Ten-Year Follow-Up of Collision Tumors Composed of Craniopharyngioma and Pituitary Adenoma: A Case Report and Literature Review

Abstract

Although craniopharyngioma (CP) and pituitary adenoma (PA) are common tumors of the parasellar lesions, the coexistence of CP and PA is very rare. A 48-year-old male visited our hospital because of consciousness disturbance. The neuroimaging revealed a sellar tumor contact with a massive suprasellar cyst including calcification. Preoperative diagnosis was CP, and the patient underwent craniotomy to resolve the suprasellar mass effect. The histological examination disclosed adamantinomatous CP, and subsequently a transsphenoidal approach was chosen for the residual intrasellar tumor. Against expectations, the histological diagnosis was not CP but PA. The patient underwent gamma knife surgery for the residual tumor, and the postoperative course was good. After a 10-year follow-up, both lesions were still completely controlled. If we had suspected and diagnosed the tumor involved as not only CP but also PA at the first operation, the second operation could have been avoided because we would have chosen gamma knife surgery for the residual tumor. We should draw attention to this rare situation for differential diagnosis of parasellar tumor to avoid unnecessary surgery and to decide the best strategy for treatment. In addition, the biological behavior of collision tumors composed of CP and PA is probably the same as solitary CP or PA based on a long-term follow-up of our case.

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

“…Secondary tumors that have been described as co-occurring with pituitary adenomas include gangliocytomas, pilocytic astrocytomas, craniopharyngiomas, spindle cell astrocytomas, pituicytomas, granular cell tumors, and Rathke's cleft cysts. 19 20 21 25 Collision tumors consisting of a pituitary adenoma and parasellar meningioma are exceedingly rare. There are several case reports and series describing the coexistence of a pituitary adenoma and sellar/suprasellar meningioma, although none have reported a specific diagnosis of clear cell meningioma.…”

“…A literature review was conducted using PubMed to identify available case reports and case series on collision tumors occurring in the sellar or suprasellar region of the brain from 1986 to 2022, linking “collision tumor” and “sella” or “suprasellar” or “parasellar” or “pituitary.” The search regarding clear cell meningioma utilized the search terms “clear cell meningioma” and “without dural attachment.” After independent evaluation for content and relevance, we identified a total of 30 articles published from the years 1986 to 2022 that describe collision tumors comprising PitNETs and various co-occurring tumors, and 6 articles published from 2009 to 2021 describing the diagnosis of clear cell meningioma without a dural attachment. The results of this literature review are shown in Tables 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 and 2 . 31 32 33 34 35 36 37 …”

A Collision Tumor of Pit-1/SF-1-positive Double Pituitary Adenoma and a Craniopharyngioma Coexisting with Graves' Disease

“…The first case of a collision tumor of a pituitary adenoma with a craniopharyngioma was reported in 1971, 7) and to date, 22 cases have been reported. The histological diagnosis of pituitary adenoma in 22 reported cases was GH positive in one case, 22) ACTH positive in three, 16,21,25) PRL positive in six, [7][8][9][10][11]13,19) gonadotropin positive in three, 6,14,15) multiple in one, 5) none in four, 12,17,20,24) and unknown in four. 7,18,23,26) All craniopharyngiomas were of the adamantinomatous type, except for one that was papillary type.…”

Angiosarcoma in Collision With a Merkel Cell Carcinoma: Case Report and Literature Review

“…Not applicable, because this article does not contain any clinical trials. 24 Squamous cell carcinoma Basal cell carcinoma USA/2019 Miyazaki et al 25 Craniopharyngioma Pituitary adenoma Japan/2019 Kufeld et al 26 Adenoid cystic carcinoma Squamous cell carcinoma Germany/2004 Fukaya et al 23 Chordoma Hemangioblastoma Japan/1976…”