The sellar region as presenting theater for hematologic malignancies-A 17-year single-center experience.

Autor: Pekic S; Medical Faculty, University of Belgrade, Belgrade, Serbia.; Clinic for Endocrinology, Diabetes and Diseases of the Metabolism, University Clinical Center of Serbia, Belgrade, Serbia., Stojanovic M; Medical Faculty, University of Belgrade, Belgrade, Serbia.; Clinic for Endocrinology, Diabetes and Diseases of the Metabolism, University Clinical Center of Serbia, Belgrade, Serbia., Manojlovic Gacic E; Medical Faculty, University of Belgrade, Belgrade, Serbia.; Institute of Pathology, Belgrade, Serbia., Antic D; Medical Faculty, University of Belgrade, Belgrade, Serbia.; Clinic for Hematology, University Clinical Center of Serbia, Belgrade, Serbia., Milojevic T; Clinic for Neurosurgery, University Clinical Center of Serbia, Belgrade, Serbia., Milicevic M; Medical Faculty, University of Belgrade, Belgrade, Serbia.; Clinic for Neurosurgery, University Clinical Center of Serbia, Belgrade, Serbia., Stanimirovic A; Clinic for Neurosurgery, University Clinical Center of Serbia, Belgrade, Serbia., Doknic M; Medical Faculty, University of Belgrade, Belgrade, Serbia.; Clinic for Endocrinology, Diabetes and Diseases of the Metabolism, University Clinical Center of Serbia, Belgrade, Serbia., Miljic D; Medical Faculty, University of Belgrade, Belgrade, Serbia.; Clinic for Endocrinology, Diabetes and Diseases of the Metabolism, University Clinical Center of Serbia, Belgrade, Serbia., Banjalic S; Center for Radiology and Magnetic Resonance Imaging, University Clinical Center of Serbia, Belgrade, Serbia., Jovanovic M; Medical Faculty, University of Belgrade, Belgrade, Serbia.; Center for Radiology and Magnetic Resonance Imaging, University Clinical Center of Serbia, Belgrade, Serbia., Jemuovic Z; Clinic for Endocrinology, Diabetes and Diseases of the Metabolism, University Clinical Center of Serbia, Belgrade, Serbia., Nikolic Djurovic M; Medical Faculty, University of Belgrade, Belgrade, Serbia.; Clinic for Endocrinology, Diabetes and Diseases of the Metabolism, University Clinical Center of Serbia, Belgrade, Serbia., Grujicic D; Medical Faculty, University of Belgrade, Belgrade, Serbia.; Clinic for Neurosurgery, University Clinical Center of Serbia, Belgrade, Serbia., Popovic V; Medical Faculty, University of Belgrade, Belgrade, Serbia., Petakov М; Medical Faculty, University of Belgrade, Belgrade, Serbia.; Clinic for Endocrinology, Diabetes and Diseases of the Metabolism, University Clinical Center of Serbia, Belgrade, Serbia.
Jazyk: angličtina
Zdroj: Endocrine journal [Endocr J] 2022 Sep 28; Vol. 69 (9), pp. 1079-1090. Date of Electronic Publication: 2022 Apr 08.
DOI: 10.1507/endocrj.EJ21-0790
Abstrakt: Hematological neoplastic mass lesions of the sellar region are rare. We identified five cases of hematological malignancy with first presentation in the sellar region from our departmental database of 1,405 patients (0.36%) with sellar lesions diagnosed over the 17-year period (2005-2021). All patients were females (mean age 55.2 ± 3.4 years). One patient had multiple myeloma (MM), one patient had acute myeloid leukemia (AML), while three other patients had lymphoma (intravascular lymphoma (IVL, n = 1) or non-Hodgkin's lymphoma (NHL, n = 2). Most patients presented with ophthalmoplegia, and one patient with diabetes insipidus (DI), with short duration of symptoms (median 30 days). All patients had an elevated erythrocyte sedimentation rate and altered blood count, while patients with lymphoma had elevated lactate dehydrogenase (LDH). Sellar mass was demonstrated in three patients while the patient with IVL had an empty sella and in the AML patient posterior lobe T1W hyperintensity was lost. Two patients (IVL and NHL) presented with multiple anterior pituitary deficiencies and one patient (AML) had DI. All patients were treated with chemotherapy. Two patients responded well to treatment (one had reversed hypopituitarism), while three patients died. Differential diagnosis of sellar-parasellar pathology should include suspicion of hematological malignancy, particularly in patients with short duration of nonspecific symptoms, neurological signs (ophthalmoplegia), blood count alterations and LDH elevation, pituitary dysfunction and imaging features atypical for pituitary adenoma. Early diagnosis is crucial for timely initiation of hematological treatment aimed at inducing disease remission and partial or full recovery of pituitary function.
Databáze: MEDLINE
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