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SUMMARY The‘empty’sella syndrome is now a more frequent diagnosis due to the increased use of pneumoencephalography in the evaluation of the enlarged pituitary fossa. This syndrome has also been classified into a‘primary’form in which there has been no prior pituitary irradiation or surgery, and a ‘secondary’ form in which the empty sella is found after such procedures. Most patients with the primary empty sella syndrome are found to have normal pituitary function while about 30% have varying degrees of hypopituitarism (Neelon et al., 1973).

It is not widely appreciated, however, that the primary empty sella may harbour a pituitary tumour with resultant acromegaly. In this report we describe two such patients who presented with active acromegaly. This entity of pituitary tumour in a primary empty sella merits careful consideration since the coexistence of these two findings may influence the therapeutic approach that might otherwise be appropriate for the pituitary tumour.