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CC BY-NC-ND 4.0 · J Neurol Surg Rep 2024; 85(01): e1-e10
DOI: 10.1055/s-0043-1777792
Case Report

Pituitary Adenoma Coexistent with Sellar Clear Cell Meningioma Unattached to the Dura: Case Report and Treatment Considerations

Grégoire P. Chatain
1   Department of Neurosurgery, University of Colorado School of Medicine, Aurora, Colorado, United States
,
Keanu Chee 
1   Department of Neurosurgery, University of Colorado School of Medicine, Aurora, Colorado, United States
,
Meghan Driscoll
2   Department of Pathology, University of Colorado, School of Medicine, Aurora, Colorado, United States
,
B.K. Kleinschmidt-DeMasters
1   Department of Neurosurgery, University of Colorado School of Medicine, Aurora, Colorado, United States
2   Department of Pathology, University of Colorado, School of Medicine, Aurora, Colorado, United States
,
Kevin O. Lillehei
1   Department of Neurosurgery, University of Colorado School of Medicine, Aurora, Colorado, United States
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Abstract

Collision tumors involving the sella are rare. Intrasellar collision tumors are most commonly composed of a combination of pituitary adenomas and pituitary neuroendocrine tumors; however, collision tumors consisting of a pituitary adenoma and intrasellar meningioma are exceedingly rare. The authors present the case of a 47-year-old man who presented with progressive right eye vision loss. Magnetic resonance imaging showed a large, heterogeneously enhancing sellar mass with suprasellar extension. Using a transcranial approach with a right subfrontal craniotomy, near-total resection of the mass was achieved. Histologic analysis confirmed a diagnosis of a gonadotroph adenoma with concomitant clear cell meningioma (CCM). This patient was discharged with improvement in visual acuity and no signs of diabetes insipidus. Given the indistinguishable radiographic characteristics of pituitary adenoma and CCM, a preoperative diagnosis of a collision tumor was difficult. This case was uniquely challenging since the CCM component lacked the classic dural attachment that is associated with meningiomas on neuroimaging. CCMs are classified as central nervous system (CNS) World Health Organization (WHO) grade 2 tumors and tend to behave more aggressively, therefore warranting close surveillance for signs of tumor recurrence. This is the first case to report a collision tumor consisting of pituitary adenoma and CCM.

Keywords

collision tumors - meningioma - pituitary adenoma - sella

Informed Consent

Informed consent was deemed unnecessary for this work by the Colorado Multiple Institutional Review Board.




