Hard calcified intrasellar schwannoma mimicking pituitary adenoma: A case report and review of the literature

• Few cases of intrasellar schwannomas have been reported.
• Total resection of very firm intrasellar tumor by endoscopic approach.
• There is no obvious origin for schwannoma within the sella.
• Lateral sellar nerve plexus, perivascular Schwann cells, sensory nerves of the dura.

BackgroundIntrasellar location of schwannoma is extremely rare, although intracranial schwannomas are common in the central nervous system. The aim of the present study is to describe a calcified intrasellar schwannoma case.Materials and methodsWe represent a 45-year-old woman who had suffered from headaches; right side facial pain and visual disturbance which had worsen during the last week prior to admission. Physical examinations were normal except for the bitemporal visual field hemianopia which match with perimetry examination. MRI demonstrated an unusual seemingly calcified mass lesion in the sellar region which was mimicking pituitary macro adenoma.ResultTotal resection of the tumor achieved through endoscopic transnasal transsphenoidal approach by extracapsular dissection and pathologic examination of the tumor revealed calcified schwannoma.ConclusionThe differential diagnoses of sellar and suprasellar lesions include pituitary adenomas, craniopharyngiomas, meningiomas, and many others. However, schwannoma is not usually included, because the occurrence of schwannoma in the sellar or suprasellar region is extremely rare. Only few cases of intrasellar schwannomas have been reported in the literature, all of which presented a suprasellar extension similar to that of our case. Fascinating surgical point is managing very firm tumor through transsphenoidal corridor which we handle it by very sharp, debulking and extracapsular removal.