The clinical and imaging comparisons between sellar extraventricular neurocytoma and nonfunctional pituitary macroadenoma

We aimed to explore the clinical and imaging features of sellar extraventricular neurocytoma (EVN) through a comparison between sellar EVN and nonfunctional pituitary macroadenoma. 19 cases of EVN and 27 cases of nonfunctional pituitary macroadenoma were retrospectively included, and their clinical and imaging findings were analyzed. Compared with sellar EVNs, nonfunctional pituitary macroadenomas were more common with cystic changes (51.9% vs. 21.1%, P = 0.035), intratumoral hemorrhage (29.6% vs. 0, P = 0.027), and vesicle signs (33.3% vs. 0, P = 0.015). Compared with nonfunctional pituitary macroadenomas, sellar EVNs were common with solid lesions (78.9% vs. 48.1%, P = 0.035), obvious MR enhancement (89.5% vs. 55.6%, P = 0.014), eccentric cavernous sinus involvement (84.2% vs. 44.4%, P = 0.007), and dural tail sign (68.4% vs. 22.2%, P = 0.002). Compared with nonfunctional pituitary macroadenoma, sellar EVN was more common with subtotal resection (37.0% vs. 68.4%, P = 0.036) and postoperative radiotherapy (14.8% vs. 78.9%, P < 0.001). However, there was no significant difference in recurrence and progression-free survival between the two groups, although the gross total resection rate of nonfunctional pituitary macroadenomas was higher (59.3% vs. 21.1%, P = 0.010). Solid lesions with obvious MR enhancement, dural tail sign, and eccentric cavernous sinus involvement could suggest sellar EVN in the condition of negative pituitary hormone. The clinical and imaging comparisons between sellar EVN and nonfunctional pituitary macroadenoma were helpful for clinical diagnosis and treatment.