Marco Tulio Sette Dos Santos, Daniel Joaquim Diogo Moreira Barbosa, Daniel Braga Cliquet, Jorge Luis do Carmo, Raffaela Neves Mont'Alverne Napoleão, Gisele Souza da Silva, André Oliveira Sette Dos Santos, Maria Eduarda Oliveira Sette Dos Santos, Paulo Henrique Pires de Aguiar
This case highlights the diagnostic challenges associated with postoperative sellar lesions and emphasizes the importance of histopathological confirmation in distinguishing foreign body granulomas from recurrent pituitary adenomas.
BACKGROUND: Foreign body granuloma of the pituitary gland is an exceptionally rare inflammatory lesion that may mimic recurrent adenoma on neuroimaging.
CASE DESCRIPTION: We report the case of a 44-year-old woman who previously underwent endonasal endoscopic surgery for a nonfunctioning pituitary adenoma and later developed a sellar mass secondary to a foreign body granulomatous reaction. Magnetic resonance imaging suggested tumor recurrence; however, gadolinium-enhanced imaging was not performed because of the patient's known gadolinium allergy. Histopathological examination revealed xanthogranulomatous inflammation and a multinucleated giant-cell reaction to the suture material, without evidence of neoplastic recurrence.
CONCLUSION: This case highlights the diagnostic challenges associated with postoperative sellar lesions and emphasizes the importance of histopathological confirmation in distinguishing foreign body granulomas from recurrent pituitary adenomas.