title: An unusual pituitary stalk lesion: What is the place of surgery?
abstract: BACKGROUND
  Sellar and suprasellar primary melanocytic tumors are exceptional occurrences. Besides the difficulty of differential diagnosis between a primary and secondary lesion, treatment of these pathologies is still unclear and controversial.
  
  
  METHODS
  We describe the case of a 36-year-old woman with no relevant previous medical history who presented with 1 month history of diabetes insipidus, blurred vision and generalized weakness; a brain MRI disclosed an atypical pituitary stalk lesion; initially the tumor was biopsied through an endonasal endoscopic approach that revealed a melanocytic tumor; the patient was afterwards managed by a second stage extended endonasal endoscopic approach achieving a subtotal tumor removal. The overall survival was of 14 months due to the multidisciplinary management including surgery, radio and chemotherapy.
  
  
  CONCLUSIONS
  If a biopsy is essential to deal with these invasive lesions, treatment including surgical resection should be part of a multidisciplinary approach.
authors.affiliation: Service de neurochirurgie, hôpital Hautepierre, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67098 Strasbourg, France.
authors.forename: J
authors.initials: J
authors.lastname: Todeschi
authors.affiliation: Service de neurochirurgie, hôpital Hautepierre, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67098 Strasbourg, France.
authors.forename: S
authors.initials: S
authors.lastname: Chibbaro
authors.affiliation: Service de radiothérapie, centre de lutte contre le cancer Paul-Strauss, 67065 Strasbourg, France.
authors.forename: J-B
authors.initials: JB
authors.lastname: Clavier
authors.affiliation: Service d'anatomo-pathologie, hôpital Hautepierre, 67098 Strasbourg, France.
authors.forename: B
authors.initials: B
authors.lastname: Lhermitte
authors.affiliation: Service de médecine interne, endocrinologie et nutrition, hôpital Hautepierre, 67098 Strasbourg, France.
authors.forename: B
authors.initials: B
authors.lastname: Goichot
authors.affiliation: Service de neurochirurgie, hôpital Hautepierre, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67098 Strasbourg, France. Electronic address: f.proust@neurochirurgie.fr.
authors.forename: F
authors.initials: F
authors.lastname: Proust
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D003606:Dacarbazine / Q000031:analogs & derivatives / Q000627:therapeutic use; D003919:Diabetes Insipidus / Q000209:etiology; D004724:Endoscopy / Q000379:methods*; D017809:Fatal Outcome; D005260:Female; D006423:Hemianopsia / Q000209:etiology; D006801:Humans; D007018:Hypopituitarism / Q000209:etiology; D007211:Indoles / Q000627:therapeutic use; D008545:Melanoma / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*; D010911:Pituitary Neoplasms / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*; D013449:Sulfonamides / Q000627:therapeutic use; D000077204:Temozolomide; D014057:Tomography, X-Ray Computed; D000077484:Vemurafenib
chemical_list: D000970:Antineoplastic Agents; D007211:Indoles; D013449:Sulfonamides; D000077484:Vemurafenib; D003606:Dacarbazine; D000077204:Temozolomide
keywords: Melanoma; Pituitary; Sellar; Sellar melanocytic tumor