Tumores de células gigantes do esfenóide: relato de 3 casos e revisão da literatura

Novaes, Virgílio; Pinaud, Marcelo; Paranhos, J. L.; D'Alessandro, J. Roberto

doi:10.1590/S0004-282X1977000100007

Resumos

Três casos de tumores de células gigantes do esfenoide são expostos, sendo salientada a importância do perfeito conhecimento destes tumores pelo neuro-cirurgião. Apesar de serem tumores raros têm um bom prognóstico quando não são abordados de maneira agressiva. A semelhança sintomatológica e radio-lógica com outros tumores da região selar é enfatizada, usando-se dados recolhidos na literatura e na análise dos 3 casos pessoais. A abordagem terapêutica proposta, biópsia e descompressão por via transesfenoidal seguida de radioterapia é devida à alta mortalidade e morbidade obtida quando estes tumores são abordados pelos métodos neurocirúrgicos clássicos, craniotomia frontal e exerese mais ampla do tumor.

Three cases of giant cell tumor of the sphenoid bone are reported together with a revision of the previously reported cases in the neurosurgical literature. The importance of this tumor in the neurosurgical pathology is stressed, mainly to the impossibility of a correct diagnosis on a clinical and radiological basis. A good prognosis is possible with a least agressive surgery, transsphenoidal biopsy and decompression, followed by radiotherapy.

Tumores de células gigantes do esfenoide: relato de 3 casos e revisão da literatura

Giant cell tumors of the sphenoid bone: report of three cases and review of literature

Virgílio Novaes^I; Marcelo Pinaud^I; J. L. Paranhos^I; J. Roberto D'Alessandro^II

^ISeção de Neurocirurgia, Clinica São Vicente, Gávea, Rio de Janeiro

^IIInstituto de Neurologia, São José do Rio Prêto, São Paulo

RESUMO

Três casos de tumores de células gigantes do esfenoide são expostos, sendo salientada a importância do perfeito conhecimento destes tumores pelo neuro-cirurgião. Apesar de serem tumores raros têm um bom prognóstico quando não são abordados de maneira agressiva. A semelhança sintomatológica e radio-lógica com outros tumores da região selar é enfatizada, usando-se dados recolhidos na literatura e na análise dos 3 casos pessoais. A abordagem terapêutica proposta, biópsia e descompressão por via transesfenoidal seguida de radioterapia é devida à alta mortalidade e morbidade obtida quando estes tumores são abordados pelos métodos neurocirúrgicos clássicos, craniotomia frontal e exerese mais ampla do tumor.

SUMMARY

Three cases of giant cell tumor of the sphenoid bone are reported together with a revision of the previously reported cases in the neurosurgical literature. The importance of this tumor in the neurosurgical pathology is stressed, mainly to the impossibility of a correct diagnosis on a clinical and radiological basis. A good prognosis is possible with a least agressive surgery, transsphenoidal biopsy and decompression, followed by radiotherapy.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Seção de Neurocirurgia, Clinica São Vicente - Rua João Borges 204, Gávea - 20000 Rio de Janeiro, RJ - Brasil.

1. ARSENI, C; HORVATH, L.; MARETSIS, M. & CARP, N. - Giant cell tumours of the calvaria. J. Neurosurg. 42: 535, 1975.
2. BELLANGER, W. C. & DYKE, C. G. - Roentgen diagnosis of malignant nasopharyngeal tumours. Amer. J. Roentgen 50: 9, 1943.
3. BERMAM, H. L. - The treatment of benign giant cell tumour of the vertebra, by irradiation. Radiology 83: 202, 1964.
4. CAHAN, W. G.; WOODWARD, H. Q.; HIGINBOTHAM, N.; STEWART, F. W. & COLEY, B. L. - Sarcoma arrising in irradiated bone. Cancer 1: 3, 1948.
5. COLEY, W. B. - Malignant changes in the so-called benign giant cell tumour. Amer. J. Surg. 28 : 768, 1935.
6. COLEY, B. L. - Neoplasms of Bone and Related Conditions. 2ş Ed., Paul Hoeber Inc., New York, 1949.
7. CRUZ, M.; COLEY, B. L. & STEWART, F. W. - Post-irradiation bone sarcomas. Cancer 10 : 72, 1957.
8. DAHLIN, D. C. - Bone Tumours: General Aspects and Analysis of 2276 cases. Charles Thomas Pub., Springfield (Illinois), 1957.
9. DEBAY GRICOURT, N. - Les possibilites chirurgicales dans les tumeurs osseuses de la base du crâne. Tese, Amiens (France), 1971.
10. DECKER, E. R. & MALIS, L. I. - Surgical approaches to midline lesions at the base of the skull. J. Mount Sinai Hosp. 37 : 84, 1970.
11. DEROME, P. - Les tumeurs spheno-ethmoidales. Possibilites d'exerese et de reparation chirurgicale. Neurochirurgie (Paris) 18: su. 1: 135, 1972.
12. ECHOLS, D. H. - Giant cell tumour of the sphenoid bone. J. Neurosurg. 2: 16, 1945.
13. ELLER, J. L.; DECKER, J. T. & BRITTIS, A. L. - Roentgen therapy for a giant cell tumor of the sphenoid bone. Radiol. Clin. 37 : 36, 1968.
14. EMLEY, W. E. - Giant cell tumor of the sphenoid bone. Arch. Otolaryngol. 94_: 369, 1971.
15. FALCONER, M. A.; BAILLEY, I. C. & DUCHEN, L. W. - Surgical treatment of chordoma and chondroma of the skull base. J. Neurosurg. 29 : 261, 1968.
16. FRIEDMAM, M. & PEARLMAM, A. W. - Benign giant cell tumor of bone: radiation therapy for each type. Radiology 91: 1151, 1968.
17. GEE, V. R. & PUGH, D. G. - Giant cell tumor of bone. Radiology 70: 33, 1958.
18. GESCHICKTER, C. F. - Some unnusual features of giant cell tumor. Surg. Clin. N. Amer. 16: 1381, 1936.
19. GEISSINGER, J. D.; SIQUEIRA, E. B. & ROSS, E. R. - Giant cell tumours of the sphenoid bone. J. Neurosurg. 32: 665, 1970
20. GRIFEY, L. E. & TEDESCHI, L. G. - Giant cell tumor of sphenoid; Complication of Paget's disease of bone. Arch. Otolaryngol. 87 : 615, 1968.
21. GUPTA, I. M.; CUPTA, O. P. & SOMANT, H. S.; BHATIA, P. L.; AGARVAL, A. K. & PANT, G. C. - Giant cell tumor of the sphenoid bone. Ann. Otol. Rhinol. Laryng. 84: 359, 1975.
22. HANDOUSA, A. B. - Osteoclastoma in relation to the nose. J. Laryng. Otol. 65: 549, 1951.
23. BUTTER, R. V.; FOOT, F. W.; FRAZELL, E. L. & FRANCIS, K. C. - Giant ceil tumor complicating Paget's disease of bone. Cancer 16: 1044, 1963.
24. HUTTER, R. V.; WORCESTER, J. N.; FRANCIS, K. C; FOOT, F. W. & STEWART, F. W. - Benign and malignant giant cell tumor of bone. Cancer 15: 653, 1962.
JAFFE, H. L.; LICHTENSTEIN, L. & PORTIS, R. B. - Giant cell tumor of bone: its pathologic appearance, granding and suposed variants and treatment. Arch. Pathol. 30: 993, 1940.
26. JOHNSON, E. W. & DAHLIN, D. C. - Treatment of giant cell tumor of bone, J. Bone Joint Surg. 41 A: 895, 1959.
27. KANAKA, T. S. - Giant ceil tumor of the skull. Neurology (Minneapolis) 13: 14, 1966.
28. KAUFMAM, E. H. - Non-traumatic cerebrospinal fluid rhinorrhea. Arch. Neurology (Chicago) 21: 59, 1969.
29. KEPLINGER, J. E. & BUCY, P. C. - Giant cell tumor of spine. Ann. Surg. 154; 648, 1961.
30. LASJAUNIAS, P. DOYON, D.; VIGNAUD, J. & MORET, J. - Progress in the arteriographic study of the cavernous sinus diseases. In Advances in cerebral angiography, Salamon, G., ed., Springer Verlag, Berlin, 1975, pg. 323.
31. LICHTENSTEIN, L. - Bone Tumours. C. V. Mosby Co., St. Louis, Miss, 1965.
32. MARTINS, A. N. & DEAN, D. F. - Giant cell tumors of the sphenoiJ bone: malignant transformation following radiotherapy. Surgical Neurology 2: 105, 1974.
33. McNERNEY, J. C. - Giant cell tumor of bones of the skull. J. Neurosurg. 6: 169, 1949.
34. MICHEL, L. A. - Giant cell tumor of the sinuses. Laryngoscope 69: 320, 1959.
35. MILLER, W. F.; HOLMAM, C. B.; M. B. & DEVINE, K. D. - Roentgenologic manifestations of malignant tumors of the nasopharynx. Amer. J. Roentgen. 106: 813, 1969.
36. MNAYMNEH, W. A.; DUDLEY, H. R. & MNAYMNEH, L. G. - Excision of giant cell tumors. J. Bone Joint Surg. 46 A: 63, 1964.
37. MURPHY, W. R. & ACKERMAM, L. V. - Benign and malignant giant cell tumor of bone. Cancer 9: 317, 1956.
38. NUGENT, G. R.; SPRINKLE, P. & BLOOR, B. M. - Sphenoid sinus mucoceles. J. Neurosurg. 32: 443, 1970.
39. PEIMER, R. - Benign giant cell tumor of skull and nasal sinuses. Arch. Otolaryngol. 60: 186, 1954.
40. PITKETHLY, D. T. & KEMPE, L. G. - Giant cell tumor of sphenoid. J. Neurosurg. 30: 301, 1969.
41. RAMAMURTHI, B.; VISVANATHAN, G. S. & PILLAI, K. M. - Osteoclastoma of the skull. J. Neurosurg. 12: 287, 1955.
42. RASKIN, P.; ROWE, S. N. & FIELD, J. B. - Hyperparathyroidism presenting as a giant cell tumor of the middle cranial fossa. Ann. Int. Med. 69: 301, 1968.
43. SCHAJOWICZ, F. - Giant cell tumor of bone: a pathological and histological study. J. Bone Joint Sur. 43 A: 1, 1961.
44. UTNE, J. R. & PUGH, D. G. - The roentgenologic aspects of chordoma. Amer. J. Roentgen. 74: 593, 1955.
45. VAN WART, C. A.; DEDO, E. E. & McCOY, E. G. - Carcinoma of the sphenoid sinus. Ann. Otol. Rhinol. Laryngol. 82 318, 1973.
46. WALTER, J. - Giant cell tumor of bone; osteoclastoma and giant cell tumours variants. Survey of a radiotherapeutic series. Clin. Radiol. 11: 114, 1960.
47. ZINGESSER, L. H. & SCHECKTER, M. M. - The radiology of masses lying within and adjacent to the tentorial hiatus. Brit. J. Radiol. 37 : 486, 1964.
48. ZOLTAN, L. & FÉNIES, I. - Stereotactic diagnosis and radioactive treatment in a case of spheno-occipital chordoma. J. Neurosurg. 17: 888, 1960.

