Challenging Diagnosis and Surgical Management of a Symptomatic Sellar Spine

World Neurosurg. 2016 Jul:91:669.e7-669.e10. doi: 10.1016/j.wneu.2016.03.046. Epub 2016 Mar 24.

Abstract

Background: The sellar spine is a rare, bony growth that typically arises from the dorsum sellae. Few cases have been described in the literature thus far, and most are asymptomatic and incidentally found. We describe the case of a 19-year-old female in whom a sellar spine was noted to be associated with pituitary glandular deformation and symptomatic optic apparatus compression.

Case description: The medical records including clinical data, pathologic, and imaging findings pertaining to the single patient presented herein were retrospectively reviewed. The patient underwent resection of the hyperostotic sellar spine for decompression of the optic chiasm and pituitary gland via an endoscopic endonasal approach. She immediately reported complete resolution of her bitemporal visual deficits. Her headaches completely resolved, she had no further transient visual deficits, and all other prior presenting symptoms and signs resolved.

Conclusion: Recognition of a sellar spine can be elusive, and removal of a symptomatic one may be technically challenging. It is important to consider this entity in the differential diagnosis of a patient with headaches and bitemporal visual deficits.

Keywords: Dorsum sella; Endoscopic endonasal surgery; Hyperostosis.

Publication types

  • Case Reports

MeSH terms

  • Decompression, Surgical / methods*
  • Endoscopes
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Pituitary Gland / diagnostic imaging
  • Pituitary Gland / pathology*
  • Pituitary Gland / surgery
  • Sella Turcica* / abnormalities
  • Sella Turcica* / diagnostic imaging
  • Sella Turcica* / surgery
  • Spine / abnormalities*
  • Spine / diagnostic imaging
  • Spine / surgery*
  • Tomography Scanners, X-Ray Computed
  • Young Adult