Publikationsverlauf

Eingereicht: 28. August 2023

Angenommen: 05. November 2023

Artikel online veröffentlicht:
09. Januar 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Schöning JV, Flitsch J, Lüdecke DK. et al. Multiple tumorous lesions of the pituitary gland. Hormones (Athens) 2022; 21 (04) 653-663
    CrossrefPubMedGoogle Scholar
  • 2 Yamada K, Hatayama T, Ohta M, Sakoda K, Uozumi T. Coincidental pituitary adenoma and parasellar meningioma: case report. Neurosurgery 1986; 19 (02) 267-270
    CrossrefPubMedGoogle Scholar
  • 3 Tajika Y, Kubo O, Takeshita M, Tajika T, Shimizu T, Kitamura K. An intracranial collision tumor composed of intrasellar gangliocytoma and pituitary adenoma. No Shinkei Geka 1989; 17 (12) 1181-1186
    PubMedGoogle Scholar
  • 4 Prevedello DM, Thomas A, Gardner P, Snyderman CH, Carrau RL, Kassam AB. Endoscopic endonasal resection of a synchronous pituitary adenoma and a tuberculum sellae meningioma: technical case report. Neurosurgery 2007; 60 (4, Suppl 2): E401 , discussion E401
    PubMedGoogle Scholar
  • 5 Karavitaki N, Scheithauer BW, Watt J. et al. Collision lesions of the sella: co-existence of craniopharyngioma with gonadotroph adenoma and of Rathke's cleft cyst with corticotroph adenoma. Pituitary 2008; 11 (03) 317-323
    CrossrefPubMedGoogle Scholar
  • 6 Moshkin O, Scheithauer BW, Syro LV, Velasquez A, Horvath E, Kovacs K. Collision tumors of the sella: craniopharyngioma and silent pituitary adenoma subtype 3: case report. Endocr Pathol 2009; 20 (01) 50-55
    CrossrefPubMedGoogle Scholar
  • 7 Koutourousiou M, Kontogeorgos G, Wesseling P, Grotenhuis AJ, Seretis A. Collision sellar lesions: experience with eight cases and review of the literature. Pituitary 2010; 13 (01) 8-17
    CrossrefPubMedGoogle Scholar
  • 8 Rivera J, Alves S, Bianchi CC, Al-Mutawa N, Guiot MC, Zeitouni A. An unusual collision tumor comprising a prolactinoma and a plasmocytoma originating from the sellar region. Pituitary 2010; 13 (02) 189-193
    CrossrefPubMedGoogle Scholar
  • 9 Sahli R, Christ E, Kuhlen D, Giger O, Vajtai I. Sellar collision tumor involving pituitary gonadotroph adenoma and chondroma: a potential clinical diagnosis. Pituitary 2011; 14 (04) 405-408
    CrossrefPubMedGoogle Scholar
  • 10 Jin G, Hao S, Xie J, Mi R, Liu F. Collision tumors of the sella: coexistence of pituitary adenoma and craniopharyngioma in the sellar region. World J Surg Oncol 2013; 11: 178
    CrossrefPubMedGoogle Scholar
  • 11 Mahvash M, Igressa A, Pechlivanis I, Weber F, Charalampaki P. Endoscopic endonasal transsphenoidal approach for resection of a coexistent pituitary macroadenoma and a tuberculum sellae meningioma. Asian J Neurosurg 2014; 9 (04) 236
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 12 Karsy M, Sonnen J, Couldwell WT. Coincident pituitary adenoma and sellar meningioma. Acta Neurochir (Wien) 2015; 157 (02) 231-233
    CrossrefPubMedGoogle Scholar
  • 13 Matyja E, Maksymowicz M, Grajkowska W. et al. Ganglion cell tumours in the sella turcica in close morphological connection with pituitary adenomas. Folia Neuropathol 2015; 53 (03) 203-218
    CrossrefPubMedGoogle Scholar
  • 14 Lim KZ, Goldschlager T, Chandra RV, Hall J, Uren B, Pullar M. Co-occurrence of pituitary adenoma with suprasellar and olfactory groove meningiomas. Basic Clin Neurosci 2016; 7 (04) 361-365
    PubMedGoogle Scholar
  • 15 Ban VS, Chaudhary BR, Allinson K, Santarius T, Kirollos RW. Concomitant primary CNS lymphoma and FSH-pituitary adenoma arising within the sella. entirely coincidental?. Neurosurgery 2017; 80 (01) E170-E175
    CrossrefPubMedGoogle Scholar
  • 16 Heng LJ, Jia D, Gong L, Zhang W, Ma J, Qu Y. Endoscopic endonasal resection of a mixed lesion of gangliocytoma and nonfunctioning pituitary adenoma. World Neurosurg 2017; 106: 1050.e1-1050.e6
