Sellar-suprasellar pituitary lymphoma mimicking pituitary adenoma: a case report with literature review

Sellar-suprasellar lymphoma (SSL) is an extremely rare tumor, constituting fewer than 1%. It is a variant of primary central nervous system lymphoma. SSL is usually seen in people around 60 years of age, exhibiting a slight female predominance. Diffuse large B-cell lymphoma represents the most predominant subtype. We report a 57-year-old female with a 9-month history of worsening severe left-sided headaches involving the left eye, associated with nausea, vomiting, blurred vision, and significant unintentional weight loss. Initial imaging revealed a pituitary tumor, and she was diagnosed with a pituitary macroadenoma. She underwent endoscopic trans-sphenoidal debulking. Histopathological examination confirmed a high-grade diffuse large B-cell lymphoma. She was treated with chemotherapy and radiotherapy which reduced the mass and improved her symptoms. Our case underscores the importance of considering SSL, particularly in patients with unusual sellar masses. Effective treatment needs a multidisciplinary approach, integrating radiotherapy and endocrine support when demanded.