Tuberculum sellae meningioma

Tuberculum sellae meningiomas arise from the dura of the tuberculum sellae, the bony ridge in front of the pituitary fossa, and often extend onto the planum sphenoidale, into the optic canals or around the anterior clinoid processes.

Because they grow beneath the optic nerves and chiasm, the classic presentation is gradual, often asymmetric, visual loss or visual field defects. Improving or preserving vision is a central goal of surgery.

They can be removed through a transcranial route (such as pterional, supraorbital or bifrontal approaches) or an endoscopic endonasal route. The choice depends on tumor size, lateral extension, optic canal invasion and encasement of arteries, and each route carries a different profile of visual, endocrine and CSF leak risk.