• Journal of Korean Neurosurgical Society
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• v.37 no.2
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• pp.157-159
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• 2005

The authors present two cases of intrasellar schwannoma, a condition rarely reported in the literature. The patients presented with symptoms of hypopituitarism. Sellar magnetic resonance imaging(MRI) revealed intrasellar masses extending into the suprasellar region, with the normal pituitary gland also identifiable in the imaging study. The tumors were removed via trans-sphenoidal route, and found to be very firm, unlike usual pituitary adenomas. Tissue diagnosis confirmed the tumors as schwannoma.

• Journal of Korean Neurosurgical Society
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• v.52 no.2
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• pp.152-155
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• 2012

A Rathke's cleft cyst (RCC) is a benign pituitary cyst derived from the remnant of Rathke's pouch, and usually presents as an intrasellar lesion with varying degrees of suprasellar extension. However, to date, a description of a primary prepontine RCC with no intrasellar component has not been reported. The author describes an exceptional case of a symptomatic RCC located behind the sella turcica in a 41-year-old woman who presented with severe headache. The author also provides an embryological hypothesis of the development of an ectopic RCC, with a special emphasis on radiologic characteristics.

• Journal of Korean Neurosurgical Society
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• v.65 no.4
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• pp.591-597
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• 2022

Objective : Pituitary adenomas frequently extend into the suprasellar space. After a suprasellar tumor is removed, the superiorly extended arachnoid becomes redundant and sinks down into the intrasellar space which often hiders visualization and accessibility to the hidden space behind the evaginated arachnoid. We introduced arachnoid remodeling by clipping technique, and evaluated its usefulness and safety during TSS. Methods : Total 223 patients who underwent arachnoid remodeling with our new clipping technique were included. Redundant arachnoid was clipped along the dural edge with multiple 2.6-mm titanium clips until the redundant arachnoid membrane no longer blocked the surgical route. To check for possible deterioration of hormonal function by this technique, we assessed anterior pituitary function of 166 patients who underwent arachnoid remodeling by clipping and compared this with those of other 429 control patients. Results : Our technique greatly enhanced the accessibility and visualization of intrasellar and parasellar spaces, both of which are generally hindered by redundant arachnoid during transsphenoidal surgery (TSS). We found no difference in anterior pituitary function between a clip-assisted arachnoid remodeling group and the control group, implying that this technique does not result in hypopituitarism. Conclusion : During TSS for pituitary adenomas with suprasellar extension, arachnoid remodeling by clipping technique is very useful and convenient for the management of the redundant arachnoid membrane to enhance visualization and surgical accessibility.

• Journal of Korean Neurosurgical Society
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• v.30 no.1
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• pp.20-25
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• 2001

Objectives : A substantial number of craniopharyngiomas recur despite gross total excision. The purpose of our study was to investigate pattern of recurrence and to verify prognostic factors for recurrence after gross total excision of craniopharyngiomas in children. Methods : A series of 36 patients with craniopharyngiomas were reviewed. All patients had undergone gross total excision and none of them received radiotherapy after initial surgery. Fifteen were girls and twenty-one were boys, with a mean age of 7.3 years(range, one to 15 years). The mean follow-up period was 52 months(range, one to 149 months). Recurrence was noted in 14 patients within 83 months(mean 31.4 months). Results : The overall three-year recurrence free survival rate was 65%, and the five-year recurrence-free survival rate was 55%. Regular neuroimaging follow-up at six to 12-month intervals detected tumor recurrence of a smaller size before symptoms developed(p<0.05). At the first surgical procedure, the optic nerve/chiasm(n=23) was the most common adhesion site. The most frequent sites of recurrence were the optic nerve/chiasm(n=6) and the pitiutary fossa(n=6). Tumor location was the single significant clinical predictor of recurrence. The five-year recurrence-free survival rate was 39% for those who had an intrasellar tumor component and 81% for those who did not (p<0.05). Conclusion : Craniopharyngiomas with intrasellar components should be followed cautiously and regular followup of patients should be emphasized, even when the tumors are totally resected.