    CrossrefPubMedGoogle Scholar
  • 17 Zhao Y, Zhang H, Lian W. et al. Collision tumors composed of meningioma and growth hormone-secreting pituitary adenoma in the sellar region: case reports and a literature review. Medicine (Baltimore) 2017; 96 (50) e9139
    CrossrefPubMedGoogle Scholar
  • 18 Amirjamshidi A, Mortazavi SA, Shirani M, Saeedinia S, Hanif H. Coexisting pituitary adenoma and suprasellar meningioma-a coincidence or causation effect: report of two cases and review of the literature. J Surg Case Rep 2017; 2017 (05) rjx039
    CrossrefPubMedGoogle Scholar
  • 19 Levitus CF, Charitou MMAN. An incidental collision tumor of the sella turcica. AACE Clin Case Rep 2019; 5 (04) e247-e249
    CrossrefPubMedGoogle Scholar
  • 20 Malli A, Melissaris S, Dimitriadi A, Choreftaki T, Georgakoulias N. A coexisting pilocytic astrocytoma and a prolactinoma: a case report of collision tumors and literature review. Cureus 2019; 11 (06) e4911
    PubMedGoogle Scholar
  • 21 Miyazaki T, Kowari K, Eda H, Kambara M, Maruyama R, Akiyama Y. Ten-year follow-up of collision tumors composed of craniopharyngioma and pituitary adenoma: a case report and literature review. Case Rep Med 2019; 2019: 8080163
    CrossrefPubMedGoogle Scholar
  • 22 Snyder R, Fayed I, Dowlati E, Seager A, Mason RB. Pituitary adenoma and craniopharyngioma collision tumor: diagnostic, treatment considerations, and review of the literature. World Neurosurg 2019; 121: 211-216
    CrossrefPubMedGoogle Scholar
  • 23 de Vries F, Lobatto DJ, Zamanipoor Najafabadi AH. et al. Unexpected concomitant pituitary adenoma and suprasellar meningioma: a case report and review of the literature. Br J Neurosurg 2023; 37 (04) 677-681
    CrossrefPubMedGoogle Scholar
  • 24 Bteich F, El Khoury L, Nohra G, Trak V, Yazbek S, Akiki M. Pituitary adenoma and papillary craniopharyngioma: a rare case of collision tumor and review of the literature. World Neurosurg 2020; 139: 63-69
    CrossrefPubMedGoogle Scholar
  • 25 de Almeida Verdolin A, Lamback EB, Ventura N. et al. Collision sellar lesions: coexistence of pituitary adenoma and Rathke cleft cyst-a single-center experience. Endocrine 2020; 68 (01) 174-181
    CrossrefPubMedGoogle Scholar
  • 26 Gezer E, Cantürk Z, Selek A. et al. Cushing's disease due to a pituitary adenoma as a component of collision tumor: a case report and review of the literature. J Med Case Rep 2020; 14 (01) 59
    CrossrefPubMedGoogle Scholar
  • 27 Shareef Z, Kerndt C, Nessel T, Mistry D, Figueroa B. Collision tumor in the pituitary, concurrent pituitary adenoma, and craniopharyngioma. Case Rep Otolaryngol 2020; 2020: 9584090
    PubMedGoogle Scholar
  • 28 Bao YY, Wu X, Ding H, Hong T. Endoscopic endonasal resection of coexisting pituitary adenoma and meningioma: two cases' report and literature review. Neurochirurgie 2021; 67 (06) 611-617
    CrossrefPubMedGoogle Scholar
  • 29 Ren S, Lu Q, Xiao Y. et al. Coexistence of pituitary adenoma and primary pituitary lymphoma: a case report and review of the literature. Front Surg 2022; 9: 842830
    CrossrefPubMedGoogle Scholar
  • 30 Lu W, Shengkai Y, Yu W, Aimin L, Shiwei Y, Kang X. Case report: clinical report of co-occurrence of pituitary adenoma and meningioma in the sellar region after meningioma treatment. Front Neurol 2022; 13: 1042106
    CrossrefPubMedGoogle Scholar
  • 31 Miranda P, Simal JA, Vila M, Hernández M, Menor F, Alvarez-Garijo JA. Posterior fossa clear cell meningioma without dural attachment in a child. Childs Nerv Syst 2009; 25 (03) 389-392
    CrossrefPubMedGoogle Scholar
  • 32 Ko JK, Choi BK, Cho WH, Choi CH. Non-dura based intaspinal clear cell meningioma. J Korean Neurosurg Soc 2011; 49 (01) 71-74
    CrossrefPubMedGoogle Scholar
