Decision-Making and Management in a Patient With Coexistent Colloid Cyst and Pituitary Macroadenoma: A Case Report

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2022 Apr 11

PMID 35399429

Authors

Grant Koskay

Patrick Opperman

Frank M Mezzacappa

Daniel Surdell

Affiliations

Soon will be listed here.

Abstract

The coexistence of separate and distinct primary intracranial tumors is rare. Specifically, there are no previous reports of a colloid cyst coexisting with a pituitary macroadenoma. We present the case of a 40-year-old male with a colloid cyst associated with mild enlargement of the right lateral ventricle and a coexistent pituitary macroadenoma with compression of the optic apparatus. An endoscopic endonasal transsphenoidal surgery (EETS) for resection of the pituitary mass was performed first due to the patient's complaints of acute visual changes. He then underwent a right frontal craniotomy for resection of the colloid cyst one month later. The patient recovered without residual deficits in vision, and he did not require ventricular shunting after removal of the colloid cyst. We aimed to discuss our decision-making process and the management of these coexistent lesions.

References

Gerges M, Arnaout M, El Asri A, Cummock M, Roshdy A, Anand V . Increased frequency of cataract surgery in patients over age 50 with pituitary macroadenomas and chiasmal compression. Pituitary. 2019; 22(4):405-410. DOI: 10.1007/s11102-019-00970-y. View

Shashidhar A, Arimappamagan A, Madhusudhan N, Narasinga Rao K, Bhat D, Shukla D . Transcranial approach for pituitary adenomas - An evaluation of surgical approaches over two decades and factors influencing peri-operative morbidity. Clin Neurol Neurosurg. 2020; 200:106400. DOI: 10.1016/j.clineuro.2020.106400. View

Ezzat S, Asa S, Couldwell W, Barr C, Dodge W, Vance M . The prevalence of pituitary adenomas: a systematic review. Cancer. 2004; 101(3):613-9. DOI: 10.1002/cncr.20412. View

Inoshita N, Nishioka H . The 2017 WHO classification of pituitary adenoma: overview and comments. Brain Tumor Pathol. 2018; 35(2):51-56. DOI: 10.1007/s10014-018-0314-3. View

Elshamy W, Burkard J, Gerges M, Erginoglu U, Aycan A, Ozaydin B . Surgical approaches for resection of third ventricle colloid cysts: meta-analysis. Neurosurg Rev. 2021; 44(6):3029-3038. DOI: 10.1007/s10143-021-01486-5. View

Stachura K, Grzywna E, Krzyzewski R, Kwinta B . Retrospective evaluation of endoscopic treatment in colloid cyst of the third ventricle. Wideochir Inne Tech Maloinwazyjne. 2021; 16(3):604-611. PMC: 8512511. DOI: 10.5114/wiitm.2021.103957. View

Sheikh A, Mendelson Z, Liu J . Endoscopic versus microsurgical resection of colloid cysts: a systematic review and meta-analysis of 1,278 patients. World Neurosurg. 2014; 82(6):1187-97. DOI: 10.1016/j.wneu.2014.06.024. View

Daly A, Tichomirowa M, Beckers A . The epidemiology and genetics of pituitary adenomas. Best Pract Res Clin Endocrinol Metab. 2009; 23(5):543-54. DOI: 10.1016/j.beem.2009.05.008. View

Vorbau C, Baldauf J, Oertel J, Gaab M, Schroeder H . Long-Term Results After Endoscopic Resection of Colloid Cysts. World Neurosurg. 2018; 122:e176-e185. DOI: 10.1016/j.wneu.2018.09.190. View

10.

Mehta G, Lonser R . Management of hormone-secreting pituitary adenomas. Neuro Oncol. 2016; 19(6):762-773. PMC: 5464431. DOI: 10.1093/neuonc/now130. View

11.

Solari D, Cavallo L, Cappabianca P . Surgical approach to pituitary tumors. Handb Clin Neurol. 2014; 124:291-301. DOI: 10.1016/B978-0-444-59602-4.00019-8. View

12.

Alkhaibary A, Baydhi L, Alharbi A, Alshaikh A, Khairy S, Abbas M . Endoscopic versus Open Microsurgical Excision of Colloid Cysts: A Comparative Analysis and State-of-the-Art Review of Neurosurgical Techniques. World Neurosurg. 2021; 149:e298-e308. DOI: 10.1016/j.wneu.2021.02.032. View

13.

Jenkinson M, Mills S, Mallucci C, Santarius T . Management of pineal and colloid cysts. Pract Neurol. 2021; . PMC: 8327315. DOI: 10.1136/practneurol-2020-002838. View

14.

Molitch M . Diagnosis and Treatment of Pituitary Adenomas: A Review. JAMA. 2017; 317(5):516-524. DOI: 10.1001/jama.2016.19699. View

15.

Moller M, Andersen M, Glintborg D, Pedersen C, Halle B, Kristensen B . Endoscopic vs. microscopic transsphenoidal pituitary surgery: a single centre study. Sci Rep. 2020; 10(1):21942. PMC: 7736852. DOI: 10.1038/s41598-020-78823-z. View

16.

Zhu J, Wang Z, Zhang Y, Liu J, Li X, Deng K . Suprasellar pituitary adenomas: a 10-year experience in a single tertiary medical center and a literature review. Pituitary. 2020; 23(4):367-380. DOI: 10.1007/s11102-020-01043-1. View

17.

Allehaibi E, H Almalki M, Brema I . Plurihormonal pituitary macroadenoma: a case report. J Med Case Rep. 2021; 15(1):407. PMC: 8320198. DOI: 10.1186/s13256-021-02948-6. View