Intrasellar chordomas mimicking pituitary adenoma

Thodou, Eleni; Kontogeorgos, George; Scheithauer, Bernd W.; Lekka, Ioanna; Tzanis, Spyros; Mariatos, P; Laws, Edward R.

doi:10.3171/foc.2000.8.2.9

Cited by 11 publications

(27 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…32,55,56 Within the clivus, the notochord has a sinuous course, thus explaining the diverse origin and projections of cranial base chordomas. 56 Chordomas arising from the most rostral notochord extension in the dorsum sellae present as sellar 96 or parasellar tumors. Those arising from the most ventral aspect of the clivus can present as nasopharyngeal chordomas, 16,42,75,80,108 whereas those associated with the body and dorsal aspect of the clivus manifest as sphenooccipital or petrosal lesions.…”

mentioning

confidence: 99%

Skull base chordomas: overview of disease, management options, and outcome

Lanzino¹,

As²,

Mb³

et al. 2001

FOC

103

View full text Add to dashboard Cite

Cranial base chordomas are locally invasive tumors that, from a midline, clival location, extend in different directions and display various patterns of skull base invasion. Although histologically benign, their invasive nature makes true “oncological” resection virtually impossible to achieve in most cases, despite modern skull base surgical techniques. Moreover, because of the tumor's location and proximity to critical neural and vascular structures, surgery-related morbidity can be significant when an aggressive resection is undertaken. Cytoreductive surgery assumes a critical role in the management of these lesions. The choice of surgical approach and the extent of resection are dependent on several factors: location and extension of the tumor, the surgeon's philosophy and familiarity with a specific approach, and the patient's preexisting clinical status. Proton-beam radiotherapy seems to be effective as an adjunct to surgery in achieving local tumor control. The timing of radiation therapy, however, remains controversial. Gamma knife surgery has been proposed as an adjunctive therapy, but the limited experience and short follow-up periods do not permit formulation of meaningful conclusions at this time. Recurrences are common, although in a subset of patients prolonged disease-free survival is demonstrated.

show abstract

mentioning

confidence: 99%

Skull base chordomas: overview of disease, management options, and outcome

Lanzino¹,

As²,

Mb³

et al. 2001

FOC

103

View full text Add to dashboard Cite

show abstract

“…Chordomas are rare, slow-growing malignant tumors that arise from remnants of the notochord and consequently are located rostrally and caudally along the midline of the neuroaxis (6,15,27,44). Chordomas represent approximately 2% of all malignant tumors of the bone and 0.1% to 0.2% of all intracranial neoplasms (42).…”

Section: Discussionmentioning

confidence: 99%

“…Despite a recent review that described only 22 patients with primary ISC since 1960, our extensive retrospective review of the literature yielded 16 additional cases of chordoma with sellar involvement (15,44).…”

Section: Navas M Et Al: Intrasellar Chordoma and Pptamentioning

confidence: 99%

“…Ultrastructurally, chordomas lack malignant features such as necrosis or hemorrhage, although occasional mitotic figures and cellular pleomorphism may be present, that is of no prognostic significance (5,15,44). The immunohistochemical profile of chordomas includes reactivity to cytokeratins, vimentin, and epithelial membrane antigen (EMA) (15).…”

Section: Case Reportmentioning

confidence: 99%

“…Additional studies with dynamic MR imaging and spectroscopy may help differentiate ISC from other skull base lesions (27,44).…”

Section: Case Reportmentioning

confidence: 99%

See 2 more Smart Citations

Intrasellar chordoma associated with a primitive persistent trigeminal artery.

Navas¹,

Martinez²,

Barbosa³

et al. 2014

Turkish Neurosurgery

View full text Add to dashboard Cite

Chordomas located primarily in the sellar region are uncommon, and may be misdiagnosed non-functioning pituitary adenoma. Furthermore, the association of a persistent primitive trigeminal artery (PPTA) with an intrasellar chordoma is extremely rare, and no similar cases have been reported in the literature to date. The coexistence of intrasellar chordoma (ISC) and PPTA makes safe and complete tumor resection challenging, and preoperative endovascular occlusion of this artery may be helpful.We report a case of a 32-year-old man who developed right hemifacial paresthesias and a cranial nerve six palsy. MRI study demonstrated the presence of a primary ISC associated with a PPTA. Angiographic balloon test occlusion of the PPTA revealed no neurological changes, so this vessel was endovascularly occluded by coiling. The lesion was subtotally removed through a sublabial transsphenoidal approach, without intraoperative bleeding complications. Histological examination of the lesion was consistent with the diagnosis of chordoma.Detailed preoperative neurovascular evaluation may be useful to detect vascular anomalies associated with intracranial chordomas, such as PPTA. In this report we emphasize the importance of appropriate treatment of vascular anomalies prior intrasellar lesions resection that may facilitate surgery and avoid potential hazardous intraoperative bleeding complications. Sağ hemifasiyal parestezi ve kraniyal altıncı sinir palsisi gelişen 32 yaşında bir erkek olgu bildiriyoruz. MRG çalışması PPTA ile ilişkili bir primer ISC varlığını gösterdi. PPTA'nın anjiyografik balon test oklüzyonu nörolojik değişikliğe neden olmadığından sarmal (koil) ile bu damar endovasküler olarak tıkandı. Lezyon sublabial transsfenoidal yaklaşımla intraoperatif bir kanama komplikasyonu olmadan subtotal olarak çıkartıldı. Lezyonun histolojik incelemesi kordoma tanısıyla uyumluydu.İntrakraniyal kordomalarla ilişkili PPTA gibi vasküler anomalileri saptamak için ayrıntılı preoperatif nörovasküler değerlendirme faydalı olabilir. Bu raporda, intrasellar lezyonların rezeksiyonundan önce cerrahiyi kolaylaştırabilecek ve tehlikeli intraoperatif kanama komplikasyonlarından kaçınmayı sağlayacak şekilde vasküler anomalilerin uygun tedavisinin önemini vurguluyoruz.

show abstract

Sellar chordoma presenting as pseudo-macroprolactinoma with unilateral third cranial nerve palsy

Wang

et al. 2012

Chin. J. Cancer Res.

View full text Add to dashboard Cite

We described a 61-year-old female with a sellar chordoma, which presented as pseudo-macroprolactinoma with unilateral third cranial nerve palsy. Physical examination revealed that her right upper lid could not be raised by itself, right eyeball movement limited to the abduction direction, right pupil dilated to 4.5 mm with negative reaction to light, and hemianopsia in bitemporal sides. CT scanning showed a hyperdense lesion at sellar region without bone destruction. Magnetic resonance imaging (MRI) revealed the tumor was 2.3 cm×1.8 cm×2.6 cm, with iso-intensity on T1WI, hyper-intensity on T2WI and heterogeneous enhancement on contrast imaging. Endocrine examination showed her serum prolactin level increased to 1,031.49 mIU/ml. The tumor was sub-totally resected via pterional craniotomy under microscope and was histologically proven to be a chordoma. Postoperatively, she recovered uneventfully but ptosis and hemianopsia remained at the 6th month.

show abstract

Intrasellar chordomas mimicking pituitary adenoma

Cited by 11 publications

References 39 publications

Skull base chordomas: overview of disease, management options, and outcome

Skull base chordomas: overview of disease, management options, and outcome

Intrasellar chordoma associated with a primitive persistent trigeminal artery.

Sellar chordoma presenting as pseudo-macroprolactinoma with unilateral third cranial nerve palsy

Contact Info

Product

Resources

About