Alghamdi Abdulaziz M, Alghamdi Abdulkarim M, Samkari Alaa, Samman Afnan, Lary Ahmed
College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.
Surg Neurol Int. 2023 Sep 15;14:331. doi: 10.25259/SNI_646_2023. eCollection 2023.
Xanthogranuloma of the sellar region is an extremely rare benign entity with only case reports and series documented in the literature. We aim to describe in this report a case of a suprasellar xanthogranuloma that was diagnosed initially as a cystic craniopharyngioma.
A 28-year-old woman presented to the clinic with a 2-week history of headaches, blurred vision, nausea, and vomiting. She had no medical or surgical history, no signs of hormonal disturbances, and no family history of brain tumors or endocrine diseases. Her neurological examination was unremarkable except for bitemporal hemianopia on visual field testing. A magnetic resonance imaging of the brain showed a cystic mass in the sellar region that was compressing the optic chiasm with radiological features representing cystic craniopharyngioma. She underwent endoscopic transnasal transsphenoidal surgery to excise the mass, and only subtotal excision was achieved to preserve the pituitary function. The histopathology confirmed the diagnosis of a xanthogranuloma of the sellar region. The postoperative course was unremarkable, and she did not receive any adjuvant therapy. There was no recurrence of the clinical symptoms or the mass during the 18-month follow-up period.
Although xanthogranuloma is uncommon, it should be included in the differential diagnosis of sellar/suprasellar lesions. Due to its wide range of radiological features that sometimes can mimic other lesions, a definitive diagnosis can only be made postoperatively. Surgical excision is the most accepted treatment with a favorable prognosis and low rates of recurrence.
鞍区黄色肉芽肿是一种极其罕见的良性病变，文献中仅有病例报告和系列病例记载。我们旨在本报告中描述一例最初被诊断为囊性颅咽管瘤的鞍上黄色肉芽肿病例。
一名28岁女性因头痛、视力模糊、恶心和呕吐2周病史就诊。她无内科或外科病史，无激素紊乱体征，无脑肿瘤或内分泌疾病家族史。除视野检查发现双侧颞侧偏盲外，其神经系统检查无异常。脑部磁共振成像显示鞍区有一个囊性肿块，压迫视交叉，影像学特征提示为囊性颅咽管瘤。她接受了内镜经鼻蝶窦手术切除肿块，但仅实现了次全切除以保留垂体功能。组织病理学确诊为鞍区黄色肉芽肿。术后病程顺利，她未接受任何辅助治疗。在18个月的随访期内，临床症状或肿块均未复发。
尽管黄色肉芽肿并不常见，但在鞍区/鞍上病变的鉴别诊断中应考虑到。由于其广泛的影像学特征有时可模仿其他病变，只能在术后做出明确诊断。手术切除是最常用的治疗方法，预后良好，复发率低。
