This 67 year-old man experienced the sudden onset of generalized headache followed by visual troubles. Examination showed a poor visual acuity of the right eye with a palsy of the right third nerve and signs of panhypopituitarism confirmed by endocrinologic testing. CT- scan and MRI showed a large sellar tumor with a necrotic portion in the middle, so that the pre-operative diagnosis was: pituitary adenoma. The tumor was removed through a trans-sphenoïdal approach. The pathologic diagnosis was benign schwannoma. A review of the literature showed that this was the second reported case of an intra sellar schwannoma mimicking a pituitary adenoma clinically as well as radiologically. Surgical removal of these lesions by a trans-sphenoïdal approach seems to be more difficult than for an adenoma. The histopathogenic origin of such tumors could be either ectopic schwann cells of peri-vascular schwann cells in the sellar region.
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