Endoscopic Endonasal Transsphenoidal Removal of an Intra-Suprasellar Schwannoma Mimicking a Pituitary Adenoma

 

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Abstract

Intracranial schwannomas, accounting for 8 to 10 % of all primary brain neoplasms, are relatively frequent intracranial tumors, but a “pure” intrasellar localization is exceptional. We report the case of an intra-suprasellar schwannoma mimicking a non-functioning pituitary macroadenoma both radiographically and clinically. A 73-year-old man presented with an episode of lipothymia followed by episodes of mental confusion. The neurological investigations revealed a bitemporal hemianopia and a hypopituitaric status. The neuroradiological investigations showed an intra-suprasellar mass resembling a pituitary adenoma. The patient underwent surgery performed by means of an endoscopic endonasal transsphenoidal approach, with a subtotal excision of the tumor. The histopathological studies revealed a cellular schwannoma. The review of the literature disclosed another 8 cases of intrasellar schwannomas. The possibility of an intrasellar schwannoma has to be considered in the differential diagnoses of neoplastic and non-neoplastic lesions of the sellar area.

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Prof. Paolo Cappabianca

Dipartimento di Scienze Neurologiche · Cattedra di Neurochirurgia · Università degli Studi di Napoli Federico II

Via Sergio Pansini 5

80131 Napoli

Italy

Phone: +39-81-746-2582

Fax: +39-81-746-2497

Email: cappabia@unina.it