2Koç Üniversitesi Hastanesi, İstanbul, Türkiye DOI : 10.5137/1019-5157.TND.3372 AIM: The aim of this study is to present our sellar and parasellar metastasis (SaPM) series of 10 cases in which we performed endoscopic endonasal transsphenoidal resection, and to discuss important clinical, radiological and endocrinological points in the diagnosis and treatment phase in the light of the literature.
MATERIAL and METHODS: In this study conducted using the EETC series of 1100 cases performed by a single surgical team, the data of 10 patients who underwent endoscopic endonasal transsphenoidal surgery (EETC) between June 2013 and December 2023 and were histopathologically confirmed to have metastases were retrospectively examined. Demographic characteristics of all patients, clinical history, symptoms at presentation, radiological findings, histopathological diagnosis, cranial nerve involvement, preoperative and postoperative hormonal disorders, amount of surgical resection, adjuvant therapies, and surgical complications of all patients were examined.
RESULTS: The mean age of the patients was 55.5 (30-80) years. The most common (40%) metastatic histology among the 10 cases was identified as lung adenocarcinoma. The most common symptom at presentation was headache (50%). Cranial nerve neuropathy was observed in 3 patients (30%) involving the 3rd cranial nerve in 3 cases and the 6th cranial nerve in 3 cases. Six of the followed patients had a fatal outcome. Improvement in symptoms was observed in two patients with visual impairment during the postoperative period.
CONCLUSION: Due to their rarity, SaPMs can easily be confused with other pathologies preoperatively. Metastases should be considered in the surgical treatment of sellar pathologies, and taken into account when planning treatment.
Anahtar Kelimeler : Cranial metastasis, Survival time, Adenohypophyseal insufficiency, Diabetes insipidus, Endoscopic transsphenoidal surgery