Collision sellar lesions: experience with eight cases and review of the literature.
The concomitant presence of a pituitary adenoma with a second sellar lesion in patients operated upon for pituitary adenoma is an uncommon entity. Although rare, quite a great variety of lesions have been indentified coexisting with pituitary adenomas. In fact, most combinations have been described before, but an overview with information on the frequency of combined pathologies in a large series has not been published. We present a series of eight collision sellar lesions indentified among 548 transsphenoidally resected pituitary adenomas in two Neurosurgical Departments. The histological studies confirmed a case of sarcoidosis within a non-functioning pituitary adenoma, a case of intrasellar schwannoma coexisting with growth hormone (GH) secreting adenoma, two Rathke's cleft cysts combined with pituitary adenomas, three gangliocytomas associated with GH-secreting adenomas, and a case of a double pituitary adenoma. The pertinent literature is discussed with emphasis on pathogenetic theories of dual sellar lesions. Although there is no direct evidence to confirm the pathogenetic relationship of collision sellar lesions, the number of cases presented in literature makes the theory of an incidental occurrence rather doubtful. Suggested hypotheses about a common embryonic origin or a potential interaction between pituitary adenomas and the immune system are presented.
Koutourousiou
Maria
M
Department of Neurosurgery, G. Gennimatas Athens General Hospital, 154 Messogion Ave, 115 27, Athens, Greece. mkoutourousiou@yahoo.gr
Kontogeorgos
George
G
Wesseling
Pieter
P
Grotenhuis
Andre J
AJ
Seretis
Andreas
A
D049913:ACTH-Secreting Pituitary Adenoma / Q000473:pathology; D000328:Adult; D000368:Aged; D020863:Central Nervous System Cysts / Q000473:pathology; D005260:Female; D005729:Ganglioneuroma / Q000473:pathology; D006651:Histocytochemistry; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000175:diagnosis / Q000473:pathology*; D009442:Neurilemmoma / Q000473:pathology; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D012658:Sella Turcica / Q000473:pathology*