Empty sella syndrome

Empty sella syndrome
Classification and external resources
ICD-9-CM 253.8
DiseasesDB 31523
MedlinePlus 000349
MeSH D004652
Empty sella in MRI (T2w sagittal)

Empty sella syndrome (abbreviated ESS) is where the pituitary gland shrinks or becomes flattened,[1] filling the sella turcica, or "Turkish Saddle", with cerebrospinal fluid on imaging instead of the normal pituitary. ESS can be found in the radiological workup of pituitary disorders, or as an incidental finding when imaging the brain.

Classification

There are two types of ESS: primary and secondary.

Associated conditions and diagnosis

ESS may be associated with early onset of puberty, growth hormone deficiency, pituitary tumors, or pituitary gland dysfunction. ESS has also been found to be linked with low testosterone or Hypogonadism in men.

MRI scans are useful in evaluating ESS and differentiating it from other disorders that produce an enlarged sella.

Differential diagnosis

The major differential to consider in empty sella syndrome is intracranial hypertension, of both unknown and secondary causes, and an epidermoid cyst, which can mimic cerebrospinal fluid due to its low density on CT scans, although MRI can usually distinguish the latter diagnosis.[2]

Treatment

Unless the syndrome results in other medical problems, treatment for endocrine dysfunction associated with pituitary malfunction is symptomatic and supportive. In some cases, surgery may be needed.

Prognosis

ESS is not a life-threatening illness.

References

  1. Wisse, Brent (Last reviewed on 11/7/2013). "Empty sella syndrome". University of Maryland Medical Center. Check date values in: |date= (help)
  2. González-Tortosa, J (2009). "Primary empty sella: Symptoms, physiopathology, diagnosis and treatement". Neurocirugia (Asturias, Spain) 20 (2): 132–51. PMID 19448958.

External links

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