Journal of neurological surgery. Part B, Skull base · 2025
Pituitary Stalk Lesion Sampling by Transsphenoidal Posterior Lobe Biopsy: A Case Series.
СтатьяНазвание и аннотация: Перевод в очереди
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Hiatt Kyly, Abecassis Zachary A, Eaton Jessica, Hanks Thomas, Raub Spencer, Baird-Daniel Eliza, Zhao Zirun, El-Ghazali Fatima, Nistal Dominic, Jamshidi Aria, Hartl Kaitlyn, Child Dan, Lee Amy, Bly Randall, Ferreira Manuel, Ruzevick Jacob, Emerson Samuel
Аннотация
OBJECTIVE: This study aims to assess the safety and efficacy of performing posterior lobe pituitary biopsy in patients with pituitary stalk lesions compared with direct stalk biopsy.
DESIGN: We performed a single-institution retrospective review of four patients who underwent endoscopic transsphenoidal surgery of the posterior pituitary lobe for a lesion of the pituitary stalk without clear diagnosis, despite noninvasive workup.
PARTICIPANTS: Four patients with known pituitary stalk lesions who underwent posterior pituitary biopsy without tumor resection.
MAIN OUTCOME MEASURES: The main outcomes were postprocedural endocrine function across all axes compared with preoperative function, postprocedural morbidities, and ability to obtain an accurate histologic diagnosis from biopsy.
RESULTS: A total of 100% (4/4) patients were histologically diagnosed based on tissue from transsphenoidal biopsy of the posterior lobe. There was no worsening of preoperative endocrine function. One patient experienced a cerebrospinal fluid leak. There were no other postoperative complications. None of the patients experienced worsening of vision attributable to biopsy.
CONCLUSION: Transsphenoidal posterior lobe biopsy has a low-risk profile and high diagnostic capacity in patients presenting with a lesion of the pituitary stalk of uncertain etiology.
DESIGN: We performed a single-institution retrospective review of four patients who underwent endoscopic transsphenoidal surgery of the posterior pituitary lobe for a lesion of the pituitary stalk without clear diagnosis, despite noninvasive workup.
PARTICIPANTS: Four patients with known pituitary stalk lesions who underwent posterior pituitary biopsy without tumor resection.
MAIN OUTCOME MEASURES: The main outcomes were postprocedural endocrine function across all axes compared with preoperative function, postprocedural morbidities, and ability to obtain an accurate histologic diagnosis from biopsy.
RESULTS: A total of 100% (4/4) patients were histologically diagnosed based on tissue from transsphenoidal biopsy of the posterior lobe. There was no worsening of preoperative endocrine function. One patient experienced a cerebrospinal fluid leak. There were no other postoperative complications. None of the patients experienced worsening of vision attributable to biopsy.
CONCLUSION: Transsphenoidal posterior lobe biopsy has a low-risk profile and high diagnostic capacity in patients presenting with a lesion of the pituitary stalk of uncertain etiology.