Posterior transpetrosal approach to a suprasellar retroinfundibular pituicytoma: A case report and comprehensive literature review

Abstract

Introduction

Pituicytomas are rare benign glial neoplasms (WHO grade I) located in the sellar or suprasellar regions, arising from the neurohypophysis and infundibular area. They typically present with symptoms due to the slow growth of the tumor, including hormonal changes, visual impairment, and headaches.

Research question

This case report evaluates the effectiveness of the posterior transpetrosal approach for the resection of a retroinfundibular suprasellar pituicytoma, focusing on preserving pituitary function and minimizing surgical risks.

Material and methods

We present a 59-year-old female with a pituicytoma diagnosed by MRI and digital subtraction angiography (DSA). Preoperative embolization was performed to reduce the tumor’s vascularity. The patient underwent a left posterior transpetrosal approach for tumor resection, with key surgical steps focusing on preserving the pituitary stalk, optic chiasm, and perforating vessels.

Results

The posterior transpetrosal approach provided excellent exposure, enabling near-total resection of the tumor. The patient had no new neurological deficits postoperatively, and follow-up MRI at 6 months showed no tumor recurrence.

Discussion and conclusion

This case demonstrates the safety and efficacy of the posterior transpetrosal approach for pituicytoma resection. The approach allowed for optimal visualization and preservation of critical structures, particularly the pituitary stalk, leading to a favorable clinical outcome. Our findings, supported by a literature review, suggest that this technique is a valuable option for tumors in retroinfundibular and suprasellar locations.