{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:17:15Z","timestamp":1784557035868,"version":"3.55.0"},"reference-count":11,"publisher":"Bioscientifica","content-domain":{"domain":["edm.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2017,7,7]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>Spontaneous reossification of the sellar floor after transsphenoidal surgery has been rarely reported. Strontium ranelate, a divalent strontium salt, has been shown to increase bone formation, increasing osteoblast activity. We describe an unusual case of a young patient with Cushing\u2019s disease who was treated with strontium ranelate for low bone mass who experienced spontaneous sellar reossification after transsphenoidal surgery. A 21-year-old male presented with Cushing\u2019s features. His past medical history included delayed puberty diagnosed at 16 years, treated with testosterone for 3 years without further work-up. He was diagnosed with Cushing\u2019s disease initially treated with transsphenoidal surgery, which was not curative. The patient did not come to follow-up visits for more than 1 year. He was prescribed strontium ranelate 2\u2009g orally once daily for low bone mass by an outside endocrinologist, which he received for more than 1 year. Two years after first surgery he was reevaluated and persisted with active Cushing\u2019s disease. Magnetic resonance image revealed a left 4\u2009mm hypointense mass, with sphenoid sinus occupation by a hyperintense material. At repeated transsphenoidal surgery, sellar bone had a very hard consistency; surgery was complicated and the patient died. Sellar reossification negatively impacted surgery outcomes in this patient. While this entity is possible after transsphenoidal surgery, it remains unclear whether strontium ranelate could have affected sellar ossification.<\/jats:p>\n                  <jats:sec>\n                    <jats:title>Learning points:<\/jats:title>\n                    <jats:list list-type=\"bullet\">\n                      <jats:list-item>\n                        <jats:p>Delayed puberty can be a manifestation of Cushing\u2019s syndrome. A complete history, physical examination and appropriate work-up should be performed before initiating any treatment.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Sellar reossification should always be taken into account when considering repeated transsphenoidal surgery. Detailed preoperative evaluation of bony structures by computed tomography ought to be performed in all cases of reoperation.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>We speculate if strontium ranelate may have affected bone mineralization at the sellar floor. We strongly recommend that indications for prescribing this drug should be carefully followed.<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:sec>","DOI":"10.1530\/edm-17-0037","type":"journal-article","created":{"date-parts":[[2017,7,7]],"date-time":"2017-07-07T07:35:48Z","timestamp":1499412948000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":0,"title":["Spontaneous reossification of the sella in transsphenoidal reoperation associated with strontium ranelate"],"prefix":"10.1530","volume":"2017","author":[{"given":"Maria Mercedes","family":"Pineyro","sequence":"first","affiliation":[{"name":"1Cl\u00ednica de Endocrinolog\u00eda y Metabolismo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daiana","family":"Arrestia","sequence":"additional","affiliation":[{"name":"1Cl\u00ednica de Endocrinolog\u00eda y Metabolismo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"Elhordoy","sequence":"additional","affiliation":[{"name":"1Cl\u00ednica de Endocrinolog\u00eda y Metabolismo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramiro","family":"Lima","sequence":"additional","affiliation":[{"name":"2Neurocirug\u00eda, Hospital de Cl\u00ednicas, Facultad de Medicina, Universidad de la Rep\u00fablica, Montevideo Uruguay"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saul","family":"Wajskopf","sequence":"additional","affiliation":[{"name":"2Neurocirug\u00eda, Hospital de Cl\u00ednicas, Facultad de Medicina, Universidad de la Rep\u00fablica, Montevideo Uruguay"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raul","family":"Pisabarro","sequence":"additional","affiliation":[{"name":"1Cl\u00ednica de Endocrinolog\u00eda y Metabolismo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Pilar","family":"Serra","sequence":"additional","affiliation":[{"name":"1Cl\u00ednica