Abstract.
Objective and importance: Primary intracranial neuroblastomas are rare. They generally arise in the supratentorial parenchyma or paraventricular region. Even more rare are primary sellar neuroblastomas. We present a neuroblastoma that arose in the sellar region and mimicked a non-functioning pituitary adenoma. Clinical presentation: This 33-year-old man presented with bitemporal hemianopsia. MRI showed a sellar mass with suprasellar extension mimicking a pituitary adenoma. Intervention: Because of tumor recurrence and dissemination to the cervical region, he underwent 6 operations and radiosurgery. Detailed histologic examination confirmed the diagnosis of neuroblastoma. Postoperative conventional radiotherapy was effective in reducing the size of the tumor. Conclusion: Neuroblastoma should be considered in the differential diagnosis of patients with sellar lesions.
Key Words
neuroblastoma pituitary tumors sellar lesions sella turcica radiotherapyPreview
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References
- 1.Fitzhugh GS, Allen MS, Rucker TN, Sprinkle PM. Olfactory neruroblastoma (aesthesioneuroblastoma). Arch Otolaryngol 1965;81:161–168.Google Scholar
- 2.Lewis JS, Hutter RVP, Tollefsen R, Foote FW. Nasal tumors of olfactory origin. Arch Otolaryngol 1965;81:169–174.PubMedGoogle Scholar
- 3.Berger MS, Edwards MS, Wara WM, Levin VA, Wilson CB. Primary cerebral neuroblastoma. Long-term follow-up review and therapeutic guidelines. J Neurosurg 1983;59:418–423.PubMedGoogle Scholar
- 4.Horten BC, Rubinstein LJ. Primary cerebral neuroblastoma: a clinicopathological study of 35 cases. Brain 1976;99:735–756.PubMedGoogle Scholar
- 5.Lach B, Rippstein PRT, Benoit BG, Staines W. Differentiating neuroblastoma of pituitary gland: neuroblastic transformation of epithelial adenoma cells. J Neurosurg 1996;85:953–960.PubMedGoogle Scholar
- 6.Roy A, Timothy J, Anthony R, Chakrabarty A. Aesthesioneuroblastoma arising in pituitary gland. Neuropathol Appl Neurobiol 2000;26:177–179.CrossRefPubMedGoogle Scholar
- 7.Sarwar M. Primary sellar parasellar aesthesioneuroblastoma. Am J Roentgenol 1979;133:140–141.Google Scholar
- 8.Berger L, Luc R. L'esthésioneuroépithéliome olfactif. Bull Assoc Fr Etude Cancer 1924;13:410–421.Google Scholar
- 9.Morita A, Ebersold MJ, Olsen KD, Foote RL, Lewis JE, Quast LM. Esthesioneuroblastoma: Prognosis and management. Neurosurgery 1993;32:706–715.PubMedGoogle Scholar
- 10.Bevan JS, Asa SL, Rossi ML, Esiri MM, Adams CB, Burke CW. Intrasellar gangliocytoma containing gastrin and growth hormone-releasing hormone associated with a growth hormone-secreting pituitary adenoma. Clin Endocrinol 1989;30:213–224.Google Scholar
- 11.Burchiel KJ, Shaw CM, Kelly WA. A mixed functional microadenoma and ganglioneuroma of the pituitary fossa. Case report. J Neurosurg 1983;58:416–420.PubMedGoogle Scholar
- 12.Fischer EG, Morris JH, Kettyle WM. Intrasellar gangliocytoma and syndromes of pituitary hypersecretion. Case report. J Neurosurg 1983;59:1071–1075.PubMedGoogle Scholar
- 13.Horvath E, Kovacs K, Scheithauer BW, Lloyd RV, Smyth HS. Pituitary adenoma with neuronal choristoma (PANCH): composite lesion or lineage infidelity? Ultrastruct Pathol 1994;18:565–574.PubMedGoogle Scholar
- 14.Jakumeit HD, Zimmermann V, Guiot G. Intrasellar gangliocytomas. Report of four cases. J Neurosurg 1974;40:626–630.PubMedGoogle Scholar
- 15.Kamel OW, Horoupian DS, Silverberg GD. Mixed gangliocytoma-adenoma: a distinct neuroendocrine tumor of the pituitary fossa. Hum Pathol 1989;20:1198–1203.PubMedGoogle Scholar
- 16.Li JY, Recadot O, Kujas M, Kouadri M, Peillon F, Racadot J. Immunocytochemistry of four mixed pituitary adenomas and intrasellar gangliocytoma associated with different clinical syndromes: Acromegaly, amenorrhea-galactorrhea, Cushing's disease and isolated tumoral syndrome. Acta Neuropathol 1989;77:320–328.CrossRefPubMedGoogle Scholar
- 17.McKeever PE, Blaivas M, Sima AAF. Neoplasms of the sellar region: Surgical Pathology of the Pituitary Gland. W. B. Saunders Co., 1993:141–210.Google Scholar
- 18.Azzarelli B, Richards DE, Anton AH, Roessman U. Cerebral neuroblastoma. Electron mcroscopic observations and chatecholamine determinations. J Neuropathol Exp Neurol 1977;36:384–397.PubMedGoogle Scholar
- 19.Greenberg R, Rosenthal I, Falk GS. Electron microscopy of human tumors secreting cathecholamines: correlation with biochemical data. J Neuropathol Exp Neurol 1969;28:475–500.PubMedGoogle Scholar
- 20.Grisoli F, Vicentelli F, Boudouresque G, Delpuech F, Hassoun J, Raybaud C. Primary cerebral neuroblastoma in an adult man. Surg Neurol 1981;16:266–270.PubMedGoogle Scholar
- 21.Martinnes-Compos A, Dannies PS. A possible differentiation of anterior pituitary cells in collagen gels into neurons. Cell Tissue Res 1986;244:21–26.Google Scholar
- 22.Schechter J, Windle JJ, Stauber C, Mellon PL. Neural tissue within anterior pituitary tumors generated by oncogene expression in transgenic mice. Neuroendocrinology 1992;56:300–311.PubMedGoogle Scholar
- 23.Unger F, Waich C, Stammberger H, Papaefthymious G, Haselsberger K, Pendi G. Olfactory neuroblastoma (esthesioneuroblastoma): report of six cases treated by a novel combination of endoscopic surgery and radiosurgery. Minim Invasive Neurosurg 2000;44:79–84.Google Scholar
- 24.Waich C, Stammberger H, Unger F, Anderhuber W. A new therapy concept in esthesioneuroblastoma. Laryngorhinootologie 2000;79:743–748.Google Scholar
- 25.Dulguerov P, Allal AS, Calcaterra TC. Esthesioneuroblastoma: a meta-analysis and review. Lancet Oncol 2001;2:683–690.CrossRefPubMedGoogle Scholar