ArticleInternational journal of surgery case reports2025
Sellar and parasellar paraganglioma mimicking pituitary macroadenoma in a young female: A rare case report.
Article in International journal of surgery case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction and importance: Sellar and parasellar paragangliomas are exceptionally rare neuroendocrine tumors, often mistaken for pituitary adenomas or meningiomas due to their anatomical location and radiological similarities. This report presents a rare case of sellar-parasellar paraganglioma, highlighting diagnostic challenges and management strategies. Presentation of case: A 25-year-old female presented with progressive visual disturbances, headache, and lactational amenorrhea. Clinical examination revealed bitemporal hemianopia and diplopia. Imaging showed a 6.0 cm lobulated sellar-suprasellar mass with left temporal fossa extension, hypointense on T1, hyperintense on T2, with a classic "salt and pepper" appearance and strong contrast enhancement. Initial endonasal transsphenoidal surgery was aborted due to uncontrollable bleeding. Subsequent transcranial surgery achieved near-total resection, with histopathological confirmation of paraganglioma. Clinical discussion: The highly vascular tumor necessitated a transcranial approach for maximal resection. Post-operatively, the patient's visual symptoms partially improved, but she developed left-sided ptosis. Stereotactic radiotherapy was planned for residual tumor. Histopathology showed round to oval cells in nests, positive for chromogranin A, with minimal atypia. Conclusion: Sellar-parasellar paragangliomas pose significant diagnostic and therapeutic challenges due to their rarity, radiological mimicry, and hypervascularity. Accurate preoperative diagnosis requires high suspicion, advanced imaging, and histopathological confirmation. A multidisciplinary approach combining microsurgery and adjuvant radiotherapy is essential for optimal management.
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