Differential diagnosis of a sellar mass

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

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