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Single-fraction stereotactic radiosurgery for spindle cell oncocytoma: preliminary experience and systematic review of the literature

Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

Purpose

Spindle cell oncocytoma (SCO) is a rare benign pituitary tumor. No patient series regarding stereotactic radiosurgery (SRS) for SCO has been published. We report the clinical outcomes of SCO treated with single-fraction SRS, as well as a systematic review of the literature.

Methods

Retrospective cohort series and systematic literature review.

Results

Five patients (four male, one female) having single-fraction SRS for persistent or recurrent SCO between 2002 and 2018. Median age was 56 (range 54–79) years. Pre-SRS treatments included transsphenoidal resection (TSR) (n = 3), multiple TSR (n = 1), and TSR, radiotherapy, and craniotomy (n = 1). Median target volume was 4.7 (range 1.8–8.4) cm3, with a median tumor margin dose of 17 (range 14–20) Gy. Median follow-up was 24 (range 10–69) months. All radiation-naïve patients achieved tumor control after SRS; tumor progression was noted 24 months after SRS in one patient who failed prior radiotherapy. No radiation-induced complications were observed after SRS. Systematic literature review of 43 cases in addition to the five cases presented here showed that tumor progression/recurrence was more frequent after STR compared to GTR (P < 0.001). Ten previous cases of radiotherapy for SCO have been reported, but most did not detail radiation volumes, doses, or outcomes.

Conclusions

SCO are uncommon sellar lesions with a propensity for progression or recurrence. Based on the clinically aggressive course of these tumors, adjuvant SRS after STR or at the time of tumor recurrence should be considered. Further case accumulation and follow-up is required to better understand the long-term treatment outcomes after single-fraction SRS for these rare tumors.

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Authors and Affiliations

  1. Department of Neurologic Surgery, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA

    Soliman Oushy, Christopher S. Graffeo, Avital Perry, Michael J. Link & Bruce E. Pollock

  2. Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN, USA

    Michael J. Link

  3. Radiation Oncology, Mayo Clinic, Rochester, MN, USA

    Scott L. Stafford & Bruce E. Pollock

Authors
  1. Soliman Oushy
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  2. Christopher S. Graffeo
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  3. Avital Perry
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Correspondence to Bruce E. Pollock.

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Oushy, S., Graffeo, C.S., Perry, A. et al. Single-fraction stereotactic radiosurgery for spindle cell oncocytoma: preliminary experience and systematic review of the literature. J Neurooncol 144, 325–332 (2019). https://doi.org/10.1007/s11060-019-03231-x

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  • DOI: https://doi.org/10.1007/s11060-019-03231-x

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