Xanthogranuloma of the sellar region: a systematic review

Guerrero-Pérez, Fernando; Marengo, Agustina Pia; Vilarrasa, Núria; Vidal, N.; Ruiz-Roig, Núria; Sanchez-Fernández, Juan José; Torres-Díaz, Alberto; Sanmillán, José L.; Pérez-Maraver, Manuel; Villabona, Carles

doi:10.1007/s42000-023-00432-y

Cited by 7 publications

(21 citation statements)

References 51 publications

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“…In a systematic review performed by Guerrero-Pérez et al, a total of 71 cases of sellar xanthogranuloma were included in the analysis. The average age at diagnosis in these cases was reported to be approximately 35 years old [ 3 ]. The present case, involving a two-year-old toddler, stands out due to the rarity of a sellar xanthogranuloma diagnosis at such a young age.…”

Section: Discussionmentioning

confidence: 99%

“…The clinical presentation of sellar xanthogranulomas can vary, but common symptoms include headache, visual disturbances, and symptoms related to endocrine deficits [ 3 ]. Some cases of sellar xanthogranuloma manifest as obstructive hydrocephalus with acute changes in consciousness [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…The literature contains a limited number of case reports documenting sellar xanthogranulomas, with even fewer involving pediatric patients. For instance, a review of the literature revealed only a small number of clinical reports confirming sellar xanthogranuloma, and among these, a very limited number were identified in the pediatric population [ 2 , 3 ]. Here, we report a case of sellar xanthogranuloma of the sellar region manifesting as a focal neurological deficit in a two-year-old patient.…”

Section: Introductionmentioning

confidence: 99%

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Sellar Xanthogranulomatosis in a Two-Year-Old Girl: A Case Report

Ayasa,

Rahhal,

Najjar

et al. 2023

Cureus

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Sellar xanthogranulomas are extremely rare intracranial lesions, particularly in pediatric patients, and their diagnostic and therapeutic challenges prompt thorough investigation. We describe a case of a two-year-old toddler diagnosed with sellar xanthogranuloma, highlighting the challenges encountered in its diagnosis and management. The child presented with symptoms, including headache, ptosis of the left eye, and neurological deficits. Brain computed tomography (CT) and magnetic resonance imaging (MRI) revealed a hypodense sellar lesion. The patient underwent a left pterional craniotomy for resection of the mass. Histopathological examination suggested the diagnosis of sellar xanthogranuloma, characterized by foamy macrophages, giant cells, lymphocytic infiltrates, fibrous proliferation, necrotic detritus, and hemosiderin deposits. Further diagnostic precision was achieved through immunohistochemical staining, including CD1a and langerin, which successfully ruled out the possibility of Langerhans cell histiocytosis (LCH), reinforcing the diagnosis of sellar xanthogranuloma. The successful surgical resection of the lesion led to a favorable outcome, evidenced by the significant alleviation of symptoms as well as the restoration of normal neurological function. Post-operative assessments demonstrated a marked improvement in the patient's quality of life, and there were no observed complications or recurrence of the lesion during the follow-up period. In summary, our case report not only highlights the rarity and diagnostic challenges of sellar xanthogranulomas but also emphasizes the importance of collaborative medical expertise in achieving accurate diagnosis and successful therapeutic outcomes in pediatric patients. The successful management of this case offers valuable insights into the clinical presentation, diagnostic complexities, and treatment strategy of sellar xanthogranulomas, further enriching our understanding of this uncommon intracranial pathology.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Sellar Xanthogranulomatosis in a Two-Year-Old Girl: A Case Report

Ayasa,

Rahhal,

Najjar

et al. 2023

Cureus

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“…Their presentations can range from asymptomatic incidental and hormonal effects to compressive local mass effects with presenting symptoms related to the specific anatomical landmarks of the sella turcica and the surrounding parasellar region. [ 2 , 3 ] A 10-year retrospective analysis of 1367 abnormal sellar/ parasellar magnetic resonance imaging (MRI) findings found that the most common diagnosis was pituitary adenoma and only 216 cases (18%) were non-adenomatous lesions. Out of the 216 cases, 42 (19%) were Rathke’s cleft cysts, 32 (15%) were craniopharyngiomas, 32 (15%) were meningiomas, and only one case (0.7%) of xanthogranuloma.…”

Section: Introductionmentioning

confidence: 99%

“…Out of the 216 cases, 42 (19%) were Rathke’s cleft cysts, 32 (15%) were craniopharyngiomas, 32 (15%) were meningiomas, and only one case (0.7%) of xanthogranuloma. [ 2 , 3 ] Xanthogranuloma, also known as cholesterol granuloma, is a non-neoplastic histological rare brain lesion characterized by both granuloma and xanthoma cells and is usually located in the middle ear, petrous apex, paranasal sinuses, choroid plexus, and trigone of the lateral ventricle. [ 3 , 4 ] Xanthogranuloma of the sellar region is an extremely rare entity with only case reports and series documented in the literature.…”

Section: Introductionmentioning

confidence: 99%

Xanthogranuloma of the suprasellar region mimicking cystic craniopharyngioma: A case report

Alghamdi,

Samkari

et al. 2023

Surgical Neurology International

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Background: Xanthogranuloma of the sellar region is an extremely rare benign entity with only case reports and series documented in the literature. We aim to describe in this report a case of a suprasellar xanthogranuloma that was diagnosed initially as a cystic craniopharyngioma. Case Description: A 28-year-old woman presented to the clinic with a 2-week history of headaches, blurred vision, nausea, and vomiting. She had no medical or surgical history, no signs of hormonal disturbances, and no family history of brain tumors or endocrine diseases. Her neurological examination was unremarkable except for bitemporal hemianopia on visual field testing. A magnetic resonance imaging of the brain showed a cystic mass in the sellar region that was compressing the optic chiasm with radiological features representing cystic craniopharyngioma. She underwent endoscopic transnasal transsphenoidal surgery to excise the mass, and only subtotal excision was achieved to preserve the pituitary function. The histopathology confirmed the diagnosis of a xanthogranuloma of the sellar region. The postoperative course was unremarkable, and she did not receive any adjuvant therapy. There was no recurrence of the clinical symptoms or the mass during the 18-month follow-up period. Conclusion: Although xanthogranuloma is uncommon, it should be included in the differential diagnosis of sellar/suprasellar lesions. Due to its wide range of radiological features that sometimes can mimic other lesions, a definitive diagnosis can only be made postoperatively. Surgical excision is the most accepted treatment with a favorable prognosis and low rates of recurrence.

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From obesity in ancient times to the very latest vital research data on metabolic syndrome and other significant updates

Stratakis

2023

Hormones

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Xanthogranuloma of the sellar region: a systematic review

Cited by 7 publications

References 51 publications

Sellar Xanthogranulomatosis in a Two-Year-Old Girl: A Case Report

Sellar Xanthogranulomatosis in a Two-Year-Old Girl: A Case Report

Xanthogranuloma of the suprasellar region mimicking cystic craniopharyngioma: A case report

From obesity in ancient times to the very latest vital research data on metabolic syndrome and other significant updates

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