Case Report

Xanthogranuloma of the Sellar Region in a patient with Acromegaly

Vita Stagno, Sara Baldo, Marialaura Del Basso De Caro, Felice Esposito, Luigi M. Cavallo and Paolo Cappabianca
World Journal of Pathology 2013, 2:5

Abstract

Introduction

Xanthogranuloma is a rare pathological entity, recently added to the WHO brain tumor classification.

Case report

A 22-year-old man was admitted to our Department with a history of progressive growth of acral extremities and mandibular prognatism. Clinical symptoms and blood-tests were suggestive of acromegaly. A sellar MRI revealed an intrasellar mass extending into the suprasellar region, consistent with the diagnosis of pituitary macroadenoma. A preoperative treatment with somatostatin-analogs for a year caused the suppression of the augmented growth hormone, but no reduction of the tumor size. The patient was then operated by means of an endoscopic endonasal transphenoidal approach. Histological examination revealed the presence of granulomatous tissue with cholesterol clefts, marked hemosiderin deposits and no epithelial component. The final diagnosis was of xanthogranuloma of the sellar region. A three and eighteen month post-op MRI confirmed the total tumor removal, while endocrinological test revealed the normalization of GH blood values.

Conclusion

This is the first case reported in the literature of a xanthogranuloma of the sellar region occurred in a patient with acromegaly.

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