Xanthogranuloma of the Sellar Region

To the Editor: A 36‐year‐old female patient was admitted to Peking Union Medical College Hospital complaining of 6 years of headache. Magnetic resonance imaging (MRI) showed an intrasellar lesion with homogeneous hyperintense on T1‐weighted images and T2‐weighted images and inhomogeneous contrast enhancement by the gadolinium administration [Figure 1a and 1b]. Rathke’s cleft cyst was initially diagnosed preoperatively, and the tumor was totally resected by transsphenoidal surgery. Histopathology revealed that granulomatous tissue consisted of cholesterol clefts, lymphoplasmacellular infiltrates, marked hemosiderin deposits, and multinucleated foreign body giant cells around cholesterol clefts [Figure 1e‐1g]. Immunohistochemical staining showed strong positive of CD68, but negative of S100 and SMA [Figure 1h‐1j], which was consistent with a diagnosis of xanthogranuloma of the sellar region. Postoperatively, MRI scans showed that there is no residual tumor [Figure 1c and 1d], and her severe headache was improved rapidly, the endocrine laboratory tests indicated that all the results were within normal limits. The most recent follow‐up MRI was scanned at 36 months postoperatively and there was no sign of tumor recurrence.