Osteochondroma of the sella turcica presenting with intratumoral hemorrhage.
A 29-year-old man presented with a primary sellar turcica osteochondroma manifesting as intratumoral hemorrhage mimicking pituitary apoplexy. The patient suffered sudden onset of headache concomitant with vision loss in the left eye. Radiography and computed tomography detected destruction and calcification of the sellar turcica. Magnetic resonance imaging revealed a heterogeneously enhanced suprasellar mass that had elevated and compressed the optic chiasm. The preoperative diagnosis was hemorrhagic pituitary adenoma, craniopharyngioma, meningioma, or chordoma based on the signal heterogeneity of the lesion. To relieve the symptoms and make a definitive diagnosis, surgical removal via a basal interhemispheric approach was carried out. The tumor was not totally removed because of tight adhesion to the pituitary stalk, but postoperative ophthalmological examination revealed improvement of the visual disturbance. The histological diagnosis was osteochondroma based on the presence of mature chondrocytes and osteomatous tissue. Osteochondroma should be included in the differential diagnosis of tumors with acute hemorrhage in the sella turcica.
Inoue
Tomoo
T
Department of Neurosurgery, Aomori Prefectural Central Hospital, Aomori, Japan. tomoo49@gmail.com
Takahashi
Noboru
N
Murakami
Kensuke
K
Nishimura
Shinjitsu
S
Kaimori
Mitsuomi
M
Nishijima
Michiharu
M
D000328:Adult; D002114:Calcinosis / Q000209:etiology / Q000473:pathology; D003399:Craniotomy; D019299:Decompression, Surgical; D003937:Diagnosis, Differential; D051270:Headache Disorders, Primary / Q000209:etiology; D006801:Humans; D020300:Intracranial Hemorrhages / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D009408:Nerve Compression Syndromes / Q000209:etiology; D009897:Optic Chiasm / Q000473:pathology; D015831:Osteochondroma / Q000098:blood supply / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D010899:Pituitary Apoplexy / Q000175:diagnosis; D012658:Sella Turcica / Q000098:blood supply / Q000473:pathology* / Q000601:surgery; D012888:Skull Neoplasms / Q000098:blood supply / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D014786:Vision Disorders / Q000209:etiology