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Pediatric Case of Xanthogranuloma in the Sellar Region Presenting a Visual Disturbance Successfully Treated with Endoscopic Endonasal Surgery.
World Neurosurg. 2018 Jun; 114:22-26.WN

Abstract

BACKGROUND

Xanthomatous pituitary diseases rarely occur in childhood. We report a rare pediatric case of a xanthogranuloma that developed in the sellar region, resulting in a visual disturbance that was treated successfully with endoscopic endonasal surgery.

CASE DESCRIPTION

A 13-year-old boy came to us with a headache and visual disturbance that occurred 1 month prior. Clinical examination findings showed that he was alert with signs of bitemporal hemianopsia. An endocrinologic examination showed partial hypopituitarism, and brain magnetic resonance imaging revealed a cystic mass in the sellar turcica compressing the optic apparatus. Endoscopic endonasal surgery was performed to decompress the optic apparatus, and the mass was removed. Histopathologic analysis of the tumor demonstrated granulomatous tissue with cholesterol clefts, foamy macrophages, and multinucleated giant cells, with no epithelial component. The diagnosis was xanthogranuloma of the sellar region. The patient gradually recovered from the visual disturbance and was free from any neurologic signs or symptoms 6 months after surgery.

CONCLUSIONS

Xanthogranuloma, although rare, should be considered as a differential diagnosis of a sellar or suprasellar lesion, even in children.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Department of Neurosurgery, Nara Medical University, Nara, Japan. Electronic address: fnishi@naramed-u.ac.jp.

Department of Neurosurgery, Nara Medical University, Nara, Japan.

Department of Neurosurgery, Nara Medical University, Nara, Japan.

Department of Neurosurgery, Nara Medical University, Nara, Japan.

Department of Neurosurgery, Nara Medical University, Nara, Japan.

Department of Neurosurgery, Nara Medical University, Nara, Japan.

MeSH

AdolescentHumansMaleNasal CavityNeuroendoscopySella TurcicaVision DisordersXanthogranuloma, Juvenile

Pub Type(s)

Case Reports

Journal Article

Language

eng

PubMed ID

29524707

Citation

Nishimura, Fumihiko, et al. "Pediatric Case of Xanthogranuloma in the Sellar Region Presenting a Visual Disturbance Successfully Treated With Endoscopic Endonasal Surgery." World Neurosurgery, vol. 114, 2018, pp. 22-26.

Nishimura F, Park YS, Motoyama Y, et al. Pediatric Case of Xanthogranuloma in the Sellar Region Presenting a Visual Disturbance Successfully Treated with Endoscopic Endonasal Surgery. World Neurosurg. 2018;114:22-26.

Nishimura, F., Park, Y. S., Motoyama, Y., Nakagawa, I., Yamada, S., & Nakase, H. (2018). Pediatric Case of Xanthogranuloma in the Sellar Region Presenting a Visual Disturbance Successfully Treated with Endoscopic Endonasal Surgery. World Neurosurgery, 114, 22-26. https://doi.org/10.1016/j.wneu.2018.02.155

Nishimura F, et al. Pediatric Case of Xanthogranuloma in the Sellar Region Presenting a Visual Disturbance Successfully Treated With Endoscopic Endonasal Surgery. World Neurosurg. 2018;114:22-26. PubMed PMID: 29524707.

* Article titles in AMA citation format should be in sentence-case

TY - JOUR T1 - Pediatric Case of Xanthogranuloma in the Sellar Region Presenting a Visual Disturbance Successfully Treated with Endoscopic Endonasal Surgery. AU - Nishimura,Fumihiko, AU - Park,Young-Soo, AU - Motoyama,Yasushi, AU - Nakagawa,Ichiro, AU - Yamada,Shuichi, AU - Nakase,Hiroyuki, Y1 - 2018/03/07/ PY - 2017/12/31/received PY - 2018/02/22/revised PY - 2018/02/26/accepted PY - 2018/3/11/pubmed PY - 2018/6/9/medline PY - 2018/3/11/entrez KW - Endoscopic endonasal surgery KW - Sellar region KW - Visual disturbance KW - Xanthogranuloma SP - 22 EP - 26 JF - World neurosurgery JO - World Neurosurg VL - 114 N2 - BACKGROUND: Xanthomatous pituitary diseases rarely occur in childhood. We report a rare pediatric case of a xanthogranuloma that developed in the sellar region, resulting in a visual disturbance that was treated successfully with endoscopic endonasal surgery. CASE DESCRIPTION: A 13-year-old boy came to us with a headache and visual disturbance that occurred 1 month prior. Clinical examination findings showed that he was alert with signs of bitemporal hemianopsia. An endocrinologic examination showed partial hypopituitarism, and brain magnetic resonance imaging revealed a cystic mass in the sellar turcica compressing the optic apparatus. Endoscopic endonasal surgery was performed to decompress the optic apparatus, and the mass was removed. Histopathologic analysis of the tumor demonstrated granulomatous tissue with cholesterol clefts, foamy macrophages, and multinucleated giant cells, with no epithelial component. The diagnosis was xanthogranuloma of the sellar region. The patient gradually recovered from the visual disturbance and was free from any neurologic signs or symptoms 6 months after surgery. CONCLUSIONS: Xanthogranuloma, although rare, should be considered as a differential diagnosis of a sellar or suprasellar lesion, even in children. SN - 1878-8769 UR - https://www.unboundmedicine.com/medline/citation/29524707/Pediatric_Case_of_Xanthogranuloma_in_the_Sellar_Region_Presenting_a_Visual_Disturbance_Successfully_Treated_with_Endoscopic_Endonasal_Surgery_ DB - PRIME DP - Unbound Medicine ER -