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Sellar and Suprasellar Disorders

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Pediatric Neuroradiology

Abstract

The pituitary gland, or hypophysis, is an ovoid body that is continuous with the infundibulum, a hollow, conical, inferior process originating from the tuber cinereum. It lies within the sella turcica and is covered superiorly by a circular diaphragm of dura mater, pierced centrally by an aperture for the infundibulum [1].

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References

  1. Gray’s Anatomy, 38th edn. Edinburgh: Churchill Livingstone, 1995.

    Google Scholar 

  2. Hayman LA, Hinck VC. Clinical Brain Imaging. Normal Structure and Functional Anatomy. St. Louis: Mosby, 1992.

    Google Scholar 

  3. Ikeda H, Suzuki J, Sasano N, Niizuma H. The development and morphogenesis of the human pituitary gland. Anat Embryol (Berl) 1988; 178:327–336.

    Article  CAS  PubMed  Google Scholar 

  4. Moore KL. The Developing Human. Clinically Oriented Embryology, 4th edn. Philadelphia: W.B. Saunders Co, 1988.

    Google Scholar 

  5. Auroux M, Haegel P. Organogenése. Système nerveux, organes de sens, intégration neuro-endocrinienne. In: Tuchmann-Duplessis H (ed) Embryologie. Travaux Pratiques et Enseignement Dirigé, 3ème ed. Paris: Masson; 1992.

    Google Scholar 

  6. Heitzmann A, Jan M, Lecomte P, Ruchoux MM, Lhuintre Y, Tillet Y. Ectopic prolactinoma within the sphenoid sinus. Neurosurgery 1989; 24:279–282.

    Article  CAS  PubMed  Google Scholar 

  7. Trandafir T, Sipot C, Froicu P. On a possible neural ridge origin of the adenohypophysis. Endocrinologie 1990; 28:67–72.

    CAS  PubMed  Google Scholar 

  8. Kollias SS, Ball WS, Prenger EC. Review of the embryologic development of the pituitary gland and report of a case of hypophyseal duplication detected by MRI. Neuroradiology 1995; 37:3–12.

    Article  CAS  PubMed  Google Scholar 

  9. Horvath E, Scheithauer BW, Kovacs K, Lloyd RV. Regional neuropathology: hypothalamus and pituitary. In: Graham DI, Lantos PL (eds) Greenfield’s Neuropathology, 6th edn. London: Arnold, 1997:1007–1094.

    Google Scholar 

  10. Parks JS, Adess ME, Brown MR. Genes regulating hypothalamic and pituitary development. Acta Paediatr Suppl 1997; 423:28–32.

    CAS  PubMed  Google Scholar 

  11. Elster AD. Modern imaging of the pituitary. Radiology 1993; 187:1–14.

    CAS  PubMed  Google Scholar 

  12. Wolpert SM, Osborne M, Anderson M, Runge VM. The bright pituitary gland: a normal MR appearance in infancy. AJNR Am J Neuroradiol 1988; 9:1–3.

    CAS  PubMed  Google Scholar 

  13. Cox TD, Elster AD. Normal pituitary gland: changes in shape, size, and signal intensity during the 1st year of life at MR imaging. Radiology 1991; 179:721–724.

    CAS  PubMed  Google Scholar 

  14. Dietrich RB, Lis LE, Greensite FS, Duane P. Normal MR appearance of the pituitary gland in the first 2 years of life. AJNR Am J Neuroradiol 1995; 16:1413–1419.

    CAS  PubMed  Google Scholar 

  15. Asa SL, Kovacs K, Laszlo FA, Damokos I, Ezrin C. Human fetal adenohypophysis: histologic and immunocytochemical analsysis. Neuroendocrinology 1986; 43:308–316.

    Article  CAS  PubMed  Google Scholar 

  16. Elster AD, Chen MTM, Williams DW III, Key LL: Pituitary gland: MR imaging of physiologic hypertrophy in adolescence. Radiology 1990; 174:681–685.

