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Cuoco JA, Strohman AC, Stopa BM, Stump MS, Entwistle JJ, Witcher MR, Olasunkanmi AL. Supratentorial cortical ependymoma: A systematic literature review and case illustration. Rare Tumors 2022; 14:20363613221112432. [PMID: 35836750 PMCID: PMC9274435 DOI: 10.1177/20363613221112432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/10/2022] [Indexed: 11/26/2022] Open
Abstract
Cortical ependymomas are currently not considered a subgroup of supratentorial
ependymomas; however, there is a growing body of literature investigating the
natural history of these lesions compared to supratentorial ependymomas. We
performed a systematic literature review of cortical ependymomas with a focus on
the natural history, clinical characteristics, and clinical outcomes of these
lesions as compared to supratentorial ependymomas. Our search revealed 153
unique cases of cortical ependymomas. The mean age on presentation was
21.2 years. Males and females comprised 58.8% (90/153) and 41.2% (63/153) of
cases, respectively. The most common presenting symptom was seizure activity
occurring in 44.4% of the cohort (68/153). The recently recognized
C11orf95-RELA fusion was identified in 13.7% of the cohort
(21/153) and 95.5% of cases (21/22) reporting molecular characterization. World
Health Organization grades 2 and 3 were reported in 52.3% (79/151) and 47.7%
(72/151) of cases, respectively. The frontal lobe was involved in the majority
of cases (54.9%, 84/153). Gross total resection was achieved in 80.4% of cases
(123/153). Tumor recurrence was identified in 27.7% of cases (39/141). Mean
clinical follow-up was 41.3 months. Mean overall survival of patients who
expired was 27.4 months whereas mean progression-free survival was 15.0 months.
Comparatively, cortical ependymomas with
C11orf95-RELA fusions and supratentorial
ependymomas with C11orf95 RELA fusions exhibited differing
clinical outcomes. Further studies with larger sample sizes are necessary to
investigate the significance of RELA fusions on survival in
cortical ependymomas and to determine whether cortical ependymomas with
C11orf95-RELA fusions should be classified
as a distinct entity.
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Affiliation(s)
- Joshua A Cuoco
- Section of Neurosurgery, Carilion Clinic, Roanoke, VA, USA.,School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA.,Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Andrew C Strohman
- Section of Neurosurgery, Carilion Clinic, Roanoke, VA, USA.,Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Brittany M Stopa
- Section of Neurosurgery, Carilion Clinic, Roanoke, VA, USA.,Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Michael S Stump
- Virginia Tech Carilion School of Medicine, Roanoke, VA, USA.,Department of Pathology, Carilion Clinic, Roanoke, VA, USA
| | - John J Entwistle
- Section of Neurosurgery, Carilion Clinic, Roanoke, VA, USA.,School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA.,Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Mark R Witcher
- Section of Neurosurgery, Carilion Clinic, Roanoke, VA, USA.,School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA.,Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Adeolu L Olasunkanmi
- Section of Neurosurgery, Carilion Clinic, Roanoke, VA, USA.,School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA.,Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
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Zhao L, Jiang Y, Wang Y, Bai Y, Liu L, Li Y. Case Report: Sellar Ependymomas: A Clinic-Pathological Study and Literature Review. Front Endocrinol (Lausanne) 2021; 12:551493. [PMID: 34168614 PMCID: PMC8218727 DOI: 10.3389/fendo.2021.551493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 04/19/2021] [Indexed: 11/20/2022] Open
Abstract
Ependymomas are primary glial tumors arising from cells related to the ependymal lining of the ventricular system. They are classified into at least nine different molecular subtypes according to molecular phenotype, histological morphology, and tumor location. Primary sellar ependymoma is an extremely rare malignancy of the central nervous system, with only 12 known cases reported in humans. We herein report a case of ependymoma located at the pituitary region in a 44-year-old female patient and discuss the molecular subtype, natural history, clinical presentation, radiological findings, histological features, immunohistochemical characteristics, ultrastructural examinations, treatment, and prognosis of sellar ependymoma. This case report may serve as a helpful reference for clinicians and radiologists in clinical practice.
