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DIFFERENTIAL DIAGNOSIS OF SELLAR MASSES

1999; Elsevier BV; Volume: 28; Issue: 1 Linguagem: Inglês

10.1016/s0889-8529(05)70058-x

1558-4410

Pamela U. Freda, Kalmon D. Post,

Meningioma and schwannoma management

Pituitary adenomas are the most common cause of a mass in the sella. In as many as 9% of cases, other etiologies are responsible for mass lesions in the sellar region54, 131 (Table 1). The differential diagnosis of nonpituitary sellar masses is broad and includes cell rest tumors, germ cell tumors, gliomas, meningiomas, metastatic tumors, vascular lesions, and granulomatous, infectious, and inflammatory processes (Table 2). Differentiating among these potential etiologies may not always be straightforward because many of these lesions, tumorous and nontumorous, may mimic the clinical, endocrinologic, and radiographic presentations of pituitary adenomas. In some cases, there are no features that clearly distinguish the unusual etiologies from the clinically nonfunctioning pituitary adenoma. In others, certain endocrine, neurologic, and radiographic findings that are more characteristic of patients with a nonpituitary sellar mass may be present and can help in their differentiation. Correct preoperative diagnosis is clinically important because the treatment of choice for many of these nonpituitary sellar masses differs from that of a pituitary tumor. This article provides an overview of the clinical and radiographic characteristics of both pituitary tumors and the nonpituitary lesions found in the sellar/parasellar region and discusses in detail the specific nonpituitary etiologies of the sellar mass.