    CAS  PubMed  Google Scholar 

  17. Tien R. Neurophysins in the neonatal adenohypophysis. Proceedings of ASNR Annual Meeting, May 1993, Vancouver.

    Google Scholar 

  18. Abernethy LJ. Imaging of the pituitary in children with growth disorders. Eur J Radiol 1998; 26:102–108.

    Article  CAS  PubMed  Google Scholar 

  19. Simmons GE, Suchnicki JE, Rak KM, Damiano TR. MR imaging of the pituitary stalk: size, shape, and enhancement pattern. AJR Am J Roentgenol 1992; 159:375–377.

    CAS  PubMed  Google Scholar 

  20. Ekblom M, Ketonen L, Kuuliala I, Pelkonen R. Pituitary function in patients with enlarged sella turcica and primary empty sella syndrome. Acta Med Scand 1981; 209:31–35.

    CAS  PubMed  Google Scholar 

  21. Ommaya AK, Di Chiro G, Baldwin M, Pennybacker JB. Nontraumatic cerebrospinal fluid rhinorrea. J Neurol Neurosurg Psychiatry 1968; 31:214–225.

    Article  CAS  PubMed  Google Scholar 

  22. Kaufman B, Tomsak RL, Kaufman BA, Arafah BU, Bellon EM, Selman WR, Modic MT. Herniation of the suprasellar visual system and third ventricle into empty sellae: morphologic and clinical considerations. AJR Am J Roentgenol 1989;152:597–608.

    CAS  PubMed  Google Scholar 

  23. Castillo M, Mukherji SK. Imaging of the Pediatric Head, Neck, and Spine. Philadelphia: Lippincott-Raven, 1996.

    Google Scholar 

  24. Hamon-Kérautret M, Soto Ares G, Demondion X, Rouland V, Francke JP, Pruvo JP. Duplication of the pituitary gland in a newborn with median cleft face syndrome and nasal teratoma. Pediatr Radiol 1998; 28:290–292.

    Article  PubMed  Google Scholar 

  25. Ryals BD, Brown DC, Levin SW. Duplication of the pituitary gland as shown by MR. AJNR Am J Neuroradiol 1993; 14:137–139.

    CAS  PubMed  Google Scholar 

  26. Abrahams J, Trefelner E, Boulware S. Idiopathic growth hormone deficiency: MR findings in 35 patients. AJNR Am J Neuroradiol 1991; 12:155–160.

    CAS  PubMed  Google Scholar 

  27. Hamilton J, Blaser S, Daneman D. MR imaging of idiopathic growth hormone deficiency. AJNR Am J Neuroradiol 1998; 19:1609–1615.

    CAS  PubMed  Google Scholar 

  28. Triulzi F, Scotti G, Di Natale B, Pellini C, Lukezic M, Scognamiglio M, Chiumello G. Evidence of a congenital midline brain anomaly in pituitary dwarfs: a magnetic resonance imaging study in 101 patients. Pediatrics 1994; 93:409–416.

    CAS  PubMed  Google Scholar 

  29. Maghnie M, Triulzi F, Larizza D, Scotti G, Beluffi G, Cecchini A, Severi F. Hypothalamic-pituitary dwarfism: comparison between MR imaging and CT findings. Pediatr Radiol 1990; 20:229–235.

    Article  CAS  PubMed  Google Scholar 

  30. Bozzola M, Adamsbaum C, Biscaldi I, Zecca M, Cisternino M, Genovese E, Richard I, Kalifa G, Chaussain JL. Role of magnetic resonance imaging in the diagnosis and prognosis of growth hormone deficiency. Clin Endocrinol 1996; 45:21–26.

    Article  CAS  Google Scholar 

  31. Nagel BH, Palmbach M, Petersen D, Ranke MB. Magnetic resonance images of 91 children with different causes of short stature: pituitary size reflects growth hormone secretion. Eur J Pediatr 1997;156: 758–763.

    Article  CAS  PubMed  Google Scholar 

  32. Benshoff ER, Katz BH. Ectopia of the posterior pituitary gland as a normal variant: assessment with MR imaging. AJNR Am J Neuroradiol 1989; 11:709–712.

