A rare case of primary sellar melanoma

• Verfasst von: Tüttenberg, Jochen [VerfasserIn]
• Verfasst von: Back, Walter [VerfasserIn]
• Verfasst von: Wenz, Frederik [VerfasserIn]
• Verfasst von: Schadendorf, Dirk [VerfasserIn]
• Titel: A rare case of primary sellar melanoma
• Titelzusatz: Case report
• Verf.angabe: Jochen Tüttenberg, Wolfram Fink, Walter Back, Frederik Wenz, Dirk Schadendorf, and Claudius Thomé
• E-Jahr: 2004
• Jahr: May 2004
• Umfang: 4 S.
• Fussnoten: Gesehen am 25.11.2020
• Titel Quelle: Enthalten in: Journal of neurosurgery
• Ort Quelle: Charlottesville, Va. : American Assoc. of Neurological Surgeons, 1944
• Jahr Quelle: 2004
• Band/Heft Quelle: 100(2004), 5, Seite 931-934
• ISSN Quelle: 1933-0693
• DOI: doi:10.3171/jns.2004.100.5.0931
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1741073839

Abstract

The authors report on the case of a 37-year-old woman in whom a primary sellar malignant melanoma mimicking a hemorrhagic pituitary macroadenoma was treated. This entity is exceedingly rare; only five cases are described in the literature. The patient presented with rapid deterioration of vision within a 2-week period. After an ophthalmological diagnosis of chiasmal syndrome was made, magnetic resonance (MR) imaging of the head revealed an intra- and suprasellar mass that was elevating and compressing the optic chiasm. Because of the signal heterogeneity of the lesion a hemorrhagic pituitary macroadenoma was assumed; the lesion was transsphenoidally resected. Histological examination of the specimen showed a malignant melanocytic tumor with immunopositivity for S100 protein and HMB-45. Despite extensive staging no other primary melanotic tumor was found. Thus, a primary sellar melanoma was diagnosed. Postoperative MR images demonstrated no residual tumor. For adjuvant therapy the region around the sella turcica received 40.4 Gy stereotactically guided radiation. A 24-month follow-up examination revealed no tumor recurrence.</p><p>This represents the sixth case of such a lesion reported in the literature, the third case evaluated using MR imaging, and the first case with a progression-free survival of 24 months. Thus, the authors advocate that management of primary sellar melanoma should include gross-total removal and postoperative stereotactic radiotherapy.