Giant sellar metastasis from renal cell carcinoma A case report and literature review

Rationale: Sellar metastasis is a rare and complex disease whose clinical features are strongly associated with the primary malignancy. Here, we present a rare case of giant sellar metastasis spread from renal cell carcinoma (RCC). Patient concerns: A 30-year-old Chinese woman was admitted to our Hospital, reporting headache, nasal congestion, nausea, vomiting, and a sharp decline in her right eye vision. Diagnoses: Brain magnetic resonance imaging (MRI) revealed an invasive sellar mass with cavernous sinus and nasal cavity extension. Additionally, the patient had a medical history of right radical nephrectomy for clear-cell RCC. Interventions: The patient underwent a successful subtotal resection of the tumor. Final pathological diagnosis confirmed sellar metastasis from RCC. After surgery, the patient was referred to our medical oncology department and received further systemic therapy. Outcomes: No light perception remained in her right eye even after prompt surgical decompression. Follow-up MRI showed subtotal resection of the giant sellar metastasis. Lesson: Sellar metastasis, although rare, should be particularly considered for elderly patients with deteriorating visual function and medical histories of cancer.