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Collision tumors of the sella: coexistence of pituitary adenoma and craniopharyngioma in the sellar region.

Jin G, Hao S, Xie J, Mi R, Liu F - World J Surg Oncol (2013)

Bottom Line: Histopathological and immunohistochemical examinations of the excised tissue revealed a pituitary adenoma in the first operation and a craniopharyngioma in the second operation.Retrospective analysis found the coexistence of a pituitary adenoma and a craniopharyngioma, known as a collision tumor.Instead of the transsphenoidal approach, a craniotomy should be performed, to explore the suprasellar region.

View Article: PubMed Central - HTML - PubMed

Affiliation: Brain Tumor Research Center, Beijing Neurosurgical Institute & Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing 100050, China.

ABSTRACT
Collision tumors of the sellar region are relatively uncommon and consist mainly of more than one type of pituitary adenoma or a cyst or cystic tumor. The association of a pituitary adenoma and a craniopharyngioma is particularly rare. This study describes a rare occurrence in which a pituitary adenoma and a craniopharyngioma coexisted in the sellar region. The case involves a 47-year-old woman who underwent transsphenoidal surgery with subtotal tumor resection and reoperation using an interhemispheric transcallosal approach for total microsurgical resection of the tumor because the visual acuity in her left eye had re-deteriorated. Histopathological and immunohistochemical examinations of the excised tissue revealed a pituitary adenoma in the first operation and a craniopharyngioma in the second operation. Retrospective analysis found the coexistence of a pituitary adenoma and a craniopharyngioma, known as a collision tumor. Instead of the transsphenoidal approach, a craniotomy should be performed, to explore the suprasellar region.

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Photomicrographs of the pathological specimen. (A) Features of pituitary adenoma (H &E, ×100). Negative immunohistochemical staining for: (B) growth hormone, (C) prolactin, (D) follicle-stimulating hormone, (E) thyroid-stimulating hormone, (F) luteinizing hormone, (G) ACTH.
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Figure 2: Photomicrographs of the pathological specimen. (A) Features of pituitary adenoma (H &E, ×100). Negative immunohistochemical staining for: (B) growth hormone, (C) prolactin, (D) follicle-stimulating hormone, (E) thyroid-stimulating hormone, (F) luteinizing hormone, (G) ACTH.

Mentions: Transsphenoidal surgery was performed. The tumor was pinkish-gray and soft, and some parts had a rich blood supply with hemorrhage. Subtotal tumor resection was achieved. Staining with H & E revealed a pituitary adenoma consisting of a diffused expansion of cells with pseudo-acinar and pseudo-papillary features (Figure 2A). Immunohistochemical stains for growth hormone, prolactin, follicle-stimulating hormone, thyroid-stimulating hormone, luteinizing hormone, and ACTH were negative, revealing a nonfunctional pituitary adenoma (Figure 2B-G). After surgery, the patient had transient diabetes insipidus and hyponatremia, but she demonstrated fast recovery and her vision improved.


Collision tumors of the sella: coexistence of pituitary adenoma and craniopharyngioma in the sellar region.

Jin G, Hao S, Xie J, Mi R, Liu F - World J Surg Oncol (2013)

Photomicrographs of the pathological specimen. (A) Features of pituitary adenoma (H &E, ×100). Negative immunohistochemical staining for: (B) growth hormone, (C) prolactin, (D) follicle-stimulating hormone, (E) thyroid-stimulating hormone, (F) luteinizing hormone, (G) ACTH.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3750462&req=5

Figure 2: Photomicrographs of the pathological specimen. (A) Features of pituitary adenoma (H &E, ×100). Negative immunohistochemical staining for: (B) growth hormone, (C) prolactin, (D) follicle-stimulating hormone, (E) thyroid-stimulating hormone, (F) luteinizing hormone, (G) ACTH.
Mentions: Transsphenoidal surgery was performed. The tumor was pinkish-gray and soft, and some parts had a rich blood supply with hemorrhage. Subtotal tumor resection was achieved. Staining with H & E revealed a pituitary adenoma consisting of a diffused expansion of cells with pseudo-acinar and pseudo-papillary features (Figure 2A). Immunohistochemical stains for growth hormone, prolactin, follicle-stimulating hormone, thyroid-stimulating hormone, luteinizing hormone, and ACTH were negative, revealing a nonfunctional pituitary adenoma (Figure 2B-G). After surgery, the patient had transient diabetes insipidus and hyponatremia, but she demonstrated fast recovery and her vision improved.

Bottom Line: Histopathological and immunohistochemical examinations of the excised tissue revealed a pituitary adenoma in the first operation and a craniopharyngioma in the second operation.Retrospective analysis found the coexistence of a pituitary adenoma and a craniopharyngioma, known as a collision tumor.Instead of the transsphenoidal approach, a craniotomy should be performed, to explore the suprasellar region.

View Article: PubMed Central - HTML - PubMed

Affiliation: Brain Tumor Research Center, Beijing Neurosurgical Institute & Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing 100050, China.

ABSTRACT
Collision tumors of the sellar region are relatively uncommon and consist mainly of more than one type of pituitary adenoma or a cyst or cystic tumor. The association of a pituitary adenoma and a craniopharyngioma is particularly rare. This study describes a rare occurrence in which a pituitary adenoma and a craniopharyngioma coexisted in the sellar region. The case involves a 47-year-old woman who underwent transsphenoidal surgery with subtotal tumor resection and reoperation using an interhemispheric transcallosal approach for total microsurgical resection of the tumor because the visual acuity in her left eye had re-deteriorated. Histopathological and immunohistochemical examinations of the excised tissue revealed a pituitary adenoma in the first operation and a craniopharyngioma in the second operation. Retrospective analysis found the coexistence of a pituitary adenoma and a craniopharyngioma, known as a collision tumor. Instead of the transsphenoidal approach, a craniotomy should be performed, to explore the suprasellar region.

Show MeSH
Related in: MedlinePlus