Non-adenomatous sellar lesions: single-centre 10-year experience

Santos, Francisco Sousa; Dias, Lídia Nunes; Henriques, Vanessa; Marques, Catarina; Chorão, Martinha; Duarte, João Sequeira; Limbert, Clotilde; Costa, João; Graça, Joana; Vasconcelos, Carlos; Cabral, José; Ramos, Sância

doi:10.1007/s42000-018-0064-y

Cited by 4 publications

(1 citation statement)

References 14 publications

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“…Sellar tumors constitute 10–15% of all intracranial tumors, with pituitary adenomas representing 90% of these cases ( 6 ). Our study presents eight cases of unusual sellar lesions encountered in our neurosurgery department from October 2020 to March 2023.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic endonasal transsphenoidal surgery for unusual sellar lesions: eight cases and review of the literature

Wu,

Deng,

Qian

et al. 2024

Front. Neurol.

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BackgroundPreoperative imaging for some unusual lesions in the sellar region can pose challenges in establishing a definitive diagnosis, impacting treatment strategies.MethodsThis study is a retrospective analysis of eight cases involving unusual sellar region lesions, all treated with endoscopic endonasal transsphenoidal surgery (EETS). We present the clinical, endocrine, and radiological characteristics, along with the outcomes of these cases.ResultsAmong the eight cases, the lesions were identified as follows: Solitary fibrous tumor (SFT) in one case, Lymphocytic hypophysitis (LYH) in one case, Cavernous sinus hemangiomas (CSH) in one case, Ossifying fibroma (OF) in two cases; Sphenoid sinus mucocele (SSM) in one case, Pituitary abscess (PA) in two cases. All patients underwent successful EETS, and their diagnoses were confirmed through pathological examination. Postoperatively, all patients had uneventful recoveries without occurrences of diabetes insipidus or visual impairment.ConclusionOur study retrospectively analyzed eight unusual lesions of the sellar region. Some lesions exhibit specific imaging characteristics and clinical details that can aid in preoperative diagnosis and inform treatment strategies for these unusual sellar diseases.

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Section: Discussionmentioning

confidence: 99%

Endoscopic endonasal transsphenoidal surgery for unusual sellar lesions: eight cases and review of the literature

Wu,

Deng,

Qian

et al. 2024

Front. Neurol.

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Systematic Review of Treatment Options and Therapeutic Responses for Lesions of the Sella and Orbit: Evidence-Based Recommendations

et al. 2023

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Diabetes insipidus secondary to sellar/parasellar lesions

Angelousi

Mytareli

Xekouki

et al. 2021

J Neuroendocrinology

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Diabetes insipidus (DI) is a well‐recognised transient or permanent complication following transsphenoidal surgery for pituitary adenomas or other sellar/parasellar lesions. However, data regarding the prevalence of pre‐operative DI in sellar/parasellar lesions other than pituitary adenomas are scarce. We systematically reviewed the existing data for defining the prevalence of DI before any treatment in adult patients with sellar/parasellar lesions, excluding pituitary adenomas and metastatic lesions. In total, 646 patients with sellar/parasellar lesions presenting with DI at diagnosis were identified. The most common pathologies of sellar/parasellar lesions presenting with DI at diagnosis were lymphocytic hypophysitis (26.5%), craniopharyngiomas (23.4%), Langerhans's cell histiocytosis (18.9%) and Rathke's cleft cyst (12.7%), accounting for the vast majority (more than 80%) of these lesions. Overall, DI at diagnosis was found in 23.4% of all patients with sellar/parasellar lesions, albeit with a wide range from 10.6% to 76.7%, depending on the nature of the pathology. The highest prevalence of DI was found in less commonly encountered lesions namely germ‐cell tumours (76.7%), abscesses (55.4%) and neurosarcoidosis (54.5%), each accounting for less than 3% of all sellar/parasellar lesions. Most DI cases (68.8%) were associated with anterior pituitary hormonal deficiencies, in contrast to pituitary adenomas that rarely present with DI. The enlargement and enhancement of the pituitary stalk were the most common findings on magnetic resonance imaging besides the loss of the high signal of the posterior pituitary on T1‐weighted images. Resolution of DI spontaneously or following systemic and surgical management occurred in 22.4% of cases. Post‐operative DI, not evident before surgery, was found in 27.8% of non‐adenomatous sellar/parasellar lesions, and was transient in 11.6% of them. Besides distinctive imaging features and symptoms, early recognition of DI in such lesions is important because it directs the diagnosis towards a non‐adenomatous sellar/parasellar tumour and the early initiation of appropriate treatment.

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Non-adenomatous sellar lesions: single-centre 10-year experience

Cited by 4 publications

References 14 publications

Endoscopic endonasal transsphenoidal surgery for unusual sellar lesions: eight cases and review of the literature

Endoscopic endonasal transsphenoidal surgery for unusual sellar lesions: eight cases and review of the literature

Systematic Review of Treatment Options and Therapeutic Responses for Lesions of the Sella and Orbit: Evidence-Based Recommendations

Diabetes insipidus secondary to sellar/parasellar lesions

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