[Interdisciplinary Management of Sellar Masses]

Area of Science:

• Neuroendocrinology
• Neurosurgery
• Oncology

Background:

• Sellar masses present with diverse symptoms including hypopituitarism, hormone hypersecretion (prolactinoma, acromegaly, Cushing's disease), and neurological deficits like visual impairment.
• Benign pituitary adenomas and cystic lesions are the most common sellar masses, with an increasing number discovered as incidentalomas.
• Effective management necessitates a comprehensive understanding of the varied clinical presentations and underlying pathologies.

Purpose of the Study:

• To outline the diagnostic work-up and therapeutic strategies for sellar masses.
• To emphasize the importance of an interdisciplinary approach in managing these complex conditions.
• To highlight critical postoperative care considerations.

Main Methods:

• Diagnostic work-up involves laboratory evaluation for hormone imbalances and Magnetic Resonance Imaging (MRI) of the pituitary gland.
• Visual field examination is mandatory if the optic chiasm is compromised.
• Symptomatic masses, excluding prolactinomas, are typically resected via endoscopic transsphenoidal surgery; debulking and radiotherapy are options for invasive or non-resectable tumors.

Main Results:

• Endoscopic transsphenoidal surgery is the primary resection method for most symptomatic sellar masses.
• Debulking and radiotherapy are considered for invasive tumors, with the goal of relieving optic chiasm pressure.
• Postoperative management requires vigilant attention to fluid balance and potential hypopituitarism.

Conclusions:

• Interdisciplinary collaboration is essential for optimal management of sellar masses.
• Tailored treatment strategies, combining surgery, radiotherapy, and medical management, improve patient outcomes.
• Careful postoperative monitoring and management of complications like hypopituitarism are crucial.