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Sellar and Parasellar Tumors Diagnosis, Treatments, and Outcomes

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Sellar and Parasellar Tumors Diagnosis, Treatments, and Outcomes Sellar and Parasellar Tumors Diagnosis, Treatments, and Outcomes 000_Laws11_FM.indd0_Laws11_FM.indd i 77/9/11/9/11 55:40:40 PPMM 000_Laws11_FM.indd0_Laws11_FM.indd iiii 77/9/11/9/11 55:40:40 PPMM Sellar and Parasellar Tumors Diagnosis, Treatments, and Outcomes Edward R. Laws Jr., MD, FACS Professor of Neurosurgery Harvard Medical School Director Pituitary–Neuroendocrine Program Department of Neurosurgery Brigham and Women’s Hospital Boston, Massachusetts Jason P. Sheehan, MD, PhD, FACS Alumni Professor Department of Neurological Surgery University of Virginia Charlottesville, Virginia Thieme New York · Stuttgart 000_Laws11_FM.indd0_Laws11_FM.indd iiiiii 77/9/11/9/11 55:40:40 PPMM Thieme Medical Publishers, Inc. 333 Seventh Ave. New York, NY 10001 Executive Editor: Kay Conerly Managing Editor: Lauren Henry Editorial Assistant: Yasmine Kasi Editorial Director, Clinical Reference: Michael Wachinger Production Editor: Kenneth L. Chumbley International Production Director: Andreas Schabert Vice President, International Marketing and Sales: Cornelia Schulze Vice President, Finance and Accounts: Sarah Vanderbilt President: Brian D. Scanlan Compositor: Kenneth L. Chumbley, Publisher Printer: Leo Paper Group Library of Congress Cataloging-in-Publication Data Sellar and parasellar tumors / [edited by] Edward R. Laws Jr., Jason Sheehan. p. ; cm. Includes bibliographical references. ISBN 978-1-60406-421-6 (hardback) 1. Sella turcica —Tumors. 2. Pituitary gland—Tumors. 3. Skull base—Tumors. I. Laws, Edward R. II. Sheehan, Jason P. [DNLM: 1. Adenoma—surgery. 2. Pituitary Neoplasms—surgery. 3. Neurosurgical Procedures—methods. 4. Pitu- itary Neoplasms—pathology. 5. Sella Turcica—pathology. 6. Sella Turcica—surgery. WK 585] RC280S45 2011 616.99’447—dc23 2011018947 Copyright ©2012 by Thieme Medical Publishers, Inc. This book, including all parts thereof, is legally protected by copyright. Any use, exploitation, or commercialization outside the narrow limits set by copyright legislation without the publisher’s consent is illegal and liable to prosecution. This applies in particular to photostat reproduction, copying, mimeographing or duplication of any kind, translating, preparation of microfi lms, and electronic data processing and storage. Important note: Medical knowledge is ever-changing. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy may be required. The authors and editors of the material herein have consulted sources believed to be reliable in their eff orts to provide information that is complete and in accord with the standards ac- cepted at the time of publication. However, in view of the possibility of human error by the authors, editors, or publisher of the work herein or changes in medical knowledge, neither the authors, editors, nor publisher, nor any other party who has been involved in the preparation of this work, warrants that the information contained herein is in every respect accurate or complete, and they are not responsible for any errors or omissions or for the results obtained from use of such information. Readers are encouraged to confi rm the information contained herein with other sources. For example, readers are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the information contained in this publication is accurate and that changes have not been made in the recommended dose or in the contraindications for administration. This recommendation is of particular importance in connection with new or infrequently used drugs. Some of the product names, patents, and registered designs referred to in this book are in fact registered trademarks or proprietary names even though specifi c reference to this fact is not always made in the text. Therefore, the appearance of a name without designation as proprietary is not to be construed as a representation by the publisher that it is in the public domain. Printed in China 5 4 3 2 1 ISBN 978-1-60406-421-6 000_Laws11_FM.indd0_Laws11_FM.indd iviv 77/9/11/9/11 55:40:40 PPMM Contents Foreword ............................................................................................................................................................................... vii Preface .................................................................................................................................................................................... ix Contributors ......................................................................................................................................................................... xi 1 Introduction and Historical Perspective ........................................................................................................ 