Acta Neurochirurgica

, Volume 159, Issue 11, pp 2209–2216 | Cite as

Extent of surgical resection and tumor size predicts prognosis in granular cell tumor of the sellar region

  • Abdul-Kareem Ahmed
  • Hassan Y. Dawood
  • David L. Penn
  • Timothy R. Smith
Original Article - Brain Tumors

Abstract

Background

Rarely, granular cell tumor (GCT) occurs in the sellar region. The natural history of this clinical entity is not well known. This study sought to determine the clinical features and long-term outcome of GCT of the sellar region.

Methods

Institutional databases, the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database, and PubMed/EMBASE were searched for GCT of the sellar region. Patient-level data were extracted where available, including age, sex, symptoms, tumor size and location, presumed diagnosis, surgical approach and result, subtotal resection (STR) and gross-total resection (GTR), use of radiation, and outcome. The primary endpoints of recurrence and survival were determined.

Results

A total of 141 cases were analyzed. The mean age at diagnosis was 48.9 (SD 15.3) with a female predominance (sex ratio 1.49:1). Almost all patients experienced either or both neurological and endocrine symptoms. The most common pre-operative diagnosis was pituitary adenoma. Approximately 60% of patients were treated with surgery, 57.7% with a craniotomy, and 39.7% with a transsphenoidal approach. The 5-year overall survival (OS) was 84.7% (standard error, SE 4.2). Patients with tumors less than 2.5 cm experienced a greater 5-year OS (100.0%) than patients with tumors 2.5 cm or larger (74.0%, SE: 11.7), (Mantel–Cox, p = 0.024). GTR resulted in a greater 5-year OS (95.7%, SE 4.3) than STR (88.8%, SE 5.5) and no surgery or biopsy alone (75.0%, SE 15.3) (Mantel–Cox, p = 0.016). The use of radiation therapy did not improve OS. The 5-year progression-free survival rate was 80.8% (SE 9.2).

Conclusions

Granular cell tumor of the sellar region is a relatively benign neoplasm with neurological and endocrine clinical manifestations. Surgical resection is appropriate for management. Tumor size and extent of resection influence overall survival.

Keywords

Granular cell tumor Pituicytoma Transsphenoidal surgery Radiation therapy 

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© Springer-Verlag GmbH Austria 2017

Authors and Affiliations

  1. 1.Warren Alpert Medical School of Brown UniversityProvidenceUSA
  2. 2.Computational Neurosciences Outcomes Center, Department of Neurosurgery, Brigham & Women’s HospitalHarvard Medical SchoolBostonUSA
  3. 3.Warren Alpert Medical School of Brown UniversityProvidenceUSA
  4. 4.Department of Neurosurgery, Brigham & Women’s HospitalHarvard Medical SchoolBostonUSA

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