The Diaphragma Sellae Meningioma - A Rare Differential Diagnosis of Non-Functioning Pituitary Adenoma

Abstract

It is important to differentiate the rare Diaphragma sellae meningioma from the quite common hormonally inactive pituitary adenoma, especially with regards to the surgical approach. The differentiation could, however, be problematic. We report the case of a 66-year-old woman with a Diaphragma sellae meningioma, which became apparent through a visual field and visual acuity disorder. Successful radical tumor extirpation was achieved via the transsphenoidal approach, since the space-occupying lesion was initially thought to be a hormonally inactive pituitary macroadenoma. However, histological investigation confirmed a meningioma. A careful retrospective analysis of the MRI revealed the possibility of a meningioma having been overlooked, since not all distinguishing features of this lesion were manifested. These criteria, as well as the principles of the surgical approach for treating sellar space-occupying lesions are discussed.

Zusammenfassung

Für die Operationsplanung ist aufgrund der verschiedenen Zugangswege die Differenzierung zwischen dem seltenen Diaphragma sellae-Meningeom und dem häufigen hormoninaktiven Hypophysenmakroadenom wichtig. Dies kann jedoch problematisch sein.
Wir berichten über eine 66-jährige Patientin mit einem Diaphragma sellae-Meningeom, symptomatisch durch Visus- und Gesichtsfeldstörungen, die unter der Annahme eines Makroadenoms transsphenoidal erfolgreich operiert wurde. Retrospektiv lässt sich anhand der MRT-Bilder der Verdacht auf ein Meningeom aussprechen, jedoch treffen nicht alle bislang für diesen Tumor als eindeutig beschriebenen Kriterien zu. Diese Kriterien und die prinzipiellen operativen Zugänge werden diskutiert.

Key words

Diaphragma sellae meningioma - non-functioning pituitary adenoma - MRI - surgical approaches

Schlüsselwörter

Diaphragma sellae-Meningeom - hormoninaktives Hypophysenmakroadenom - MRT-Diagnostik - operative Therapie

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