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Arquivos de Neuro-Psiquiatria

Print version ISSN 0004-282X

Arq. Neuro-Psiquiatr. vol.72 no.11 São Paulo Nov. 2014

http://dx.doi.org/10.1590/0004-282X20140161 

Images in Neurology

Not all sellar masses are macroadenomas: think also in metastasis

Nem todas massas selares são macroadenomas: pense também em metástases

Paulo Victor Sgobbi de Souza1 

Wladimir Bocca Vieira de Rezende Pinto2 

Adrialdo José dos Santos2 

1Universidade Federal de São Paulo, Sao Paulo SP, Brazil

2Departamento de Neurologia e Neurocirurgia, Universidade Federal de São Paulo, Sao Paulo SP, Brazil


A 54-year-old woman presented with a 3-month-history of blurred vision and refractory headache. Examination revealed severe bilateral visual acuity compromise, normal campimetry and bilateral papilledema. As a mean to investigate raised intracranial pressure, neuroimaging studies were performed and showed extensive sellar mass (Figure). Patient underwent transsphenoidal approach for resection of pituitary mass which disclosed metastasis of neuroendocrine lung tumor. Chest CT showed a mass in the anterior segment of right lower lobe of lung. Although symptomatic pituitary gland tumors are common in clinical practice1, metastatic disease represent a rare cause of sellar tumors, mainly of breast and lung primary origin2.

Figure (A) Cranial CT scan showing a solid lesion in the sellar and suprasellar region with heterogeneous enhancement; (B) Coronal brain MRI sections disclosing a mass with heterogeneous enhancement on post-gadolinium T1 weighted images; (C) and with heterogeneous signal in T2-weighted images, hyperintense in its central portion and hypointense in its periphery; (D) Chest CT scan showing the presence of an irregular consolidation in the anterior basal segment of the lower lobe of the right lung associated with partial atelectasis (white arrow). 

References

. Rennert J, Doerfler A. Imaging of sellar and parasellar lesions. Clin Neurol Neurosurg. 2007;109(2):111-24. http://10.106/j.clineuro.2006.11.001 [ Links ]

. Komninos J, Vlassopoulou V, Protopapa D, Korfias S, Kontogeorgos G, Sakas DE. Tumors metastatic to the pituitary gland: case report and literature review. J Clin Endocrinol Metab. 2004;89(2):574-80. http://dx.doi.org/10.1210/jc.2003-030395 [ Links ]

Received: May 20, 2014; Revised: August 20, 2014; Accepted: September 08, 2014

Correspondence: Wladimir Bocca Vieira de Rezende Pinto; Departamento de Neurologia e Neurocirurgia, Universidade Federal de São Paulo; Rua Pedro de Toledo, 650; 04023-900 São Paulo SP, Brasil; E-mail: wladimirbvrpinto@gmail.com

Conflict of interest: There is no conflict of interest to declare.

Creative Commons License This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.