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Affiliation(s)
- Liyan Zhao
- Department of Clinical Laboratory, Second Hospital of Jilin University, Changchun, China
| | - Yining Jiang
- Department of Neurosurgery, First Hospital of Jilin University, Changchun, China
| | - Yubo Wang
- Department of Neurosurgery, First Hospital of Jilin University, Changchun, China
| | - Yang Bai
- Department of Neurosurgery, First Hospital of Jilin University, Changchun, China
| | - Liping Liu
- Department of Clinical Laboratory, Second Hospital of Jilin University, Changchun, China
| | - Yunqian Li
- Department of Neurosurgery, First Hospital of Jilin University, Changchun, China
- *Correspondence: Yunqian Li,
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Guerrero-Pérez F, Marengo AP, Vidal N, Iglesias P, Villabona C. Primary tumors of the posterior pituitary: A systematic review. Rev Endocr Metab Disord 2019; 20:219-238. [PMID: 30864049 DOI: 10.1007/s11154-019-09484-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
In 2017, the World Health Organization established that pituicytoma, granular cell tumor (GCT), spindle cell oncocytoma (SCO) and sellar ependymomas (SE) are posterior pituitary tumors (PPT). They probably arise from the pituicytes and may constitute a unique histopathological entity. We carried out a systematic review using PubMed's database. A total of 266 patients with pathological diagnosis of PPT (135 pituicytomas, 69 GCT, 47 SCO, 8 SE and 7 mixed histology tumors) were analyzed. Gender distribution was identical and median age at diagnosis was 48 ± 21.8 years. Main presentation symptoms were visual disorders (n = 142; 58.1%), headache (n = 99; 40.5%), hypopituitarism (n = 84; 34.4%), hypercortisolism (n = 10; 4.1%), polyuriapolydipsia (n = 6; 2.4%) and acromegaly features (n = 5; 2.0%). On MRI, 122 (47.6%) patients showed sellar with suprasellar extension masses, 67 (23.1%) were suprasellar and 63 (24.6%) exclusively sellar. Median tumor size was 22.0 ± 14.2 mm. Two hundred sixty four patients underwent surgery, transphenoidal access was selected in 132 (64.4%) and craniotomy in 58 (28.3%). Complications were hypopituitarism (n = 70; 42.1%), diabetes insipidus (n = 55; 33.1%) and hemorrhage (n = 50; 30.1%). Tumor persisted in 93 patients (45.6%) and recurred in 13 (6.4%). Regarding comparison between main types of PPT, SCO patients were diagnosed later (60.0 vs 47.0 vs 47.0 years, p = 0.023), the tumor was larger 25.0 mm [10.8] vs 20.0 mm [14.2] vs 2.0 mm [15.0] and they were frequently sellar with suprasellar extension tumors (71.7% vs 46.2% vs 32.8%, p = 0.003) compared to pituicytoma and GCT. In conclusion, PPT are rare tumors and have been misdiagnosed mainly as non-functioning pituitary adenomas. Different types of PPT share similar epidemiology, clinical manifestations and surgical outcomes. Surgery is the only curative option but complications and subtotal resection are common.
