World premiere: transoral robot-assisted excision for nasopharyngeal ectopic pituitary adenoma

Eur Arch Otorhinolaryngol. 2024 Dec;281(12):6705-6709. doi: 10.1007/s00405-024-08850-3. Epub 2024 Jul 31.

Abstract

Background: Pituitary adenoma (PA), though rare, has seen increased incidence with widespread MRI use, enabling incidental diagnosis. Prevalence is approximately 1 case per 1000 in the general population. PAs are benign neoplasms, constituting 10 to 20% of intracranial tumours. Ectopic pituitary adenoma developed outside the sella turcica is exceptional. It may be hormonally active or not. These are called nonfunctional pituitary adenomas.

Methods: Here is reported a case of a man in his eighties with a nasopharyngeal ectopic pituitary adenoma treated by robot-assisted excision using a combined route. CARE guidelines have been respected.

Results: A man in his eighties, asymptomatic, underwent an MRI for dizziness, revealing a nasopharyngeal mass. Despite being asymptomatic, nasofibroscopy revealed a reddish oval-shaped tissue mass attached to the roof of the nasopharynx. Biopsy identified a neuroendocrine tumor G1/G2. Imaging showed no local invasion or distant metastases. A multidisciplinary team decided on a robot-assisted surgical excision through the mouth, coupled with nasal endoscopy. The procedure achieved complete excision with clear margins and no adverse event has occurred.

Conclusions: This unique case involved the successful transoral robot-assisted excision of a nasopharyngeal ectopic pituitary adenoma, highlighting an innovative surgical approach.

Keywords: Endocrine surgery; Endoscopic surgery; Minimal-invasive surgery; Nasopharynx; Pituitary adenoma; Robot.

Publication types

  • Case Reports

MeSH terms

  • Adenoma* / diagnostic imaging
  • Adenoma* / pathology
  • Adenoma* / surgery
  • Aged, 80 and over
  • Humans
  • Magnetic Resonance Imaging* / methods
  • Male
  • Nasopharyngeal Neoplasms* / diagnostic imaging
  • Nasopharyngeal Neoplasms* / pathology
  • Nasopharyngeal Neoplasms* / surgery
  • Natural Orifice Endoscopic Surgery / methods
  • Pituitary Neoplasms* / diagnostic imaging
  • Pituitary Neoplasms* / pathology
  • Pituitary Neoplasms* / surgery
  • Robotic Surgical Procedures* / methods