• Journal of Korean Neurosurgical Society
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• v.29 no.8
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• pp.1098-1102
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• 2000

Pituitary abscess is a very rare disorder, since antibiotics therapy has become widely available. Clinically and radiologically, the preoperative diagnosis of pituitary abscess is difficult because of its features which may be identical to those of any space-occupying lesions of the sella turcica. A combination of clinical features, such as meningitis, paranasal sinusitis and panhypopituitarism with intrasellar cystic lesion with homogeneous ring enhancement on computed tomography or magnetic resonance image should raise the suspicion of a pituitary abscess. Drainage of the abscess through trans-sphenoidal approach, appropriate antibiotics therapy, endocrine assessment and hormonal replacement should bring complete recovery to the patient. The authors review the literature and report two cases of primary pituitary abscess.

• Journal of Korean Neurosurgical Society
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• v.54 no.3
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• pp.250-252
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• 2013

Intra-cranial aneurysm can be incidental findings in patients with pituitary adenomas, and are usually located outside the pituitary region. However, the coexistence of intrasellar (not intracranial) aneurysms with pituitary adenomas is extremely rare. We report a patient with an incidental superior hypophygeal aneurysm embedded within a non-functional pituitary adenoma which was treated by transsphenoidal surgery after endovascular coil embolization.

• Journal of Korean Neurosurgical Society
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• v.39 no.4
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• pp.306-309
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• 2006

Ectopic pituitary adenoma, occurring outside the sella turcica without any continuity with intrasellar pituitary gland is very rare. So far, less than 90 such cases have been reported in the literature. Regarding to ectopic locations, suprasellar region, sphenoid sinus and clivus have been reported in decending order of frequency. To our best knowledge, growth hormone-secreting ectopic pituitary adenoma in the clivus has never been reported. With the pertinent literature review, we present our unique case with its characteristic magnetic resonance imaging and immunohistochemical features.

• Journal of Korean Neurosurgical Society
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• v.45 no.6
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• pp.375-377
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• 2009

A 49-year-old woman presented with headache, vomiting and visual disturbance. Neurological examination revealed bitemporal hemianopsia with poor visual acuity. Magnetic resonance imaging showed a bulky intra-suprasellar mass, which was isointense with brain parenchyma on T1-weighted images, and slightly hyperintense on T2-weighted images. After gadolinium administration, the mass was homogeneously enhanced. The mass was partially removed by the endonasal transsphenoidal approach and then the remnant mass was totally removed by the transcranial approach five months later. We found a yellowish mass which was attached to the diaphragm sellae in operation field. Histopathological examination of the tumor revealed the characteristic features of a schwannoma. We report an unusual case of an intra-suprasellar schwannoma resembling a non-functioning pituitary macroadenoma both clinically and radiologically.

• Journal of Korean Neurosurgical Society
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• v.30 no.9
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• pp.1130-1133
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• 2001

Athke's cleft cysts are believed to be derived from remnants of Rathke's pouch, a dorsal invagination of the stomodeum. Although these cysts are characteristically small, asymptomatic and intrasellar in location, they occasionally provoke symtoms with enlargement to compress surrounding structures. It is characteristically lined by stratified squamous epithelium with keratinization on a layer of connective tissue. The cells of the anterior pituitary lobe, from which pituitary adenomas develop, are also formed by the proliferation of the anterior wall of Rathke's pouch. Thus, Rathke's cleft cyst and pituitary adenomas are considered to have a common ancestry. We report a rare case in which the preoperative diagnosis was pituitary adenoma, but the pathologic diagnosis was a combination of a Rathke's cleft cyst and a coincidental pituitary adenoma.

• Investigative Magnetic Resonance Imaging
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• v.19 no.2
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• pp.117-121
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• 2015

Chordoid glioma is a rare, low-grade brain neoplasm typically located in the third ventricle. Herein, we report an unusual case of histologically confirmed chordoid glioma located in the pituitary fossa and suprasellar region, not attached to the third ventricle. A 57-year-old woman presented with a 2-month history of headache and visual disturbance. Magnetic resonance imaging revealed an ovoid mass in the pituitary fossa and suprasellar region, compressing the optic chiasm without involvement of the third ventricle. The tumor showed low signal intensity on T1-weighted images and iso- to high signal intensity on T2-weighted images, with strong and homogenous contrast enhancement. Subtotal resection was performed via the transcranial approach, and the patient subsequently received adjuvant gamma knife radiosurgery. However, the residual mass showed disease progression 5 months after the initial surgery.