Sellar xanthogranuloma: A diagnostic challenge

Autor: Ahoud Alharbi, Ali Alkhaibary, Abeer Alaglan, Sami Khairy, Zahra Alkhunaizi, Fahd AlSufiani, Ali H. Alassiri, Ahmed Alkhani
Rok vydání: 2022
Předmět:
Zdroj: Surgical Neurology International. 13:76
ISSN: 2152-7806
Popis: Background: Sellar xanthogranulomas are rare intracranial lesions comprising Case Description: A 43-year-old female, known to have diabetes, hypothyroidism, and polycystic ovarian syndrome, presented with a 2-week history of sudden right-sided facial deviation, periorbital pain, and moderate-intensity headache. The patient also reported amenorrhea not improving with polycystic ovarian syndrome treatment. Neurologic examination showed bilateral visual field defects and impaired visual acuity. Computed tomography scan, without contrast, revealed a hypodense sellar lesion with areas of hyperdensity. Magnetic resonance imaging showed a well-defined sellar lesion, exhibiting high signals on T1-weighted and T2-weighted images. The patient underwent microscopic trans-nasal trans-sphenoidal excision of the lesion. Histological sections of the sellar lesion revealed fibrous connective tissue with chronic inflammatory cells and cholesterol clefts, suggestive of xanthogranuloma. The patient is currently followed up at neurosurgery, endocrinology, and ophthalmology clinics with periodic laboratory/radiological investigations. Conclusion: Sellar xanthogranulomas remain rare intracranial lesions with few cases reported in the literature. Patients mostly present with severe hypopituitarism and visual dysfunction. They show no characteristic radiological features. The diagnosis is confirmed histopathologically, and the prognosis is generally favorable.
Databáze: OpenAIRE