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A rare case of primary sellar melanoma: Case report

The authors report on the case of a 37-year-old woman in whom a primary sellar malignant melanoma mimicking a hemorrhagic pituitary macroadenoma was treated. This entity is exceedingly rare; only five cases are described in the literature. The patient presented with rapid deterioration of vision wit...

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Hauptverfasser: Tüttenberg, Jochen (VerfasserIn) , Back, Walter (VerfasserIn) , Wenz, Frederik (VerfasserIn) , Schadendorf, Dirk (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: May 2004
In: Journal of neurosurgery
Year: 2004, Jahrgang: 100, Heft: 5, Pages: 931-934
ISSN:1933-0693
DOI:10.3171/jns.2004.100.5.0931
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.3171/jns.2004.100.5.0931
Verlag, lizenzpflichtig, Volltext: https://thejns.org/view/journals/j-neurosurg/100/5/article-p931.xml
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Verfasserangaben:Jochen Tüttenberg, Wolfram Fink, Walter Back, Frederik Wenz, Dirk Schadendorf, and Claudius Thomé

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520 |a The authors report on the case of a 37-year-old woman in whom a primary sellar malignant melanoma mimicking a hemorrhagic pituitary macroadenoma was treated. This entity is exceedingly rare; only five cases are described in the literature. The patient presented with rapid deterioration of vision within a 2-week period. After an ophthalmological diagnosis of chiasmal syndrome was made, magnetic resonance (MR) imaging of the head revealed an intra- and suprasellar mass that was elevating and compressing the optic chiasm. Because of the signal heterogeneity of the lesion a hemorrhagic pituitary macroadenoma was assumed; the lesion was transsphenoidally resected. Histological examination of the specimen showed a malignant melanocytic tumor with immunopositivity for S100 protein and HMB-45. Despite extensive staging no other primary melanotic tumor was found. Thus, a primary sellar melanoma was diagnosed. Postoperative MR images demonstrated no residual tumor. For adjuvant therapy the region around the sella turcica received 40.4 Gy stereotactically guided radiation. A 24-month follow-up examination revealed no tumor recurrence.</p><p>This represents the sixth case of such a lesion reported in the literature, the third case evaluated using MR imaging, and the first case with a progression-free survival of 24 months. Thus, the authors advocate that management of primary sellar melanoma should include gross-total removal and postoperative stereotactic radiotherapy. 
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