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Affiliation(s)
- Fernando Guerrero-Pérez
- Department of Endocrinology, Bellvitge University Hospital, Carrer de la Feixa Llarga, s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Agustina Pia Marengo
- Department of Endocrinology, Bellvitge University Hospital, Carrer de la Feixa Llarga, s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Noemi Vidal
- Department of Pathology, Bellvitge University Hospital, Carrer de la Feixa Llarga, s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Pedro Iglesias
- Department of Endocrinology, Puerta de Hierro Majadahonda University Hospital, Calle Manuel de Falla, 1, 28222, Majadahonda, Madrid, Spain
| | - Carles Villabona
- Department of Endocrinology, Bellvitge University Hospital, Carrer de la Feixa Llarga, s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain
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Wang M, Zhang R, Liu X, Li D, Zhao P, Zuo Y, Zhang P, Wang J, Sun H. Supratentorial Cortical Ependymomas: A Retrospective Series of 13 Cases at a Single Center. World Neurosurg 2018; 112:e772-e777. [PMID: 29408575 DOI: 10.1016/j.wneu.2018.01.153] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 01/18/2018] [Accepted: 01/19/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Cortical ependymomas (CEs), supratentorial ependymomas that selectively involve the cerebral cortex, are relatively rare neoplasms that have not been extensively described. The purpose of our study was to identify the clinical features, radiologic characteristics, and treatment of a series of such tumors. METHODS Thirteen patients with CEs from our hospital were included in this study. Epidemiologic characteristics, clinical features, imaging findings, treatment methods, and clinical outcomes were reviewed retrospectively. RESULTS The patients consisted of 7 men and 6 women with mean age of 31.1 ± 23.2 years (range, 4-74 years). The most common clinical manifestation was seizure (n = 11; 85%), followed by headache (n = 2; 15%). None of the tumors were incidentally detected. Eight CEs were located in the right hemisphere and 5 in the left side. The 2 most common tumor locations were the frontal (n = 5; 38%) and parietal lobe (n = 5; 38%). All patients underwent surgical resection. Gross total resection was achieved in 12 patients (92%), and subtotal resection was performed in 1 patient (8%). Ten of the 11 patients who presented with seizure are seizure-free after surgery (91% seizure-free rate). According to the World Health Organization classification system, 9 tumors (69%) were Grade II (ependymoma) and 4 (31%) were Grade III (anaplastic ependymoma). The mean follow-up was 52 months (range, 20-88 months). No recurrence was observed in patients with Grade II CEs. Of 4 patients with Grade III CEs, 2 (50%) suffered from tumor recurrence after initial treatment. CONCLUSIONS CEs are a rare subset of supratentorial ependymomas that selectively involve the cerebral cortex. Most CEs are low grade and present with seizures. Anaplastic CEs show a greater recurrence rate and a relatively poor prognosis. Gross total resection with or without adjuvant radiotherapy is currently the optimal treatment for CEs. CEs seem to have a more favorable prognosis than other supratentorial ependymomas.
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Affiliation(s)
- Mengmeng Wang
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Rende Zhang
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xueyou Liu
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Dongming Li
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Peichao Zhao
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuchao Zuo
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Peng Zhang
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Junkuan Wang
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hongwei Sun
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
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Wang S, Zong W, Li Y, Wang B, Ke C, Guo D. Pituitary Ependymoma: A Case Report and Review of the Literature. World Neurosurg 2017; 110:43-54. [PMID: 29102750 DOI: 10.1016/j.wneu.2017.10.134] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 10/22/2017] [Accepted: 10/24/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Pituitary ependymoma is exceptionally rare. Its etiology, clinical presentation, radiologic feature, and treatment strategy are still a matter of debate. Only 7 human cases with limited data were reported in the English literature, and now we described another case of pituitary ependymoma. We also systematically reviewed previously reported cases and described its potential etiology, clinical presentation, radiologic features, pathology, immunohistochemical analysis, and ultrastructural examinations. CASE DESCRIPTION A lesion in pituitary fossa was discovered in a 40-year-old man after suffering a progressive deterioration of vision in his right eye for >1 year with intermittent headache. The lesion was microsurgically resected and proved to be ependymoma upon pathologic and histologic examination. The patient made a fully recovery after surgery. CONCLUSIONS To our knowledge, only 7 patients with ependymoma in the sellar region have been described in the English literature. We reported 1 more case of pituitary ependymoma and discussed the potential etiology, clinical presentation, radiologic features, pathology, immunohistochemical analysis, ultrastructural examinations, treatment, surgery, radiotherapy, chemotherapy, and prognosis of pituitary ependymoma. The case report may serve as a helpful reference for clinicians and radiologists.
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Affiliation(s)
- Sheng Wang
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Weifeng Zong
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Youwei Li
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Baofeng Wang
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Changsu Ke
- Department of Pathology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Dongsheng Guo
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.
