A Systematic Review of Sellar and Parasellar Brown Tumors: An Analysis of Clinical, Diagnostic, and Management Profiles

Mohamedkazim M. Alwani, Gina N. Monaco, Sydney M. Harmon, Obi I. Nwosu, Alexander Vortmeyer, Troy D. Payner, Jonathan Ting

Research output: Contribution to journalArticle

Abstract

Objective: To systematically review and analyze clinical, diagnostic, and management trends in sellar and parasellar brown tumors reported in existing literature. Methods: In this systematic review, PubMed, Ovid MEDLINE, Scopus, and Google Scholar databases were searched for reported cases of sellar/parasellar brown tumors. Relevant titles and abstracts were screened in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Articles meeting inclusion criteria were subjected to data extraction, summarization, and analysis. A rare case of parasellar brown tumor was also presented. Results: Eight reports (including the current report) were eligible for inclusion. Mean patient age was 42.75 years. Reported symptoms included visual disturbances (n = 6), headache (n = 5), fatigue (n = 3), nausea/vomiting (n = 2), chest pain (n = 1), neck pain (n = 1), and dysphagia (n = 1). In cases where computed tomography findings were provided (n = 6), lesions were noted to be expansile and lytic. Lesions were hyperintense on T2-weighted magnetic resonance imaging (66.7%) and demonstrated contrast enhancement (83.3%). Histology unanimously showed multinucleated giant cells in a fibrovascular connective tissue stroma. Dramatic symptom resolution was noted in all patients who underwent resection of the sellar/parasellar brown tumor (n = 4; 50%). Conclusions: Sellar/parasellar brown tumors are a rare, tertiary manifestation of hyperparathyroidism and can be elusive to diagnose. Diagnosis requires a high index of clinical suspicion in addition to comprehensive biochemical testing, imaging, and histopathologic analysis. Surgical extirpation is favored in cases where the lesion is causing compressive symptoms, or if it is unresponsive to management of hyperparathyroidism.

Original languageEnglish (US)
JournalWorld Neurosurgery
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Hyperparathyroidism
Neoplasms
Neck Pain
Giant Cells
Deglutition Disorders
Chest Pain
PubMed
MEDLINE
Connective Tissue
Nausea
Vomiting
Fatigue
Headache
Meta-Analysis
Histology
Tomography
Magnetic Resonance Imaging
Databases

Keywords

  • Brown tumor
  • Hyperparathyroidism
  • Parasellar tumor
  • Sellar tumor
  • Sphenoid sinus tumor

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

A Systematic Review of Sellar and Parasellar Brown Tumors : An Analysis of Clinical, Diagnostic, and Management Profiles. / Alwani, Mohamedkazim M.; Monaco, Gina N.; Harmon, Sydney M.; Nwosu, Obi I.; Vortmeyer, Alexander; Payner, Troy D.; Ting, Jonathan.

In: World Neurosurgery, 01.01.2019.

Research output: Contribution to journalArticle

Alwani, Mohamedkazim M. ; Monaco, Gina N. ; Harmon, Sydney M. ; Nwosu, Obi I. ; Vortmeyer, Alexander ; Payner, Troy D. ; Ting, Jonathan. / A Systematic Review of Sellar and Parasellar Brown Tumors : An Analysis of Clinical, Diagnostic, and Management Profiles. In: World Neurosurgery. 2019.
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abstract = "Objective: To systematically review and analyze clinical, diagnostic, and management trends in sellar and parasellar brown tumors reported in existing literature. Methods: In this systematic review, PubMed, Ovid MEDLINE, Scopus, and Google Scholar databases were searched for reported cases of sellar/parasellar brown tumors. Relevant titles and abstracts were screened in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Articles meeting inclusion criteria were subjected to data extraction, summarization, and analysis. A rare case of parasellar brown tumor was also presented. Results: Eight reports (including the current report) were eligible for inclusion. Mean patient age was 42.75 years. Reported symptoms included visual disturbances (n = 6), headache (n = 5), fatigue (n = 3), nausea/vomiting (n = 2), chest pain (n = 1), neck pain (n = 1), and dysphagia (n = 1). In cases where computed tomography findings were provided (n = 6), lesions were noted to be expansile and lytic. Lesions were hyperintense on T2-weighted magnetic resonance imaging (66.7{\%}) and demonstrated contrast enhancement (83.3{\%}). Histology unanimously showed multinucleated giant cells in a fibrovascular connective tissue stroma. Dramatic symptom resolution was noted in all patients who underwent resection of the sellar/parasellar brown tumor (n = 4; 50{\%}). Conclusions: Sellar/parasellar brown tumors are a rare, tertiary manifestation of hyperparathyroidism and can be elusive to diagnose. Diagnosis requires a high index of clinical suspicion in addition to comprehensive biochemical testing, imaging, and histopathologic analysis. Surgical extirpation is favored in cases where the lesion is causing compressive symptoms, or if it is unresponsive to management of hyperparathyroidism.",
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