Sellar chondroma in a pediatric patient treated endoscopically: illustrative case.

BACKGROUND: Sellar chondromas are extremely rare benign cartilaginous tumors, representing less than 0.3% of intracranial tumors. Their occurrence in the pediatric population is exceptionally rare and their clinical and radiological presentation frequently mimics that of more common sellar lesions, making preoperative diagnosis particularly challenging.

OBSERVATIONS: The authors present the case of a 16-year-old female patient with a sellar chondroma treated via a transsphenoidal endoscopic approach and adjuvant radiosurgery. The patient presented with headache, bitemporal hemianopsia, and hormonal alterations. Preoperative imaging suggested craniopharyngioma as the leading diagnosis. Subtotal resection was performed due to firm tumor adherence to the medial wall of the right cavernous sinus, and histopathological examination confirmed the diagnosis of chondroma. Adjuvant radiosurgery was subsequently initiated for the residual tumor.

LESSONS: This case highlights the importance of considering sellar chondroma in the differential diagnosis of heterogeneous sellar lesions in the pediatric population even when imaging suggests a more common entity. When gross-total resection is not achievable due to neurovascular involvement, adjuvant radiosurgery represents a safe complementary strategy. Definitive diagnosis relies on histopathological confirmation. https://thejns.org/doi/10.3171/CASE26226.