Abstract：
Xanthogranuloma of the sellar region is a rare chronic inflammatory lesion resulting from secondary hemorrhage, inflammation, infarction, and necrosis of an existing Rathke\'s cleft cyst, craniopharyngioma, or pituitary adenoma. Sellar xanthogranulomas are challenging to differentiate from other cystic lesions preoperatively due to the lack of characteristic imaging features. We performed a literature overview of the clinical and paraclinical features, treatment options, and long-term outcomes of patients with sellar xanthogranuloma, focusing on the preoperative radiological diagnosis. The hyperintense signal in both T1- and T2-weighted sequences, cystic or partially cystic morphology, ovoid shape, sellar epicenter, intra- and suprasellar location, intratumoral calcifications, linear rim contrast enhancement, and the absence of cavernous sinus invasion suggest xanthogranuloma in the preoperative differential diagnosis. An endoscopic endonasal gross total resection without radiotherapy is the preferred first-line treatment. Given the low rate of recurrence rate and low chance of endocrinological recovery, a mass reduction with decompression of the optic apparatus may represent an appropriate surgical goal. Identifying the xanthogranulomas\' mutational profile could complement histopathological diagnosis and give insight into their histo-pathogenesis. A better preoperative neuroimagistic diagnosis of sellar xanthogranulomas and differentiation from lesions with a poorer prognosis, such as craniopharyngioma, would result in an optimal personalized surgical approach.
摘要：
鞍区黄色肉芽肿是由继发性出血引起的罕见慢性炎性病变，炎症,梗塞,以及Rathke裂隙囊肿的坏死,颅咽管瘤,或者垂体腺瘤.鞍区黄色肉芽肿由于缺乏特征性影像学特征，因此在术前与其他囊性病变区分具有挑战性。我们对临床和临床特征进行了文献综述，治疗方案,鞍区黄色肉芽肿患者的长期结局，专注于术前放射学诊断。T1和T2加权序列中的高强度信号，囊性或部分囊性形态，卵形,震中,鞍内和鞍上位置，肿瘤内钙化,线性边缘对比度增强，无海绵窦浸润提示黄色肉芽肿术前鉴别诊断。无放疗的鼻内镜全切是首选的一线治疗。鉴于复发率低，内分泌恢复的机会低，随着光学装置的减压的质量减少可以代表适当的手术目标。确定黄色肉芽肿的突变谱可以补充组织病理学诊断，并深入了解其组织发病机理。鞍区黄色肉芽肿的术前神经影像学诊断较好，与预后较差的病变的鉴别，比如颅咽管瘤，将导致最佳的个性化手术方法。
