Trans-nasal Trans-sphenoidal Endoscopic Resection of Spindle Cell Oncocytoma of Adenohypophysis: The First Case Report in a Child and a Review of Literature

Abstract

Spindle cell oncocytoma (SCO) is a rare tumor of adenohypophysis, arising from the sellar region. So far, about 35 cases of SCO in the sellar region have been reported. In this report, we present the first case of pediatric SCO and review the literature concerning the tumor origin, clinical presentations, radiological features, and treatment modalities. An 8-year-old male was referred to our clinic with progressive visual loss in the left eye and headache over the past 6 months. Cranial magnetic resonance imaging revealed a solid adenohypophysis mass with suprasellar extension, as well as compression and displacement of the optic chiasm. The patient underwent endoscopic trans-sphenoidal resection of the tumor. The tumor was diagnosed as SCO based on the histological study. He did not receive radiation therapy. The patient's condition remained stable, with no radiological recurrence in the past follow-up 2 years after the surgery.

Keywords: Adenohypophysis; sellar region; spindle cell oncocytoma; trans-sphenoidal.

Figure 1

(a,b,c) post-contrast Magnetic resonance images (MRI) revealed an enhancing huge sellar-suprasellar mass with involvement of right cavernous sinus and optic nerve compression

Figure 2

Photomicrograph of a hematoxylin and eosin (H&E) stained section of the tumor, showing interlacing fascicles of mono morph spindle cells and epithelioid cells. The cells had an abundant eosinophilic cytoplasm. necrosis, mitoses, or invasion was not observed. (a) Cells were spindle-shaped with round to ovoid nucleiand no mitotic activity (b)

Figure 3

Post operative MRI show gross total resection of tumor with very small residue in right cavernous sinus