Publication

[Interdisciplinary Management of Sellar Masses]

Journal Paper/Review - Jul 1, 2019

Units
PubMed
Doi

Citation
Bischofberger-Baumann B, Ebert A, Hader C, Fournier J, Bilz S. [Interdisciplinary Management of Sellar Masses]. Praxis (Bern 1994) 2019; 108:599-608.
Type
Journal Paper/Review (Deutsch)
Journal
Praxis (Bern 1994) 2019; 108
Publication Date
Jul 1, 2019
Issn Print
1661-8157
Pages
599-608
Brief description/objective

Interdisciplinary Management of Sellar Masses Sellar masses may present with an impairment of pituitary function (hypopituitarism), hormone hypersecretion (prolactinoma, acromegaly, glucocorticoid excess) or neurological symptoms (visual impairment, headache). An increasing number of them is discovered as an incidentaloma. Among the various entities, benign pituitary adenomas and cystic lesions are most frequently encountered. The work-up includes a laboratory evaluation for hormone hyper- or hyposecretion and an MRI of the pituitary gland. If the optic chiasm is compromised, a visual field examination is mandatory. Except for prolactinomas, symptomatic sellar masses are usually resected via an endoscopic transsphenoidal approach. If a total resection is not feasible because of the invasion of surrounding structures, debulking to relieve pressure from the optic chiasm is the primary goal and radiotherapy may be considered. Residual hormone excess can be treated medically. In the early postoperative period special attention to the development and treatment of disordered body water homeostasis and hypopituitarism is crucial. Interdisciplinary work-up and decision making are of utmost importance and will offer the best management.