Chromophobe adenoma and chiasmal syndrome without enlargement of the bony sella.
Four cases of chiasmal syndrome resulting from chromophobe adenoma with normal-sized sella turcica are reported. The predominantly suprasellar growth of these tumors was probably the result of a well-pneumatized sphenoid sinus and/or a congenitally deficient diaphragma sellae. In patients with chiasmal syndrome, a high suspicion of a surgically treatable lesion must be maintained in spite of radiographs showing a normal-sized sella. In spite of the difficulties presented by normal variations, subtle findings should be searched for on the plain films and given additional weight in the patient with a chiasmal syndrome. An aggressive diagnostic work-up, including pneumoencephalography with thin-section tomography, should be pursued in all such patients before accepting some alternate explanation, such as demyelinating disease, for visual impairment.
D000238:Adenoma, Chromophobe / Q000150:complications*; D000328:Adult; D006801:Humans; D008297:Male; D008875:Middle Aged; D009897:Optic Chiasm; D009900:Optic Nerve; D010911:Pituitary Neoplasms / Q000150:complications*; D012658:Sella Turcica; D013577:Syndrome; D014786:Vision Disorders / Q000209:etiology*