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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 showing the features of craniopharyngioma: (A) wet keratin (arrow, H & E, ×100), (B) multiple layers of squamous epithelium (H & E, ×200).
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Figure 5: Photomicrographs of the pathological specimen showing the features of craniopharyngioma: (A) wet keratin (arrow, H & E, ×100), (B) multiple layers of squamous epithelium (H & E, ×200).

Mentions: The patient underwent a right frontal craniotomy using an interhemispheric transcallosal approach for total microsurgical resection of the tumor. The tumor was situated in the suprasellar area and premesencephalon. It was cystic, soft, and yellow-white. Histopathological studies revealed an adamantinomatous craniopharyngioma characterized by squamous epithelium arranged in a trabecular pattern as well as nodules of wet keratin (Figure 5). The post-operative course of the patient was uneventful, with the exception of transient diabetes insipidus and hyponatremia. Endocrinologic testing showed only that levels of free T3 and thyroid-stimulating hormone were slightly lower than normal. The patient’s visual acuity improved again. After 3 months, a follow-up MRI confirmed complete resection of the tumor (Figure 6).


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 showing the features of craniopharyngioma: (A) wet keratin (arrow, H & E, ×100), (B) multiple layers of squamous epithelium (H & E, ×200).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 5: Photomicrographs of the pathological specimen showing the features of craniopharyngioma: (A) wet keratin (arrow, H & E, ×100), (B) multiple layers of squamous epithelium (H & E, ×200).
Mentions: The patient underwent a right frontal craniotomy using an interhemispheric transcallosal approach for total microsurgical resection of the tumor. The tumor was situated in the suprasellar area and premesencephalon. It was cystic, soft, and yellow-white. Histopathological studies revealed an adamantinomatous craniopharyngioma characterized by squamous epithelium arranged in a trabecular pattern as well as nodules of wet keratin (Figure 5). The post-operative course of the patient was uneventful, with the exception of transient diabetes insipidus and hyponatremia. Endocrinologic testing showed only that levels of free T3 and thyroid-stimulating hormone were slightly lower than normal. The patient’s visual acuity improved again. After 3 months, a follow-up MRI confirmed complete resection of the tumor (Figure 6).

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