Siddiqui Mehdi, Thoms Dewey, Samples Derek, Caron Jean
Long School of Medicine, University of Texas Health San Antonio, San Antonio, Texas, United States.
Department of Neurosurgery, University of Texas Health San Antonio, San Antonio, Texas, United States.
Surg Neurol Int. 2019 Jul 5;10:139. doi: 10.25259/SNI-59-2019. eCollection 2019.
Sellar masses comprise 14-18% of all intracranial tumors. Pituitary adenomas account for 85% of these lesions, while 15% of sellar masses stem from other etiologies. Intratumoral hemorrhage (apoplexy), while not exceptionally common, can be discovered at presentation. While the hemorrhage pattern is typically contained within the tumor, an extension of bleeding beyond the sella has been reported.
A 55-year-old female presented with an anterior interhemispheric subarachnoid hemorrhage and extensive intraventricular hemorrhage (IVH). Initially, the IVH was thought to be due to a ruptured aneurysm. After further workup, a hemorrhagic sellar mass was diagnosed. The patient underwent transsphenoidal resection of a pituitary adenoma. The patient returned to the emergency department6 weeks later with an atypical rapidly expanding sellar mass. After tumor debulking, the pathology revealed an atypical teratoid/rhabdoid tumor (ATRT). Here, we reviewed this and other such cases of sellar ATRT.
The early diagnosis of sellar ATRT with lack of integrase interactor 1 expression and elevated Ki67 proliferation indices can prompt more aggressive attempted gross total resection, chemotherapy, and radiation treatments.
鞍区肿物占所有颅内肿瘤的14% - 18%。垂体腺瘤占这些病变的85%，而15%的鞍区肿物源于其他病因。瘤内出血（卒中）虽不特别常见，但在就诊时可能被发现。虽然出血模式通常局限于肿瘤内，但也有报道称出血可延伸至鞍区以外。
一名55岁女性出现大脑前间脑下蛛网膜下腔出血和广泛的脑室内出血（IVH）。最初，IVH被认为是由于动脉瘤破裂所致。经过进一步检查，诊断为出血性鞍区肿物。患者接受了垂体腺瘤经蝶窦切除术。6周后，患者因一个非典型的快速增大的鞍区肿物返回急诊科。肿瘤减压后，病理显示为非典型畸胎样/横纹肌样瘤（ATRT）。在此，我们回顾了该病例及其他此类鞍区ATRT病例。
对缺乏整合酶相互作用蛋白1表达且Ki67增殖指数升高的鞍区ATRT进行早期诊断，可促使采取更积极的尝试性全切除、化疗和放射治疗。
