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Intrasellar chordoma associated with a primitive persistent trigeminal artery
Marta Navas1, Pedro Martinez, Sophia F Shakur
1La Princesa University Hospital, Department of Neurosurgery, Madrid, Spain.
Turkish Neurosurgery
|February 3, 2015
Summary
Intrasellar chordomas are rare and can mimic pituitary adenomas. Preoperative endovascular occlusion of a persistent primitive trigeminal artery (PPTA) facilitated safe surgical resection of a coexisting intrasellar chordoma.
Area of Science:
- Neurosurgery
- Neuroradiology
- Endovascular Therapy
Background:
- Intrasellar chordomas are rare tumors that can be misdiagnosed as non-functioning pituitary adenomas.
- The coexistence of intrasellar chordoma (ISC) and a persistent primitive trigeminal artery (PPTA) is exceptionally rare, with no prior reports in medical literature.
Observation:
- A 32-year-old male presented with right hemifacial paresthesias and a cranial nerve VI palsy.
- MRI revealed an intrasellar chordoma associated with a PPTA.
- Angiographic balloon test occlusion of the PPTA showed no neurological deficits.
Findings:
- Endovascular coiling successfully occluded the PPTA.
- Subtotal tumor resection was achieved via a sublabial transsphenoidal approach without intraoperative bleeding.
- Histological examination confirmed the diagnosis of chordoma.
Implications:
- Preoperative identification of vascular anomalies like PPTA in patients with intracranial chordomas is crucial.
- Management of associated vascular anomalies before resecting intrasellar lesions can simplify surgery and prevent complications.
- This case highlights the importance of a multidisciplinary approach in managing complex sellar region tumors.
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