Two Autopsy Cases Assessing the Association of Rare Tumors Adjacent to the Sella turcica with Cause of Death and a Review of the Literature

Case 1 is an 80 year-old female, who consumed alcohol in a bar, fell down the stairs upon returning home, and was later found deceased. A postmortem CT did not confirm the presence of a tumor. An autopsy confirmed diffuse subarachnoid hemorrhage and a tumor, with a white surface covered by microvasculature pressing on the optic chiasma. The cause of death was traumatic subarachnoid hemorrhage due to an injury to the head while under the influence of alcohol. However, given the formation of a tumor pressing on the optic nerve, a possible causal relationship between the epidermoid cyst and the head injury cannot be excluded. Case 2 is a 60 year-old male, discovered dead in his own home. The autopsy confirmed subarachnoid hemorrhage around the base of the brain, and there was a hematoma-like tumor connected to the pituitary gland. The cause of death was determined to be pituitary bleeding due to pituitary adenoma. As seen in these cases, it is possible that a tumor at the base of the brain, which is a difficult location for identification, would impact the process of death; therefore, studying the grade of tumor, stage, and its involvement in the cause of death are diagnostically critical in forensic autopsies.