1 Edward R. Laws Jr. and Zachary N. Litvack 2 Anatomy of the Sellar and Parasellar Region ................................................................................................ 8 Albert L. Rhoton Jr. 3 Radiologic Evaluation and Diagnosis for Pathology in the Sellar and Parasellar Region ................. 50 Prashant Raghavan and Max Wintermark 4 Medical Evaluation and Management ............................................................................................................ 61 Mary Lee Vance 5 Ophthalmologic Evaluation and Management ............................................................................................ 65 Steven A. Newman 6 Surgical Treatment of Pituitary Adenomas ................................................................................................... 124 Soriya Motivala, Yakov Gologorsky, Joshua Bederson, and Kalmon D. Post 7 Surgical Treatment of Meningiomas ............................................................................................................... 135 Ossama Al-Mefty and Ian F. Dunn 8 Surgical Treatment of Craniopharyngiomas ................................................................................................. 145 R. Michael Scott and Edward R. Smith 9 Surgical Treatment of Chordomas and Chondrosarcomas ....................................................................... 155 Devyani Lal, Nancy J. Fischbein, and Griffi th R. Harsh IV 10 Surgical Treatment of Rathke Cleft Cysts ....................................................................................................... 170 Erin N. Kiehna, Spencer C. Payne, and John A. Jane Jr. 11 Transsphenoidal Approaches to the Sellar and Parasellar Area ............................................................... 177 Daniel M. Prevedello 12 Transcranial Approaches to the Sellar and Parasellar Area ...................................................................... 187 Bradley N. Bohnstedt, Todd Eads, R. Shane Tubbs, and Aaron A. Cohen-Gadol 13 Radiation Therapy ................................................................................................................................................ 199 Itai Pashtan, Kevin S. Oh, and Jay S. Loeffl er 14 Stereotactic Radiosurgery .................................................................................................................................. 216 Ricky Medel, Brian Williams, and Jason P. Sheehan v 000_Laws11_FM.indd0_Laws11_FM.indd v 77/9/11/9/11 55:40:40 PPMM vi Contents 15 Intracavitary Radiation for Cystic Craniopharyngiomas ........................................................................... 229 L. Dade Lunsford, Ajay Niranjan, Hideyuki Kano, Peter Kang, and Douglas Kondziolka 16 Chemotherapy Options for Sellar and Parasellar Tumors ......................................................................... 236 Arnaldo Neves Da Silva and David Schiff Index ....................................................................................................................................................................................... 247 000_Laws11_FM.indd0_Laws11_FM.indd vivi 77/9/11/9/11 55:40:40 PPMM Foreword The unique association of vascular, neural, and endocrine microsurgical techniques. These have been utilized within anatomy within the central skull base that comprises the the context of an improved understanding of the pathol- sellar and parasellar region and the varieties of patholo- ogy, with the imperative that the treatment (or therapy) gies that arise in this part of the skull base provide con- must optimize control of the pathology, while minimizing siderable challenges to the neurosurgeon. Management morbidity. of lesions in this region continues to generate consider- This book collects the leaders in the various facets of the able controversy, as there is often a fi ne balance between management options that have evolved over the past two treatment-outcome related to the pathology and the decades. It covers the broad topics involved with evalua- morbidity produced by the management. tion of the pathology and the variety of treatment options. With this book, Edward Laws Jr. and Jason Sheehan have It is highly recommended to all neurosurgeons and radio- edited the fi rst comprehensive guide to the management therapists involved in the management of patients with of the large varieties of pathologies that arise in the sellar sellar and parasellar pathology. and parasellar area. Over the past two decades, changes in management practices have been underpinned by a bet- Andrew H. Kaye, MB BS, MD, FRACS ter understanding of the nature of the pathology, improved James Stewart Professor of Surgery imaging, and a refi nement of both surgical and
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