suprasellar_lesion

Suprasellar lesion

see also Sellar lesion and parasellar lesions.

May enlarge, erode, or destroy the sella turcica. Considerations in adults (adenoma is the most common enhancing pituitary lesion) are different than for children (adenomas are rare, craniopharyngioma and germinoma are more common).

Tumors having epicenter within the sella

Pituitary tumor:

1. adenohypophyseal tumors

a) adenoma

microadenoma: < 1cm diameter

macroadenoma: ≥ 1cm diameter

invasive pituitary adenoma: Includes aggressive tumors of Nelson’s syndrome

b) pituitary carcinoma or carcinosarcoma

2. neurohypophyseal tumors

a) metastases: the most common tumor found in the posterior pituitary (presumably due to rich blood supply): breast and lung are most common primaries

b) pituicytoma: the most common tumor arising from neurohypophysis/pituitary stalk (i.e., primary)

c) astrocytoma: arising from stalk or posterior pituitary

see Suprasellar tumors.

Craniopharyngioma.

Germ cell tumor.

Suprasellar meningioma.

Tuberculum sellae meningioma.


Suprasellar aneurysm

Basilar bifurcation aneurysms may occasionally be seen on CT or MRI as round mass in region of suprasellar cistern.


Rathke cleft cyst

Suprasellar arachnoid cyst.

glioma

hypothalamic glioma

optic nerve or chiasm (optic glioma)

metastasis

chordoma

parasitic infections: cysticercosis

suprasellar cyst from dilated third ventricle


Suprasellar lesions present a surgical challenge due to their complex relationship with surrounding neurovascular structures. Of the approaches for these lesions, bifrontal basal interhemispheric approach (BBIA) gives a midline perspective of suprasellar anatomy and has certain advantages over lateral approaches.

  • suprasellar_lesion.txt
  • Last modified: 2021/03/25 12:20
  • by administrador