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Last updated: June 25, 2025View editorial policy

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Differential Diagnosis for Sellar Mass Lesion

  • Single most likely diagnosis
    • Pituitary Adenoma: This is the most common type of sellar mass lesion, accounting for approximately 90% of all sellar masses. Pituitary adenomas are benign tumors that arise from the pituitary gland and can cause symptoms due to hormone overproduction or mass effect on surrounding structures.
  • Other Likely diagnoses
    • Craniopharyngioma: A type of brain tumor that occurs near the pituitary gland, craniopharyngiomas are typically benign but can cause significant symptoms due to their location and potential to compress or invade surrounding structures.
    • Rathke's Cleft Cyst: A benign cystic lesion that forms from remnants of the Rathke's pouch, which is an embryonic structure that gives rise to the pituitary gland. These cysts can cause symptoms similar to those of pituitary adenomas.
    • Meningioma: A type of tumor that arises from the meninges, the protective membranes surrounding the brain and spinal cord. Meningiomas can occur in the sellar region and may cause symptoms due to compression of the pituitary gland or surrounding structures.
  • Do Not Miss diagnoses
    • Pituitary Apoplexy: A medical emergency that occurs when a pituitary adenoma suddenly hemorrhages or infarcts, leading to acute symptoms such as severe headache, visual loss, and altered mental status. Prompt recognition and treatment are crucial to prevent long-term damage.
    • Lymphocytic Hypophysitis: An inflammatory condition that affects the pituitary gland, often occurring in pregnant or postpartum women. It can cause symptoms similar to those of pituitary adenomas and requires prompt recognition to initiate appropriate treatment.
  • Rare diagnoses
    • Germinoma: A type of germ cell tumor that can occur in the sellar region, often presenting with diabetes insipidus, visual disturbances, or other symptoms related to the pituitary gland.
    • Chordoma: A rare, slow-growing malignant tumor that can occur in the sellar region, often presenting with symptoms related to compression of surrounding structures.
    • Metastatic Disease: Although rare, metastatic lesions to the sellar region can occur, often originating from breast, lung, or other primary cancers.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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