The authors declare no conflict of interest
Despite the extensive experience gained by neurosurgeons in diagnosis and treatment of the chiasmosellar area disorders, there is still a number of relatively understudied nosologies because of their rarity. These nosologies include cysts of the chiasmosellar area, which make up colloidal cysts, arachnoid cysts, Rathke cleft cysts, epidermoid and dermoid cysts.
The clinical symptoms of neoplasms of the chiasmosellar area are similar, which complicates their differential diagnosis without neuroimaging research methods significantly. But even MRI does not necessarily allow to establish a precise diagnosis. A common situation is when any neoplasm in chiasmosellar area is described by a radiologist as a pituitary adenoma [1]. This is likely to be due to the fact that pituitary adenoma is the most common chiasmosellar area disorder. But this error can lead to a number of intra-surgical problems. Pre-surgical differential diagnosis of chiasmosellar cysts is an important stage in preparation for a surgery, which allows you to determine the surgical approach in advance. Each type of chiasmosellar area cysts has its own particular features of surgical technique, which allow to minimize the recurrences and reduce the complications [2–5].
Knowledge of differential diagnostic features of pituitary adenomas and various types of chiasmosellar area cysts would mitigate the cases of incorrect diagnosis and improve the treatment efficacy.
This study is intended to increase the efficacy of diagnosis of the chiasmosellar area cysts by defining the criteria for their differential diagnosis.
We have reviewed 1,740 case histories of the patients operated with transsphenoidal endoscopic access for neoplasms in the chiasmosellar area in 3 specialized neurosurgical departments of Federal Centres of the Russian Federation. The study enrolled 94 patients from the Neurosurgery Clinic of the Kirov Military Medical Academy, the Neurosurgery Department of the Pavlov First Saint Petersburg State Medical University, and Neurosurgery Department No. 6 of the Almazov National Medical Research Centre in 2009–2018.