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6
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Lee JS, Cho KH, Hong EK, Shin SH. Pituitary Ependymoma, 10-Year Follow-Up after Partial Resection and Radiation Therapy. Brain Tumor Res Treat 2017; 5:94-98. [PMID: 29188210 PMCID: PMC5700033 DOI: 10.14791/btrt.2017.5.2.94] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 06/11/2017] [Accepted: 06/19/2017] [Indexed: 11/23/2022] Open
Abstract
Ependymoma usually arises within the ventricles and central canal of the spinal cord. These tumors, found in the sellar region, are extremely rare. We report a case of pituitary ependymoma followed up over 10 years. A 59-year-old male patient presented with fatigue, general weakness, erectile dysfunction, and loss of body hair, including pubic hair. Brain magnetic resonance imaging (MRI) revealed a 3.3×3.5×2.3-cm sellar and suprasellar snowman-shaped enhancing mass. The tumor was partially resected via the trans-sphenoidal approach followed by postoperative radiation therapy. The pathologic confirmation was pituitary ependymoma. At the 10-year follow up, MRI revealed no evidence of tumor progression. With lack of knowledge about pituitary ependymoma, our case is the only case in which the disease has been well controlled over a long period of time without tumor progression.
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Affiliation(s)
- Jong Seok Lee
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea
| | - Kwan Ho Cho
- Proton Therapy Center, National Cancer Center, Goyang, Korea
| | - Eun Kyung Hong
- Department of Pathology, National Cancer Center, Goyang, Korea
| | - Sang-Hoon Shin
- Neuro-Oncology Clinic, National Cancer Center, Goyang, Korea
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Parish JM, Bonnin JM, Goodman JM, Cohen-Gadol AA. Intrasellar ependymoma: Clinical, imaging, pathological, and surgical findings. J Clin Neurosci 2015; 22:638-41. [DOI: 10.1016/j.jocn.2014.10.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 10/17/2014] [Indexed: 10/23/2022]
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9
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Bian LG, Sun QF, Wu HC, Jiang H, Sun YH, Shen JK. Primary choroid plexus papilloma in the pituitary fossa: case report and literature review. Acta Neurochir (Wien) 2011; 153:851-7. [PMID: 21140177 DOI: 10.1007/s00701-010-0884-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2010] [Accepted: 11/12/2010] [Indexed: 11/30/2022]
Abstract
Choroid plexus papillomas are rare tumors of the central nervous system and are usually confined to the ventricular system. We illustrated a primary choroid plexus papilloma in the pituitary fossa. A 31-year-old female presented with amenorrhea and intermittent galactorrhoea, with no visual complaints in the last 2 years. Endocrine testing showed no hormone excess or deficiency of the pituitary and target glands, except for a higher prolactin level (56 ng/ml). A sharply circumscribed regular mass in the sellar region occupying the entire sella turcica and extending into the suprasellar cistern was demonstrated on MR imaging with gadolinium diethylenetriamine pentaacetic acid. The patient underwent an endonasal trans-sphenoidal approach. Complete microsurgical excision and complete preservation of the normal pituitary gland was achieved, with normal prolactin level. The histopathology showed that the lesion was a choroid plexus papilloma. Theories of the origin, the differential diagnosis, and treatment of the rare tumor are discussed.
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Affiliation(s)
- Liu-Guan Bian
- Department of Neurosurgery, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, People's Republic of China.
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Belcher R, Chahal HS, Evanson J, Afshar F, Marino S, Grossman AB. Recurrent pituitary ependymoma: a complex clinical problem. Pituitary 2010; 13:176-82. [PMID: 18704689 DOI: 10.1007/s11102-008-0139-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Ependymomas rarely arise from the region of the pituitary fossa, with only four cases previously reported in the literature. We present a complex case of a recurrent ependymoma of the parasellar region which has been difficult to clinically manage due to its tendency to recurrence. Our patient has had four operations over the last 28 years, with external beam radiotherapy, but still has residual tumor and is currently panhypopituitary and with significant visual loss. We believe there is considerable uncertainty as to the optimal management of any future progression, which seems likely, and are currently considering the use of radiosurgery with careful sparing of the optic chiasm, or possibly the chemotherapeutic agent temozolomide. Our case emphasises the recurrent nature of this rare but difficult tumor.
