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Evolving Strategies for Resection of Sellar/Parasellar Synchronous Tumors via Endoscopic Endonasal Approach: A Technical Case Report and Systematic Review of the Literature.
World Neurosurg. 2020 Jan; 133:381-391.e2.WN

Abstract

BACKGROUND

Data on the endonasal endoscopic approach (EEA) to treat sellar/parasellar synchronous tumors remain sparse. This work aims to describe a minimally invasive approach with intraoperative magnetic resonance imaging (MRI) to remove a large sellar/parasellar synchronous tumor, and presents a systematic literature review.

METHODS

The preoperative MRI of a 54-year-old woman revealed a sellar lesion (28 × 19 × 16 mm), presumably a pituitary macroadenoma, and a second extra-axial lesion (22 × 36 × 20 mm) expanding from the tuberculum sellae to the planum sphenoidale with encasement of the anterior communicating complex, presumably a meningioma. We used intraoperative MRI to assess the extent of the resection before reconstructing the large skull base defect. Furthermore, we systematically reviewed pertinent articles retrieved by a PubMed/Embase database search between 1961 and December 2018.

RESULTS

Out of 63 patients with synchronous tumors reported in 43 publications, we found 3 patients in which the tumor was removed by EEA. In these 3 patients and the presented case, the resection of both lesions was successful, without major approach-related morbidity or mortality. More extensive removal of endonasal structures to gain an adequate tumor exposure was not necessary. We did not find any previous reports describing the benefits of intraoperative MRI in the presented setting.

CONCLUSIONS

In the rare case of a synchronous meningioma and pituitary adenoma of the sellar region, intraoperative MRI might be beneficial in confirming residual disease before skull base reconstruction, and therefore radiologic follow-up.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Roethlisberger M
Department of Neurosurgery, University Hospital Basel, University of Basel, Basel, Switzerland; Department of Neurosurgery, University Malaya Specialist Centre, University of Malaya, Kuala Lumpur, Malaysia; Department of Otorhinolaryngology, University Malaya Specialist Centre, University of Malaya, Kuala Lumpur, Malaysia. Electronic address: Michel.Roethlisberger@usb.ch.
Jayapalan RR
Department of Neurosurgery, University Malaya Specialist Centre, University of Malaya, Kuala Lumpur, Malaysia.
Hostettler IC
Stroke Research Centre, University College London, Institute of Neurology, London, United Kingdom.
Bin Abd Kadir KA
Department of Biomedical Imaging, University Malaya Specialist Centre, University of Malaya, Kuala Lumpur, Malaysia.
Mun KS
Department of Pathology, University Malaya Specialist Centre, University of Malaya, Kuala Lumpur, Malaysia.
Brand Y
Department of Neurosurgery, University Hospital Basel, University of Basel, Basel, Switzerland; Department of Oto-Rhino-Lanryngology, Cantonal Hospital Graubuenden, Graubuenden, Switzerland.
Mariani L
Department of Neurosurgery, University Hospital Basel, University of Basel, Basel, Switzerland.
Prepageran N
Department of Otorhinolaryngology, University Malaya Specialist Centre, University of Malaya, Kuala Lumpur, Malaysia.
Waran V
Department of Neurosurgery, University Malaya Specialist Centre, University of Malaya, Kuala Lumpur, Malaysia.

MeSH

AdenomaFemaleHumansMeningeal NeoplasmsMeningiomaMiddle AgedNeoplasms, Multiple PrimaryNeuroendoscopyPituitary Neoplasms

Pub Type(s)

