Which tumor is associated with bitemporal hemianopsia or junctional scotoma?

Bitemporal hemianopsia or junctional scotoma is most commonly associated with a lesion in the area of the optic chiasm. Pituitary adenomas, which often arise from the pituitary gland located just below the optic chiasm, can lead to pressure on the optic chiasm as they enlarge. This pressure causes a characteristic visual field defect known as bitemporal hemianopsia, where patients lose vision in the outer (temporal) fields of both eyes.

In addition to bitemporal hemianopsia, craniopharyngiomas also occur in the same region and can cause similar visual field defects, but the most classic association is with pituitary adenomas due to their prevalence and direct impact on the optic chiasm with growth. Astrocytomas and brainstem gliomas typically do not affect the optic chiasm in a manner that leads to these specific visual field defects, as they are located in different areas of the brain and have other symptom profiles.