Srinivas Chivukula1, Richard Everson1, Michael Linetsky2, Anthony Heaney3, Laura Bonelli4, Marilene B Wang5, Marvin Bergsneider6. 1. Department of Neurosurgery, David School of Medicine, University of California, Los Angeles, California, USA. 2. Department of Radiology, David School of Medicine, University of California, Los Angeles, California, USA. 3. Division of Endocrinology, David School of Medicine, University of California, Los Angeles, California, USA. 4. Department of Ophthalmology, David School of Medicine, University of California, Los Angeles, California, USA. 5. Department of Head and Neck Surgery, David School of Medicine, University of California, Los Angeles, California, USA. 6. Department of Neurosurgery, David School of Medicine, University of California, Los Angeles, California, USA. Electronic address: mbergsneider@mednet.ucla.edu.
Abstract
BACKGROUND: The sellar spine is a rare, bony growth that typically arises from the dorsum sellae. Few cases have been described in the literature thus far, and most are asymptomatic and incidentally found. We describe the case of a 19-year-old female in whom a sellar spine was noted to be associated with pituitary glandular deformation and symptomatic optic apparatus compression. CASE DESCRIPTION: The medical records including clinical data, pathologic, and imaging findings pertaining to the single patient presented herein were retrospectively reviewed. The patient underwent resection of the hyperostotic sellar spine for decompression of the optic chiasm and pituitary gland via an endoscopic endonasal approach. She immediately reported complete resolution of her bitemporal visual deficits. Her headaches completely resolved, she had no further transient visual deficits, and all other prior presenting symptoms and signs resolved. CONCLUSION: Recognition of a sellar spine can be elusive, and removal of a symptomatic one may be technically challenging. It is important to consider this entity in the differential diagnosis of a patient with headaches and bitemporal visual deficits.
BACKGROUND: The sellar spine is a rare, bony growth that typically arises from the dorsum sellae. Few cases have been described in the literature thus far, and most are asymptomatic and incidentally found. We describe the case of a 19-year-old female in whom a sellar spine was noted to be associated with pituitary glandular deformation and symptomatic optic apparatus compression. CASE DESCRIPTION: The medical records including clinical data, pathologic, and imaging findings pertaining to the single patient presented herein were retrospectively reviewed. The patient underwent resection of the hyperostotic sellar spine for decompression of the optic chiasm and pituitary gland via an endoscopic endonasal approach. She immediately reported complete resolution of her bitemporal visual deficits. Her headaches completely resolved, she had no further transient visual deficits, and all other prior presenting symptoms and signs resolved. CONCLUSION: Recognition of a sellar spine can be elusive, and removal of a symptomatic one may be technically challenging. It is important to consider this entity in the differential diagnosis of a patient with headaches and bitemporal visual deficits.