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Juvenile Xanthogranuloma of the Sellar Region with a 5-Year Medical History: Case Report and Literature Review.
Pediatr Neurosurg. 2021; 56(5):440-447.PN

Abstract

INTRODUCTION

Xanthogranuloma of the sellar region is a rare benign lesion, and there are few cases reported in children. Its histogenesis is controversial, and it is difficult to strictly differentiate it from craniopharyngioma (CP), Rathke's cleft cyst, or pituitary adenoma.

CASE PRESENTATION

A 16-year-old boy presented with a rare xanthogranuloma of the sellar region after complaining of retardation of growth 5 years previously. The ophthalmologic evaluation revealed no visual field disturbance. Endocrinological examination revealed hypopituitarism. Magnetic resonance imaging showed an intrasellar mass extending into the suprasellar region and compressing the optic chiasma, which appeared mixed signals on T1-weighted images. Endonasal transsphenoidal resection of the tumor was performed. Histological analysis of the tumor sections demonstrated granulomatous tissue with cholesterol clefts, hemosiderin deposits, fibrous tissues, multinucleated giant cells, and lymphocyte. Thus, the tumor was pathologically diagnosed as xanthogranuloma of the sellar region, which is different from adamantinomatous CP. There was no epithelial tissue in any part of the tumor including tumor capsule but have focal necrosis and calcification. His endocrinological dysfunction did not recover, so a hormonal replacement was continuously required.

CONCLUSION

Xanthogranuloma of the sellar region is a rare entity but must be considered in the differential diagnosis of lesions of the sellar region, even in pediatric population. We should think about this disease when dealing with children with stunted growth accompanied by a long medical history. Our case demonstrates the natural progression of the disease, suggesting that xanthogranuloma of the sellar region without epithelial components may be an independent disease.

Authors+Show Affiliations

Medical College, Qingdao University, Qingdao City, China.Department of Neurosurgery, Chengyang People's Hospital, Qingdao City, China.Medical College, Qingdao University, Qingdao City, China.Medical College, Qingdao University, Qingdao City, China.Department of Neurosurgery, The Affiliated Hospital of Qingdao University, Qingdao City, China.

Pub Type(s)

Case Reports
Review

Language

eng

PubMed ID

34192694

Citation

Cheng, Dekui, et al. "Juvenile Xanthogranuloma of the Sellar Region With a 5-Year Medical History: Case Report and Literature Review." Pediatric Neurosurgery, vol. 56, no. 5, 2021, pp. 440-447.
Cheng D, Yang F, Li Z, et al. Juvenile Xanthogranuloma of the Sellar Region with a 5-Year Medical History: Case Report and Literature Review. Pediatr Neurosurg. 2021;56(5):440-447.
Cheng, D., Yang, F., Li, Z., Qv, F., & Liu, W. (2021). Juvenile Xanthogranuloma of the Sellar Region with a 5-Year Medical History: Case Report and Literature Review. Pediatric Neurosurgery, 56(5), 440-447. https://doi.org/10.1159/000515517
Cheng D, et al. Juvenile Xanthogranuloma of the Sellar Region With a 5-Year Medical History: Case Report and Literature Review. Pediatr Neurosurg. 2021;56(5):440-447. PubMed PMID: 34192694.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Juvenile Xanthogranuloma of the Sellar Region with a 5-Year Medical History: Case Report and Literature Review. AU - Cheng,Dekui, AU - Yang,Fengyu, AU - Li,Ziji, AU - Qv,Fan, AU - Liu,Wei, Y1 - 2021/06/30/ PY - 2020/10/18/received PY - 2021/02/26/accepted PY - 2021/7/1/pubmed PY - 2021/10/29/medline PY - 2021/6/30/entrez KW - Adolescent KW - Craniopharyngioma KW - Growth delay KW - Hypopituitarism KW - Xanthogranuloma of the sellar region SP - 440 EP - 447 JF - Pediatric neurosurgery JO - Pediatr Neurosurg VL - 56 IS - 5 N2 - INTRODUCTION: Xanthogranuloma of the sellar region is a rare benign lesion, and there are few cases reported in children. Its histogenesis is controversial, and it is difficult to strictly differentiate it from craniopharyngioma (CP), Rathke's cleft cyst, or pituitary adenoma. CASE PRESENTATION: A 16-year-old boy presented with a rare xanthogranuloma of the sellar region after complaining of retardation of growth 5 years previously. The ophthalmologic evaluation revealed no visual field disturbance. Endocrinological examination revealed hypopituitarism. Magnetic resonance imaging showed an intrasellar mass extending into the suprasellar region and compressing the optic chiasma, which appeared mixed signals on T1-weighted images. Endonasal transsphenoidal resection of the tumor was performed. Histological analysis of the tumor sections demonstrated granulomatous tissue with cholesterol clefts, hemosiderin deposits, fibrous tissues, multinucleated giant cells, and lymphocyte. Thus, the tumor was pathologically diagnosed as xanthogranuloma of the sellar region, which is different from adamantinomatous CP. There was no epithelial tissue in any part of the tumor including tumor capsule but have focal necrosis and calcification. His endocrinological dysfunction did not recover, so a hormonal replacement was continuously required. CONCLUSION: Xanthogranuloma of the sellar region is a rare entity but must be considered in the differential diagnosis of lesions of the sellar region, even in pediatric population. We should think about this disease when dealing with children with stunted growth accompanied by a long medical history. Our case demonstrates the natural progression of the disease, suggesting that xanthogranuloma of the sellar region without epithelial components may be an independent disease. SN - 1423-0305 UR - https://www.unboundmedicine.com/medline/citation/34192694/Juvenile_Xanthogranuloma_of_the_Sellar_Region_with_a_5_Year_Medical_History:_Case_Report_and_Literature_Review_ DB - PRIME DP - Unbound Medicine ER -