21/208. Suprasellar malignant mixed germ cell tumour presenting as craniopharyngioma.A 15 year old boy presented with diminution in vision of both eyes, diabetes insipidus and hypopituitarism. MRI was suggestive of a large suprasellar and retrosellar craniopharyngioma with stretching of the optic chiasma. Histopathological findings on the first surgical specimen were interpreted as a craniopharyngioma. He was reoperated on account of clinical deterioration and increase in tumour size. Histological examination this time revealed derivatives of all three germ cell lineages along with areas of embryonal carcinoma, and yolk sac tumour besides squamous cysts, establishing the diagnosis of malignant mixed germ cell tumour. serum and CSF were strongly positive for alpha foetoproteins.- - - - - - - - - - ranking = 1keywords = sella (Clic here for more details about this article) |
22/208. Radical surgery in a neonate with craniopharyngioma. report of a case.ultrasonography revealed a suprasellar tumor in a fetus at 28 weeks of gestation. The male newborn, delivered 10 weeks later, was operated at the age of 17 days, and a craniopharyngioma was completely removed. Intraoperatively, inappropriate secretion of antidiuretic hormone occurred and was followed by diabetes insipidus causing imbalance of fluid and electrolytes. The tumor recurred and was totally removed 1 year later. Further development was uneventful and, at the age of 8 years, the boy is in generally good mental and physical condition except for a left-sided hemiparesis. In contrast to the poor outcome of neonatal craniopharyngioma reviewed in the literature, this case may encourage radical surgery even in the very young.- - - - - - - - - - ranking = 0.16666666666667keywords = sella (Clic here for more details about this article) |
23/208. Extensive ossification in a craniopharyngioma.A rare extensive ossification occurred in a suprasellar craniopharyngioma of a man who died at 21 years of age. The tumor produced headache, retarded physical and mental development, visual disturbances, and increased intracranial pressure. The neoplasm recurred after surgical and roentgenological treatments. Differentiation of multipotential mesenchymal cells or mesenchymal type cells within the tumor has been suggested as the mode of occurrence of bone in this craniopharyngioma.- - - - - - - - - - ranking = 0.16666666666667keywords = sella (Clic here for more details about this article) |
24/208. Kleptomania in a patient with a right frontolimbic lesion.OBJECTIVE: The authors report the case of a patient in whom kleptomania developed in the course of a right frontolimbic behavior syndrome after undergoing surgery. BACKGROUND: Kleptomania is a behavior abnormality that is classified as an impulse-control disorder; however, little is known about its organic correlates. METHOD: history included neurologic data, neuropsychological data, electroencephalographic data, and magnetic resonance images. RESULTS: observation of kleptomania associated with a large sellar craniopharyngioma with right-sided extension suggests that the site of a lesion may be crucial for the development of an impulse-control disorder. CONCLUSIONS: The authors discuss kleptomania in the context of functional deficits associated with damage to orbitofrontal-subcortical circuits, and they suggest that kleptomania is a neuropsychiatric symptom that can be conceptualized as being an uncommon compulsive display of impulse dyscontrol.- - - - - - - - - - ranking = 0.16666666666667keywords = sella (Clic here for more details about this article) |
25/208. Atypical magnetic resonance imaging findings of craniopharyngioma.Three cases of craniopharyngiomas with atypical MRI findings are reported. The first patient had a nasopharyngeal craniopharyngioma. Its unusual location made diagnosis difficult. The second patient had a massive craniopharyngioma with extensive cystic expansion, involving the anterior, middle and posterior cranial fossae, and extending into the foramen magnum. The tumour of the third patient involved the suprasellar region with a large extension into the third ventricle, and demonstrated a predominantly high signal intensity on all T1-weighted, proton-weighted and T2-weighted images. These patients further stressed the complexity of MRI findings in craniopharyngiomas.- - - - - - - - - - ranking = 0.16666666666667keywords = sella (Clic here for more details about this article) |
26/208. Postoperative spinal seeding of craniopharyngioma. Case report.The authors present a case of postoperative spinal seeding of papillary craniopharyngioma. This 27-year-old man who had previously undergone subtotal removal of a suprasellar craniopharyngioma was admitted because of low-back and right leg pain. Results of neurological examination showed a limitation in straight-leg raising in the right side with no sensorimotor changes. magnetic resonance imaging of the lumbar spine demonstrated multiple enhanced intradural extramedullary masses causing spinal cord compression. Pathological examination of the tumor tissue obtained via laminectomy revealed papillary craniopharyngioma, which had the same histological features as those of the previous suprasellar tumor. Several ectopic recurrences of craniopharyngioma have been reported; however, the authors believe that this is the first published report of the spinal seeding of craniopharyngioma.- - - - - - - - - - ranking = 0.33333333333333keywords = sella (Clic here for more details about this article) |
