• World Neurosurg · Dec 2023

    Perisellar tumor coexisting with unruptured cerebral aneurysm: single-stage or staged surgery?

    • Xi Chen Wan, Yu Xing Chen, Ye Xiong, Jie Wu, Shan Si Chen, Bin Tang, Tao Hong, and Xiao Wu.
    • Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, China.
    • World Neurosurg. 2023 Dec 1; 180: e46e55e46-e55.

    ObjectiveThe coexistence of perisellar tumors and intracranial aneurysms was previously considered a rare phenomenon. In this study, we introduce our experience with surgical strategies for the treatment of such coexisting pathologies.MethodsThis retrospective study reviews the medical records and intraoperative videos of patients with coexisting pathologies of perisellar tumors and aneurysms from Nov 2017 to Oct 2022.ResultsOur study involved 20 patients, including 9 males and 11 females. Three patients selected the single-stage endoscopic endonasal approach (EEA), including one with a type of MP trigeminal schwannoma with an anterior communicating aneurysm, 1 with a pleomorphic xanthoastrocytoma with a left internal carotid artery paraclinoid aneurysm, and 1 with a recurrent pituitary adenoma with a right internal carotid artery paraclinoid aneurysm. Thirteen patients chose tumor resection first through the EEA with embolization or aneurysm conservation. There were also 2 patients with irregularly shaped aneurysms who chose embolization before tumor resection. All tumors were completely removed, with only a few patients experiencing recurrence and postoperative complications, and the follow-up of the aneurysms was also stable. There were also 2 patients who chose conservative management for both tumors and aneurysms, but unfortunately, one of them suffered from aneurysm rupture and eventually died. No cerebrospinal fluid rhinorrhea, severe intracranial infection, or surgical-related hemorrhage was found in any patients.ConclusionsStaged surgery or conservative treatment for aneurysms can be considered a safe and effective strategy for the treatment of coexisting pathologies. However, in very selected cases, the single-stage EEA can be used as part of a comprehensive treatment for such coexisting pathologies.Copyright © 2023 Elsevier Inc. All rights reserved.

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