{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:55:44Z","timestamp":1790729744486,"version":"4.1.0"},"reference-count":16,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"13","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,9,28]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Visual dysfunction related to sellar lesions is usually attributed to chronic compression of the optic chiasm, typically following an insidious, progressive course. Abrupt or disproportionately rapid visual failure should therefore prompt careful evaluation for alternative or additional mechanisms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 69-year-old woman experienced progressive visual deterioration over 3 months, followed by near-complete bilateral visual loss within 1 week. Visual field testing showed severe bilateral generalized depression. Dedicated sellar enhanced MRI revealed a large sellar-suprasellar mass compressing the optic chiasm. In addition to mass effect, contrast-enhanced images demonstrated optic tract enhancement and avid leptomeningeal enhancement, raising concern for spread along the optic tracts and meningeal dissemination beyond the primary sellar-suprasellar region. Axial fluid-attenuated inversion recovery sequences further showed bilateral optic tract hyperintensity with signal abnormalities extending to the adjacent hypothalamic structures. The patient underwent endoscopic transsphenoidal tumor resection. Pathological examination confirmed aggressive B-cell lymphoma (CD20+, CD79a+, CD5+, Ki-67 index 90%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>This case emphasizes that, in sellar lesions presenting with rapidly progressive visual loss, radiological assessment should extend beyond the sellar mass and optic chiasm to include the optic tracts and adjacent postchiasmatic visual pathway.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE26610\">https:\/\/thejns.org\/doi\/10.3171\/CASE26610<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case26610","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:03:26Z","timestamp":1790121806000},"source":"Crossref","is-referenced-by-count":0,"title":["Bilateral visual failure with optic tract involvement in sellar-suprasellar lymphoma: illustrative case"],"prefix":"10.3171","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4413-8362","authenticated-orcid":true,"given":"Xiao-Yi","family":"Guo","sequence":"first","affiliation":[{"name":"Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9720-738X","authenticated-orcid":true,"given":"Yijun","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Center of Pituitary Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"12","key":"bib1","series-title":"Eye (Lond)","first-page":"2279","article-title":"Neuro-ophthalmic evaluation and management of pituitary disease","volume":"38","author":"Wang","year":"2024","unstructured":"Wang MTMMeyer JADanesh-Meyer HV.Neuro-ophthalmic evaluation and management of pituitary disease. Eye (Lond). 2024;38(12):2279-2288. doi:10.1038\/s41433-024-03187-x"},{"issue":"5","key":"bib2","series-title":"J Clin Endocrinol Metab","first-page":"1431","article-title":"Pituitary MRI standard and advanced sequences: role in the diagnosis and characterization of pituitary adenomas","volume":"107","author":"Gadelha","year":"2022","unstructured":"Gadelha MRBarbosa MALamback EBWildemberg LEKasuki LVentura N.Pituitary MRI standard and advanced sequences: role in the diagnosis and characterization of pituitary adenomas. J Clin Endocrinol Metab. 2022;107(5):1431-1440. doi:10.1210\/clinem\/dgab901"},{"key":"bib3","series-title":"World Neurosurg","first-page":"e862","article-title":"Clinical significance of tumor-related edema of optic tract affecting visual function in patients with sellar and suprasellar tumors","volume":"132","author":"Ju","year":"2019","unstructured":"Ju DGJeon CKim KHClinical significance of tumor-related edema of optic tract affecting visual function in patients with sellar and suprasellar tumors. World Neurosurg. 2019;132:e862-e868. doi:10.1016\/j.wneu.2019.07.218"},{"issue":"2","key":"bib4","series-title":"J Neurooncol","first-page":"339","article-title":"Primary central nervous system lymphoma involving the hypothalamic-pituitary axis: a case series and pooled analysis","volume":"147","author":"Shin","year":"2020","unstructured":"Shin DWKim JHKim YHCho YHHong SH.Primary central nervous system lymphoma involving the hypothalamic-pituitary axis: a case series and pooled analysis. J Neurooncol. 2020;147(2):339-349. doi:10.1007\/s11060-020-03422-x"},{"key":"bib5","series-title":"J Clin Endocrinol Metab","first-page":"dgaf620","article-title":"Hypothalamic-pituitary axis involvement in primary central nervous system lymphoma: a systematic review","author":"Sager-La Ganga","year":"2025","unstructured":"Sager-La Ganga CNavas-Moreno VSebasti\u00e1n-Valles FCannata-Ortiz JMarazuela M.Hypothalamic-pituitary axis involvement in primary central nervous system lymphoma: a systematic review. J Clin Endocrinol Metab. 2025:dgaf620. doi:10.1210\/clinem\/dgaf620"},{"key":"bib6","series-title":"Neuropsychiatr Dis Treat","first-page":"733","article-title":"Secondary central nervous system lymphoma: spectrum of morphological MRI appearances","volume":"14","author":"Malikova","year":"2018","unstructured":"Malikova HBurghardtova MKoubska EMandys VKozak TWeichet J.Secondary central nervous system lymphoma: spectrum of morphological MRI appearances. Neuropsychiatr Dis Treat. 