Pituitary adenoma associated with xanthogranuloma

Area of Science:

• Endocrinology
• Neuropathology
• Oncology

Background:

• Sellar Xanthogranuloma (XG) is a rare, non-neoplastic inflammatory lesion of the sellar region, recognized by the WHO in 2000.
• Pituitary Adenoma (PA) is a common tumor, but its association with XG (PA/XG) is exceptionally rare, with only 16 reported cases.

Observation:

• This report presents a case of PA/XG, detailing its unique radiologic and pathological characteristics.
• The case highlights the diagnostic difficulties due to the lack of specific clinical and imaging signs for PA/XG.

Findings:

• Histological examination revealed characteristic features of XG, including hemorrhage, necrosis, fibrosis, inflammation, cholesterol clefts, and giant cells.
• The co-occurrence of PA and XG suggests a potential link, possibly involving subclinical pituitary apoplexy.

Implications:

• Understanding the histogenesis of PA/XG is crucial for improving pre-operative diagnosis and patient management.
• This case contributes to the limited literature on PA/XG, emphasizing the need for further research into rare sellar lesions.