Introduction: Spindle cell oncocytoma (SCO) is a rare sellar and suprasellar tumor that is often radiologically indistinguishable from other pituitary macroadenomas. SCO is a WHO grade I lesion with a favorable clinic course. This entity first described in 2002 by Roncaroli and included in mass lesions of pituitary region in 2007 WHO classification of central nervous system. This tumor is composed mainly of fascicles of spindle cells and includes epitheloidal cells in a lesser extent. Surgery has been chosen as the favorable treatment for this tumor where adjuvant radiotherapy after surgery has been used in 4 cases and gamma knife radiosurgery has been used in one case.
Methods: We retrospectively reviewed 5 cases of spindle cell oncocytoma in which gamma knife surgery has been used postsurgical residual tumors. There were 4 males and 1 female patients and mean age was 52.6 years (range 41-61). The patients were followed-up for a mean duration of 33 months. The mean volume of residual tumors at the gamma knife were 2.06 cc (range 0.4-4.2 cc). In the time of gamma knife radiosurgery all patients were under medical treatment for hypopituitarism. The most common symptoms after surgery and before gamma knife radiosurgery were visual problems (n=3) and fatigue (n=2). Patients also presented with headache, infertility and loss of body hair. The mean marginal dose was 13.5 Gy (range 12-14 Gy).
Results: All patients demonstrated tumor growth control (2 smaller and 3 stable). There were no change in the endocrinological status. There were no complications related to the treatment.
Conclusions: Gamma knife radiosurgery achieves excellent results with respect to tumor control. This series demonstrates that GKRS is a good option for residual spindle cell oncocytomas.
Patient Care: With using gamma knife radio surgery the quality of life in these patients will improve.
Learning Objectives: Treatment options for SCO
Efficacy of radiation on SCO
Safety of radiation on SCO