Sellar, suprasellar, and parasellar masses: Imaging features and neurosurgical approaches

Neuroradiol J. 2022 Jun;35(3):269-283. doi: 10.1177/19714009211055195. Epub 2021 Dec 2.

Abstract

The sellar, suprasellar, and parasellar space contain a vast array of pathologies, including neoplastic, congenital, vascular, inflammatory, and infectious etiologies. Symptoms, if present, include a combination of headache, eye pain, ophthalmoplegia, visual field deficits, cranial neuropathy, and endocrine manifestations. A special focus is paid to key features on CT and MRI that can help in differentiating different pathologies. While most lesions ultimately require histopathologic evaluation, expert knowledge of skull base anatomy in combination with awareness of key imaging features can be useful in limiting the differential diagnosis and guiding management. Surgical techniques, including endoscopic endonasal and transcranial neurosurgical approaches are described in detail.

Keywords: Cavernous sinus; parasellar mass; sellar mass; skull base; suprasellar mass.

MeSH terms

  • Endoscopy / methods
  • Humans
  • Magnetic Resonance Imaging / methods
  • Neurosurgical Procedures / methods
  • Pituitary Neoplasms* / diagnostic imaging
  • Pituitary Neoplasms* / pathology
  • Pituitary Neoplasms* / surgery
  • Sella Turcica / diagnostic imaging
  • Sella Turcica / pathology
  • Sella Turcica / surgery
  • Skull Base
  • Skull Base Neoplasms*