Osteochondroma of the Sella Turcica: A Rare Mimic in the Spectrum of Sellar Masses

Abstract Osteochondroma (OC) is the most common benign bone tumor, typically arising from long bones formed through endochondral ossification. Its occurrence within the intracranial cavity is extremely rare, accounting for only 0.1 to 0.2% of all intracranial tumors. Even more exceptional is its presence in the sellar/parasellar region, with only five cases previously reported in the literature. This report describes the sixth known case of a sellar OC in a 30-year-old female who presented with progressive visual loss and bitemporal hemianopia. Radiological investigations revealed a calcified mass in the sellar-suprasellar region, initially suspected to be a calcified pituitary adenoma or chordoma. The patient underwent endoscopic transsphenoidal resection, and histopathological analysis confirmed the diagnosis of OC based on classic features including a hyaline cartilage cap, underlying bone with endochondral ossification, and absence of mitotic activity or nuclear atypia. Postoperatively, the patient showed significant visual improvement and was treated with adjuvant radiotherapy due to the tumor's central location. This case highlights the importance of considering OC in the differential diagnosis of calcified sellar masses and underscores the value of a multidisciplinary approach—including imaging, surgical resection, and histopathological evaluation—in establishing an accurate diagnosis and guiding effective management.