A case of sellar chordoma mimicking a non-functioning pituitary adenoma with survival of more than 10 years.
A rare case of sellar chordoma occurring in a 67-year-old woman who survived for more than 10 years is presented. Clinical signs and symptoms masqueraded as a non-functioning pituitary adenoma with visual disturbance and hypopituitarism. Initial computed tomography (CT) showed an intrasellar mixed dense mass with suprasellar extension, accompanied by non-homogeneous contrast enhancement. Partial removal of the mass was accomplished via right fronto-temporal craniotomy. Histological examination revealed a typical chordoma with no malignancy. After postoperative irradiation, the patient was discharged with clinical improvement. Serial CT and magnetic resonance imaging 8 years after treatment disclosed a regrowth of the intrasellar lesion, which extended to the sphenoid sinus and clivus, accompanied by non-homogeneous contrast enhancement. The patient underwent subtotal removal of the recurrent tumor through a sublabial transsphenoidal approach. Histological examination confirmed the previous diagnosis. Immunohistochemical study demonstrated positive cytoplasmic expression of vimentin, epithelial membrane antigen, keratin and S-100 protein, in contrast with a lack of appearance of carcinoembryonic antigen. After reoperation, she completely recovered and has survived for more than 10 years with good quality of life.
Kagawa
T
T
Department of Neurosurgery, Shimane Medical University.
Takamura
M
M
Moritake
K
K
Tsutsumi
A
A
Yamasaki
T
T
D000236:Adenoma / Q000175:diagnosis*; D000368:Aged; D002817:Chordoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging; D009026:Mortality; D009364:Neoplasm Recurrence, Local; D010911:Pituitary Neoplasms / Q000175:diagnosis*; D012888:Skull Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D013997:Time Factors; D014057:Tomography, X-Ray Computed