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

Guishan Jin,Ruifang Mi,Jian Xie,Shuyu Hao,Fusheng Liu

doi:10.1186/1477-7819-11-178

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.

Highlights

Pituitary adenomas and craniopharyngiomas are two types of common tumors in the sellar or suprasellar areas
We present a case in which a pituitary adenoma and a craniopharyngioma were found to coexist
Electron microscopy showed adenoma cells with the ultrastructural features of a silent pituitary adenoma subtype 3. Aside from these three cases, in which the pituitary adenoma and craniopharyngioma components were admixed, additional cases in which the two components are distinct have been reported. Our study describes another case with the association of a pituitary adenoma and a craniopharyngioma, in which the two components are separated

Summary

Background

Pituitary adenomas and craniopharyngiomas are two types of common tumors in the sellar or suprasellar areas. Craniopharyngiomas represent 1% to 4% of all primary intracranial neoplasms and occur at a rate of 1.3 per million person years [2] The coexistence of these two neoplasms in the sellar or suprasellar areas is rare, and both lesions can attain a large size and cause similar signs and symptoms. Second admission and examination After 4 months, a follow-up MRI showed an enlarged region of isodensity in the suprasellar and prepontine areas (Figure 3, arrow point). (D-F) Contrast MRI showing an enhanced mass in the sellar and suprasellar areas with a cystic mass in the prepontine cistern Sagittal CT and MRI showed an abnormal mixed signal in the suprasellar area and the prepontine cistern, corresponding to a partial contrasting mass with clear edges (Figure 4, arrow point). After 3 months, a follow-up MRI confirmed complete resection of the tumor (Figure 6)

Discussion

Findings

14. Present case

Conclusions