PMC9978486_01
Perioperative imaging data. (A) Preoperative CT scan of the brain, axial section showing a sellar tumor with obvious calcification. (B) T2-weighted sagittal image showing hypointense sellar lesion. (C) Coronal T1-weighted image. (D) Sagittal T1-weighted image with gadolinium contrast showing hypointense sellar lesion anterior to the pituitary gland without enhancement.
fonc-13-1121140-g001.jpg
PMC9978486_01_fonc-13-1121140-g001.jpg
f1
A sellar mass with calcification was then observed during computerized tomography (CT) scanning ( Figure 1A ). On enhanced scans, the tumor showed no enhancement after gadolinium administration ( Figures 1B-D ).
Intraoperative imaging data under neuroendoscopy. (A) Intraoperative imaging indicates the yellowish tumor was firm and consisted of psammoma bodies. (B) The lesion adhered closely to the diaphragma sellae. (C) After the tumor removal, the diaphragma sellae was broken and cerebrospinal fluid leakage was observed.
fonc-13-1121140-g002.jpg
PMC9978486_01_fonc-13-1121140-g002.jpg
f2
December 2020. During the operation, a solid yellowish mass full of calcifications was identified in the sellar area ( Figures 2A-C ).
Section imaging data of the excised specimen. (A) HE staining for the excised specimen. (B) Immunohistochemical staining of TSH for the excised specimen. (C) Immunohistochemical staining of CD56 for the excised specimen. (D) Immunohistochemical staining of Syn for the excised specimen.
fonc-13-1121140-g003.jpg
PMC9978486_01_fonc-13-1121140-g003.jpg
f3
Histologic sections of the surgical specimen revealed an abundance of psammoma bodies, and nests of cells were inconspicuous among the psammoma bodies ( Figure 3A ). Moreover, the cells were negative for all other anterior pituitary hormones except follicle-stimulating hormone (FSH), epithelial membrane antigen (EMA), progesterone receptor (PR), P63, P40, and Ki67, but the cells were positive for chromogranin A (CgA), CD56, cytokeratin (CK), and synaptophysin (Syn) ( Figures 3B-D ).
Postoperative MRI imaging data. Postoperative MR images demonstrate no regrowth of the tumor. (A) Coronal noncontrast T1-weighted image. (B) Sagittal T2-weighted image. (C) Coronal contrast T1-weighted image. (D) Sagittal contrast T1-weighted image.
fonc-13-1121140-g004.jpg
PMC9978486_01_fonc-13-1121140-g004.jpg
f4
A follow-up MRI was performed 12 months after eTSS (  Figure 4  ); no regrowth of the tumor was noted, and the patient's thyroid function tests were within normal limits.