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Pituitary Chondrosarcoma: An Unusual Cause of a Sellar Mass Presenting as a Pituitary Adenoma

Departments of Endocrinology (C.A.A., G.K., A.B.G.), Neuroradiology (J.E.), Histopathology (J.G., D.G.L.), and Radiotherapy (P.N.P.), St. Bartholomew’s Hospital, London EC1A 7BE, United Kingdom

Address correspondence and requests for reprints to: Prof. A. B. Grossman, Department of Endocrinology, St. Bartholomew’s Hospital, London ECIA 7BE, United Kingdom. E-mail: a.b.grossman{at}mds.qmw.ac.uk

A 37-yr-old woman with clinical, endocrinological, and radiological features suggestive of a nonfunctioning pituitary tumor was found to have a chondrosarcoma of the pituitary sella. The bony structures around the sella were relatively uninvolved, other than showing minor erosion of the left side of the dorsum and the posterior wall of the sphenoid sinus. After partial resection of the tumor by the transsphenoidal route the patient received postoperative radiosurgery by a linear accelerator, stereotactic multiarc radiotherapy. Subsequent follow-up revealed reduction of the residual tumor. This case demonstrates that a chondrosarcoma may apparently arise directly from the pituitary fossa and suggests the efficacy of stereotactic radiosurgery, at least in the medium term. The origin, areas of involvement, management, and long-term prognosis of these rare tumors are reviewed.

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