Symptomatic Parasellar Granular Cell Tumors

Six cases of symptomatic parasellar granular cell tumor (pituicytoma, myoblastoma, choristoma) are reported. The clinical presentations included visual loss, dementia, and adenohypophyseal insufficiency. Lack of calcification and a suprasellar blush on angiography often help to differentiate these lesions from craniopharyngioma, pituitary adenoma, and optic glioma. These are the first cases studied by computed tomographic scan, which shows a high density, sharply demarcated lesion in the suprasellar region with dense, frequently homogeneous contrast enhancement. At operation these are characteristically tough, nonsuckable, vascular tumors. All previously reported patients with long survival (seven cases) have been contacted recently. The data do not support a role for postoperative radiation therapy. The surgical goal should be limited to decompression of the suprasellar if total excision seems too hazardous.