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Affiliation(s)
- Rosie Belcher
- Department of Endocrinology, Barts and the London School of Medicine, London, UK
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Scheithauer BW, Swearingen B, Whyte ETH, Auluck PK, Stemmer-Rachamimov AO. Ependymoma of the sella turcica: a variant of pituicytoma. Hum Pathol 2008; 40:435-40. [PMID: 18992914 DOI: 10.1016/j.humpath.2008.08.013] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2008] [Revised: 08/19/2008] [Accepted: 08/26/2008] [Indexed: 01/09/2023]
Abstract
A broad spectrum of neoplasms affects the sellar region. Among these, gliomas are rare, most being tumors of pituicytes such as granular cell tumor and pituicytoma. Only 4 ependymomas of the human sellar region have been reported to date and all have had classic histologic features. Herein, we describe the clinicopathologic features of a sellar, low-grade ependymoma with unusual histology, but classic ultrastructural features, occurring in an elderly patient and thus expanding the spectrum of reported cases. The literature is reviewed and concepts of histogenesis are explored, particularly an origin in "ependymal pituicytes." The concept that sellar ependymoma is pituicyte-derived is explored.
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Affiliation(s)
- Bernd W Scheithauer
- Department of Pathology and Laboratory Medicine, Mayo Clinic, Rochester, MN 55905, USA.
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Abstract
✓The authors describe a case of pituitary fossa ependymoma and discuss its immunohistochemical and ultrastructural characteristics. A 43-year-old man presented with decreased libido and panhypopituitarism. Magnetic resonance imaging demonstrated a well-demarcated enhancing lesion of the pituitary fossa that was completely resected via a trans-sphenoidal approach. Ependymomas rarely occur in the pituitary fossa, and have been reported in this location only three times in humans and once in a horse. This is the first study in which investigators examined the appearance of a pituitary ependymoma by using electron microscopy. Theories of the origin and treatment of these rare tumors are discussed as they relate to other articles on intracranial ependymomas.
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Affiliation(s)
- Karim Mukhida
- Division of Neurosurgery, University of Toronto and Toronto Western Hospital, Toronto, Ontario, Canada.
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Abstract
This article reviews published evidence on the diagnosis and classification of pituitary gland tumours and the relevance of histological and genetic features to prognosis. Much of the literature is devoted to the histological, ultrastructural, and immunocytochemical classification of pituitary adenomas (extensively supported by multicentre studies), with little consensus on the identification of prognostic features in adenomas, particularly in relation to invasion. There is a lack of correspondence between clinical and pathological criteria to identify and classify invasion, and a need to reassess the nomenclature and diagnostic criteria for invasive adenomas and carcinomas. Recent cytogenetic, genetic, and molecular biological studies have identified no consistent abnormalities in relation to pituitary tumour progression, although many genes are likely to be involved. In light of these uncertainties, an approach to the diagnosis and classification of pituitary adenomas is suggested, based on robust criteria from earlier studies and incorporating provisional data that require reassessment in large prospective studies with an adequate clinicopathological database.
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Affiliation(s)
- J W Ironside
- Division of Pathology, School of Clinical and Molecular Medicine, University of Edinburgh, Western General Hospital, Edingurgh EH4 2XU, UK.
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Abstract
Whilst pituitary adenomas are the commonest cause of a sellar mass, there are a number of other neoplastic, infectious, inflammatory, developmental and vascular aetiologies that should be considered by the radiologist. We discuss and illustrate these lesions and indicate the various magnetic resonance imaging features that are helpful in formulating an appropriate differential diagnosis.
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Affiliation(s)
- S E J Connor
- Department of Neuroradiology, King's College Hospital, London, U.K.
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