Peron Stefano, Mandelli Jaime, Galante Nicola, Colombo Stefano, Locatelli Davide
Department of Neurosurgery, ASST West Milan - Legnano Hospital, Legnano, Italy.
Department of Neurosurgery, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy.
World Neurosurg. 2017 Sep;105:1043.e1-1043.e5. doi: 10.1016/j.wneu.2017.06.171. Epub 2017 Jul 11.
Pituicytoma is a rare tumor originating from glial cells of the adult neurohypophysis and infundibulum. Surgical removal is the treatment of choice for this neoplasm. In recent years the endoscopic endonasal approach has proven to be a viable and effective alternative to standard craniotomy.
We report a case of a patient submitted to surgical treatment for a recurrence of pituicytoma, which was operated on transcranially at another hospital approximately 5 years previously. After transcranial surgery, the patient developed a symptomatic recurrence and an undisclosed intrasellar pseudoaneurysm that were treated with an endoscopic endonasal approach, but still required an intracranial approach to complete the resection.
An intrasellar pseudoaneurysm can endanger the endoscopic removal of the pituicytoma, forcing the surgeon to reevaluate a microscopic transcranial approach or to consider a staged procedure.
垂体细胞瘤是一种罕见的肿瘤，起源于成人神经垂体和漏斗部的神经胶质细胞。手术切除是该肿瘤的首选治疗方法。近年来，鼻内镜下经鼻入路已被证明是标准开颅手术的一种可行且有效的替代方法。
我们报告一例垂体细胞瘤复发患者的手术治疗情况，该患者约5年前在另一家医院接受了开颅手术。开颅手术后，患者出现症状性复发及未被发现的鞍内假性动脉瘤，采用鼻内镜下经鼻入路进行治疗，但仍需要开颅入路来完成切除。
鞍内假性动脉瘤可能危及垂体细胞瘤的内镜下切除，迫使外科医生重新评估显微镜下开颅入路或考虑分期手术。
