title: Suprasellar granular cell tumor of the neurohypophysis: surgical outcome of a very rare tumor.
abstract: OBJECTIVE
  Granular cell tumors of the neurohypophysis are rare, solitary lesions, mostly presenting in the adult age. They rarely grow to a sufficient size to cause mass effect related symptoms and they may be found in most cases incidentally at autopsy. Because of their rarity as of now they have been described only as case reports or included in small clinical series.
  
  
  METHODS
  We report a series of 11 patients, who underwent surgery for granular cell tumors of the neurohypophysis between 1996 and 2013 in a single center.
  
  
  RESULTS
  Mean follow-up time after treatment was 92.2 months (range 9-231 months). Mean age at surgery was 40.7 years (range 12-66 years). There were 7 males (63.6 %) and 4 females (36.4 %). Main symptoms at presentation were: hyperprolactinemia (72.7 %), visual impairment (45.5 %) and headache (36 %). Except for 2 patients, all the others underwent surgery as primary treatment at our Institution, through a transsphenoidal (54.5 %) or a transcranial approach (45.5 %). Overall- and progression-free survival times for the entire series (calculated from the time of diagnosis) were 112.9 and 100.5 months respectively. There was one case of perioperative death in a patient who had undergone repeat transcranial surgery for residual tumor.
  
  
  CONCLUSIONS
  Although extremely rare, granular cell tumors of the neurohypophysis have to be considered in the differential diagnosis of suprasellar masses, to avoid misleading interpretation and consequent wrong therapeutic management. Early diagnosis, extensive tumor removal, opportune indication of adjuvant radiotherapy are the keys to manage these cases.
authors.affiliation: Department of Neurosurgery and Gamma Knife Radiosurgery, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy. gagliardi.filippo@hsr.it.
authors.forename: Filippo
authors.initials: F
authors.lastname: Gagliardi
authors.affiliation: Department of Neurosurgery and Gamma Knife Radiosurgery, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy.
authors.forename: Alfio
authors.initials: A
authors.lastname: Spina
authors.affiliation: Department of Neurosurgery and Gamma Knife Radiosurgery, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy.
authors.forename: Lina Raffaella
authors.initials: LR
authors.lastname: Barzaghi
authors.affiliation: Department of Neurosurgery and Gamma Knife Radiosurgery, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Bailo
authors.affiliation: Department of Neurosurgery and Gamma Knife Radiosurgery, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Losa
authors.affiliation: Service of Pathology, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy.
authors.forename: Maria Rosa
authors.initials: MR
authors.lastname: Terreni
authors.affiliation: Department of Neurosurgery and Gamma Knife Radiosurgery, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Mortini
mesh_terms: D000172:Acromegaly / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D016371:Cranial Irradiation; D003919:Diabetes Insipidus / Q000209:etiology; D018572:Disease-Free Survival; D005260:Female; D016586:Granular Cell Tumor / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006177:Gynecomastia / Q000209:etiology; D006801:Humans; D006966:Hyperprolactinemia / Q000209:etiology; D007016:Hypophysectomy; D007037:Hypothyroidism / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010904:Pituitary Gland, Posterior; D010911:Pituitary Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D018714:Radiotherapy, Adjuvant; D014786:Vision Disorders / Q000209:etiology; D055815:Young Adult
keywords: Granular cell tumor; Neurohypophysis; Pituitary neoplasm; Radiotherapy