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Silent Corticotroph Adenomas Demonstrate Predilection for Sphenoid Sinus, Cavernous Sinus, and Clival Invasion Compared with Other Subtypes.
Himstead, Alexander S; Wells, Alicia C; Kurtz, Joshua S; Moldenhauer, Matthew R; Davies, Jordan L; Fote, Gianna M; Bitner, Benjamin F; Chu, Eleanor; Mohyeldin, Ahmed; Hsu, Frank P K; Kuan, Eduard C.
Afiliación
  • Himstead AS; Department of Neurological Surgery, University of California, Orange, California, USA.
  • Wells AC; Department of Neurological Surgery, University of California, Orange, California, USA.
  • Kurtz JS; Department of Neurological Surgery, University of California, Orange, California, USA.
  • Moldenhauer MR; Department of Neurological Surgery, University of California, Orange, California, USA.
  • Davies JL; Department of Neurological Surgery, University of California, Orange, California, USA.
  • Fote GM; Department of Neurological Surgery, University of California, Orange, California, USA.
  • Bitner BF; Department of Otolaryngology-Head and Neck Surgery, University of California, Orange, California, USA.
  • Chu E; Department of Radiological Sciences, University of California, Orange, California, USA.
  • Mohyeldin A; Department of Neurological Surgery, University of California, Orange, California, USA.
  • Hsu FPK; Department of Neurological Surgery, University of California, Orange, California, USA.
  • Kuan EC; Department of Neurological Surgery, University of California, Orange, California, USA; Department of Otolaryngology-Head and Neck Surgery, University of California, Orange, California, USA. Electronic address: eckuan@uci.edu.
World Neurosurg ; 2024 Aug 21.
Article en En | MEDLINE | ID: mdl-39154957
ABSTRACT

BACKGROUND:

Nonfunctional pituitary neuroendocrine tumors (PitNETs) exhibit wide variability in growth pattern based on subtype. Silent corticotroph adenomas (SCAs) demonstrate aggressive growth compared with other nonfunctional pituitary adenomas (NFPAs), especially into the cavernous sinus. In this study, we sought to characterize other growth patterns of SCAs compared with NFPAs.

METHODS:

We performed a retrospective analysis of all patients with nonfunctional PitNETs treated with surgical resection via endoscopic endonasal approach at a single institution from August 1, 2018, to May 11, 2024. Preoperative computed tomography and magnetic resonance imaging were reviewed to determine extension into the suprasellar space, sphenoid sinus, cavernous sinus, and clivus.

RESULTS:

The study comprised 91 patients, including 20 SCAs and 71 NFPAs. SCAs demonstrated significantly greater rates of growth into the sphenoid sinus (55.0% vs. 23.94%, P = 0.013), clivus (65.0% vs. 16.9%, P < 0.0001), and cavernous sinus (defined as Knosp grade 3 or 4; 55.0% vs. 23.35%, P = 0.016). Other NFPAs were more likely to grow into the suprasellar space (92.96% vs. 75.0%, P = 0.038). Tumor volume was similar between groups (11.93 cm3 vs. 9.06 cm3, P = 0.2).

CONCLUSIONS:

Silent corticotroph PitNETs demonstrate predilection for invasion of bony structures, with higher rates of growing through the sellar floor into the sphenoid sinus, growing posteroinferiorly into the clivus and laterally into the cavernous sinuses. Other nonfunctional PitNETs tended to follow the path of least resistance, growing superiorly into the suprasellar space. These differences in growth patterns may account for some of the clinical challenges of treating silent corticotroph PitNETs.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: World Neurosurg Asunto de la revista: NEUROCIRURGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: World Neurosurg Asunto de la revista: NEUROCIRURGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos