Sellar Lymphoma: A Rare Entity with an Ordinary Clinical Presentation

Primary CNS lymphomas account for 2% of cerebral neoplasms in immunocompetent patients and its incidence has been increasing recently. Pituitary lymphomas, on the other hand, are extremely rare entities, representing only 0.1 and 0.3% of all sellar tumors.

We describe a patient with a primary pituitary lymphoma, as a second neoplasm, after a successful leukemia treatment. The 16-year-old girl presented with amenorrhea, headache and visual field defect. Magnetic resonance imaging (MRI) revealed a sellar mass lesion extending to the suprasellar compartment and extending to both cavernous sinuses. Endoscopic transsphenoidal exploration was performed and, despite the initial clinical diagnoses of a macroadenoma, it showed diffuse large B cell lymphoma.

The entity of pituitary lymphoma is extremely rare. Clinical and radiological diagnosis is usually difficult, because there are no specific findings. Therefore, a sellar lymphoma should be considered in the differential diagnosis of a macroadenoma, especially in patients with a history of immunosuppression.