PDF(Pubmed)
Abstract：
Intracranial xanthogranulomas (XGs) have been found at various sites, but xanthogranuloma of the sellar region is extremely rare. We report about a case of sellar XG in a 34-year-old female. Magnetic resonance imaging showed a solid-cystic mass located at the sella turcica. The cystic component was hyperintense on the T1-weighted image (WI) and T2WI. The solid component was hyperintense on T1WI and hypointense on T2WI. There was peripheral enhancement after gadolinium administration. The diagnosis of cystic macroadenoma was considered before surgery. Final diagnosis of XG was confirmed by histopathological examination after surgical resection. Gross total resection of the lesion was achieved using the microscope through endoscopic endonasal transsphenoidal approach. The patient had a good outcome and no symptom of diabetes insipidus, hormonal evaluation did not show any alterations compatible with hypopituitarism and prolactin levels were normal XG should receive diagnostic consideration for the sellar mass lesions with cystic components hyperintense on T1WI and T2WI, solid components hyperintense on T1WI and hypointense on T2WI, and CT without evidence of calcifications. It is important to consider the possibility of XG when pertinent, as it facilitates a proper surgical approach strategy.
摘要：
颅内黄色肉芽肿（XGs）已被发现在不同的地点，但是鞍区黄色肉芽肿极为罕见。我们报告了一例34岁女性的鞍状XG病例。磁共振成像显示位于蝶鞍上的囊实性肿块。在T1加权图像（WI）和T2WI上，囊性成分呈高强度。固体成分在T1WI上呈高强度，在T2WI上呈低信号。钆给药后外周增强。手术前考虑囊性大腺瘤的诊断。手术切除后通过组织病理学检查证实XG的最终诊断。通过内窥镜经鼻蝶入路，使用显微镜实现了病变的完全切除。患者预后良好，无尿崩症症状，激素评估未显示任何与垂体功能减退症和催乳素水平相符的改变，正常XG应接受T1WI和T2WI上具有囊性成分高信号的鞍区肿块病变的诊断考虑，固体成分在T1WI上呈高强度，在T2WI上呈低强度，和CT没有钙化的证据.重要的是要考虑XG的可能性，因为它有助于正确的手术方法。
