A simple sellar and suprasellar cyst, by David Netuka

An endonasal approach to sellar lesions is a standard and well-established technique. Endoscopic techniques enable to increase the field of vision. Expanded endonasal approaches have been described in the last two decades.

A 73-year-old male came to our attention in January 2011. He underwent a CT and later on MRI during his stay in a psychiatric ward due to worsening of his severe depression. MRI disclosed a sellar and suprasellar cystic lesion with no evident solid part (Fig. 1-3). The pituitary gland was pushed dorsocranially, chiasm was compressed. Further investigation showed an incomplete bitemporal hemianopsia and hypopituitarism (no diabetes insipidus). Medical history: COPD, chronic constipation, ankylosing spondylitis.

Figure 1

Figure 2

Figure 3

* 1. Is any surgery indicated? Which approach and technique should be applied?