The "chameleon" sellar lesions: a case report of unexpected sellar lesions.

Front Neurol

Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli "Federico II", Naples, Italy.

Published: April 2023

AI Article Synopsis

  • The sellar region in the brain can have lots of different types of growths, making it tricky for doctors to identify problems correctly.
  • Researchers studied three unusual cases that looked like common brain tumors but turned out to be different types of diseases.
  • It's important for doctors to work together and consider all possibilities before surgery, as this helps manage unexpected findings better.

Article Abstract

Introduction: The sellar region and its boundaries represent a challenging area, harboring a variety of tissues of different linings. Therefore, a variety of diseases can arise or involve in this area (i.e., neoplastic or not). A total of three challenging cases of "chameleon" sellar lesions treated via EEA were described, and the lesions mimicked radiological features of common sellar masses such as craniopharyngiomas and/or pituitary adenomas, and we also report a literature review of similar cases.

Methods: A retrospective analysis of three primary cases was conducted at the Università degli Studi di Napoli Federico II, Naples, Italy. Clinical information, radiological examinations, and pathology reports were illustrated.

Results: A total of three cases of so-called "chameleon" sellar lesions comprising two men and one woman were reported. Based on the intraoperative finding and pathological examination, we noticed that case 1 had suprasellar glioblastoma, case 2 had a primary neuroendocrine tumor, and case 3 had cavernous malformation.

Conclusion: Neurosurgeons should consider "unexpected" lesions of the sellar/suprasellar region in the preoperative differential diagnosis. A multidisciplinary approach with the collaboration of neurosurgeons, neuroradiologists, and pathologists plays a fundamental role. The recognition of unusual sellar lesions can help surgeons with better preoperative planning; so an endoscopic endonasal approach may represent a valid surgical technique to obtain decompression of the optic apparatus and vascular structures and finally a pathological diagnosis.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10164933PMC
http://dx.doi.org/10.3389/fneur.2023.1149858DOI Listing

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