Postnatal sellar spine growth: A case report and literature review
Takahiro Hosokawa1, Yoshitake Yamada, Yumiko Sato
1Department of Radiology, Saitama Children's Medical Center, Saitama Department of Diagnostic Radiology, Keio University School of Medicine, Shinjuku-ku, Tokyo Department of Neurosurgery, Saitama Children's Medical Center, Saitama, Japan.
Insights
A sellar spine, a bony spur, may grow after birth and is not always detectable early. This study suggests a potential link between sellar spine growth and precocious puberty in a young girl.
Area of Science:
- Neuroanatomy
- Pediatric Endocrinology
Background:
- A sellar spine is an anterior bony spur from the dorsum sellae, theorized to be a congenital ossified notochordal remnant.
- Congenital malformations like sellar spines are typically presumed detectable at birth.
Observation:
- This report details the first case of a typical sellar spine in an 8-year-old girl presenting with precocious puberty.
- Initial magnetic resonance imaging (MRI) at 4 months showed no sellar spine or pituitary deformation.
- Computed tomography (CT) scans revealed the sellar spine grew from 3.8 mm at 9 years to 4.7 mm at 12 years.
Findings:
- The sellar spine was not detectable in infancy, suggesting it may be too small for early detection and grows postnatally.
- The growing sellar spine potentially deformed the developing pituitary gland.
Implications:
- This case challenges the assumption that sellar spines are always detectable at birth.
- The findings suggest a possible association between sellar spine development and precocious puberty due to pituitary gland deformation.
Background:
A sellar spine is a bony spur protruding anteriorly from the central portion of the dorsum sellae. Its etiology is an ossified notochordal remnant of the cephalic end of the notochord. It is presumed to be a congenital malformation based on magnetic resonance imaging (MRI) findings of sellar spine in a 4-year-old boy. A sellar spine should therefore be detectable at birth with or without ossification, and the posterior pituitary lobe should be displaced.
Methods And Results:
Here we review the literature and report the first case of typical sellar spine in an 8-year-old girl who presented with precocious puberty, but her MRI taken at age 4 months for a febrile convulsion did not show a sellar spine or posterior pituitary lobe deformation. T1-weighted sagittal images at 8 years old showed a bony structure protruding anteriorly from the central portion of the dorsum sellae. The length of this lesion was 3.8 mm on computed tomography (CT) scanning at 9 years old, and it elongated to 4.7 mm on CT at 12 years old.
Conclusions:
Based on the present case, we speculate that the sellar spine would be too small to detect early in development and would grow in size after birth. In this case, a sellar spine and precocious puberty were potentially associated due to deformation of the growing pituitary gland.
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