    Google Scholar 

  33. Pinto G, Netchine I, Sobrier ML, Brunelle JC, Souberbielle JC, Brauner R. Pituitray stalk interruption syndrome: a clinical-biological-genetic assessment of its pathogenesis. J Clin Endocrinol Metab 1997; 82:3450–3454.

    Article  CAS  PubMed  Google Scholar 

  34. Denton ER, Powrie JK, Ayers AB, Sonksen PH. Posterior pituitary ectopia and hypopituitarism—magnetic resonance appearances of four cases and a review of the literature. Br J Radiol 1996; 69:402–406.

    Article  CAS  PubMed  Google Scholar 

  35. Maintz D, Benz-Bohm G, Gindele A, Schönau E, Pfäffle R, Lackner K. Posterior pituitary ectopia: another hint toward a genetic etiology. AJNR Am J Neuroradiol 2000; 21:1116–1118.

    CAS  PubMed  Google Scholar 

  36. Fofanova O, Takamura N, Kinoshita E, Vorontsov A, Vladimirova, Dedov I, Peterkova V, Yamashita S. MR imaging of the pituitary gland in children and young adults with congenital combined pituitary hormone deficiency associated with PROP1 mutations. AJR Am J Roentgenol 2000; 174:555–559.

    CAS  PubMed  Google Scholar 

  37. Ward L, Chavez M, Huot C, Lecocq P, Collu R, Décarie JC, Martial JA, Van Vliet G. Severe congenital hypopituitarism with low prolactin levels and age-dependent anterior pituitary hypoplasia: a clue to a PIT-1 mutation. J Pediatr 1998; 132:1036–1038.

    Article  CAS  PubMed  Google Scholar 

  38. Maghnie M, Cosi G, Genovese E, Manca-Bitti ML, Cohen A, Zecca S, Tinelli C, Gallucci M, Bernasconi S, Boscherini B, Severi F, Aricò M. Central diabetes insipidus in children and young adults. N Engl J Med. 2000; 343:998–1007.

    Article  CAS  PubMed  Google Scholar 

  39. Maghnie M, Genovese E, Bernasconi S, Binda S, Arico M. Persistent high MR signal of the posterior pituitary gland in central diabetes insipidus. AJNR Am J Neuroradiol 1997; 18:1749–1752.

    CAS  PubMed  Google Scholar 

  40. Leger J, Velasquez A, Garel C, Hassan M, Czernichow P. Thickened pituitary stalk on magnetic resonance imaging in children with central diabetes insipidus. J Clin Endocrinol Metab 1999; 84:1954–1960.

    Article  CAS  PubMed  Google Scholar 

  41. Tien R, Kucharczyk J, Kucharczyk W. MR imaging of the brain in patients with diabetes insipidus. AJNR Am J Neuroradiol 1991; 12:533–542.

    CAS  PubMed  Google Scholar 

  42. Mootha SL, Barkovich AJ, Grumbach MM, Edwards MS, Gitelman SE, Kaplan SL, Conte FA. Idiopathic hypothalamic diabetes insipidus, pituitary stalk thickening, and the occult intracranial germinoma in children and adolescent. J Clin Endocrinol Metab 1997; 82:1362–1367.

    Article  CAS  PubMed  Google Scholar 

  43. Scolding NJ, Keller-Wood H, Shaw C, Shneerson J, Antoun N. Wolfram syndrome: hereditary diabetes mellitus with brainstem and optic atrophy. Ann Neurol 1996; 39:352–360.

    Article  CAS  PubMed  Google Scholar 

  44. Rando TA, Horton JC, Layzer RB. Wolfram syndrome: evidence of a diffuse neurodegenerative disease by magnetic resonance imaging. Neurology 1992; 42:1220–1224.

    CAS  PubMed  Google Scholar 

  45. Galluzzi P, Filosomi G, Vallone IM, Bardelli AM, Venturi C. MRI of Wolfram syndrome (DIDMOAD). Neuroradiology 1999; 41:729–731.

