Primary Sellar Paraganglioma: Case Report with Literature Review and Immunohistochemistry Resource

World Neurosurg. 2019 May:125:32-36. doi: 10.1016/j.wneu.2019.01.094. Epub 2019 Jan 29.

Abstract

Background: Differential diagnosis of sellar masses includes adenoma, meningioma, craniopharyngioma, and metastasis. Primary paraganglioma is seldom considered. We present a case of this unique pathology, review the relevant literature, and compile a compendium of immunohistochemical characteristics for use as a resource.

Case description: A 73-year-old woman presented to the hospital with visual changes in her left hemifield. Noncontrast head computed tomography demonstrated a large sellar mass with suprasellar extension and displacement of the optic chiasm (diameter of 3.1 cm). Magnetic resonance imaging was unobtainable owing to an incompatible pacemaker. Computed tomography characterization was most consistent with a macroadenoma. Given the acute visual decline, surgical decompression via an endonasal transsphenoidal route was performed without complication. A diagnosis of paraganglioma was made based on histopathology. Following resection, the patient's visual field deficit improved. Computed tomography body imaging was negative for a metastatic origin.

Conclusions: Paraganglioma is a rare but potential differential diagnosis to consider when evaluating sellar masses.

Keywords: Chromaffin; Glomus cell; Paraganglioma; Pathology; Pituitary adenoma; Sella.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adenoma / diagnostic imaging*
  • Adenoma / surgery
  • Aged
  • Diagnosis, Differential
  • Female
  • Humans
  • Optic Chiasm / chemistry
  • Optic Chiasm / diagnostic imaging*
  • Optic Chiasm / surgery
  • Paraganglioma / diagnostic imaging*
  • Paraganglioma / surgery
  • Pituitary Neoplasms / diagnostic imaging*
  • Pituitary Neoplasms / surgery
  • Sella Turcica / chemistry
  • Sella Turcica / diagnostic imaging*
  • Sella Turcica / surgery