Incidental detection of sellar spine on a CBCT volume: clinical and radiographic considerations

Sellar spine (SS) is a developmental anomaly of the pituitary fossa resulting in a bony spur projection anteriorly from the dorsum sellae. Etiology remains unclear; however, the most prevalent hypothesis is that it is a remnant of the notochord. SS is a rare entity with a few reported cases exclusively in neuroradiological and neurosurgical literature. It can be asymptomatic in many patients; however, it may cause various endocrinological and ophthalmological symptoms because it impinges on the pituitary gland. The current case report presents an incidental finding of SS in a 12-year-old male whose cone beam computed tomography was taken for dental treatment. Follow-up imaging taken after 3 years revealed an increase in the size of the spine, validating the previous claims that SS will grow over time. This case report presents an early detection of SS in a preadolescent, providing an opportunity for long-term follow-up to evaluate its temporal evolution, and will help establish the clinical profile of these patients. Furthermore, it highlights the role of oral radiologists in the early identification of the SS when viewing cone beam computed tomography.