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Updated: Jul 1, 2025
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Chronic lymphocytic leukemia/small lymphocytic lymphoma arising in the pituitary gland: illustrative case
Hang Zhou1, Xiaowei Zhang1, Xin Jia2
11Departments of Neurological Surgery, and.
Insights
A rare sellar mass was diagnosed as chronic lymphocytic leukemia/small lymphocytic lymphoma in a 60-year-old female. Endoscopic surgery and zanubrutinib treatment resulted in a good recovery and normal quality of life.
Area of Science:
- Neurology
- Oncology
- Pathology
Background:
- A rare case of a sellar mass was incidentally discovered during examination for a scalp injury.
- The mass was pathologically confirmed as non-Hodgkin's small B-cell lymphoma, leading to a diagnosis of chronic lymphocytic leukemia/small lymphocytic lymphoma.
- Hematological solid tumors in the pituitary gland are exceptionally rare, with limited reported cases in living patients.
Purpose of the Study:
- To report a unique case of chronic lymphocytic leukemia/small lymphocytic lymphoma presenting as a sellar mass.
- To detail the diagnostic and therapeutic journey for this rare sellar area disease.
Main Methods:
- Endoscopic surgical excision of the sellar tumor.
- Postoperative follow-up and standardized treatment with zanubrutinib.
- Hormone replacement therapy.
Main Results:
- Complete tumor excision was achieved via an endoscopic approach.
- The patient experienced a favorable postoperative recovery.
- The patient maintained a normal quality of life post-treatment.
Conclusions:
- This case represents a novel instance of chronic lymphocytic leukemia/small lymphocytic lymphoma in the sellar region.
- Successful management involved a multidisciplinary approach combining surgery and targeted therapy.
- The case highlights the importance of thorough investigation and tailored treatment for rare sellar pathologies.
Background:
The authors describe a 60-year-old female who underwent a correlative examination for an accidental scalp injury, revealing a sellar mass, which was surgically excised and pathologically confirmed to be a non-Hodgkin's small B-cell lymphoma. These findings in combination with the immunophenotype led to a final diagnosis of chronic lymphocytic leukemia/small lymphocytic lymphoma. Previous studies have shown that hematological solid tumors occurring in the pituitary gland are extremely rare, and there are only approximately three other cases of living patients with similarities to this case, all of which had ambiguous expression of subsequent hematological treatment.
Observations:
In this case, the authors used an endoscopic approach to completely excise the tumor. Follow-up of the patient was continued after surgery, and the patient is currently receiving standardized treatment with zanubrutinib.
Lessons:
This patient did not have any previous history of tumor, had a good postoperative recovery with a normal quality of life, and still receives hormone replacement and zanubrutinib on a standardized basis. This is a complete case that has not been previously reported and reveals the diagnostic and therapeutic process of rare diseases in the sellar area.
