Abstract：
Knowledge of xanthogranuloma (XG) of the sellar region comes from short series or single cases. We performed a systematic review, using the PubMed, Web of Science, Embase, Scopus, eLibrary, and BIOSIS Preview databases, of all cases reported from 2000 to the present. We also describe one unreported patient treated in our institution. A search of the literature revealed that of 71 patients 50.7% were male and that mean age at diagnosis was 34.7 ± 19.2 years old. Median time from clinical onset until diagnosis was 7 (3-21) months. Hypopituitarism (70.4%), visual disorders (64.7%), headache (53.5%), and polyuria-polydipsia (28.2%) were the most common symptoms. On MRI, median tumor size was 20 (16-29) mm, while 71.8% were sellar/suprasellar and less frequently exclusively suprasellar (15.5%) or sellar (12.7%). On T1-weighted imaging, XG was hyperintense in 76.3% of patients, while it showed variable appearance on T2-weighted imaging. The tumor showed cystic features in 50.7%, gadolinium enhancement in 45.1%, and calcification in 22.5% of patients. All patients underwent surgery (77.4% transphenoidal approach and 18.3% craniotomy), with hypopituitarism (56.4%), diabetes insipidus (34.5%), and visual defects (7.3%) being the most common complications. Total/subtotal resection was achieved in 93.5%, while the tumor was partially removed in 6.6%. Median follow-up was 24 (6-55) months and no tumor recurrence or remnant growth was reported in 97.5% of cases. In conclusion, XG affects the younger population, manifested by hormonal deficit and mass effect symptoms. Surgery is safe and offers excellent outcomes, though hypopituitarism is frequent post-surgery. Tumor recurrence or remnant growth is rare and radiological surveillance is a good option for patients with remnant lesions.
摘要：
鞍区黄色肉芽肿（XG）的知识来自短系列或单个病例。我们进行了系统的审查,使用PubMed，WebofScience,Embase,Scopus,eLibrary,和BIOSIS预览数据库，在2000年至今报告的所有病例中。我们还描述了一名在我们机构接受治疗的未报告患者。文献搜索显示，71例患者中有50.7％为男性，诊断时的平均年龄为34.7±19.2岁。从临床发作到诊断的中位时间为7（3-21）个月。垂体功能低下（70.4%），视力障碍(64.7%)，头痛（53.5%），多尿多饮(28.2%)是最常见的症状。核磁共振成像,中位肿瘤大小为20（16-29）mm，而71.8%为鞍上/鞍上，频率较低，仅为鞍上（15.5%）或鞍上（12.7%）。在T1加权成像中，76.3%的患者XG为高信号,而在T2加权成像上显示出可变的外观。50.7%的肿瘤表现为囊性特征，钆提高了45.1%，22.5%的患者出现钙化。所有患者均接受手术（77.4%经蝶入路和18.3%开颅手术），伴有垂体功能减退（56.4%），尿崩症（34.5%），视觉缺陷(7.3%)是最常见的并发症。总/次全切除率达到93.5%，而6.6%的肿瘤部分切除。中位随访时间为24（6-55）个月，97.5％的病例没有报告肿瘤复发或残留生长。总之,XG影响年轻人，表现为荷尔蒙缺乏和质量效应症状。手术是安全的，并提供良好的结果，尽管垂体功能减退症在手术后很常见。肿瘤复发或残余生长很少见，放射学监测是残余病变患者的良好选择。
