Abstract
Disclosure: C. Rizk: None. G. Sydney: None. P. Gopal: None. S. Omay: None. P. Balasubramanian: None.
Background: Ectopic salivary tissue within the sella is rare and mostly asymptomatic. Preoperative diagnosis is often challenging as they mimic pituitary neoplasms and the diagnosis is typically made after resection or biopsy. We present a case of ectopic intrasellar salivary gland tissue confirmed on histopathology in a patient who was presumed to have a meningioma on her initial imaging performed for the evaluation of headache. Case Presentation: A 61-year-old female presented with 4 month history of severe bifrontal headache and bilateral upper extremity weakness. Brain MRI was performed revealing a 2.8 x 2.6 x 1.9 cm mass along the left petroclival region extending into the sella, and into the left cavernous sinus with deviation of the pituitary stalk. The MR imaging characteristics were consistent with meningioma. Endocrine biochemical evaluation was unremarkable. Given the discordance between the patient’s clinical presentation and imaging characteristics and the short duration of her symptoms, endoscopic endonasal biopsy of the sellar lesion was performed for a definitive diagnosis. Histopathology was consistent with benign seromucinous salivary gland tissue with chronic inflammatory infiltrate. To rule out metastatic disease, DOTATATE PET scan was done which showed tracer uptake within the sella and the left cavernous sinus but no other abnormality. The patient was managed conservatively with improvement in her symptoms, and the lesion has remained stable on serial MRI imaging over the last one year. Conclusion: Ectopic salivary gland tissue in the sellar region is a rare finding and is typically asymptomatic. When symptoms do occur, they are often attributed to leakage of glandular secretions leading to localized inflammation. In uncommon instances, larger lesions may cause endocrine disturbances, including hyperprolactinemia or growth hormone deficiency. Definitive diagnosis generally relies on histopathological evaluation, and the overall prognosis is excellent.
Presentation: Sunday, July 13, 2025