Rita Snyder1, Islam Fayed1, Ehsan Dowlati2, Adair Seager3, Robert B Mason4. 1. Department of Neurosurgery, Medstar Georgetown University Hospital, Washington, DC, USA. 2. Department of Neurosurgery, Medstar Georgetown University Hospital, Washington, DC, USA. Electronic address: edowlati@gmail.com. 3. Department of Pathology, Medstar Washington Hospital Center, Washington, DC, USA. 4. Department of Neurosurgery, Medstar Washington Hospital Center, Washington, DC, USA.
Abstract
BACKGROUND: Different diseases may occur within the same anatomic space and invade one another. Lesions of this nature are described as collision tumors. Collision tumors of the sella are rare, with pituitary adenoma-craniopharyngiomas having been described in only 15 cases. We discuss common and rare lesions of the sellar region, their neurodiagnostic qualities, and treatment considerations. CASE DESCRIPTION: We present the case of a 49-year-old woman presenting with symptoms of headache and blurred vision who underwent a 2-stage procedure and was found to have a craniopharyngioma and corticotrophic pituitary adenoma in collision. We review the literature on various combinations of sellar collision lesions, noting diagnostic and treatment considerations. Neuroimaging, intraoperative pathology, and histologic review help to provide optimum treatment when unusual conditions of the sella arise. CONCLUSIONS: Many mechanisms for the development of collision lesions have been theorized, and further investigation may provide definitive answers regarding the origin of these neoplastic entities.
BACKGROUND: Different diseases may occur within the same anatomic space and invade one another. Lesions of this nature are described as collision tumors. Collision tumors of the sella are rare, with pituitary adenoma-craniopharyngiomas having been described in only 15 cases. We discuss common and rare lesions of the sellar region, their neurodiagnostic qualities, and treatment considerations. CASE DESCRIPTION: We present the case of a 49-year-old woman presenting with symptoms of headache and blurred vision who underwent a 2-stage procedure and was found to have a craniopharyngioma and corticotrophic pituitary adenoma in collision. We review the literature on various combinations of sellar collision lesions, noting diagnostic and treatment considerations. Neuroimaging, intraoperative pathology, and histologic review help to provide optimum treatment when unusual conditions of the sella arise. CONCLUSIONS: Many mechanisms for the development of collision lesions have been theorized, and further investigation may provide definitive answers regarding the origin of these neoplastic entities.
Authors: Jarnail Bal; Michael Bruneau; Moncef Berhouma; Jan F Cornelius; Luigi M Cavallo; Roy T Daniel; Sebastien Froelich; Emmanuel Jouanneau; Torstein R Meling; Mahmoud Messerer; Pierre-Hugues Roche; Henry W S Schroeder; Marcos Tatagiba; Idoya Zazpe; Dimitrios Paraskevopoulos Journal: Acta Neurochir (Wien) Date: 2022-01-25 Impact factor: 2.216