Pavan Vasoya1, Saritha Aryan1, Sumit Thakar2, Laxminadh Sivaraju1, Nandita Ghosal3, Alangar S Hegde1. 1. Department of Neurosurgery, Sri Sathya Sai Institute of Higher Medical Sciences, Bangalore, India. 2. Department of Neurosurgery, Sri Sathya Sai Institute of Higher Medical Sciences, Bangalore, India. Electronic address: sumit.thakar@gmail.com. 3. Department of Pathology, Sri Sathya Sai Institute of Higher Medical Sciences, Bangalore, India.
Abstract
BACKGROUND: Intracranial paragangliomas are infrequent and those occurring in the sellar-suprasellar region are rare, with only 31 cases described in literature. CASE DESCRIPTION: We describe 2 cases of sellar-suprasellar paragangliomas in the light of a literature review. The first patient was a 13-year-old boy who presented with an intensely enhancing lesion in the sellar-suprasellar region with multiple flow voids within. Resection of the lesion was limited to a biopsy in view of its hypervascular nature. A second attempt at resection following partial embolization of the lesion was also unsuccessful. The tumor showed progressive reduction in size following radiotherapy. The second case was a 20-year-old man who presented with a similar tumor in the same location. He also had a probable metastatic deposit in the foramen of Magendie. An attempted surgical resection of the suprasellar lesion was abandoned after a biopsy. The patient improved symptomatically after radiotherapy. CONCLUSIONS: We report 2 cases of paraganglioma occurring in a rare location. Presence of flow voids within tumors in the sellar-suprasellar location should alert the surgeon to this entity. The hypervascular nature of these tumors may limit the extent of resection. In cases of inadequate tumor decompression, or if there is evidence of growth of residual tumor, radiotherapy can help to stabilize the disease.
BACKGROUND: Intracranial paragangliomas are infrequent and those occurring in the sellar-suprasellar region are rare, with only 31 cases described in literature. CASE DESCRIPTION: We describe 2 cases of sellar-suprasellar paragangliomas in the light of a literature review. The first patient was a 13-year-old boy who presented with an intensely enhancing lesion in the sellar-suprasellar region with multiple flow voids within. Resection of the lesion was limited to a biopsy in view of its hypervascular nature. A second attempt at resection following partial embolization of the lesion was also unsuccessful. The tumor showed progressive reduction in size following radiotherapy. The second case was a 20-year-old man who presented with a similar tumor in the same location. He also had a probable metastatic deposit in the foramen of Magendie. An attempted surgical resection of the suprasellar lesion was abandoned after a biopsy. The patient improved symptomatically after radiotherapy. CONCLUSIONS: We report 2 cases of paraganglioma occurring in a rare location. Presence of flow voids within tumors in the sellar-suprasellar location should alert the surgeon to this entity. The hypervascular nature of these tumors may limit the extent of resection. In cases of inadequate tumor decompression, or if there is evidence of growth of residual tumor, radiotherapy can help to stabilize the disease.