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In this Medicine Neurology lecture, we will be focusing on sellar masses, which are abnormal growths or tumors that develop in the sellar region of the brain. We will explore the various types of sellar masses, their clinical features, and the diagnostic and treatment options available. Specifically, we will discuss the use of imaging techniques and other investigations to diagnose sellar masses, as well as the role of surgical resection, radiation therapy, and medical management in their treatment. ▬ 📌 Sellar Masses ▬▬▬▬▬▬▬▬▬▬ Sellar masses refer to any abnormal growth, tumor, or cyst that appears in the sellar region of the brain. The sella turcica is a bony structure in the base of the skull that surrounds and protects the pituitary gland, which is responsible for producing hormones that regulate various bodily functions. Sellar masses are relatively common and can be benign or malignant. They can cause a range of symptoms and can be challenging to diagnose and treat. ▬ 📌 Causes ▬▬▬▬▬▬▬▬▬▬ Some of the common causes of sellar masses include: 👉 Pituitary adenoma This is a benign tumor that arises from the pituitary gland. It is the most common cause of sellar masses. 👉 Craniopharyngioma This is a rare type of brain tumor that develops near the pituitary gland and the optic nerves. 👉 Rathke's cleft cyst This is a benign cyst that forms from the remnants of the embryonic Rathke's pouch. 👉 Meningioma This is a tumor that arises from the meninges, the protective membranes that surround the brain and spinal cord. 👉 Metastatic tumors These are tumors that have spread to the brain from other parts of the body. 👉 Empty sella syndrome This is a condition in which the sella turcica is partially or completely empty, often due to a defect in the diaphragm that separates the sella from the brain. 👉 Inflammatory and infectious processes In rare cases, infections or inflammatory conditions can cause sellar masses. ▬ 📌 Clinical Features ▬▬▬▬▬▬▬▬▬▬ The symptoms of sellar masses can vary depending on the size and location of the tumor. Common symptoms include headaches, visual disturbances, hormonal imbalances, including growth hormone deficiencies, hypothyroidism, and sexual dysfunction. If the tumor is large, it can also cause pressure on the brain and lead to symptoms such as nausea, vomiting, and dizziness. ▬ 📌 Imaging ▬▬▬▬▬▬▬▬▬▬ Imaging studies are crucial in the diagnosis and evaluation of sellar masses. The most commonly used imaging modality is magnetic resonance imaging (MRI), which can provide detailed images of the brain and sellar region. Computed tomography (CT) scans can also be used, but MRI is preferred as it provides more detailed images. ▬ 📌 Investigations ▬▬▬▬▬▬▬▬▬▬ In addition to imaging studies, other investigations may be required to diagnose sellar masses. These may include blood tests to assess hormonal imbalances, including thyroid function tests, cortisol levels, and growth hormone levels. Visual field tests can also be used to assess any visual disturbances caused by the tumor. ▬ 📌 Treatment ▬▬▬▬▬▬▬▬▬▬ The treatment of sellar masses depends on several factors, including the type of tumor, its size and location, and the patient's overall health. For most pituitary adenomas, treatment involves a combination of medical management, surgical intervention, and radiation therapy. In some cases, the tumor may be small and not causing significant symptoms, and close monitoring with regular imaging studies may be all that is required. For malignant tumors, treatment may involve a combination of surgery, chemotherapy, and radiation therapy. ▬ 📌 Transphenoidal Surgery ▬▬▬▬▬▬▬▬▬▬ Transphenoidal surgery is a surgical procedure used to remove pituitary adenomas and other sellar masses. The surgery involves making a small incision in the nasal passage and removing the tumor through the sphenoid sinus, which is located directly behind the nasal cavity. The surgery is performed under general anesthesia and is typically well-tolerated by most patients. The benefits of transphenoidal surgery include a shorter hospital stay, a quicker recovery time, and a lower risk of complications than traditional open surgery. ▬ 🎬 5500+ sqadia.com Medical Videos ▬▬▬▬▬▬▬▬▬▬ 👩🏻⚕️ Accessible Medical Student Education 24/7/365 💡 Simplifying Medical Learning 💪 Study Hard, Dream Big, Achieve More