Aykut Gokbel, Ayse Uzuner, Atakan Emengen, Eren Yilmaz, Seda Duman Ozturk, Yonca Anik, Ihsan Anik, Savas Ceylan
{"title":"用内窥镜鼻内入路治疗钙化蝶鞍/星旁区病变:十一个垂体腺瘤病例的报告。","authors":"Aykut Gokbel, Ayse Uzuner, Atakan Emengen, Eren Yilmaz, Seda Duman Ozturk, Yonca Anik, Ihsan Anik, Savas Ceylan","doi":"10.1016/j.wneu.2024.11.066","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Calcification in pituitary adenomas is a rare occurrence and its differential diagnosis typically includes other sellar masses. Common calcifications in pituitary adenomas are classified into 2 morphological forms: capsular (eggshell-like) and multiple small nodular calcifications located within the adenoma. Also, there is a pituitary stone term. This study aims to present the results of calcified pituitary adenoma case series who underwent endoscopic endonasal approach (EEA) and the clinical, histopathological characteristics and surgical outcomes of these cases.</p><p><strong>Methods: </strong>This study conducted a retrospective cohort analysis of patients with calcified pituitary adenoma operated on by EEA between August 1997 and February 2024. The inclusion criteria were as follows: proven radiological calcification on preoperative neuroimaging, intraoperative findings of calcification, and definitive histopathological diagnosis of calcification. Among these patients, 11 cases were included.</p><p><strong>Results: </strong>The mean follow-up duration was 51.45 ± 37.24 (6-118) months. Based on the preoperative paranasal sinus computed tomography scans of patients, 9 patients (81.8%) had intratumoral calcification, 1 (9.1%) had capsular (eggshell-like) calcification, and 1 (9.1%) had both intratumoral and capsular calcification. Moreover, stone-like calcifications were observed in 4 patients (36.4%), soft-type calcifications in 3 (27.3%), hard-type calcifications in 3 (27.3%), and soft-type and hard-type calcifications in 1 (9%). Gross total resection was achieved in 9 patients (81.8%). Pathologic subtypes included nonfunctioning (n = 4), prolactin secreting (n = 3), growth hormone-secreting adenoma (n = 2), and pituitary apoplexy (n = 2). Ten patients had psammomatous-type calcifications and 1 had extensive ossification and osteoid metaplasia.</p><p><strong>Conclusions: </strong>Preoperative radiological evaluation, intraoperative classification of calcification, and postoperative histopathological assessments are crucial in the treatment of calcified adenomas. Bases on these findings, the EEA, with its advantages, is an approach that can be effectively used in the management of these calcified adenomas.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Endoscopic Endonasal Approach for Calcified Sellar/Parasellar Region Pathologies: Report of 11 Pituitary Adenoma Cases.\",\"authors\":\"Aykut Gokbel, Ayse Uzuner, Atakan Emengen, Eren Yilmaz, Seda Duman Ozturk, Yonca Anik, Ihsan Anik, Savas Ceylan\",\"doi\":\"10.1016/j.wneu.2024.11.066\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Calcification in pituitary adenomas is a rare occurrence and its differential diagnosis typically includes other sellar masses. Common calcifications in pituitary adenomas are classified into 2 morphological forms: capsular (eggshell-like) and multiple small nodular calcifications located within the adenoma. Also, there is a pituitary stone term. This study aims to present the results of calcified pituitary adenoma case series who underwent endoscopic endonasal approach (EEA) and the clinical, histopathological characteristics and surgical outcomes of these cases.</p><p><strong>Methods: </strong>This study conducted a retrospective cohort analysis of patients with calcified pituitary adenoma operated on by EEA between August 1997 and February 2024. The inclusion criteria were as follows: proven radiological calcification on preoperative neuroimaging, intraoperative findings of calcification, and definitive histopathological diagnosis of calcification. Among these patients, 11 cases were included.</p><p><strong>Results: </strong>The mean follow-up duration was 51.45 ± 37.24 (6-118) months. Based on the preoperative paranasal sinus computed tomography scans of patients, 9 patients (81.8%) had intratumoral calcification, 1 (9.1%) had capsular (eggshell-like) calcification, and 1 (9.1%) had both intratumoral and capsular calcification. Moreover, stone-like calcifications were observed in 4 patients (36.4%), soft-type calcifications in 3 (27.3%), hard-type calcifications in 3 (27.3%), and soft-type and hard-type calcifications in 1 (9%). Gross total resection was achieved in 9 patients (81.8%). Pathologic subtypes included nonfunctioning (n = 4), prolactin secreting (n = 3), growth hormone-secreting adenoma (n = 2), and pituitary apoplexy (n = 2). Ten patients had psammomatous-type calcifications and 1 had extensive ossification and osteoid metaplasia.</p><p><strong>Conclusions: </strong>Preoperative radiological evaluation, intraoperative classification of calcification, and postoperative histopathological assessments are crucial in the treatment of calcified adenomas. Bases on these findings, the EEA, with its advantages, is an approach that can be effectively used in the management of these calcified adenomas.</p>\",\"PeriodicalId\":23906,\"journal\":{\"name\":\"World neurosurgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2024-12-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World neurosurgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.wneu.2024.11.066\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World neurosurgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.wneu.2024.11.066","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Endoscopic Endonasal Approach for Calcified Sellar/Parasellar Region Pathologies: Report of 11 Pituitary Adenoma Cases.
Objective: Calcification in pituitary adenomas is a rare occurrence and its differential diagnosis typically includes other sellar masses. Common calcifications in pituitary adenomas are classified into 2 morphological forms: capsular (eggshell-like) and multiple small nodular calcifications located within the adenoma. Also, there is a pituitary stone term. This study aims to present the results of calcified pituitary adenoma case series who underwent endoscopic endonasal approach (EEA) and the clinical, histopathological characteristics and surgical outcomes of these cases.
Methods: This study conducted a retrospective cohort analysis of patients with calcified pituitary adenoma operated on by EEA between August 1997 and February 2024. The inclusion criteria were as follows: proven radiological calcification on preoperative neuroimaging, intraoperative findings of calcification, and definitive histopathological diagnosis of calcification. Among these patients, 11 cases were included.
Results: The mean follow-up duration was 51.45 ± 37.24 (6-118) months. Based on the preoperative paranasal sinus computed tomography scans of patients, 9 patients (81.8%) had intratumoral calcification, 1 (9.1%) had capsular (eggshell-like) calcification, and 1 (9.1%) had both intratumoral and capsular calcification. Moreover, stone-like calcifications were observed in 4 patients (36.4%), soft-type calcifications in 3 (27.3%), hard-type calcifications in 3 (27.3%), and soft-type and hard-type calcifications in 1 (9%). Gross total resection was achieved in 9 patients (81.8%). Pathologic subtypes included nonfunctioning (n = 4), prolactin secreting (n = 3), growth hormone-secreting adenoma (n = 2), and pituitary apoplexy (n = 2). Ten patients had psammomatous-type calcifications and 1 had extensive ossification and osteoid metaplasia.
Conclusions: Preoperative radiological evaluation, intraoperative classification of calcification, and postoperative histopathological assessments are crucial in the treatment of calcified adenomas. Bases on these findings, the EEA, with its advantages, is an approach that can be effectively used in the management of these calcified adenomas.
期刊介绍:
World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review.
The journal''s mission is to:
-To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care.
-To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide.
-To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients.
Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS