|
Focal neurological findings | Imaging | Abnormal preoperative labs (ng/mL) | Treatment | Follow-up; outcomes |
|
Oculomotor and trigeminal nerve palsies | Skull XR: mottling, sclerosis of sella turcica, and lesser wing of sphenoid. CT: normal. Carotid angiogram: medial displacement of ICA | None | Right transfrontal craniotomy + 5000 Rads | 1 year; returned to baseline |
|
None | Skull XR: enlarged sella, CT: partially empty sella, destroyed sella floor, and mass at base of sella with invasion into sphenoid sinus | PRL = 1900 | Endonasal transsphenoidal resection + cabergoline | 1 year; no recurrence, impotence resolved |
|
L eye inferior medial quadrant visual field defect | MRI: 3 × 3 cm, midline homogenous mass filling posterior nasopharynx and clivus | None | Total resection via open-door maxillotomy approach + 4550 Rads over 25 | 1 year; complete resolution of symptoms |
|
Unknown | CT/MRI: L frontotemporal hematoma, meningioma, expansile density with invasion into sphenoid bone and clivus, and encasing ICAs | None | Endonasal transsphenoidal biopsy only + radiation | No improvement, transferred to receive supportive care |
|
Unknown | MRI: tumor eroding through skull base into the clivus extending into sphenoid sinus, cavernous sinus, and surrounding ICA | Unknown | Partial endonasal transsphenoidal resection | Unknown |
|
None | Skull XR: normal size sella, slight erosion of floor CT/MRI: large enhancing mass in sphenoid sinus invading sphenoid wing and clivus | None | Partial resection via sublabial transnasal approach + 50 Gy radiation/6 wks | Unclear; “under careful observation” |
|
Unknown | MRI: clival destruction | PRL = 7 | Unknown | Unknown |
|
None | CT/MRI: clival lesion, destruction of bone | None (Post-op PRL = 34,000) | Endonasal transsphenoidal partial resection + bromocriptine | 4 months; normalization of lab values |
|
Bitemporal hemianopsia | CT: lesion in extradural sella-clivus region | Unknown | Transfacial surgery | Unknown |
|
None | CT: tumor at clivus with surrounding bony destruction. MRI: enhancing mass with cystic component, invading sphenoid sinus | PRL = 2519.8 | Cabergoline only | 6 months; resolution of lab values and symptoms |
|
Exophthalmos with external ocular movement disorders and decreased visual acuity on L | CT: bony destruction of clivus, sphenoid sinus, and medial aspect of middle cranial fossa, MRI: abnormal enhancement in sphenoid sinus | PRL = 645.7 | Endonasal transsphenoidal resection + Bromocriptine therapy | 1 year f/u; resolution of visual symptoms |
|
Unknown | Skull radiograph: normal, MRI: clival mass connected to intrasellar lesion | GH = 30.6 | Endonasal transsphenoidal resection | 1 year; normalization of lab values |
|
None | MRI: 13 mm erosive mass in clivus with focal area of bony erosion | PRL = 178 | Endonasal transsphenoidal total resection | 6 months; complete resolution of symptoms |
|
None | MRI: 2 mm hypointense lesion on pituitary gland. Clival lesion discovered incidentally during surgery | IGF-1 = 937, PRL = 26 | Endoscopic transsphenoidal; clival mass encountered and resected, pituitary unremarkable | 3 months; normalization of lab values, no report on clinical status |
|
L CN 6 palsy | MRI: lytic lesion of left clivus, compression of cavernous sinuses, clival mass, and normal sella | None | Endoscopic transsphenoidal resection | 2.5 years; resolution of CN6 palsy and no recurrence |
|
None | MRI: large tumor at height of clivus, partial destruction of surrounding bone structure | Unknown | Endoscopic transsphenoidal resection | Unknown |
|
None | MRI: enhancing lesion in clivus with extension into cavernous sinuses and encasement of the ICAs | PRL = 881.3 | Endoscopic transsphenoidal; subtotal resection and dopamine antagonist | 1 year; no symptoms |
|