Primary collision tumors of the sellar region: Experience from a single center

• Published in: Journal of clinical neuroscience 2022-06, Vol.100, p.204-211
• Main Authors: Gong, Li, Chen, Huangtao, Zhang, Wendong, Liu, Xiaoyan, Wang, Yuanyuan, Mu, Xiaorong, Zhang, Fuqin, Li, Qing, Heng, Lijun, Zhang, Wei
• Format: Article
• Language: English
• Subjects: Adenoma - complications; Adenoma - diagnostic imaging; Adenoma - surgery; Adult; Aged; Atypical teratoid/rhabdoid tumor; Carcinoma, Renal Cell; Central Nervous System Cysts - surgery; Collision tumors; Craniopharyngioma; Craniopharyngioma - surgery; Female; Ganglioneuroma; Humans; Kidney Neoplasms; Male; Meningeal Neoplasms - diagnostic imaging; Meningeal Neoplasms - surgery; Meningioma - complications; Meningioma - diagnostic imaging; Meningioma - surgery; Middle Aged; Pituitary adenoma; Pituitary Neoplasms - diagnostic imaging; Pituitary Neoplasms - surgery; Rathke’s cleft cyst; Retrospective Studies; Sellar; Young Adult
• ISSN: 0967-5868; 1532-2653
• DOI: 10.1016/j.jocn.2022.04.024

•Collision tumors/lesions are extremely rare in the sellar region.•The first adult case of collision tumor with CP and AT/RT is reported in the study.•The definitive diagnosis depends mainly on histopathology and immunohistochemistry. Collision tumors are extremely rare in the sellar region, and their features have not been fully characterized. Here, we report our single-center experience in the diagnosis and management of these tumors, focusing primarily on their clinicopathological features. We first performed a retrospective study of pathological reports from patients who had undergone surgery for pituitary adenoma (PA) or craniopharyngioma (CP) at our hospital. Next, to identify collision tumors, patients with a second pathological diagnosis—such as Rathke’s cleft cyst (RCC), gangliocytoma (GC), meningioma, or atypical teratoid/rhabdoid tumor (AT/RT)—were considered. Finally, the clinicopathological characteristics of these tumors were reviewed and analyzed. The results demonstrated that eleven of 2359 PA or CP cases (0.47 %) were found to exhibit sellar collision tumors; the patient cohort had a median age of 52 years (23–71) and was predominantly female (63.6 %, 7/11). In details, of the 2092 cases of PA, 10 were diagnosed with concurrent lesions (seven of RCC and one each of CP, meningioma, and GC). Of the 267 CP cases, a single patient presented with associated AT/RT. To our knowledge, this is the first reported adult case of this subtype. Notably, the preoperative CT and/or MRI of each patient revealed solely PA or CP. The endoscopic endonasal approach was the preferred surgery. In conclusion, the sellar collision tumors occur with low incidence, and the primary subtype is PA and RCC. Their definitive diagnosis depends primarily on pathological findings.