Meningioma selar, hemianopsia homônima bitemporal e manejo do hipopituitarismo anterior

Um relato de caso

Abstract

Sellar meningioma is a type of intracranial tumor that originates from the meningeal cells, specifically in the region of the sella turcica, where the pituitary gland is located. Although meningiomas are mostly benign and slow-growing tumors, their location in the sellar region can result in significant clinical effects due to compression of adjacent structures, including the pituitary gland, optic chiasm, cranial nerves, and blood vessels (such as branches of the carotid artery).

Clinically, patients with this condition may present with symptoms such as headache, visual disturbances (like bitemporal hemianopsia), pituitary dysfunction (hypopituitarism), and, in rare cases, diabetes insipidus. Diagnosis is generally made through complementary exams, such as magnetic resonance imaging (MRI), as it allows for detailed assessment of the tumor's size, extent, and relationship with adjacent structures.

The management of sellar meningioma depends on several factors, including the size of the tumor, the presence of symptoms, and the patient's age. Surgical resection is the treatment of choice, especially for tumors causing significant compression or visual dysfunction. Surgery can be performed via a transsphenoidal approach or craniotomy. In cases where complete surgery is not possible or when the tumor recurs, adjuvant radiotherapy may be an option.

The prognosis is usually favorable; however, the proximity to critical structures and the risk of surgical complications make the management of these tumors a clinical challenge. Long-term monitoring is essential to detect recurrences and manage late complications, such as pituitary insufficiency.