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Sellar xanthogranuloma as a diagnostic challenge: a report on five cases.

التفاصيل البيبلوغرافية
العنوان: Sellar xanthogranuloma as a diagnostic challenge: a report on five cases.
المؤلفون: Fernández SC; Centro de Microscopía Electrónica, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina., Bernhardt MC; Servicio de Patología, Clínica Universitaria Reina Fabiola, Córdoba, Argentina., Grondona E; Centro de Microscopía Electrónica, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina.; Instituto de Investigación en Ciencias de la Salud (INICSA), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina., Venier AC; Centro de Microscopía Electrónica, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina.; Instituto de Investigación en Ciencias de la Salud (INICSA), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina., Bertolino ML; Servicio de Neurocirugía, Clínica Universitaria Reina Fabiola, Córdoba, Argentina., Pautasso MJ; Servicio de Neurocirugía, Clínica Universitaria Reina Fabiola, Córdoba, Argentina., Mezzano E; Servicio de Endocrinología, Clínica Universitaria Reina Fabiola, Córdoba, Argentina., Damilano RA; Servicio de Endocrinología, Sanatorio Allende, Córdoba, Argentina., Sala CS; Servicio de Endocrinología, Sanatorio Allende, Córdoba, Argentina., Herrera EJ; Servicio de Neurocirugía, Sanatorio Allende, Córdoba, Argentina., Pesaola FN; Department of Pediatrics, School of Medicine, Genetics and Genomic Medicine, Washington University in St. Louis, Saint Louis, MO, United States., Maldonado CA; Centro de Microscopía Electrónica, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina.; Instituto de Investigación en Ciencias de la Salud (INICSA), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina., Quintar AA; Centro de Microscopía Electrónica, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina.; Instituto de Investigación en Ciencias de la Salud (INICSA), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina., De Paul AL; Centro de Microscopía Electrónica, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina.; Instituto de Investigación en Ciencias de la Salud (INICSA), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina.
المصدر: Frontiers in neuroscience [Front Neurosci] 2023 Sep 22; Vol. 17, pp. 1227144. Date of Electronic Publication: 2023 Sep 22 (Print Publication: 2023).
نوع المنشور: Case Reports
اللغة: English
بيانات الدورية: Publisher: Frontiers Research Foundation Country of Publication: Switzerland NLM ID: 101478481 Publication Model: eCollection Cited Medium: Print ISSN: 1662-4548 (Print) Linking ISSN: 1662453X NLM ISO Abbreviation: Front Neurosci Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: Lausanne : Frontiers Research Foundation
مستخلص: Xanthogranulomas are considered rare tumors, with their sellar and non-sellar frequency ranging from 1.6 to 7% among intracranial lesions, and described as a separate entity by the World Health Organization in 2000. The diagnosis of sellar xanthogranulomas is challenging, given their uncertain origin and clinical course. In addition, the limited reporting of sellar xanthogranuloma cases and the absence of characteristic images make these entities difficult to distinguish from other cystic lesions of the sellar region, such as adamantinomatous craniopharyngiomas, Rathke's cleft cysts, pituitary tumors, arachnoid cysts, epidermoid cysts, and dermoid cysts. Here, we describe the clinical presentation, radiological findings, immunohistochemical/histopathological analysis, and the ultrastructural examination by transmission electron microscopy of five sellar xanthogranulomas cases reported in two care centers in Cordoba, Argentina. Two males and three females between 37 and 73 years of age (average 51.8 years) presented with persistent headaches, generalized endocrine defects, and visual problems. MRI revealed cystic formations in the sellar region, which usually projected into adjacent tissues such as the suprasellar region or cavernous sinuses, and compressed other structures such as the optic chiasm, pituitary gland, and cranial nerves. All patients underwent surgical intervention to remove the tumor tissue. The histopathological analysis of the samples showed cellular tissue with a xanthogranulomatous appearance, inflammatory cellular infiltrate (mainly lymphocytes and macrophages), fibroblasts, abundant collagen fibers, and hemorrhages. An ultrastructural analysis helped to identify cellular infiltrates and granules resulting from tumor cell activity. The data support the hypothesis that sellar xanthogranulomas could occur as an inflammatory reaction secondary to the rupture and hemorrhage of a previous cystic process, thereby generating an expansion of the tumor body toward adjacent tissues. The information obtained from these cases contributes to the current knowledge about this disease's origin and clinical and histological evolution. However, the scarcity of patients and the observed phenotypic heterogeneity make its diagnosis still challenging. Undoubtedly, more investigations are needed to provide additional information in order to be able to achieve a more accurate diagnosis and effective treatment of this rare disease.
Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
(Copyright © 2023 Fernández, Bernhardt, Grondona, Venier, Bertolino, Pautasso, Mezzano, Damilano, Sala, Herrera, Pesaola, Maldonado, Quintar and De Paul.)
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فهرسة مساهمة: Keywords: MRI; Rathke’s cleft cyst; chronic inflammation; electron microscopy; pituitary adenoma; sellar region; xanthogranuloma
تواريخ الأحداث: Date Created: 20231009 Latest Revision: 20231031
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC10556246
DOI: 10.3389/fnins.2023.1227144
PMID: 37811322
قاعدة البيانات: MEDLINE
الوصف
تدمد:1662-4548
DOI:10.3389/fnins.2023.1227144