Clinical Diagnosis And Treatment Of Granular Cell Tumor Of Neurohypophysis

Objectives: To analyze the clinical manifestations,imaging features,surgical approaches,pathological features and prognosis of GCT of neurohypophysis in the existing literatures so as to enhance neurosurgical doctors' understanding of granular cell tumor of neurohypophysis.Cell tumor patients to make the most accurate diagnosis,reduce misdiagnosis and missed diagnosis,to give the best treatment options.Methods: Retrieved from January 2000 to January 2018 published at home and abroad during the literature related to granular cell tumor of neurohypophysis,excluding clinical data incomplete literature,combined with repeat case literature.The basic information of selected cases,epidemiological characteristics of clinical manifestations,imaging features,surgical approach,pathological features were summarized.Result: 1.Screening 36 patients in the group of 16 males and 20 females,male to female ratio of 1: 1.25.The youngest is 8 years old,the largest is 76 years old,the average age is 45 years old,40 to 50 years of patients accounted for 1/4 of the total patients.2.The general case history of 13 months,up to 8 years.About half of patients showed decreased visual acuity,visual field defects;secondly,about 40% of patients showed headache;20% of patients showed endocrine disorders.3.Auxiliary examination: In addition to occasional abnormal hormones,the other test results were normal.Imaging examination: the average diameter of the largest tumor was 2.23 cm,less in the saddle alone;80% of patients with tumors located in the saddle saddle or saddle.Brain CT showed: saddle and saddle or round slightly higher density changes.Brain MRI showed that 90% of T1-weighted images showed equal or slightly lower signals;80% of T2-weighted images showed equal or low signals,and enhanced MRI showed markedly uniform or non-uniform enhancement.4.Granular cell tumor of neurohypophysis immunohistochemical: AACT and PAS are positive expression,CK and EMA are negative expression.The positive expression of S-100 protein,NSE,TTF-1 and CD-68 were over 75%,while the positive expression of GFAP and Syn were 33% and 18% respectively.5.Into the group of 36 patients were taken surgical treatment.Among the 28 cases reported for surgical approach,9 patients underwent transnasal neoplasm resection;6 patients underwent transcranial forehead approach tumor resection;10 patients underwent pterional approach for tumor resection;1 patient underwent tumor resection on the left-upper-keyhole approach.17 patients reported tumor resection range,of which 4 cases were partial resection;subtotal cut in 8 cases;total cut in 5 cases.No specific patient in 36 patients with prognosis and follow-up information.Conclusion: 1.GCT of neurohypophysis clinical symptoms mainly due to tumor occupancy caused by its own non-specific performance.No specific performance in MRI,preoperative diagnosis difficult,the exact diagnosis based mainly on its pathological examination.2.For the clinical symptoms of GCT of neurohypophysis patients,the best treatment for radical resection within the scope of safety.For patients who are not suitable for total resection of the tumor,it is feasible to perform subtotal or partial tumor resection on decompression of normal peripheral nerve tissue.3.Physical examination found small and asymptomatic saddle and or saddle area occupancy,can be highly suspected slow growth of GCT of neurohypophysis,in order to avoid postoperative scar caused by pituitary dysfunction and other postoperative complications may be Patients to take conservative treatment,such as close follow-up of patients with visual acuity,visual field and other clinical features,regular MRI examination,rather than immediate surgical treatment.