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<p>The coexistence of three lesions in the sellar region is exceedingly rare. Only two cases with three histopathologically distinct lesions have been reported. However, here, we present a unique case of a 54-year-old female with pituitary adenoma (PA), xanthogranulomatous hypophysitis (XGH), and a Rathke cleft cyst (RCC). Clinically, the patient manifested symptoms of mass compression, such as moderate-intensity headaches and progressive visual acuity decrease. Relevant endocrinological evaluation revealed elevated free thyroxine levels without clinical manifestations. MRI revealed a suprasellar mass compatible with a macroadenoma. The patient underwent transsphenoidal endoscopic resection, resulting in a non-functional macroadenoma with associated XGH due to the rupture of RCC. Furthermore, in this article, we analyze the possible mechanisms involved in the pathogenesis of these lesions, emphasizing the type of spectrum to which they belong and the manifestations present.</p>

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Triple sellar collision lesion: a unique case of pituitary adenoma, Rathke cleft cyst, and xanthogranuloma—case report and systematic review of the literature

  • 期刊论文

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  • 发表日期：

    2025年6月6日

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  • Miguel A. Del Toro-Colín,
  • Martha Tena-Suck,
  • Alberto Santiago-Balmaseda,
  • Citlalteptl Salinas-Lara,
  • Germán Velázquez-Garcia,
  • Maria de Lourdes Aguilar-Gómez,
  • Elsa Yazmín León-Marroquín,
  • Carlos Sánchez-Garibay,
  • Alma Ortíz-Plata,
  • Roger Carrillo-Meza,
  • Noemi Gelista-Herrera,
  • Lesly Hernández-Roque,
  • Luis O. Soto-Rojas

摘要

The coexistence of three lesions in the sellar region is exceedingly rare. Only two cases with three histopathologically distinct lesions have been reported. However, here, we present a unique case of a 54-year-old female with pituitary adenoma (PA), xanthogranulomatous hypophysitis (XGH), and a Rathke cleft cyst (RCC). Clinically, the patient manifested symptoms of mass compression, such as moderate-intensity headaches and progressive visual acuity decrease. Relevant endocrinological evaluation revealed elevated free thyroxine levels without clinical manifestations. MRI revealed a suprasellar mass compatible with a macroadenoma. The patient underwent transsphenoidal endoscopic resection, resulting in a non-functional macroadenoma with associated XGH due to the rupture of RCC. Furthermore, in this article, we analyze the possible mechanisms involved in the pathogenesis of these lesions, emphasizing the type of spectrum to which they belong and the manifestations present.