Kissing carotids are a rare variant of the carotid arteries, referring to tortuous and elongated vessels that deviate medially to touch in the midline (or are in close proximity at this point) 1. Kissing carotids may be retropharyngeal or intrasphenoid.
This finding may mimic pituitary disease (both in terms of clinical presentation and on imaging) or complicate transsphenoidal surgeries if not appropriately identified.
The patient also had an incidental basilar invagination.