Pituitary Adenoma and Craniopharyngioma Collision Tumor: Diagnostic, Treatment Considerations, and Review of the Literature

World Neurosurg. 2019 Jan:121:211-216. doi: 10.1016/j.wneu.2018.10.048. Epub 2018 Oct 13.

Abstract

Background: Different diseases may occur within the same anatomic space and invade one another. Lesions of this nature are described as collision tumors. Collision tumors of the sella are rare, with pituitary adenoma-craniopharyngiomas having been described in only 15 cases. We discuss common and rare lesions of the sellar region, their neurodiagnostic qualities, and treatment considerations.

Case description: We present the case of a 49-year-old woman presenting with symptoms of headache and blurred vision who underwent a 2-stage procedure and was found to have a craniopharyngioma and corticotrophic pituitary adenoma in collision. We review the literature on various combinations of sellar collision lesions, noting diagnostic and treatment considerations. Neuroimaging, intraoperative pathology, and histologic review help to provide optimum treatment when unusual conditions of the sella arise.

Conclusions: Many mechanisms for the development of collision lesions have been theorized, and further investigation may provide definitive answers regarding the origin of these neoplastic entities.

Keywords: Collision tumor; Craniopharyngioma; Neuroimaging diagnostics; Pituitary adenoma; Sellar lesions.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adenoma / diagnostic imaging
  • Adenoma / pathology
  • Adenoma / therapy*
  • Craniopharyngioma / diagnostic imaging
  • Craniopharyngioma / pathology
  • Craniopharyngioma / therapy*
  • Diagnosis, Differential
  • Female
  • Humans
  • Middle Aged
  • Neoplasms, Multiple Primary / diagnostic imaging
  • Neoplasms, Multiple Primary / pathology
  • Neoplasms, Multiple Primary / therapy*
  • Neurosurgical Procedures
  • Pituitary Neoplasms / diagnostic imaging
  • Pituitary Neoplasms / pathology
  • Pituitary Neoplasms / therapy*