Case Reports
Journal Article
Systematic Review

Language

eng

PubMed ID

31476461

Citation

Roethlisberger, Michel, et al. "Evolving Strategies for Resection of Sellar/Parasellar Synchronous Tumors Via Endoscopic Endonasal Approach: a Technical Case Report and Systematic Review of the Literature." World Neurosurgery, vol. 133, 2020, pp. 381-391.e2.
Roethlisberger M, Jayapalan RR, Hostettler IC, et al. Evolving Strategies for Resection of Sellar/Parasellar Synchronous Tumors via Endoscopic Endonasal Approach: A Technical Case Report and Systematic Review of the Literature. World Neurosurg. 2020;133:381-391.e2.
Roethlisberger, M., Jayapalan, R. R., Hostettler, I. C., Bin Abd Kadir, K. A., Mun, K. S., Brand, Y., Mariani, L., Prepageran, N., & Waran, V. (2020). Evolving Strategies for Resection of Sellar/Parasellar Synchronous Tumors via Endoscopic Endonasal Approach: A Technical Case Report and Systematic Review of the Literature. World Neurosurgery, 133, 381-e2. https://doi.org/10.1016/j.wneu.2019.08.102
Roethlisberger M, et al. Evolving Strategies for Resection of Sellar/Parasellar Synchronous Tumors Via Endoscopic Endonasal Approach: a Technical Case Report and Systematic Review of the Literature. World Neurosurg. 2020;133:381-391.e2. PubMed PMID: 31476461.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evolving Strategies for Resection of Sellar/Parasellar Synchronous Tumors via Endoscopic Endonasal Approach: A Technical Case Report and Systematic Review of the Literature. AU - Roethlisberger,Michel, AU - Jayapalan,Ronie Romelean, AU - Hostettler,Isabel Charlotte, AU - Bin Abd Kadir,Khairul Azmi, AU - Mun,Kein Seong, AU - Brand,Yves, AU - Mariani,Luigi, AU - Prepageran,Narayanan, AU - Waran,Vicknes, Y1 - 2019/08/30/ PY - 2019/02/18/received PY - 2019/08/12/revised PY - 2019/08/14/accepted PY - 2019/9/3/pubmed PY - 2020/1/28/medline PY - 2019/9/3/entrez KW - Endoscopic endonasal transsphenoidal surgery KW - Intraoperative magnetic resonance imaging KW - Pituitary adenoma KW - Sella KW - Synchronous tumor KW - Tuberculum sellae meningioma SP - 381 EP - 391.e2 JF - World neurosurgery JO - World Neurosurg VL - 133 N2 - BACKGROUND: Data on the endonasal endoscopic approach (EEA) to treat sellar/parasellar synchronous tumors remain sparse. This work aims to describe a minimally invasive approach with intraoperative magnetic resonance imaging (MRI) to remove a large sellar/parasellar synchronous tumor, and presents a systematic literature review. METHODS: The preoperative MRI of a 54-year-old woman revealed a sellar lesion (28 × 19 × 16 mm), presumably a pituitary macroadenoma, and a second extra-axial lesion (22 × 36 × 20 mm) expanding from the tuberculum sellae to the planum sphenoidale with encasement of the anterior communicating complex, presumably a meningioma. We used intraoperative MRI to assess the extent of the resection before reconstructing the large skull base defect. Furthermore, we systematically reviewed pertinent articles retrieved by a PubMed/Embase database search between 1961 and December 2018. RESULTS: Out of 63 patients with synchronous tumors reported in 43 publications, we found 3 patients in which the tumor was removed by EEA. In these 3 patients and the presented case, the resection of both lesions was successful, without major approach-related morbidity or mortality. More extensive removal of endonasal structures to gain an adequate tumor exposure was not necessary. We did not find any previous reports describing the benefits of intraoperative MRI in the presented setting. CONCLUSIONS: In the rare case of a synchronous meningioma and pituitary adenoma of the sellar region, intraoperative MRI might be beneficial in confirming residual disease before skull base reconstruction, and therefore radiologic follow-up. SN - 1878-8769 UR - https://www.unboundmedicine.com/medline/citation/31476461/Evolving_Strategies_for_Resection_of_Sellar/Parasellar_Synchronous_Tumors_via_Endoscopic_Endonasal_Approach:_A_Technical_Case_Report_and_Systematic_Review_of_the_Literature_ DB - PRIME DP - Unbound Medicine ER -