Datas de Publicação

Publicação nesta coleção
29 Ago 2012
Data do Fascículo
Mar 1977

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ARSENI, C; HORVATH, L.; MARETSIS, M. & CARP, N. - Giant cell tumours of the calvaria. J. Neurosurg. 42: 535, 1975.

[2] 2. BELLANGER, W. C. & DYKE, C. G. - Roentgen diagnosis of malignant nasopharyngeal tumours. Amer. J. Roentgen 50: 9, 1943.

[3] 3. BERMAM, H. L. - The treatment of benign giant cell tumour of the vertebra, by irradiation. Radiology 83: 202, 1964.

[4] 4. CAHAN, W. G.; WOODWARD, H. Q.; HIGINBOTHAM, N.; STEWART, F. W. & COLEY, B. L. - Sarcoma arrising in irradiated bone. Cancer 1: 3, 1948.

[5] 5. COLEY, W. B. - Malignant changes in the so-called benign giant cell tumour. Amer. J. Surg. 28 : 768, 1935.

[6] 6. COLEY, B. L. - Neoplasms of Bone and Related Conditions. 2ş Ed., Paul Hoeber Inc., New York, 1949.

[7] 7. CRUZ, M.; COLEY, B. L. & STEWART, F. W. - Post-irradiation bone sarcomas. Cancer 10 : 72, 1957.

[8] 8. DAHLIN, D. C. - Bone Tumours: General Aspects and Analysis of 2276 cases. Charles Thomas Pub., Springfield (Illinois), 1957.

[9] 9. DEBAY GRICOURT, N. - Les possibilites chirurgicales dans les tumeurs osseuses de la base du crâne. Tese, Amiens (France), 1971.

[10] 10. DECKER, E. R. & MALIS, L. I. - Surgical approaches to midline lesions at the base of the skull. J. Mount Sinai Hosp. 37 : 84, 1970.

[11] 11. DEROME, P. - Les tumeurs spheno-ethmoidales. Possibilites d'exerese et de reparation chirurgicale. Neurochirurgie (Paris) 18: su. 1: 135, 1972.

[12] 12. ECHOLS, D. H. - Giant cell tumour of the sphenoid bone. J. Neurosurg. 2: 16, 1945.

[13] 13. ELLER, J. L.; DECKER, J. T. & BRITTIS, A. L. - Roentgen therapy for a giant cell tumor of the sphenoid bone. Radiol. Clin. 37 : 36, 1968.

[14] 14. EMLEY, W. E. - Giant cell tumor of the sphenoid bone. Arch. Otolaryngol. 94_: 369, 1971.

[15] 15. FALCONER, M. A.; BAILLEY, I. C. & DUCHEN, L. W. - Surgical treatment of chordoma and chondroma of the skull base. J. Neurosurg. 29 : 261, 1968.

[16] 16. FRIEDMAM, M. & PEARLMAM, A. W. - Benign giant cell tumor of bone: radiation therapy for each type. Radiology 91: 1151, 1968.

[17] 17. GEE, V. R. & PUGH, D. G. - Giant cell tumor of bone. Radiology 70: 33, 1958.

[18] 18. GESCHICKTER, C. F. - Some unnusual features of giant cell tumor. Surg. Clin. N. Amer. 16: 1381, 1936.

[19] 19. GEISSINGER, J. D.; SIQUEIRA, E. B. & ROSS, E. R. - Giant cell tumours of the sphenoid bone. J. Neurosurg. 32: 665, 1970

[20] 20. GRIFEY, L. E. & TEDESCHI, L. G. - Giant cell tumor of sphenoid; Complication of Paget's disease of bone. Arch. Otolaryngol. 87 : 615, 1968.

[21] 21. GUPTA, I. M.; CUPTA, O. P. & SOMANT, H. S.; BHATIA, P. L.; AGARVAL, A. K. & PANT, G. C. - Giant cell tumor of the sphenoid bone. Ann. Otol. Rhinol. Laryng. 84: 359, 1975.

[22] 22. HANDOUSA, A. B. - Osteoclastoma in relation to the nose. J. Laryng. Otol. 65: 549, 1951.

[23] 23. BUTTER, R. V.; FOOT, F. W.; FRAZELL, E. L. & FRANCIS, K. C. - Giant ceil tumor complicating Paget's disease of bone. Cancer 16: 1044, 1963.

[24] 24. HUTTER, R. V.; WORCESTER, J. N.; FRANCIS, K. C; FOOT, F. W. & STEWART, F. W. - Benign and malignant giant cell tumor of bone. Cancer 15: 653, 1962.

[25] JAFFE, H. L.; LICHTENSTEIN, L. & PORTIS, R. B. - Giant cell tumor of bone: its pathologic appearance, granding and suposed variants and treatment. Arch. Pathol. 30: 993, 1940.

[26] 26. JOHNSON, E. W. & DAHLIN, D. C. - Treatment of giant cell tumor of bone, J. Bone Joint Surg. 41 A: 895, 1959.

