Incidentally detected sellar spine in a patient with Cushing’s syndrome: a case report

• Published in: Journal of international medical research Vol. 48; no. 7; p. 300060520940159
• Main Authors: Lee, Hyo-jae, Lee, Yun Young, Baek, Byung Hyun, Yoon, Woong, Kim, Seul Kee
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.07.2020; Sage Publications Ltd; SAGE Publishing
• Subjects: Adenoma; Adrenocorticotropic Hormone; Adult; Case Report; Case reports; Cushing Syndrome - complications; Cushing Syndrome - diagnostic imaging; Female; Humans; Magnetic Resonance Imaging; Petrosal Sinus Sampling; Pituitary Neoplasms; exploratory surgery; inferior petrosal sinus sampling; sellar magnetic resonance imaging; Cushing’s syndrome; pituitary adenoma; Sellar spine
• ISSN: 0300-0605; 1473-2300
• DOI: 10.1177/0300060520940159

Sellar spine, a bony spur extending anteriorly from the dorsum sellae, is a very rare anatomical variant. Several hypotheses regarding its etiology have been proposed, including the strongly supported theory of a cephalic ossified notochordal remnant. Sellar spine is usually detected incidentally in patients who have no definite symptoms, but several cases have reportedly accompanied endocrinopathies such as precocious puberty, hypopituitarism, or galactorrhea/oligomenorrhea. However, no published reports have described sellar spine in a patient with Cushing’s syndrome. We herein report a case of sellar spine detected during the evaluation of Cushing’s disease in a 29-year-old woman who underwent inferior petrosal sinus sampling, computed tomography, magnetic resonance imaging, and exploratory surgery. There was no evidence of a pituitary microadenoma, but a sellar spine was present in the operative field. Thus, the sellar spine might have caused Cushing’s syndrome in this case, although the exact mechanism is unknown.