Imaging Characteristics of a Hypervascular Pituitary Spindle Cell Oncocytoma on Magnetic Resonance Imaging and Digital Subtraction Angiography.


Journal

World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275

Informations de publication

Date de publication:
Jan 2020
Historique:
received: 06 08 2019
revised: 19 09 2019
accepted: 20 09 2019
pubmed: 1 10 2019
medline: 25 1 2020
entrez: 1 10 2019
Statut: ppublish

Résumé

Spindle cell oncocytomas (SCOs) are rare neuroendocrine tumors of the posterior pituitary that are often misdiagnosed as nonfunctional pituitary tumors. Fewer than 50 cases of SCOs have been described in the literature, and many of these reports have documented the tumors to be hypervascular on imaging or histology. We present the first cerebral angiography imaging findings of an SCO before primary resection. The discovery of a prominent tumor blush, enlarged meningohypophyseal feeders bilaterally, and prominent tumor draining veins aided in preoperative planning and subsequent successful endoscopic transsphenoidal surgical resection. Despite being a rare entity, SCOs should be included in the differential diagnosis when working up a hypervascular sellar tumor. Flow voids may be present on initial magnetic resonance imaging evaluation. Subsequent digital subtraction angiography can be used to further investigate abnormal vasculature and aid in surgical planning.

Sections du résumé

BACKGROUND BACKGROUND
Spindle cell oncocytomas (SCOs) are rare neuroendocrine tumors of the posterior pituitary that are often misdiagnosed as nonfunctional pituitary tumors. Fewer than 50 cases of SCOs have been described in the literature, and many of these reports have documented the tumors to be hypervascular on imaging or histology.
CASE DESCRIPTION METHODS
We present the first cerebral angiography imaging findings of an SCO before primary resection. The discovery of a prominent tumor blush, enlarged meningohypophyseal feeders bilaterally, and prominent tumor draining veins aided in preoperative planning and subsequent successful endoscopic transsphenoidal surgical resection.
CONCLUSIONS CONCLUSIONS
Despite being a rare entity, SCOs should be included in the differential diagnosis when working up a hypervascular sellar tumor. Flow voids may be present on initial magnetic resonance imaging evaluation. Subsequent digital subtraction angiography can be used to further investigate abnormal vasculature and aid in surgical planning.

Identifiants

pubmed: 31568904
pii: S1878-8750(19)32539-2
doi: 10.1016/j.wneu.2019.09.108
pii:
doi:

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

56-59

Informations de copyright

Copyright © 2019 Elsevier Inc. All rights reserved.

Auteurs

Yangchun Li (Y)

Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA. Electronic address: yxl1845@miami.edu.

Stephanie H Chen (SH)

Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.

Dallas Sheinberg (D)

Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.

Simon Buttrick (S)

Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.

Corinna G Levine (CG)

Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA.

Rita G Bhatia (RG)

Department of Radiology, University of Miami Miller School of Medicine, Miami, Florida, USA.

Byron L Lam (BL)

Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, Florida, USA.

Joshua Pasol (J)

Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, Florida, USA.

Alejandro R Ayala (AR)

Department of Endocrinology, University of Miami Miller School of Medicine, Miami, Florida, USA.

Robert M Starke (RM)

Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.

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Classifications MeSH