    Article  CAS  PubMed  Google Scholar 

  46. Fahmy JL, Kaminsky CK, Kaufman F, Nelson MD Jr, Parisi MT. The radiological approach to precocious puberty. Br J Radiol 2000; 73:560–567.

    CAS  PubMed  Google Scholar 

  47. Tortori-Donati P, Fondelli MP, Rossi A, Cama A, Brisigotti M, Pellicano G. Extraventricular neurocytoma with ganglionic differentiation associated with complex partial seizures. AJNR Am J Neuroradiol 1999; 20:724–727.

    CAS  PubMed  Google Scholar 

  48. Kao SC, Cook JS, Hansen JR, Simonson TM. MR imaging of the pituitary gland in central precocious puberty. Pediatr Radiol 1992; 22:481–484.

    Article  CAS  PubMed  Google Scholar 

  49. Perignon F, Brauner R, Argyropoulou M, Brunelle F. Precocious puberty in girls: pituitary height as an index of hypothalamo-pituitary activation. J Clin Endocrinol Metab 1992; 75:1170–1172.

    Article  CAS  PubMed  Google Scholar 

  50. Sharafuddin MJ, Luisiri A, Garibaldi LR, Fulk DL, Klein JB, Gillespie KN, Graviss ER. MR imaging diagnosis of central precocious puberty: importance of changes in the shape and size of the pituitary gland. AJR Am J Roentgenol 1994; 162:1167–1173.

    CAS  PubMed  Google Scholar 

  51. Shuangshoti S, Netsky MG, Nashold BS Jr. Epithelial cysts related to sella turcica. Proposed origin from neuroepithelium. Arch Patol 1970; 90:444–450.

    CAS  Google Scholar 

  52. Graziani N, Dufour H, Figarella-Branger A, Donnet A, Bouillot P, Grisoli F. Do the suprasellar neurenteric cyst, the Rathke cyst and the colloid cyst constitute a same entity? Acta Neurochir (Wien) 1995; 133:174–180.

    Article  CAS  Google Scholar 

  53. Matsushima T, Fukui M, Fujii K, Kinoshita K, Yamakawa Y. Epithelial cells in symptomatic Rathke’s cleft cysts: a lightand electron-microscopic study. Surg Neurol 1988; 30:197–203.

    Article  CAS  PubMed  Google Scholar 

  54. Osborn AG. Diagnostic Neuroradiology. St. Louis: Mosby, 1994.

    Google Scholar 

  55. Naylor MF, Scheithauer BW, Forbes GS, Tomlinson FH, Young WF. Rathke cleft cyst: CT, MR, and pathology of 23 cases. J Comput Assist Tomogr 1995; 19:853–859.

    Article  CAS  PubMed  Google Scholar 

  56. Brassier G, Morandi X, Tayiar E, Riffaud L, Chabert E, Heresbach N, Poirier JY, Carsin-Nicol B. Rathke’s cleft cysts: surgical-MRI correlation in 16 symptomatic cases. J Neuroradiol 1999; 26:162–171.

    CAS  PubMed  Google Scholar 

  57. Haddad SF, Van Gilder JC, Menezes AH. Pediatric pituitary tumors. Neurosurgery 1991; 29:509–514.

    Article  CAS  PubMed  Google Scholar 

  58. Laws ER, Sheithauer BW, Groover RV. Pituitary adenomas in childhood and adolescence. Prog Exp Tumor Res 1987; 30:359–361.

    CAS  PubMed  Google Scholar 

  59. Abe T, Lüdecke DK, Saeger W. Clinically nonsecreting pituitary adenomas in childhood and adolescence. Neurosurgery 1998; 42:744–751.

    Article  CAS  PubMed  Google Scholar 

  60. Mindermann T, Wilson CB. Pediatric pituitary adenomas. Neurosurgery 1995; 36:259–269.

    Article  CAS  PubMed  Google Scholar 

  61. Bills DC, Meyer FB. A retrospective analysis of pituitary apoplexy. Neurosurgery 1993; 33:602–609.

    Article  CAS  PubMed  Google Scholar 

  62. Shah S, Pereira J, Becker C, Aronin P. Pituitary apoplexy in adolescence: case report. Pediatr Radiol 1995; 25:S26–S27.

