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Surgical approach for suprasellar hemangioblastomas preserving the pituitary stalk: Review of the literature and report of a further case.
Journal article

Surgical approach for suprasellar hemangioblastomas preserving the pituitary stalk: Review of the literature and report of a further case.

  • Alshafai N Alshafai Neurosurgical Academy (A.N.A.), Toronto, Ontario, Canada.
  • Maduri R Department of Clinical Neurosciences, Service of Neurosurgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
  • Shail M Xavier University School of Medicine, Aruba, The Netherlands.
  • Chirchiglia D Department of Medical Sciences, University "Magna Græcia" of Catanzaro, Italy.
  • Meyronet D Centre de Pathologie et de Neuropathologie Est, Hospices Civils de Lyon, Lyon, France.
  • Signorelli F Department of Neurosurgery, Hôpital Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France; Division of Neurosurgery, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University "Aldo Moro" of Bari, Italy. Electronic address: francesco.signorelli@uniba.it.
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  • 2018-03-19
Published in:
  • Clinical neurology and neurosurgery. - 2018
Hemangioblastoma
Pituitary deficit
Pituitary stalk
Pituitary stalk preservation
Pituitary tumours
Skull base surgery
Suprasellar tumors
Von Hippel-Lindau disease
Central Nervous System
Hemangioblastoma
Humans
Pituitary Gland
Pituitary Neoplasms
Sella Turcica
Skull
English Hemangioblastomas (HBLs) are challenging vascular tumours with rare suprasellar location Surgery is recommended in patients with visual impairment, endocrine disorders or hydrocephalus. Surgical removal of pituitary stalk HBLs is challenging due to their location and high vascularity. Our narrative review was guided by the question: "what is the more suitable surgical approach to excise a suprasellar HBL?". Pertinent English literature was scrutinized from database inception to October 2016. Eighteen articles matched our selection criteria. Among the surgically treated patients, 4 were treated through a trans-sphenoidal (TS) approach, 13 through a transcranial approach (2 of them after TS failure). Five other cases were treated with radiotherapy (adjuvant in 3 cases) and 9 patients were managed with simple observation and/or medical treatment. We add a case of complete suprasellar HBL resection through an orbito-zygomatic (OZ) craniotomy with extradural anterior clinoidectomy (EAC). To achieve satisfactory oncologic results with acceptable morbidity for symptomatic suprasellar HBLs, complete tumour removal with pituitary stalk sparing should be attempted through an OZ craniotomy with EAC that provides adequate exposure of the tumour, its vascular supply and the adjacent neural structures.
Language
  • English
Open access status
closed
Identifiers
Persistent URL
https://sonar.ch/global/documents/248556
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