-Case Reports-

Sellar Chondroma with Endocrine Dysfunction that Resolved after Surgery: Case Report

Yujiro Hattori¹, Shigeyuki Tahara¹, Takuya Nakakuki², Mao Takei³, Yudo Ishii⁴, Akira Teramoto^1,5 and Akio Morita¹

¹Department of Neurosurgery, Nippon Medical School
²Department of Neurosurgery, Hikone Municipal Hospital
³Hayashi Neurosurgery Medical Clinic
⁴Department of Neurosurgery, Teikyo University
⁵Japan Labour Health and Welfare Organization, Tokyo Rosai Hospital

Chondromas originating from the sella turcica are rare, and the most common initial symptoms are headache and visual disturbance. We describe a case of sellar chondroma with endocrine impairment as an initial manifestation that completely resolved after surgery. A 40-year-old Japanese woman with amenorrhea and galactorrhea for the last 2 years was referred to our department of neurosurgery for the evaluation of high prolactin levels and a tumor in the sella turcica. A biochemical assessment indicated endocrine dysfunction. Magnetic resonance imaging and computed tomography indicated a tumor in the sella turcica. The patient's presentation favored the preoperative diagnosis of pituitary adenoma or Rathke's cleft cyst. However, because calcification was detected, other types of tumors, such as craniopharyngioma, meningioma, and chordoma, were also considered. Endoscopic transsphenoidal surgery was performed, and the possibility of a bony tumor was recognized. Finally, the tumor was completely removed, and the histopathological findings confirmed chondroma. The postoperative course was uneventful, and endocrine function improved. Five years after surgery, the patient is doing well without pituitary insufficiency, pituitary hormone medications, or signs of tumor recurrence. In cases of sellar chondroma, endocrine dysfunction sometimes precedes other symptoms, such as headache and visual disturbance. When examining a patient with an intrasellar tumor harboring calcification, clinicians must consider the possibility of sellar chondroma. Furthermore, to the best of our knowledge, this case is the first of sellar chondroma treated with endoscopic surgery to be reported.

J Nippon Med Sch 2015; 82: 146-150

Keywords
sellar chondroma, endocrine impairment, endoscopic transsphenoidal surgery

Correspondence to
Yujiro Hattori, Department of Neurosurgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
yujiro@nms.ac.jp

Received, October 14, 2014
Accepted, December 2, 2014