Primary sellar melanocytoma

Pituitary. 2021 Dec;24(6):970-977. doi: 10.1007/s11102-021-01186-9. Epub 2021 Sep 13.

Abstract

Purpose: We present an up-to-date review of all published cases of sellar melanocytoma, a benign melanocytic neoplasm arising from melanocytes present in the leptomeninges surrounding the pituitary.

Methods: Both the Medline and Embase databases were searched for case reports or case series of patients with a sellar mass consisting of melanocytes.

Results: All 14 identified patients developed symptoms due to compression of the surrounding structures. Symptoms included pituitary dysfunction and visual impairment. All patients received a transsphenoidal resection as first-line treatment. The diagnosis is made on pathological examination but deciding whether a sellar melanocytic tumor is best classified as a melanocytoma or a melanoma is not straightforward.

Discussion: Genetic analyses can help differentiate between central nervous system origin and metastasis of a cutaneous melanoma with the presence of a GNAQ and GNA11 mutations or a BRAF mutation, respectively. First choice treatment is complete resection, and in case of incomplete resection or recurrence additional radiotherapy is advised.

Keywords: Leptomeninges; Pituitary tumor; Sellar melanocytoma; Transsphenoidal surgery.

Publication types

  • Review

MeSH terms

  • Humans
  • Melanocytes
  • Melanoma*
  • Mutation
  • Pituitary Gland
  • Skin Neoplasms*