    PubMed  Google Scholar 

  63. Sakamoto Y, Takahashi M, Korogi Y, Bussaka H, Ushio Y. Normal and abnormal pituitary glands: gadopentate dimeglumine-enhanced MR imaging. Radiology 1991; 178:441–445.

    CAS  PubMed  Google Scholar 

  64. Kollias SS, Barkovich AJ, Edwards MSB. Magnetic resonance analysis of suprasellar tumors of childhood Ped Neurosurg 1991–92; 17:284–303.

    Article  Google Scholar 

  65. Poussaint TY, Barnes PD, Anthony DC, Spack N, Scott RM, Tarbell NJ. Hemorrhagic pituitary adenomas of adolescence. AJNR Am J Neuroradiol 1996; 17:1907–1912.

    CAS  PubMed  Google Scholar 

  66. Sutton LN, Wang ZJ, Wehrli SL, Marwaha S, Molloy P, Phillips PC, Zimmerman RA. Proton spectroscopy of suprasellar tumors in pediatric patients. Neurosurgery 1997; 41:388–395.

    Article  CAS  PubMed  Google Scholar 

  67. Young M, Kattner K, Gupta K. Pituitary hyperplasia resulting from primary hypothyroidism mimicking macroadenomas. Br J Neurosurg 1999; 13:138–142.

    Article  CAS  PubMed  Google Scholar 

  68. Strottman JM, Ginsberg LE, Stanton C. Langerhans cell histiocytosis involving the coprus callosum and cerebellum: gadolinium-enhanced MRI. Neuroradiology 1995; 37:289–292.

    Article  Google Scholar 

  69. Saatci I, Baskan O, Haliloglu M, Aydingoz U. Cerebellar and basal ganglion involvement in Langerhans cell histiocytosis. Neuroradiology 1999; 41:443–446.

    Article  CAS  PubMed  Google Scholar 

  70. Broadbent V, Dunger DB, Yeomans E, Kendall B. Anterior pituitary function and computed tomography/magnetic resonance imaging in patients with Langerhans cell histiocytosis and diabetes insipidus. Med Pediatr Oncol 1993; 21:649–654.

    Article  CAS  PubMed  Google Scholar 

  71. Tihan T, Fisher PG, Kepner JL, Godfraind C, McComb RD, Goldthwaite PT, Burger PC. Pediatric astrocytomas with monomorphous pilomyxoid features and a less favorable outcome. J Neuropathol Experimental Neurol 1999; 58:1061–1068.

    Article  CAS  Google Scholar 

  72. Kleihues P, Cavenee WK. Pathology and Genetics, Tumors of the Nervous System. Lyon, France: IARC Press, 1997:207–214.

    Google Scholar 

  73. Barkovich AJ. Pediatric Neuroimaging, 3nd edn. Philadelphia: Lippincott Williams & Wilkins, 2000.

    Google Scholar 

  74. Eldevik OP, Blaivas M, Gabrielsen TO, Hald JK, Chandler WF. Craniopharyngioma: radiologic and histologic findings and recurrence. AJNR Am J Neuroradiol 1996; 17:1427–1439.

    CAS  PubMed  Google Scholar 

  75. Taguchi Y, Tanaka K, Miyakita Y, Sekino H, Fujimoto M. Recurrent craniopharyngioma with nasopharyngeal extension. Pediatr Neurosurg 2000; 32:140–144.

    Article  CAS  PubMed  Google Scholar 

  76. Bunin GR, Surawicz TS, Witman PA, Preston-Martin S, Davis F, Bruner JM. The descriptive epidemiology of craniopharyngioma. J Neurosurg 1998; 89:547–551.