27/208. Does craniopharyngioma metastasize? Case report and review of the literature.OBJECTIVE AND IMPORTANCE: A rare case of recurrent craniopharyngioma at an ectopic location is described. This recurrence suggested cerebrospinal fluid seeding. CLINICAL PRESENTATION: A 65-year-old man presented for follow-up of persisting visual field defect. He had undergone total resection of a suprasellar craniopharyngioma via a subfrontal approach 3 years before presentation. Recent magnetic resonance imaging scans revealed a contrast-enhancing tumor with cystic and solid components at the right temporal lobe. The primary tumor bed was intact. INTERVENTION: A temporal craniotomy was performed for total resection of the tumor. Intraoperative findings revealed that the recurrent tumor was anatomically unrelated to the previous surgical track. Histological studies of the tumor specimen demonstrated a benign craniopharyngioma. cerebrospinal fluid spreading was suspected to be the sole route for the recurrence. CONCLUSION: The case presented here and a review of reports on remote recurrence of craniopharyngioma suggest that care is required during intraoperative handling of the tumor and that long-term follow-up should be performed even in patients whose primary tumor was resected completely.- - - - - - - - - - ranking = 0.16666666666667keywords = sella (Clic here for more details about this article) |
28/208. mazindol administration improved hyperphagia after surgery for craniopharyngioma--case report.A 54-year-old man presented with visual disturbance and polydipsia. magnetic resonance imaging disclosed a cystic mass which extended from the intrasellar to the suprasellar region. Bifrontal craniotomy was performed and the tumor was totally removed. Histological findings confirmed the diagnosis of craniopharyngioma. Postoperatively, the patient suffered from transient disorientation. About one month after the operation the patient manifested hyperphagia and he gained 15 kg in one month. mazindol, a non-amphetaminergic anorectic agent, was administered for 3 weeks. His appetite normalized and his weight fell and stabilized even after mazindol administration was ceased.- - - - - - - - - - ranking = 0.33333333333333keywords = sella (Clic here for more details about this article) |
29/208. Suprasellar squamous papillary craniopharyngioma: a case report.BACKGROUND: Craniopharyngiomas are benign neoplasms that are usually suprasellar in origin. They are considered a type of pituitary tumor that can cause hyposecretion of anterior pituitary hormones or hypopituitarism. Clinically, they may cause visual and endocrine deficiencies similar to pituitary adenoma. Histopathologically, they are distinct from pituitary adenoma and are generally classified as either adamantinomatous or squamous papillary. Adamantinomatous tumors are more common in children, whereas the squamous papillary type is found almost exclusively in adults. CASE REPORT: A 45-year-old white man came to our clinic with a history of decreased vision in his left eye for the previous five months that fluctuated. magnetic resonance imaging of the brain revealed a suprasellar multilobular mass, which was distinguishable from the pituitary gland. The patient underwent a right frontotemporal craniotomy for resection of the tumor. Histopathological analysis showed a benign squamous epithelial-lined mass consistent with squamous papillary craniopharyngioma. CONCLUSION: Craniopharyngiomas are generally considered to be adamantinomatous or squamous papillary in origin. Recently, magnetic resonance imaging has been used to distinguish between these two types of tumors, although clinically no significant difference has been found with respect to resectability. Clinical presentation, treatment options, recurrence, and differential diagnosis of craniopharyngiomas are discussed.- - - - - - - - - - ranking = 1keywords = sella (Clic here for more details about this article) |
30/208. Extended transsphenoidal approach with submucosal posterior ethmoidectomy for parasellar tumors. Technical note.The authors have developed an extended transsphenoidal approach with submucosal posterior ethmoidectomy for resection of tumors located in the cavernous sinus or the suprasellar region that are difficult to remove via the conventional transsphenoidal approach. Surgery was performed using this approach in 14 patients with large pituitary adenomas, three patients with craniopharyngiomas, and one patient with a meningioma of the tuberculum sellae. The submucosal dissection of the nasal septum used in the conventional transsphenoidal approach was extended to the superior lateral wall of the nasal cavity to expose the bony surface of the superior turbinate lying under the nasal mucosa. Submucosal posterior ethmoidectomy widened the area visualized through the conventional transsphenoidal approach both superiorly and laterally. This provided a safer and less invasive access to lesions in the cavernous sinus or the suprasellar region through the sphenoid sinus. Using this approach the authors encountered no postoperative complications, such as olfactory disturbance, cranial nerve palsy, or arterial injury. In this article the authors present the surgical methods used in this approach.- - - - - - - - - - ranking = 1.1666666666667keywords = sella (Clic here for more details about this article) |
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