Upward Oriented Sellar Spine. MRI Findings

Carpenzano, M.; Marini, Elena; Valenti, Renato; Ambrosetto, Paolo

doi:10.1177/197140091002300409

Cited by 5 publications

(10 citation statements)

References 11 publications

(11 reference statements)

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“…In all the described cases, the sellar spine was located in the midline in keeping with the foremost theory that it is an ossified remnant of the notochord. 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 The most consistent imaging morphology of the bony spur among the literature was that of a narrow cylindrical bony stalk with a mildly distended tip and a flattened triangular base in continuity with the dorsum sellae. 1 , 2 , 3 , 9 , 11 , 12 , 13 In most cases, the tip had a smooth contour; however, in one of the cases, it was irregular.…”

Section: Discussionmentioning

confidence: 95%

“…To our knowledge, this is the first reported sellar spine that arises from the mid-ventral aspect of the dorsum sellae, with most of the previously described cases in the literature arising from the inferior ventral aspect of the dorsum sellae and two arising from the superior aspect of the dorsum sellae. 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 Secondly, the history of puerpural alactogenesis and mild hypoprolactinaemia has not yet been described in any of the known reported cases in the literature.…”

Section: Introductionmentioning

confidence: 99%

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Sellar spine: A rare Bony variant of the Sella Turcica

Metelo-Liquito

Buthelezi

2022

S. Afr. j. radiol.

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A sellar spine is a rare osseous projection from the dorsum sellae, resulting in variable compression of sellar and suprasellar structures and varied clinical presentations. CT is the diagnostic modality of choice, while variable signal intensity on MRI may mimic a pituitary microadenoma. A patient presented with hypoprolactinaemia and puerperal alactogenesis due to a sellar spine diagnosed on CT Brain. Neurosurgical and endocrine review and pituitary MRI were recommended with subsequent loss to follow-up.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Sellar spine: A rare Bony variant of the Sella Turcica

Metelo-Liquito

Buthelezi

2022

S. Afr. j. radiol.

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“…A few published reports described MRI findings of sellar spine. 5 , 7 , 16 – 18 On T1- and T2-weighted MRI, most sellar spines were clearly shown as a hypointense structure protruding into the pituitary posterior lobe. On coronal T1-weighted images, sellar spine typically appears as a black dot surrounded by a hyperintense rim caused by the posterior pituitary bright spot.…”

Section: Discussionmentioning

confidence: 99%

Incidentally detected sellar spine in a patient with Cushing’s syndrome: a case report

Lee

Baek

et al. 2020

J Int Med Res

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Sellar spine, a bony spur extending anteriorly from the dorsum sellae, is a very rare anatomical variant. Several hypotheses regarding its etiology have been proposed, including the strongly supported theory of a cephalic ossified notochordal remnant. Sellar spine is usually detected incidentally in patients who have no definite symptoms, but several cases have reportedly accompanied endocrinopathies such as precocious puberty, hypopituitarism, or galactorrhea/oligomenorrhea. However, no published reports have described sellar spine in a patient with Cushing’s syndrome. We herein report a case of sellar spine detected during the evaluation of Cushing’s disease in a 29-year-old woman who underwent inferior petrosal sinus sampling, computed tomography, magnetic resonance imaging, and exploratory surgery. There was no evidence of a pituitary microadenoma, but a sellar spine was present in the operative field. Thus, the sellar spine might have caused Cushing’s syndrome in this case, although the exact mechanism is unknown.

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“…[2] The table describes 4 male and 7 female patients (excluding case report [2] as the sex is not mentioned). The mean length of the sellar spine is 5.0 ± 1.8 mm (range, 4–9 mm) (excluding case reports [2,3,7,9] because exact sellar spine lengths were not mentioned). Previous reports include various ages and chief complaints, as well as more women than men.…”

Section: Discussionmentioning

confidence: 99%

Postnatal sellar spine growth

Hosokawa

Yamada²,

Sato

et al. 2016

Medicine

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Background:A sellar spine is a bony spur protruding anteriorly from the central portion of the dorsum sellae. Its etiology is an ossified notochordal remnant of the cephalic end of the notochord. It is presumed to be a congenital malformation based on magnetic resonance imaging (MRI) findings of sellar spine in a 4-year-old boy. A sellar spine should therefore be detectable at birth with or without ossification, and the posterior pituitary lobe should be displaced.Methods and Results:Here we review the literature and report the first case of typical sellar spine in an 8-year-old girl who presented with precocious puberty, but her MRI taken at age 4 months for a febrile convulsion did not show a sellar spine or posterior pituitary lobe deformation. T1-weighted sagittal images at 8 years old showed a bony structure protruding anteriorly from the central portion of the dorsum sellae. The length of this lesion was 3.8 mm on computed tomography (CT) scanning at 9 years old, and it elongated to 4.7 mm on CT at 12 years old.Conclusions:Based on the present case, we speculate that the sellar spine would be too small to detect early in development and would grow in size after birth. In this case, a sellar spine and precocious puberty were potentially associated due to deformation of the growing pituitary gland.

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Upward Oriented Sellar Spine. MRI Findings

Abstract: The sellar spine is a rare congenital malformation due to the persistence of a notochord rest within the fetal sella turcica. We describe a unique case of a sellar spine vertically oriented displacing the pituitary stalk upwards and forwards. The MRI findings are briefly discussed.

Cited by 5 publications

References 11 publications

Sellar spine: A rare Bony variant of the Sella Turcica

Sellar spine: A rare Bony variant of the Sella Turcica

Incidentally detected sellar spine in a patient with Cushing’s syndrome: a case report

Postnatal sellar spine growth

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