    Article  CAS  PubMed  Google Scholar 

  77. Sklar CA. Craniopharyngioma: endocrine abnormalities at presentation. Pediatr Neurosurg 1994; 21(Suppl 1):18–20.

    Article  PubMed  Google Scholar 

  78. Buhl R, Lang EW, Barth H, Mehdorn HM. Giant cystic craniopharyngiomas with extension into the posterior fossa. Childs Nerv Syst 2000; 16:138–142.

    Article  CAS  PubMed  Google Scholar 

  79. Harrison MJ, Morgello S, Post KD. Epithelial cystic lesions of the sellar and parasellar region: a continuum of ectodermal derivatives? J Neurosurg 1994; 80:1018–1025.

    Article  CAS  PubMed  Google Scholar 

  80. Lafferty AR, Chrousos GP. Pituitary tumors in children and adolescents. J Clin Endocrinol Metab 1999; 84:4317–4323.

    Article  CAS  PubMed  Google Scholar 

  81. Raybaud C, Rabehanta P, Girard N. Aspects radiologiques des craniopharyngiomes. Neurochirurgie 1991; 37:44–58.

    Google Scholar 

  82. Usanov EI, Hatomkin DM, Nikulina TA, Gorban NA. Craniopharyngioma of the pineal region. Childs Nerv Syst 1999;15:4–7.

    Article  CAS  PubMed  Google Scholar 

  83. Benitez WI, Sartor KJ, Angtuaco EJC. Craniopharyngioma presenting as a nasopharyngeal mass: CT and MR findings. J Comput Assist Tomogr 1988; 12:1068–1072.

    Article  CAS  PubMed  Google Scholar 

  84. Sartoretti-Schefer S, Wichmann W, Aguzzi A, Valavanis A. MR differentiation of adamantinous and squamous-papillary craniopharyngiomas. AJNR Am J Neuroradiol 1997; 18:77–87.

    CAS  PubMed  Google Scholar 

  85. Ahmadi J, Destian S, Apuzzo ML, Segall HD, Zee CS. Cystic fluid in craniopharyngiomas: MR imaging and quantitative analysis. Radiology 1992; 182:783–785.

    CAS  PubMed  Google Scholar 

  86. Crotty TB, Scheithauer BW, Young WF, Davis DH, Shaw EG, Miller GM, Burger PC. Papillary craniopharyngioma: a clinicopathological study of 48 cases. J Neurosurg 1995; 83:206–214.

    Article  CAS  PubMed  Google Scholar 

  87. Packer RJ, Cohen BH, Coney K. Intracranial germ cell tumors. Oncologist 2000; 5:312–320.

    CAS  PubMed  Google Scholar 

  88. Chang CG, Kageyama N, Kobayashi T, Yoshida J, Negoro M. Pineal Tumors: clinical diagnosis, with special emphasis on the significance of pineal calcification. Neurosurgery 1981; 8:656–668.

    Article  CAS  PubMed  Google Scholar 

  89. Boto GR, Esparza J, Muñoz MJ, Hinojosa J, Muñoz A. Hamartoma of the suprasellar cistern in a 5-year-old girl. Childs Nerv Syst 1999; 15:131–133

    Article  CAS  PubMed  Google Scholar 

  90. Tamiya A, Saeki N, Kubota M, Oheda T, Yamaura A. Unusual MRI findings in lymphocytic hypophysitis with central diabetes insipidus. Neuroradiology 1999; 41:899–900.

    Article  CAS  PubMed  Google Scholar 

  91. Sato N, Sze G, Endo K. Hypophysitis: endocrinologic and dynamic MR findings. AJNR Am J Neuroradiol 1998; 19:439–444.

    CAS  PubMed  Google Scholar 

  92. Honegger J, Fahlbusch R, Bornemann A, Hensen J, Buchfelder M, Müller M, Nomikos P. Lymphocytic and granulomatous hypohysitis: experience with nine cases. Neurosurgery 1997; 40:713–723.

    Article  CAS  PubMed  Google Scholar 

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Tortori-Donati, P., Rossi, A., Biancheri, R. (2005). Sellar and Suprasellar Disorders. In: Pediatric Neuroradiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-26398-5_18

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