What is the differential diagnosis of a sellar mass?
The differential diagnosis of sellar masses is broad and includes (in relative order of frequency): pituitary adenomas, rest cell tumors (e.g., Rathke’s cleft cysts, craniopharyngiomas), arachnoid cysts, mesenchymal/stromal tumors (e.g., meningiomas, chordomas), neuronal/paraneuronal tumors (e.g., gangliocytomas, neuroblastomas), primary and secondary hypophysitis, tumors of the posterior pituitary (e.g., pituicytomas, spindle cell oncocytomas), germ cell tumors, and metastatic diseases. Importantly, normal physiologic hypertrophy, or pseudotumor, of the pituitary gland can occur, such as during hypothyroidism, puberty, and pregnancy, and this can be misdiagnosed as a pituitary tumor
