Objective: Sellar region tumors may origin from a various number of structures and each of themÂ have a specific clinical and radiological appearance. Among these pathological processes, one of theÂ most challenging is to distinguish between tuberculum sellae meningioma (TSM) and macroadenomaÂ hypophysis (MH). Differentiating these two entities preoperatively is very important to decide which
approach will be most suitable and beneficial. The purpose of this study is to produce a simpleÂ preoperative scoring system to differentiate these two that can be applied in specific conditions whereÂ MRI is not available or could not be performed.
Methods: This analytical retrospective cohort study
contains data obtained from patients treated in Neurosurgery Department of Dr. Hasan Sadikin
General Hospital-Bandung from 1 January 2008 until 31 December 2010. There were 34 patientsÂ enrolled in this study, in which 15 of them were diagnosed with MH and 19 patients diagnosed withÂ TSM confirmed with pathology examination.
Results: From clinical presentation we found that the
event of endocrinopathy occurs significantly in macroadenoma hypophysis (p=0.002). Whereas fromÂ radiological evaluation there were 7 parameters that significantly distinguish these two entitiesÂ including hyperostosis, sellar floor configuration, homogeneity of mass, contrast agent enhancement,Â waist configuration, peritumoral edema, and dural attachment. From these findings, we propose aÂ simple scoring system to differentiate macroadenoma hypophysis and tuberculum sellae meningiomaÂ with a 84.2% sensitivity and 100% specificity.
Conclusion: although MRI is the modality of choice in
differentiating macroadenoma hypophysis and tuberculum