E2078. Pituitary, Sella and Parasella Pathology
  1. Fafa Koudoro; University of North Carolina Chapel Hill
  2. Parth Patel; University of North Carolina Chapel Hill
  3. Valerie Jewells ; University of North Carolina Chapel Hill
Pathologies involving the pituitary, sella and parasellar regions are complex in their presentation clinically and radiographically. Knowledge of complex embryology, anatomy, varied imaging techniques (including dynamic imaging), surgical methods and understanding of endocrinology and epidemiology is required for proper diagnosis. This exhibit summarizes the various pathological processes encountered in this region and details their associated radiologic findings.

Educational Goals / Teaching Points
-Review skull base embryology and anatomy of the pituitary, sella and parasellar region -Review CT and MRI imaging techniques of the sella/parasellar region -Review common and uncommon pituitary, sella and parasellar pathology with their corresponding imaging characteristics

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
The skull base forms the floor of the cranial cavity separating the brain from facial structures and the neck. It is composed of five bones: the ethmoid, sphenoid, occipital, temporal and frontal bones. The central portion of the skull base is formed by the body of the sphenoid with the sella turcica and cavernous sinus making a few of its important components. Major pathologies include, but not limited to: · Congenital lesions (ectopic tissue, empty sella, encephaloceles, ectopic neurohypophysis, Rathke’s cleft cyst) · Benign cysts/masses (arachnoid/colloid cyst, chordoma, craniopharyngioma (2 types), hamartoma, large glomus tumor, fibrous dysplasia and meningioma) · Primary tumors (adenomas – including treatment and endocrine effects as well as complications, glioma, germinoma and Eosinophylic Granuloma) · Additional neoplastic processes (metastases, chondrosarcoma, ALL and Langerhans Histiocytosis) · Inflammatory and Infiltrative processes (IgG4, hypophysitis, hyper-eosinophilia and granulomatous disease/sarcoid) · Partum/post-partum changes (apoplexy and its complications as well as hypertrophy) · Physiologic changes with intracranial hypertension/hypotension · Drug effects · Vascular anomalies (aneurysm and C-C fistula).

The differential diagnosis for central skull base (sellar/parasellar) lesions is vast. This educational exhibit presents a radiological review of sellar/parasellar related pathologies and disorders. Anatomical/physiological effects, surgical procedure knowledge, and embryological awareness in conjunction with imaging appearance of normal variants is essential for understanding and accurate image interpretation. Hence, the authors' intent for this electronic exhibit is educational with the goal to improve diagnostic accuracy.