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Published on: January 17, 2018
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Sellar Metastases: Diagnosis and Management
Mostafa Shahein1, Thiago Albonette-Felicio2, Ricardo L Carrau3
1Department of Neurological Surgery, The Ohio State University Wexner Medical Center, N-1049 Doan Hall, W. 10th Avenue, Columbus, OH 43210, USA; Department of Neurological Surgery, Aswan University, Egypt.
Neurosurgery Clinics of North America
|September 14, 2020
Summary
Sellar metastases are rare intracranial tumors, often asymptomatic and presenting as the first sign of hidden cancers. Diagnosis involves screening or identifying neurological and hormonal symptoms, with management focusing on the primary cancer.
Area of Science:
- Neuro-oncology
- Endocrinology
- Radiology
Background:
- Sellar metastases represent a small fraction (0.87%) of all intracranial metastases.
- These lesions are frequently asymptomatic and can be the initial presentation of an occult malignancy.
- Diagnosis often occurs during screening for known primary cancers or when symptoms arise from local compression.
Purpose of the Study:
- To review the characteristics, diagnosis, and management of sellar metastases.
- To highlight the challenges in differentiating sellar metastases from common pituitary lesions.
- To emphasize the palliative nature of management focused on the primary malignancy.
Main Methods:
- Literature review of studies on sellar metastases.
- Analysis of diagnostic approaches, including imaging and clinical presentation.
- Discussion of management strategies and their palliative goals.
Main Results:
- Sellar metastases can present with neurological deficits or hormonal dysfunction due to mass effect.
- Distinguishing sellar metastases from pituitary adenomas can be diagnostically challenging.
- Management is primarily directed at the primary cancer, aiming for palliation and quality of life improvement.
Conclusions:
- Sellar metastases require careful consideration in the differential diagnosis of sellar region lesions.
- Early detection and appropriate management, focused on the primary tumor, are crucial.
- Palliative care and pathological confirmation guide treatment decisions.
