The “chameleon” sellar lesions: a case report of unexpected sellar lesions

IntroductionThe 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 v...

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Main Authors: Ilaria Bove, Raduan Ahmed Franca, Lorenzo Ugga, Domenico Solari, Andrea Elefante, Maria Laura Del Basso De Caro, Luigi Maria Cavallo
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-04-01
Series:Frontiers in Neurology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2023.1149858/full
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author Ilaria Bove
Raduan Ahmed Franca
Lorenzo Ugga
Domenico Solari
Andrea Elefante
Maria Laura Del Basso De Caro
Luigi Maria Cavallo
author_facet Ilaria Bove
Raduan Ahmed Franca
Lorenzo Ugga
Domenico Solari
Andrea Elefante
Maria Laura Del Basso De Caro
Luigi Maria Cavallo
author_sort Ilaria Bove
collection DOAJ
description IntroductionThe 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.MethodsA 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.ResultsA 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.ConclusionNeurosurgeons 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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spelling doaj.art-c6c2666b3273432d9d2f97908dbd63252023-04-24T04:17:29ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-04-011410.3389/fneur.2023.11498581149858The “chameleon” sellar lesions: a case report of unexpected sellar lesionsIlaria Bove0Raduan Ahmed Franca1Lorenzo Ugga2Domenico Solari3Andrea Elefante4Maria Laura Del Basso De Caro5Luigi Maria Cavallo6Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli “Federico II”, Naples, ItalyDepartment of Advanced Biomedical Sciences, Pathology Section, University of Naples “Federico II”, Naples, ItalyDepartment of Advanced Biomedical Sciences, University of Naples “Federico II”, Naples, ItalyDivision of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli “Federico II”, Naples, ItalyDepartment of Advanced Biomedical Sciences, University of Naples “Federico II”, Naples, ItalyDepartment of Advanced Biomedical Sciences, Pathology Section, University of Naples “Federico II”, Naples, ItalyDivision of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università degli Studi di Napoli “Federico II”, Naples, ItalyIntroductionThe 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.MethodsA 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.ResultsA 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.ConclusionNeurosurgeons 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.https://www.frontiersin.org/articles/10.3389/fneur.2023.1149858/fullsellar regiononcologyneuroimagingendoscopic endonasal surgerypathology
spellingShingle Ilaria Bove
Raduan Ahmed Franca
Lorenzo Ugga
Domenico Solari
Andrea Elefante
Maria Laura Del Basso De Caro
Luigi Maria Cavallo
The “chameleon” sellar lesions: a case report of unexpected sellar lesions
Frontiers in Neurology
sellar region
oncology
neuroimaging
endoscopic endonasal surgery
pathology
title The “chameleon” sellar lesions: a case report of unexpected sellar lesions
title_full The “chameleon” sellar lesions: a case report of unexpected sellar lesions
title_fullStr The “chameleon” sellar lesions: a case report of unexpected sellar lesions
title_full_unstemmed The “chameleon” sellar lesions: a case report of unexpected sellar lesions
title_short The “chameleon” sellar lesions: a case report of unexpected sellar lesions
title_sort chameleon sellar lesions a case report of unexpected sellar lesions
topic sellar region
oncology
neuroimaging
endoscopic endonasal surgery
pathology
url https://www.frontiersin.org/articles/10.3389/fneur.2023.1149858/full
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