Alcântara Tancredo, Justo Jerold, Jiang Tingting, Abbritti Rosaria, Lieber Stefan, Passeri Thibault, Labeyrie Marc-Antoine, Froelich Sébastien
Department of Neurosurgery, Lariboisière Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.
Neurosurgery and Neurology Department, Santa Casa de BH, Belo Horizonte, Brazil.
Brain Spine. 2025 Mar 14;5:104239. doi: 10.1016/j.bas.2025.104239. eCollection 2025.
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.
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.
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.
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.
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.
垂体细胞瘤是一种罕见的良性神经胶质肿瘤(世界卫生组织一级),位于鞍区或鞍上区,起源于神经垂体和漏斗部。由于肿瘤生长缓慢,它们通常会出现一些症状,包括激素变化、视力损害和头痛。
本病例报告评估经岩骨后入路切除漏斗后型鞍上垂体细胞瘤的有效性,重点在于保留垂体功能并将手术风险降至最低。
我们报告一名59岁女性,经磁共振成像(MRI)和数字减影血管造影(DSA)诊断为垂体细胞瘤。术前进行了栓塞以减少肿瘤的血供。患者接受了经左侧岩骨后入路肿瘤切除术,关键手术步骤着重于保留垂体柄、视交叉和穿支血管。
经岩骨后入路提供了极佳的视野,实现了肿瘤的近全切除。患者术后无新发神经功能缺损,术后6个月的随访MRI显示无肿瘤复发。
本病例证明了经岩骨后入路切除垂体细胞瘤的安全性和有效性。该入路能够最佳地显露和保留关键结构,尤其是垂体柄,从而带来良好的临床结局。我们的研究结果得到文献综述的支持,表明该技术对于漏斗后和鞍上部位的肿瘤是一种有价值的选择。