ArticleFrontiers in oncology2021
Invasive Corridor of Clivus Extension in Pituitary Adenoma: Bony Anatomic Consideration, Surgical Outcome and Technical Nuances.
Article in Frontiers in oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 14 citations in OpenAlex.
- Endoscopic endonasal approach for recurrent or residual pituitary neuroendocrine tumors.Neurosurgical review · 2026Article
- Pituitary Neuroendocrine Tumors Extending Primarily Below the Sella and into the Clivus: A Distinct Growth Pattern with Specific Challenges.Current oncology (Toronto, Ont.) · 2026Article
- Pituitary adenoma extended to the basilar sinus: Lessons from anatomical and radiological studies (Experimental Research).Neurosurgical review · 2025Article
- Challenges and opportunities for new intraoperative optical techniques in the surgical treatment of pituitary adenomas: a review.Journal of biomedical optics · 2025Review
- Beyond the sella: Expanded endoscopic endonasal approaches for pituitary tumors.Neuro-oncology advances · 2025Article
- Radiomics-based multiple machine learning approaches for investigating medial wall invasion of the cavernous sinus in pituitary adenomas.Frontiers in oncology · 2025Article
- Clival Infiltrative Lesions: A Review of Differential Diagnosis Illustrated by a Rare Case of Coexisting Invasive Pituitary Adenoma and Clival Intravascular Lymphoma.Journal of the Belgian Society of Radiology · 2025Article
- Pituitary adenoma with oculomotor cistern extension: membranous anatomy and clinical application.Acta neurochirurgica · 2023Article
- Novel imaging techniques in refractory pituitary adenomas.Pituitary · 2023Review
- Ectopic Adrenocorticotropic Hormone-Secreting Pituitary Adenoma in the Clivus Region: A Case Report.OncoTargets and therapy · 2022Article
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16 authors at 4 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundIt is well known that the clivus is composed of abundant cancellous bone and is often invaded by pituitary adenoma (PA), but the range of these cancellous bone corridors is unknown. In addition, we found that PA with clivus invasion is sometimes accompanied by petrous apex invasion, so we speculated that the petrous apex tumor originated from the clivus cancellous bone corridor. The aim of this study was to test this hypothesis by investigating the bony anatomy associated with PA with clival invasion and its clinical significance.
methodsTwenty-two cadaveric heads were used in the anatomical study to research the bony architecture of the clivus and petrous apex, including six injected specimens for microsurgical dissection and sixteen cadavers for epoxy sheet plastination. The surgical videos and outcomes of PA with clival invasion in our single center were also retrospectively reviewed.
resultsThe hypoglossal canal and internal acoustic meatus are composed of bone canals surrounded by cortical bone. The cancellous corridor within clivus starts from the sellar or sphenoid sinus floor and extends downward, bypassing the hypoglossal canal and finally reaching the occipital condyle and the medial edge of the jugular foramen. Interestingly, we found that the cancellous bone of the clivus was connected with that of the petrous apex through petroclival fissure extending to the medial margin of the internal acoustic meatus instead of a separating cortical bone between them as it should be. It is satisfactory that the anatomical outcomes of the cancellous corridor and the path of PA with clival invasion observed intraoperatively are completely consistent. In the retrospective cohort of 49 PA patients, the clival component was completely resected in 44 (89.8%), and only five (10.2%) patients in the early-stage had partial residual cases in the inferior clivus.
conclusionThe petrous apex invasion of PA is caused by the tumor invading the clivus and crossing the petroclival fissure along the cancellous bone corridor. PA invade the clivus along the cancellous bone corridor and can also cross the hypoglossal canal to the occipital condyle. This clival invasion pattern presented here deepens our understanding of the invasive characteristics of PA.
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