Hard calcified intrasellar schwannoma mimicking pituitary adenoma: a case report and review of the literature

Clin Neurol Neurosurg. 2015 Oct:137:38-43. doi: 10.1016/j.clineuro.2015.06.001. Epub 2015 Jun 18.

Abstract

Background: Intrasellar location of schwannoma is extremely rare, although intracranial schwannomas are common in the central nervous system. The aim of the present study is to describe a calcified intrasellar schwannoma case.

Materials and methods: We represent a 45-year-old woman who had suffered from headaches; right side facial pain and visual disturbance which had worsen during the last week prior to admission. Physical examinations were normal except for the bitemporal visual field hemianopia which match with perimetry examination. MRI demonstrated an unusual seemingly calcified mass lesion in the sellar region which was mimicking pituitary macro adenoma.

Result: Total resection of the tumor achieved through endoscopic transnasal transsphenoidal approach by extracapsular dissection and pathologic examination of the tumor revealed calcified schwannoma.

Conclusion: The differential diagnoses of sellar and suprasellar lesions include pituitary adenomas, craniopharyngiomas, meningiomas, and many others. However, schwannoma is not usually included, because the occurrence of schwannoma in the sellar or suprasellar region is extremely rare. Only few cases of intrasellar schwannomas have been reported in the literature, all of which presented a suprasellar extension similar to that of our case. Fascinating surgical point is managing very firm tumor through transsphenoidal corridor which we handle it by very sharp, debulking and extracapsular removal.

Keywords: Calcified; Pituitary; Schwannoma; Sellar.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adenoma / diagnosis
  • Adenoma / surgery*
  • Diagnosis, Differential*
  • Female
  • Humans
  • Meningioma / diagnosis
  • Middle Aged
  • Neurilemmoma / diagnosis
  • Neurilemmoma / surgery*
  • Pituitary Neoplasms / diagnosis
  • Pituitary Neoplasms / surgery*
  • Sella Turcica / pathology*