Abstract
Pituitary adenomas are by far the most common tumours of the sellar region, comprising 90 to 95% of all such tumours. Meningiomas, craniopharyngiomas(particularly in children), Rathke’s cleft cysts and aneurysms are the most likely differential diagnoses. The majority of pituitary tumours are asymptomatic, discovered as “incidentalomas” in the course of investigation for other conditions. The rest, along with other sellar lesions, present with symptoms of endocrine dysfunction, mass effect on surrounding structures, commonly the optic nerves or chiasm, or headache. Apart from Prolactin secreting tumours, which respond to dopamine agonists, the mainstay of treatment is surgery, with or without radiotherapy. Prior to surgery, even as an emergency, all sellar tumour patients should have thyroid function tests, Prolactin levels and adequate imaging. Any patient with a tumour with suprasellar extension should undergo formal visual field assessment. MRI scanning is the imaging modality of choice, with a CT scan for sphenoid septal anatomy if a transphenoidal approach is to be undertaken.
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References
Kontogeorgos G, Kovacs K, Horvath E, Sheithauer BW. Multiple adenomas of the human pituitary: a retrospective autopsy study with clinical implications. J Neurosurg 1991;74:243–7.
Wass JAH et al. Pituitary tumours: recommendations for service provision and guidelines for management of patients. J R Coll Physicians Lond 1997;31:628–36.
Thompson D, Powell MP, Foster O. Atypical presentation of vascular events in pituitary tumours: “nonapoplectic” pituitary apoplexy. J Neurol Neurosurg Psychiatry 1994;57:1441–2.
Powell MP, Lightman SL. The management of pituitary tumours; a handbook. London: Churchill Livingstone, 1996.
Powell MP. The recovery of vision following transsphenoidal surgery for pituitary adenomas. Br J Neurosurg 1995;6:367–73.
El-Mahady, W Powell M. Transsphenoidal management of 28 symptomatic Rathke’s cleft cysts, with special reference to visual and hormonal recovery. Neurosurgery 1998;42(1):7–17.
Ross DA, Norman D, Wilson CB. Radiologic characteristics and results of surgical management of Rathke’s cleft cysts in 43 patients. Neurosurgery 1992;30:173–9.
Louis A. Memoire sur les tumours fongueuses de la dure-mère. Memoires de l’Academie Royale de Chirurgie (Paris), 1774;5:1–59.
Cushing H. The meningiomas (dural endotheliomas): their source and favoured seats of origin. Brain 1922;45:282–316.
Gordon DE, Olson C. Meningiomas and fibroblastic neoplasia in calves induced with bovine papilloma virus. Cancer Res 1993;28:2423–31.
Hakim R, Alexander E, Loeffler JS et al. Results of linear accelerator based radiosurgery for intracranial meningiomas. Neurosurgery 1998;42:3.
Schrell UHM, Rittig MG, Anders M, Koch UH et al. Hydroxyurea for treatment of unresectable and recurrent meningiomas. Decrease in the size of meningiomas in patients treated with hydroxyurea. J Neurosurg 1997;86:840–44.
Simpson D. The recurrence of intracranial meningiomas after surgical removal. J Neurol Neurosurg Psychiatry 1957;20:22–39.
Kleihues P, Burger PC, Scheithauer BW. The new WHO classification of brain tumours. Brain Pathol 1993;3:255–68.
Abrahams JM, Forman MS, Lavi E, Goldberg H, Flamm ES. Haemangiopericytoma of the third ventricle. Case report. J Neurosurg 1999(Feb);90(2):359–62.
Mott FW, Barret JOW. Three cases of tumours of the third ventricle. Arch Neurol (London) 1899;1:417–40.
Bernstein ML, Buchino JJ. The histological similarity between craniopharyngeoma and odontogenic lesions: a reappraisal. Oral Surg 1983;56:502–11.
De Ville CJ, Grant DB, Kendall BE, Neville BGR, Stanhope R, Watkins KE et al. Management of childhood craniopharyngeoma: can the morbidity of radical surgery be predicted? J Neurosurg 1996;85:73–81.
Choux M, Lena G. In: Surgery of the third ventricle, 2nd edn. Appuzo M, editor. William & Williams: Baltimore, 1998.
Wara WM, Sneed PK, Larson DA. The role of radiation therapy in the treatment of craniopharyngeoma. Pediatr Neurosurg 1994;(suppl 1):98–100.
Kobyashi T, Tanaka T, Kida Y. Stereotactic radiosurgery of craniopharyngiomas. Pediatric Neurosurg 1994;(suppl 1):69–74.
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© 2005 Springer-Verlag London Limited
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Stacey, R.J., Powell, M.P. (2005). Sellar and Parasellar Tumors. In: Moore, A.J., Newell, D.W. (eds) Neurosurgery. Springer Specialist Surgery Series. Springer, London. https://doi.org/10.1007/1-84628-051-6_11
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DOI: https://doi.org/10.1007/1-84628-051-6_11
Publisher Name: Springer, London
Print ISBN: 978-1-85233-522-9
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