Clinical analysis of six cases with metastatic carcinoma in sellar region

Abstract

Objective Metastatic carcinoma in sellar region is a rare disease. This article is to discuss the metastatic origin, clinical manifestations, diagnosis and differential diagnosis of metastatic carcinoma in sellar region, and to summarize the experience in diagnosis and treatment of disease. Methods and Results From January 2014 to October 2019, six patients with metastatic carcinoma in sellar region were confirmed by pathological examinations after endoscopic or microscopic transsphenoidal surgery. Four patients presented with mass effect in sellar region as the first manifestation, and 2 patients were associated with a history of malignant neoplasm. The common clinical manifestations were headache and visual disturbance. The lesions mainly involved cavernous sinus and pituitary gland. Three patients whose lesions involved adenohypophysis presented with pituitary hypofunction, of which 2 patients were diagnosed as non⁃functional pituitary adenoma on admission. Conclusions Presentations associated with metastatic carcinoma in sellar region can be the first manifestation of malignant neoplasm. Compared with pituitary adenomas, metastatic carcinoma in sellar region is more prone to present with diabetes insipidus and pituitary hypofunction. Relying solely on imaging diagnosis is relatively limited, and differential diagnosis should be considered in multiple aspects to reduce the misdiagnosis rate.DOI：10.3969/j.issn.1672⁃6731.2020.03.009