Suprasellar granular cell tumor of the neurohypophysis

surgical outcome of a very rare tumor

Filippo Gagliardi, Alfio Spina, Lina Raffaella Barzaghi, Michele Bailo, Marco Losa, Maria Rosa Terreni, Pietro Mortini

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Purpose: Granular cell tumors of the neurohypophysis are rare, solitary lesions, mostly presenting in the adult age. They rarely grow to a sufficient size to cause mass effect related symptoms and they may be found in most cases incidentally at autopsy. Because of their rarity as of now they have been described only as case reports or included in small clinical series. Methods: We report a series of 11 patients, who underwent surgery for granular cell tumors of the neurohypophysis between 1996 and 2013 in a single center. Results: Mean follow-up time after treatment was 92.2 months (range 9–231 months). Mean age at surgery was 40.7 years (range 12–66 years). There were 7 males (63.6 %) and 4 females (36.4 %). Main symptoms at presentation were: hyperprolactinemia (72.7 %), visual impairment (45.5 %) and headache (36 %). Except for 2 patients, all the others underwent surgery as primary treatment at our Institution, through a transsphenoidal (54.5 %) or a transcranial approach (45.5 %). Overall- and progression-free survival times for the entire series (calculated from the time of diagnosis) were 112.9 and 100.5 months respectively. There was one case of perioperative death in a patient who had undergone repeat transcranial surgery for residual tumor. Conclusions: Although extremely rare, granular cell tumors of the neurohypophysis have to be considered in the differential diagnosis of suprasellar masses, to avoid misleading interpretation and consequent wrong therapeutic management. Early diagnosis, extensive tumor removal, opportune indication of adjuvant radiotherapy are the keys to manage these cases.

Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalPituitary
DOIs
Publication statusAccepted/In press - Jan 11 2016

Fingerprint

Granular Cell Tumor
Posterior Pituitary Gland
Neoplasms
Adjuvant Radiotherapy
Hyperprolactinemia
Vision Disorders
Residual Neoplasm
Reoperation
Disease-Free Survival
Headache
Early Diagnosis
Autopsy
Differential Diagnosis
Therapeutics

Keywords

  • Granular cell tumor
  • Neurohypophysis
  • Pituitary neoplasm
  • Radiotherapy

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Cite this

Suprasellar granular cell tumor of the neurohypophysis : surgical outcome of a very rare tumor. / Gagliardi, Filippo; Spina, Alfio; Barzaghi, Lina Raffaella; Bailo, Michele; Losa, Marco; Terreni, Maria Rosa; Mortini, Pietro.

In: Pituitary, 11.01.2016, p. 1-9.

Research output: Contribution to journalArticle

Gagliardi, Filippo ; Spina, Alfio ; Barzaghi, Lina Raffaella ; Bailo, Michele ; Losa, Marco ; Terreni, Maria Rosa ; Mortini, Pietro. / Suprasellar granular cell tumor of the neurohypophysis : surgical outcome of a very rare tumor. In: Pituitary. 2016 ; pp. 1-9.
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abstract = "Purpose: Granular cell tumors of the neurohypophysis are rare, solitary lesions, mostly presenting in the adult age. They rarely grow to a sufficient size to cause mass effect related symptoms and they may be found in most cases incidentally at autopsy. Because of their rarity as of now they have been described only as case reports or included in small clinical series. Methods: We report a series of 11 patients, who underwent surgery for granular cell tumors of the neurohypophysis between 1996 and 2013 in a single center. Results: Mean follow-up time after treatment was 92.2 months (range 9–231 months). Mean age at surgery was 40.7 years (range 12–66 years). There were 7 males (63.6 {\%}) and 4 females (36.4 {\%}). Main symptoms at presentation were: hyperprolactinemia (72.7 {\%}), visual impairment (45.5 {\%}) and headache (36 {\%}). Except for 2 patients, all the others underwent surgery as primary treatment at our Institution, through a transsphenoidal (54.5 {\%}) or a transcranial approach (45.5 {\%}). Overall- and progression-free survival times for the entire series (calculated from the time of diagnosis) were 112.9 and 100.5 months respectively. There was one case of perioperative death in a patient who had undergone repeat transcranial surgery for residual tumor. Conclusions: Although extremely rare, granular cell tumors of the neurohypophysis have to be considered in the differential diagnosis of suprasellar masses, to avoid misleading interpretation and consequent wrong therapeutic management. Early diagnosis, extensive tumor removal, opportune indication of adjuvant radiotherapy are the keys to manage these cases.",
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AB - Purpose: Granular cell tumors of the neurohypophysis are rare, solitary lesions, mostly presenting in the adult age. They rarely grow to a sufficient size to cause mass effect related symptoms and they may be found in most cases incidentally at autopsy. Because of their rarity as of now they have been described only as case reports or included in small clinical series. Methods: We report a series of 11 patients, who underwent surgery for granular cell tumors of the neurohypophysis between 1996 and 2013 in a single center. Results: Mean follow-up time after treatment was 92.2 months (range 9–231 months). Mean age at surgery was 40.7 years (range 12–66 years). There were 7 males (63.6 %) and 4 females (36.4 %). Main symptoms at presentation were: hyperprolactinemia (72.7 %), visual impairment (45.5 %) and headache (36 %). Except for 2 patients, all the others underwent surgery as primary treatment at our Institution, through a transsphenoidal (54.5 %) or a transcranial approach (45.5 %). Overall- and progression-free survival times for the entire series (calculated from the time of diagnosis) were 112.9 and 100.5 months respectively. There was one case of perioperative death in a patient who had undergone repeat transcranial surgery for residual tumor. Conclusions: Although extremely rare, granular cell tumors of the neurohypophysis have to be considered in the differential diagnosis of suprasellar masses, to avoid misleading interpretation and consequent wrong therapeutic management. Early diagnosis, extensive tumor removal, opportune indication of adjuvant radiotherapy are the keys to manage these cases.

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