de Endocrinolog\u00eda y Metabolismo"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"key20170711125525636_bib1","first-page":"390","article-title":"Repair of the sella turcica after transsphenoidal surgery","author":"Spaziante","year":"2005","journal-title":"Schmidek and Sweet\u2019s Operative Neurosurgical Techniques. Indications, Methods and Results"},{"key":"key20170711125525636_bib2","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.bone.2007.08.043","article-title":"Dual effect of strontium ranelate: stimulation of osteoblast differentiation and inhibition of osteoclast formation and resorption in vitro","volume":"42","author":"Bonnelye","year":"2008","journal-title":"Bone"},{"key":"key20170711125525636_bib3","doi-asserted-by":"crossref","first-page":"E582","DOI":"10.1227\/01.NEU.0000261577.25603.DE","article-title":"Suboptimal sphenoid and sellar exposure","volume":"60","author":"Zona","year":"2007","journal-title":"Neurosurgery"},{"key":"key20170711125525636_bib4","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/j.wneu.2015.10.073","article-title":"Bony regeneration of the sella after transsphenoidal pituitary surgery","volume":"88","author":"Yahia-Cherif","year":"2016","journal-title":"World Neurosurgery"},{"key":"key20170711125525636_bib5","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.1359\/JBMR.050405","article-title":"Long-term strontium ranelate administration in monkeys preserves characteristics of bone mineral crystals and degree of mineralization of bone","volume":"20","author":"Farlay","year":"2005","journal-title":"Journal of Bone and Mineral Research"},{"key":"key20170711125525636_bib6","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1007\/s00223-009-9317-8","article-title":"Strontium ranelate enhances callus strength more than PTH 1-34 in an osteoporotic rat model of fracture healing","volume":"86","author":"Habermann","year":"2010","journal-title":"Calcified Tissue International"},{"key":"key20170711125525636_bib7","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1359\/jbmr.071012","article-title":"Histomorphometric and microCT analysis of bone biopsies from postmenopausal osteoporotic women treated with strontium ranelate","volume":"23","author":"Arlot","year":"2008","journal-title":"Journal of Bone and Mineral Research"},{"key":"key20170711125525636_bib8","first-page":"65","article-title":"Strontium ranelate and bone healing: report of two cases.","volume":"7","author":"Tarantino","year":"2010","journal-title":"Clinical Cases in Mineral and Bone Metabolism"},{"key":"key20170711125525636_bib9","first-page":"S123","article-title":"Significance of strontium ranelate in healing of surgically fixed tibial diapyseal fractures treated with strontium ranelate vs placebo; a randomised double blind controlled trial","volume":"64","author":"Aslam","year":"2014","journal-title":"Journal of the Pakistan Medical Association"},{"key":"key20170711125525636_bib10","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1007\/s00198-015-3266-z","article-title":"Strontium ranelate as an adjuvant for fracture healing: clinical, radiological, and ultrasound findings in a randomized controlled study on wrist fractures","volume":"27","author":"Scaglione","year":"2016","journal-title":"Osteoporosis International"},{"key":"key20170711125525636_bib11","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1136\/jnnp-2012-303194","article-title":"Short-term outcome of endoscopic versus microscopic pituitary adenoma surgery: a systematic review and meta-analysis","volume":"84","author":"Ammirati","year":"2013","journal-title":"Journal of Neurology, Neurosurgery, and Psychiatry"}],"container-title":["Endocrinology, Diabetes &amp; Metabolism Case Reports"],"original-title":[],"link":[{"URL":"https:\/\/edm.bioscientifica.com\/view\/journals\/edm\/2017\/1\/EDM17-0037.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/edm.bioscientifica.com\/downloadpdf\/journals\/edm\/2017\/1\/EDM17-0037.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:46:33Z","timestamp":1784555193000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.bioscientifica.com\/edm\/article\/3454"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,7,7]]},"references-count":11,"URL":"https:\/\/doi.org\/10.1530\/edm-17-0037","relation":{},"ISSN":["2052-0573"],"issn-type":[{"value":"2052-0573","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,7,7]]}}}