[27] 27. KANAKA, T. S. - Giant ceil tumor of the skull. Neurology (Minneapolis) 13: 14, 1966.

[28] 28. KAUFMAM, E. H. - Non-traumatic cerebrospinal fluid rhinorrhea. Arch. Neurology (Chicago) 21: 59, 1969.

[29] 29. KEPLINGER, J. E. & BUCY, P. C. - Giant cell tumor of spine. Ann. Surg. 154; 648, 1961.

[30] 30. LASJAUNIAS, P. DOYON, D.; VIGNAUD, J. & MORET, J. - Progress in the arteriographic study of the cavernous sinus diseases. In Advances in cerebral angiography, Salamon, G., ed., Springer Verlag, Berlin, 1975, pg. 323.

[31] 31. LICHTENSTEIN, L. - Bone Tumours. C. V. Mosby Co., St. Louis, Miss, 1965.

[32] 32. MARTINS, A. N. & DEAN, D. F. - Giant cell tumors of the sphenoiJ bone: malignant transformation following radiotherapy. Surgical Neurology 2: 105, 1974.

[33] 33. McNERNEY, J. C. - Giant cell tumor of bones of the skull. J. Neurosurg. 6: 169, 1949.

[34] 34. MICHEL, L. A. - Giant cell tumor of the sinuses. Laryngoscope 69: 320, 1959.

[35] 35. MILLER, W. F.; HOLMAM, C. B.; M. B. & DEVINE, K. D. - Roentgenologic manifestations of malignant tumors of the nasopharynx. Amer. J. Roentgen. 106: 813, 1969.

[36] 36. MNAYMNEH, W. A.; DUDLEY, H. R. & MNAYMNEH, L. G. - Excision of giant cell tumors. J. Bone Joint Surg. 46 A: 63, 1964.

[37] 37. MURPHY, W. R. & ACKERMAM, L. V. - Benign and malignant giant cell tumor of bone. Cancer 9: 317, 1956.

[38] 38. NUGENT, G. R.; SPRINKLE, P. & BLOOR, B. M. - Sphenoid sinus mucoceles. J. Neurosurg. 32: 443, 1970.

[39] 39. PEIMER, R. - Benign giant cell tumor of skull and nasal sinuses. Arch. Otolaryngol. 60: 186, 1954.

[40] 40. PITKETHLY, D. T. & KEMPE, L. G. - Giant cell tumor of sphenoid. J. Neurosurg. 30: 301, 1969.

[41] 41. RAMAMURTHI, B.; VISVANATHAN, G. S. & PILLAI, K. M. - Osteoclastoma of the skull. J. Neurosurg. 12: 287, 1955.

[42] 42. RASKIN, P.; ROWE, S. N. & FIELD, J. B. - Hyperparathyroidism presenting as a giant cell tumor of the middle cranial fossa. Ann. Int. Med. 69: 301, 1968.

[43] 43. SCHAJOWICZ, F. - Giant cell tumor of bone: a pathological and histological study. J. Bone Joint Sur. 43 A: 1, 1961.

[44] 44. UTNE, J. R. & PUGH, D. G. - The roentgenologic aspects of chordoma. Amer. J. Roentgen. 74: 593, 1955.

[45] 45. VAN WART, C. A.; DEDO, E. E. & McCOY, E. G. - Carcinoma of the sphenoid sinus. Ann. Otol. Rhinol. Laryngol. 82 318, 1973.

[46] 46. WALTER, J. - Giant cell tumor of bone; osteoclastoma and giant cell tumours variants. Survey of a radiotherapeutic series. Clin. Radiol. 11: 114, 1960.

[47] 47. ZINGESSER, L. H. & SCHECKTER, M. M. - The radiology of masses lying within and adjacent to the tentorial hiatus. Brit. J. Radiol. 37 : 486, 1964.

[48] 48. ZOLTAN, L. & FÉNIES, I. - Stereotactic diagnosis and radioactive treatment in a case of spheno-occipital chordoma. J. Neurosurg. 17: 888, 1960.