Patient is a middle aged lady presenting with progressively increasing headache for seven to eight months, mainly in the frontal and bitemporal area, episodic at times severe pain. The headache was not associated with any nausea or vomiting. The patient noticed visual decline over last four to six months, right more than left, and now she is barely able to see on the sides bilaterally. There is no history which was suggestive of any significant hormonal abnormalities. On examination, the patient had bitemporal hemianopsia. Her motor sensory system was intact.This lady had a giant pituitary tumour with extension into the sphenoid sinus and reaching up to the third ventricular floor. Also, there were significant lateral extensions as well. However, the tumour was not encircling the Internal carotid artery. Looking to the picture, it was decided for an endoscopic endonasal excision of the tumour. The tumour was found to be soft to firm with areas of necrosis and hemorrhage . We were able to excise the tumour completely. The postops scans have been added . The patient has had CSF leak. Her vision has consistently improved. Pre Operative MRI Scan Images…