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Surgical resection of granular cell tumor of the sellar region: three indications

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Abstract

Purpose

This case series evaluates the surgical management of granular cell tumor (GCT) of the sellar region. This rare entity presents a unique diagnostic and surgical challenge.

Methods

Institutional neuropathology databases at Brigham and Women’s Hospital and Massachusetts General Hospital were searched for cases with a tissue diagnosis of GCT, and with a location in the sellar region. Patient, treatment, tumor, and follow-up data were extracted.

Results

Three patients had a diagnosis of GCT of the sellar region occurring over an 18-year period. All three patients were followed postoperatively at our multidisciplinary pituitary center (median follow-up = 30 months; range 12–30 months). Hormonal disturbances, an incidental lesion requiring diagnosis, and neurological symptoms were indications for surgery in these patients. Two patients underwent a craniotomy and one underwent endoscopic transsphenoidal surgery. All three patients were free of tumor recurrence at last follow-up. In one case tested, positive thyroid transcription factor-1 (TTF-1) immunohistochemistry was observed.

Conclusion

GCT is generally a benign tumor of the sellar region. Surgical resection is the standard treatment, more recently with transsphenoidal surgery when indicated. Surgical resection results in optimal outcome for patients.

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Funding

NIH Training Grant T32 CA009001 (DJC).

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Authors and Affiliations

  1. Department of Neurosurgery, University of Maryland Medical Center, University of Maryland School of Medicine, 22 S. Greene St., Suite S-12-D, Baltimore, MD, 21201, USA

    Abdul-Kareem Ahmed

  2. Department of Neurosurgery, Computational Neuroscience Outcomes Center, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Hassan Y. Dawood, David J. Cote & Timothy R. Smith

  3. Neuropathology and Diagnostic Molecular Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Tejus A. Bale

  4. Neuropathology Division, Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Umberto De Girolami

  5. Department of Neurosurgery, Pituitary and Neuroendocrine Center, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Edward R. Laws Jr. & Timothy R. Smith

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  1. Abdul-Kareem Ahmed
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  2. Hassan Y. Dawood
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  3. David J. Cote
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  4. Tejus A. Bale
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  6. Edward R. Laws Jr.
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  7. Timothy R. Smith
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Correspondence to Abdul-Kareem Ahmed.

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Research involving human participants and/or animals

IRB approval was obtained from Brigham & Women’s Hospital (Partners) for the search and use of institutional database data. (IRB Approval #: 2015P002352).

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Ahmed, AK., Dawood, H.Y., Cote, D.J. et al. Surgical resection of granular cell tumor of the sellar region: three indications. Pituitary 22, 633–639 (2019). https://doi.org/10.1007/s11102-019-00999-z

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  • DOI: https://doi.org/10.1007/s11102-019-00999-z

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