Brain Tumor Res Treat.  2017 Apr;5(1):49-52. 10.14791/btrt.2017.5.1.49.

A Case of Coincidental Intrasellar Chordoma and Pituitary Adenoma

• Park S
• Kim HS
• Park KS
• Nam TK
• Park YS
• Kwon JT
• Kim KT

• KMID: 2378307
• DOI: http://doi.org/10.14791/btrt.2017.5.1.49

Abstract

Although chordomas are midline tumors, primarily intrasellar chordomas are extremely rare. In this report, the authors describe the case of a 68-year-old female with partial abducens nerve palsy in the right eye due to the intrasellar cystic tumor. After endonasal trans-sphenoidal surgery, intraoperative and histopathological findings confirmed the co-occurrence of an entirely intrasellar chordoma and pituitary adenoma. To our knowledge, the present case is the third reported case of an intrasellar chordoma with a pituitary adenoma.

Keyword

Chordoma; Pituitary adenoma; Sella turcica; Pathology

MeSH Terms

Abducens Nerve Diseases
Aged
Chordoma*
Female
Humans
Pathology
Pituitary Neoplasms*
Sella Turcica

Figure

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  Fig. 1 Preoperative CT. A: Enhanced brain CT showing a thinned sellar floor and an intrasellar cystic mass compressing the right cavernous sinus without calcification. B: Sagittal images revealing the normal parasellar bony abnormalities.

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  Fig. 2 Preoperative MRI. Brain MRI revealing the intrasellar cystic tumor with a well-enhanced rim and without invasion to the cavernous sinus. A: T2 WI coronal image. B: T1 WI coronal image. C: Enhanced T1 WI coronal image. D: Enhanced T1 WI sagittal image.

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  Fig. 3 Intraoperative findings showing two different tumors. A: The intact dura and remnant bony sella (arrow). B: A yellowish and friable tumor located to the left and anterior side (arrowheads) and a cystic tumor located to the right side (arrow). C: A prominent yellowish and friable tumor (arrowheads). D: A mucoid substance in the cystic tumor (arrow).

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  Fig. 4 Histopathological findings of two different tumors. A: Pituitary adenoma: the tumor cells consist of small, oval or polyhedral cells. They are arranged in cords or an acinar pattern. The nuclei of tumor cells are round or oval and contain stippled chromatin (H&E, ×200). B: Chordoma: the neoplasm consists of strands of cells with vacuolated cytoplasm (physaliphorous cells) (H&E, ×200). The neoplastic cells of the chordoma are reactive to the (C) cytokeratin-20 and (D) epithelial membrane antigen antibody in the cytoplasm and cell membrane (×200). H&E, hematoxylin and eosin.

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