Rare collision tumor in the sellar region - pituitary adenoma combined with craniopharyngioma and case review

Abstract Collision tumors in the sellar region are very rare, mainly formed by the coexistence of two or more primary tumors from different tissue sources in the sellar region. Among them, the combination of pituitary adenoma and craniopharyngioma is particularly rare. This case describes a particularly rare case of coexistence of pituitary adenoma and craniopharyngioma in the sellar region. The case is a 59-year old female who was admitted due to a feeling of heaviness of the head for 6 + months. Brain MRI examination confirmed the presence of masses in the pituitary gland and pituitary stalk. The patient underwent total resection of intrasellar lesions via nasal transsphenoidal approach under neuroendoscopy, and postoperative pathology and immunohistochemistry confirmed non-functional pituitary adenoma. At 22 months after surgery, the patient came to the hospital due to "unclear left eye vision for 1 month". Upon reexamination, the pituitary stalk tumor significantly increased compared to before. She underwent a second surgery, which involved a microsurgical total resection of the pituitary stalk tumor through a hemispherical longitudinal fissure approach. Postoperative pathology and immunohistochemistry confirmed the diagnosis of craniopharyngioma. Looking back at the diagnosis and treatment process of this case, it was found that pituitary adenoma and craniopharyngioma coexisted in the sellar region, which is a very rare case of collision tumor in the sellar region.