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Chondroid chordoma of the sella turcica mimicking a pituitary adenoma.
Ear Nose Throat J. 2015 Oct-Nov; 94(10-11):E47-9.EN

Abstract

We report an unusual case of a chondroid chordoma of the sella turcica that mimicked the clinical and radiologic presentation of the more common pituitary adenoma. A 50-year-old man presented with bitemporal visual field deficits. Magnetic resonance imaging (MRI) detected a sellar mass that was suggestive of a pituitary adenoma. However, the intraoperative appearance of the mass was not consistent with an adenoma, and frozen-section pathology was obtained. Pathology identified the mass as a malignant lesion. Based on this finding, the mass was treated more aggressively. Chondroid chordomas are rare and slowly growing but locally aggressive tumors. The prognosis depends on the ability to totally resect the mass, so differentiating this tumor from a benign lesion is critical. An intrasellar chordoma can be confused clinically and radiologically with a pituitary adenoma. These two lesions are nearly identical on MRI, although T2-weighted imaging sometimes demonstrates higher intensity with a chondroid chordoma. Computed tomography may be helpful in demonstrating bony destruction by these lesions, as can the presence of intralesional calcifications. Intraoperative findings of bony invasion or a purple-red color may also lead the surgeon to suspect a diagnosis other than pituitary adenoma.

Authors+Show Affiliations

Division of Head and Neck Surgery, David Geffen School of Medicine at UCLA, 10833 LeConte Ave., 62-132 CHS, Los Angeles, CA 90095, USA. arthurwu@gmail.com.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

26535833

Citation

Wu, Arthur W., et al. "Chondroid Chordoma of the Sella Turcica Mimicking a Pituitary Adenoma." Ear, Nose, & Throat Journal, vol. 94, no. 10-11, 2015, pp. E47-9.
Wu AW, Bhuta S, Salamon N, et al. Chondroid chordoma of the sella turcica mimicking a pituitary adenoma. Ear Nose Throat J. 2015;94(10-11):E47-9.
Wu, A. W., Bhuta, S., Salamon, N., Martin, N., & Wang, M. B. (2015). Chondroid chordoma of the sella turcica mimicking a pituitary adenoma. Ear, Nose, & Throat Journal, 94(10-11), E47-9.
Wu AW, et al. Chondroid Chordoma of the Sella Turcica Mimicking a Pituitary Adenoma. Ear Nose Throat J. 2015 Oct-Nov;94(10-11):E47-9. PubMed PMID: 26535833.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chondroid chordoma of the sella turcica mimicking a pituitary adenoma. AU - Wu,Arthur W, AU - Bhuta,Sunita, AU - Salamon,Noriko, AU - Martin,Neil, AU - Wang,Marilene B, PY - 2015/11/5/entrez PY - 2015/11/5/pubmed PY - 2016/12/15/medline SP - E47 EP - 9 JF - Ear, nose, & throat journal JO - Ear Nose Throat J VL - 94 IS - 10-11 N2 - We report an unusual case of a chondroid chordoma of the sella turcica that mimicked the clinical and radiologic presentation of the more common pituitary adenoma. A 50-year-old man presented with bitemporal visual field deficits. Magnetic resonance imaging (MRI) detected a sellar mass that was suggestive of a pituitary adenoma. However, the intraoperative appearance of the mass was not consistent with an adenoma, and frozen-section pathology was obtained. Pathology identified the mass as a malignant lesion. Based on this finding, the mass was treated more aggressively. Chondroid chordomas are rare and slowly growing but locally aggressive tumors. The prognosis depends on the ability to totally resect the mass, so differentiating this tumor from a benign lesion is critical. An intrasellar chordoma can be confused clinically and radiologically with a pituitary adenoma. These two lesions are nearly identical on MRI, although T2-weighted imaging sometimes demonstrates higher intensity with a chondroid chordoma. Computed tomography may be helpful in demonstrating bony destruction by these lesions, as can the presence of intralesional calcifications. Intraoperative findings of bony invasion or a purple-red color may also lead the surgeon to suspect a diagnosis other than pituitary adenoma. SN - 1942-7522 UR - https://www.unboundmedicine.com/medline/citation/26535833/Chondroid_chordoma_of_the_sella_turcica_mimicking_a_pituitary_adenoma_ DB - PRIME DP - Unbound Medicine ER -