Suprasellar masses are neoplastic, vascular, congenital, or infectious/inflammatory in origin. Suprasellar masses present with a variety of neurologic or endocrine dysfunctions depending on their site of origin and mass effect on adjacent structures.
The suprasellar cistern is a cerebrospinal fluid filled space between the top of the pituitary and bottom of the hypothalamus. The pituitary stalk normally courses through this space to enter the pituitary gland and is critical for the normal operation of the pituitary.
If the pituitary stalk is affected, one can develop hypopituitarism including hypothyroidism, hypoadrenalism, hypogonadism, growth hormone deficiency and diabetes insipidus. This is why any mass lesion present in the suprasellar cistern can have profound effects on the endocrine system. The optic chiasm can also be compressed resulting in compromise of peripheral vision.
There are many different disorders that can involve the suprasellar cistern including benign and malignant tumors, metastatic disease, cysts, abscesses, infiltrative and inflammatory processes, aneurysms, harmatomas and an ectopic posterior pituitary. Not uncommonly, pituitary adenomas extend from the sella turcica (the bony cavity that houses the pituitary gland) into the suprasellar cistern resulting in compression of the pituitary stalk and optic chiasm. Individuals who develop visual field compromise and/or peripheral field defects should be suspected of having a lesion in the suprasellar cistern.
Treatment depends upon the underlying cause but often requires surgical decompression.
Programs + Services
The Neuroendocrine and Endocrine Neoplasia Clinic at Tufts Medical Center in Boston provides care for patients with hypothalamic, suprasellar and pituitary disorders.
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Learn more about our Neuroendocrine and Pituitary Program located in downtown Boston, we specialize in the diagnosis and treatment of various neuroendocrine disorders.
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