Endoscopic endonasal transsphenoidal removal of an intra-suprasellar schwannoma mimicking a pituitary adenoma.
Intracranial schwannomas, accounting for 8 to 10 % of all primary brain neoplasms, are relatively frequent intracranial tumors, but a "pure" intrasellar localization is exceptional. We report the case of an intra-suprasellar schwannoma mimicking a non-functioning pituitary macroadenoma both radiographically and clinically. A 73-year-old man presented with an episode of lipothymia followed by episodes of mental confusion. The neurological investigations revealed a bitemporal hemianopia and a hypopituitaric status. The neuroradiological investigations showed an intra-suprasellar mass resembling a pituitary adenoma. The patient underwent surgery performed by means of an endoscopic endonasal transsphenoidal approach, with a subtotal excision of the tumor. The histopathological studies revealed a cellular schwannoma. The review of the literature disclosed another 8 cases of intrasellar schwannomas. The possibility of an intrasellar schwannoma has to be considered in the differential diagnoses of neoplastic and non-neoplastic lesions of the sellar area.
Esposito
F
F
Department of Neurological Sciences, Section of Neurosurgery, Università degli Studi di Napoli Federico II, Naples, Italy.
Cappabianca
P
P
Del Basso De Caro
M
M
Cavallo
L M
LM
Rinaldi
C
C
De Divitiis
E
E
D000236:Adenoma / Q000175:diagnosis; D000368:Aged; D001932:Brain Neoplasms / Q000175:diagnosis / Q000601:surgery*; D003937:Diagnosis, Differential; D004724:Endoscopy / Q000379:methods*; D006801:Humans; D008297:Male; D009442:Neurilemmoma / Q000175:diagnosis / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D010911:Pituitary Neoplasms / Q000175:diagnosis; D013101:Sphenoid Sinus / Q000601:surgery*