  • 33 Yin S, Zhou P, Li Q, Jiang S. Intrasellar clear cell meningioma mimicking invasive pituitary adenoma: a case report and review of the literature. Turk Neurosurg 2015; 25 (06) 976-979
    PubMedGoogle Scholar
  • 34 Gupta SK, Nayak N, Gandhoke CS. et al. A giant nondural-based lumbosacral clear cell meningioma mimicking schwannoma: a case report and review of the literature. Asian J Neurosurg 2021; 16 (01) 44-50
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 35 Tsuchiya T, Ikeda S, Isoo A. et al. Intraoperative anatomical findings in pediatric clear cell meningioma of the lumbar spine: case report and literature review. NMC Case Rep J 2021; 8 (01) 519-527
    CrossrefPubMedGoogle Scholar
  • 36 Zhang X, Zhang P, Wang JJ. et al. Intraspinal clear cell meningioma without dural attachment: a case report and literature review. Medicine (Baltimore) 2021; 100 (11) e25167
    CrossrefPubMedGoogle Scholar
  • 37 Maamri K, Hadj Taieb MA, Trifa A, Elkahla G, Njima M, Darmoul M. Spinal clear cell meningioma without dural attachment: a case report and literature review. Radiol Case Rep 2022; 17 (05) 1760-1764
    CrossrefPubMedGoogle Scholar
  • 38 Vasquez CA, Downes A, Kleinschmidt-DeMasters BK, Youssef AS. Functioning pituitary adenoma with xanthogranulomatous features: review of literature and case report. J Neurol Surg B Skull Base 2019; 80 (05) 449-457
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 39 Spallone A. Meningioma as a sequel of radiotherapy for pituitary adenoma. Neurochirurgia (Stuttg) 1982; 25 (02) 68-72
    PubMedGoogle Scholar
  • 40 Zhang H, Ma L, Shu C, Dong LQ, Ma YQ, Zhou Y. Spinal clear cell meningiomas: clinical features and factors predicting recurrence. World Neurosurg 2020; 134: e1062-e1076
    CrossrefPubMedGoogle Scholar
  • 41 Gerkes EH, Fock JM, den Dunnen WF. et al. A heritable form of SMARCE1-related meningiomas with important implications for follow-up and family screening. Neurogenetics 2016; 17 (02) 83-89
    CrossrefPubMedGoogle Scholar
  • 42 Baxter DS, Smith P, Stewart K, Murphy M. Clear cell meningioma presenting as rapidly deteriorating visual field and acuity during pregnancy. J Clin Neurosci 2009; 16 (11) 1502-1504
    CrossrefPubMedGoogle Scholar
  • 43 Chen H, Li XM, Chen YC. et al. Intracranial clear cell meningioma: a clinicopathologic study of 15 cases. Acta Neurochir (Wien) 2011; 153 (09) 1769-1780
    CrossrefPubMedGoogle Scholar
  • 44 Jain D, Sharma MC, Sarkar C. et al. Clear cell meningioma, an uncommon variant of meningioma: a clinicopathologic study of nine cases. J Neurooncol 2007; 81 (03) 315-321
    CrossrefPubMedGoogle Scholar
  • 45 Ohba S, Sasaki H, Kimura T, Ikeda E, Kawase T. Clear cell meningiomas: three case reports with genetic characterization and review of the literature. Neurosurgery 2010; 67 (03) E870-E871 , discussion E871
    CrossrefPubMedGoogle Scholar
  • 46 Prayson RA, Chamberlain WA, Angelov L. Clear cell meningioma: a clinicopathologic study of 18 tumors and examination of the use of CD10, CA9, and RCC antibodies to distinguish between clear cell meningioma and metastatic clear cell renal cell carcinoma. Appl Immunohistochem Mol Morphol 2010; 18 (05) 422-428
    CrossrefPubMedGoogle Scholar
  • 47 Abs R, Parizel PM, Willems PJ. et al. The association of meningioma and pituitary adenoma: report of seven cases and review of the literature. Eur Neurol 1993; 33 (06) 416-422
    CrossrefPubMedGoogle Scholar
  • 48 Furtado SV, Dadlani R, Ghosal N, Mahadevan A, Shankar SK, Hegde AS. Co-existing thyrotropin secreting pituitary adenoma and low grade glioma: clinical considerations and literature review. J Neurosurg Sci 2009; 53 (02) 71-75
    PubMedGoogle Scholar
  • 49 Black PM, Carroll R, Glowacka D, Riley K, Dashner K. Platelet-derived growth factor expression and stimulation in human meningiomas. J Neurosurg 1994; 81 (03) 388-393
    CrossrefPubMedGoogle Scholar