected in the projection of the Turkish saddle with spread to the sphenoid sinuses (wall destruction), posterior nasal cavity and nasopharyngeal lumen. The results of endocrinological studies revealed an increase in the level of prolactin and somatotropic hormone. The patient was operated on jointly with neurosurgeons. A submucosal resection of the nasal septum was performed, the main part of the tumour in the sphenoid sinus was removed using a microscopic transseptal approach, and then the intranasal part of the tumour was removed using an endoscope.

Results. No complications were observed during the surgical intervention and during the postoperative period. The histological picture corresponded to a combined somatotropic-lactotropic adenoma of the pituitary gland. The patient was examined in six months - no recurrence of the tumour was detected.

Conclusions. The endonasal method of surgical treatment of pituitary adenoma has been shown to be effective with satisfactory immediate and long-term results.

The authors declare no conflict of interest