Perisellar Tumours Including Cysts, Hamartomas, and Vascular Tumours

Abstract

Pituitary adenomas are prevailing among perisellar tumours. That is why other perisellar tumours are often misinterpreted as pituitary adenomas. Careful consideration of the characteristic endocrinological and magnetic resonance imaging (MRI) findings are of paramount importance to differentiate between various tumours encountered in the perisellar region. With knowledge of the typical and occasionally pathognomonic signs of the different perisellar tumour entities, the correct diagnosis can often be made with a high degree of certainty even before histological confirmation of diagnosis. Diagnostic accuracy is decisive for purposeful clinical decision-making. In parallel, histopathological classification in surgical cases has further developed and molecular markers have been implemented allowing a more precise distinction and definition of tumour entities. Extended transsphenoidal skull base approaches have expanded the surgical options in the treatment of perisellar tumours. Radiotherapeutic modalities have been refined and the experience with radiosurgery or fractionated radiotherapy for perisellar tumours has significantly increased over the past 10 years. Novel targeted therapies are emerging as additional therapeutic options for solid tumours. The endovascular techniques for treatment of aneurysms including stent-assisted coiling and flow diversion have rapidly advanced. The characteristic clinical findings, the current diagnostic and therapeutic strategies, and the outcome with the advanced treatment options in non-adenomatous perisellar tumours are presented in this chapter.