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
