Differential diagnoses of sellar, parasellar and suprasellar pathologies other than tumors such as common adenoma, rathke cleft cysts and meningioma and craniopharyngiomas were presented. This retrospective study was performed including 25 patients who were operated or treated medically in between 2008 and 2019. The patients were analyzed with preoperative/postoperative magnetic resonance imaging (MRI), endocrinological and neuro-ophthalmologic examination results. Pre and post contrast sagittal T1WI, pre and post contrast dynamic coronal T1WI, coronal T2WI were obtained for MRI. Some patients were imaged several times to reach final diagnosis and treatment control. The diagnosis revealed metastatic tumors (n=3), colloid/epidermal/dermoid cysts (n=3), pilocytic astrocytomas (n=5), and one case each of hemangioblastoma, lymphoma, chordoid glioma, meckel cave schwannoma, chordoma, aneurysm, fibrous dysplasia, germ cell tumour. 3 hypophysitis, (lymphocytic/tuberculous granuloma/xanthomatous), 2 developmental chordomatous lesions (fossa navicularis, notochordal remnants), 2 hamartoma. Metastatic tumors demonstrated main growth within destructive remodelling of the dorsum sellae. Big lesions (>20 mm) showed a significantly worse outcome regarding hormonal and visual deficits. Developmental lesions (developmental chordomatous lesions (fossa navicularis, notochordal remnants), hamartoma were stabile. While some of the lesions were operated some were followed by MRI.
Conclusion: The correlation of the radiological findings with the specific clinical features maybe helpful for the differential diagnosis of rare lesions of the sellar, parasellar and suprasellar pathologies. Interdisciplinary diagnostic and therapeutic procedure for these lesions are very important to control the specific disease.
18 - 21 May 2019
European Society of Endocrinology