Intrasellar and Suprasellar Schwannoma Misdiagnosed as Pituitary Macroadenoma: A Case Report and Review of the Literature.

Abstract

Intracranial schwannomas usually arise from sensory nerves with a predilection for the trigeminal nerve and the vestibular component of the eighth cranial nerve (VIII). Schwannoma arising in the sella and extending into the suprasellar region is exceedingly rare and easily misdiagnosed as pituitary macroadenoma. Only 26 cases of intrasellar schwannomas have been reported in the literature. A patient with an intrasellar schwannoma and suprasellar extension was presurgically diagnosed as having pituitary macroadenoma. Subtotal excision of the lesion was performed via an endoscopic endonasal transsphenoidal approach. Histopathology showed schwannoma. His symptoms improved after surgery. Magnetic resonance imaging 6 months after surgery showed a remnant schwannoma in the sella. Although schwannoma in the sellar region is rare, it remains an important differential diagnosis because of different surgical approaches.