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Published in: Journal of Neuro-Oncology 2/2018

01-11-2018 | Topic Review

Granular cell tumor of the infundibulum: a systematic review of MR-radiography, pathology, and clinical findings

Authors: Jessica B. Polasek, Yosef Laviv, Fares Nigim, Rafael Rojas, Matthew Anderson, Hemant Varma, Ekkehard M. Kasper

Published in: Journal of Neuro-Oncology | Issue 2/2018

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Abstract

Introduction

Granular cell tumors (GCTs) of the infundibulum are rare in practice and literature, resulting in a lack of evidence-based standard of care. We present two characteristic cases from our institution and perform a systematic review of the existing literature to further elucidate the presentation of this tumor and guide management.

Methods

A systematic literature search was conducted according to PRISMA guidelines, yielding 42 total individual reported GCTs suitable for evaluation. Available clinical presentation, magnetic resonance imaging (MRI) characteristics, pathology, surgical approaches, and outcomes were charted. We measured frequencies of clinical characteristics and performed an outcome comparison of open versus endoscopic surgical treatment.

Results

In this pooled dataset, GCT incidence was higher in females than males (3:1). Clinical presentation peaked in the fourth decade with tumor-related symptoms. MRI appearance was characterized by T1 isointensity (50%) and T2 hypointensity or isointensity (52%) with gadolinium contrast enhancement (74%). Histopathology demonstrated positive staining for PAS, PAS-D, S100, CD68, and TTF1. In a simple uncontrolled analysis, patients who underwent endoscopic surgery experienced more symptom improvement (p = 0.006) and lower incidence of new diabetes insipidus postoperatively (p = 0.047) versus patients who underwent open microsurgery.

Conclusions

This first comprehensive review of GCTs of the infundibulum corroborates existing data and adds significant new MR-radiological information to the literature, notably a typical tumor appearance of T1 isointensity, T2 iso- to hypointensity, and gadolinium contrast enhancement. Future prospective studies should be conducted to validate our findings.
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Metadata
Title
Granular cell tumor of the infundibulum: a systematic review of MR-radiography, pathology, and clinical findings
Authors
Jessica B. Polasek
Yosef Laviv
Fares Nigim
Rafael Rojas
Matthew Anderson
Hemant Varma
Ekkehard M. Kasper
Publication date
01-11-2018
Publisher
Springer US
Published in
Journal of Neuro-Oncology / Issue 2/2018
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI
https://doi.org/10.1007/s11060-018-2986-2

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