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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
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Intrasellar xanthogranuloma mimicking macroadenoma
Iago Toledo Tartuci1, Nivaldo Adolfo da Silva Junior1, Fabio Rogerio2
1Department of Anesthesiology, Oncology and Radiology, Faculty of Medical Sciences, University of Campinas, Campinas, Brazil.
The Neuroradiology Journal
|March 23, 2023
Summary
Sellar xanthogranuloma (XG) is a rare intracranial tumor. This case highlights key MRI findings for diagnosing sellar XG, enabling appropriate surgical planning.
Area of Science:
- Neuropathology
- Neurosurgery
- Radiology
Background:
- Intracranial xanthogranulomas (XGs) are uncommon, with sellar region involvement being exceptionally rare.
- Sellar masses often mimic pituitary adenomas, posing diagnostic challenges.
Observation:
- A 34-year-old female presented with a solid-cystic sellar mass.
- MRI revealed specific signal characteristics: cystic component hyperintense on T1WI and T2WI, solid component hyperintense on T1WI and hypointense on T2WI, with peripheral enhancement.
Findings:
- Preoperative diagnosis considered cystic macroadenoma.
- Histopathological examination post-surgical resection confirmed xanthogranuloma.
- Endoscopic endonasal transsphenoidal approach achieved gross total resection with good patient outcome.
Implications:
- Xanthogranuloma should be considered in the differential diagnosis of sellar masses with characteristic MRI findings.
- Recognizing XG facilitates optimal surgical strategy and approach selection.
- Accurate diagnosis prevents misclassification and guides appropriate management of sellar lesions.
