Longhi Michele, Lavezzo Riccardo, Barresi Valeria, Bulgarelli Giorgia, D'Amico Anna, Lombardo Antonella, Zivelonghi Emanuele, Polloniato Paolo Maria, Ricciardi Giuseppe Kenneth, Sala Francesco, Musumeci Angelo, Pinna Giampietro, Nicolato Antonio
Departmental Unit of Stereotaxis, Department of Neurosciences, Hospital Trust of Verona, 37126 Verona, Italy.
Unit of Neurosurgery B, Department of Neurosciences, Hospital Trust of Verona, 37126 Verona, Italy.
Cancers (Basel). 2025 May 3;17(9):1564. doi: 10.3390/cancers17091564.
The group of so-called "sellar-region masses" consists of a heterogeneous group of neoplasms and tumor-mimicking lesions, whose differential diagnosis may be challenging due to the overlapping of clinical and radiological features, which can be found both in "common" and "uncommon" lesions. The choice of a correct treatment strategy is still arduous and requires histological analysis. Gamma Knife Radiosurgery (GKRS) has already been reported as a safe and effective treatment in these cases. The objective of this study is to evaluate single-center pre-operative data, post-operative outcomes, and long-term follow-up in patients treated with GKRS for unusual sellar tumors. We retrospectively identified and analyzed nine patients treated with GKRS from 2004 to 2015, according to a standard protocol. Lesions consist of hypothalamic hamartoma (HH), Rathke's cleft cist (RCC), Langerhans cell histiocytosis (LCH), spindle cell oncocytoma (SCO), choroid plexus papilloma (CPP), and ossifying fibroma (OF). The diagnosis was histologically confirmed in six patients that underwent surgery, while in three patients, diagnosis was based on characteristic clinical and radiological findings (two HH and one RCC). Pre-operative and post-operative data were retrieved from medical archives, and long-term follow-up was obtained through clinical and neuroradiological periodic examination. In our series, all the "rare" sellar lesions treated, had a successful radiographic and clinical response in a medium-long follow-up period. The long-term follow-up results suggest that GKRS is a safe and effective treatment in rare sellar lesions, with very low toxicity. To the best of our knowledge, this report represents the largest series of unusual sellar lesions treated with GKRS in a single high-volume center, suggesting that GKRS might be an effective non-invasive adjuvant treatment option. Further studies and a larger number of patients are needed to confirm if residuals of these rare sellar lesions might regress on their own without treatment or if other non-invasive treatments could be as effective as GKRS.
所谓的“鞍区肿块”是一组异质性的肿瘤和肿瘤样病变，由于其临床和放射学特征相互重叠，无论是“常见”还是“罕见”病变，鉴别诊断都可能具有挑战性。选择正确的治疗策略仍然很艰巨，需要进行组织学分析。伽玛刀放射外科治疗（GKRS）已被报道在这些病例中是一种安全有效的治疗方法。本研究的目的是评估在单一中心接受GKRS治疗的不常见鞍区肿瘤患者的术前数据、术后结果和长期随访情况。我们根据标准方案，回顾性地识别并分析了2004年至2015年期间接受GKRS治疗的9例患者。病变包括下丘脑错构瘤（HH）、拉克氏囊肿（RCC）、朗格汉斯细胞组织细胞增多症（LCH）、梭形细胞嗜酸细胞瘤（SCO）、脉络丛乳头状瘤（CPP）和骨化性纤维瘤（OF）。6例接受手术的患者经组织学确诊，而3例患者的诊断基于特征性的临床和放射学表现（2例HH和1例RCC）。术前和术后数据从医疗档案中获取，长期随访通过临床和神经放射学定期检查获得。在我们的系列研究中，所有接受治疗的“罕见”鞍区病变在中长期随访期内均获得了成功的影像学和临床反应。长期随访结果表明，GKRS是治疗罕见鞍区病变的一种安全有效的方法，毒性极低。据我们所知，本报告是在单一高容量中心接受GKRS治疗的最大系列不常见鞍区病变，表明GKRS可能是一种有效的非侵入性辅助治疗选择。需要进一步的研究和更多的患者来确认这些罕见鞍区病变的残留是否可能未经治疗自行消退，或者其他非侵入性治疗是否能与GKRS一样有效。