2018;14:733-740. doi:10.2147\/ndt.S157959"},{"issue":"8","key":"bib7","series-title":"Jpn J Radiol","first-page":"789","article-title":"Imaging of pituitary tumors: an update with the 5th WHO classifications\u2014part 1. Pituitary neuroendocrine tumor (PitNET)\/pituitary adenoma","volume":"41","author":"Tsukamoto","year":"2023","unstructured":"Tsukamoto TMiki Y.Imaging of pituitary tumors: an update with the 5th WHO classifications\u2014part 1. Pituitary neuroendocrine tumor (PitNET)\/pituitary adenoma. Jpn J Radiol. 2023;41(8):789-806. doi:10.1007\/s11604-023-01400-7"},{"issue":"6","key":"bib8","series-title":"Insights Imaging","first-page":"753","article-title":"Pituitary apoplexy: an update on clinical and imaging features","volume":"5","author":"Boellis","year":"2014","unstructured":"Boellis Adi Napoli ARomano ABozzao A.Pituitary apoplexy: an update on clinical and imaging features. Insights Imaging. 2014;5(6):753-762. doi:10.1007\/s13244-014-0362-0"},{"issue":"2","key":"bib9","series-title":"J Neurosurg","first-page":"318","article-title":"Rathke cleft cyst apoplexy: a newly characterized distinct clinical entity","volume":"114","author":"Chaiban","year":"2011","unstructured":"Chaiban JTAbdelmannan DCohen MSelman WRArafah BM.Rathke cleft cyst apoplexy: a newly characterized distinct clinical entity. J Neurosurg. 2011;114(2):318-324. doi:10.3171\/2010.5.Jns091905"},{"key":"bib10","series-title":"Front Neurol","first-page":"1219372","article-title":"Case report: ruptured internal carotid artery fusiform aneurysm mimicking pituitary apoplexy after stereotactic radiosurgery","volume":"14","author":"Wang","year":"2023","unstructured":"Wang PWChung MHFeng SWCase report: ruptured internal carotid artery fusiform aneurysm mimicking pituitary apoplexy after stereotactic radiosurgery. Front Neurol. 2023;14:1219372. doi:10.3389\/fneur.2023.1219372"},{"key":"bib11","series-title":"World Neurosurg","first-page":"e393","article-title":"Optico-chiasmatic distortions in pituitary adenomas: correlation between postoperative morphological reversal and follow-up functional visual recovery","volume":"191","author":"Sarkar","year":"2024","unstructured":"Sarkar SThakar SSunil AAlle PAryan SHegde AS.Optico-chiasmatic distortions in pituitary adenomas: correlation between postoperative morphological reversal and follow-up functional visual recovery. World Neurosurg. 2024;191:e393-e402. doi:10.1016\/j.wneu.2024.08.136"},{"issue":"suppl 1","key":"bib12","series-title":"Neurooncol Adv","first-page":"i40","article-title":"Nuances in visual rehabilitation after pituitary surgery","volume":"7","author":"Gupta","year":"2025","unstructured":"Gupta SBi WL.Nuances in visual rehabilitation after pituitary surgery. Neurooncol Adv. 2025;7(suppl 1):i40-i47. doi:10.1093\/noajnl\/vdae087"},{"key":"bib13","series-title":"Front Endocrinol (Lausanne)","first-page":"1479442","article-title":"A clinical practical model for preoperative prediction of visual outcome for pituitary adenoma patients in a retrospective and prospective study","volume":"15","author":"Zheng","year":"2024","unstructured":"Zheng ZWang HChen QA clinical practical model for preoperative prediction of visual outcome for pituitary adenoma patients in a retrospective and prospective study. Front Endocrinol (Lausanne). 2024;15:1479442. doi:10.3389\/fendo.2024.1479442"},{"issue":"4","key":"bib14","series-title":"Int J Surg","first-page":"896","article-title":"Preoperative volume of the optic chiasm is an easily obtained predictor for visual recovery of pituitary adenoma patients following endoscopic endonasal transsphenoidal surgery: a cohort study","volume":"109","author":"Zhang","year":"2023","unstructured":"Zhang YChen CHuang WPreoperative volume of the optic chiasm is an easily obtained predictor for visual recovery of pituitary adenoma patients following endoscopic endonasal transsphenoidal surgery: a cohort study. Int J Surg. 2023;109(4):896-904. doi:10.1097\/js9.0000000000000357"},{"issue":"8","key":"bib15","series-title":"J Clin Neurosci","first-page":"873","article-title":"Blindness following pituitary apoplexy: timing of surgery and neuro-ophthalmic outcome","volume":"15","author":"Muthukumar","year":"2008","unstructured":"Muthukumar NRossette DSoundaram MSenthilbabu SBadrinarayanan T.Blindness following pituitary apoplexy: timing of surgery and neuro-ophthalmic outcome. J Clin Neurosci. 2008;15(8):873-879. doi:10.1016\/j.jocn.2007.08.010"},{"issue":"3","key":"bib16","series-title":"J Neurooncol","first-page":"469","article-title":"The role of intervention timing and treatment modality in visual recovery following pituitary apoplexy: a systematic review and meta-analysis","volume":"170","author":"Brown","year":"2024","unstructured":"Brown NJPatel SGendreau JAbraham ME.The role of intervention timing and treatment modality in visual recovery following pituitary apoplexy: a systematic review and meta-analysis. J Neurooncol. 2024;170(3):469-482. doi:10.1007\/s11060-024-04717-z"}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/12\/13\/article-CASE26610.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/12\/13\/article-CASE26610.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/12\/13\/article-CASE26610.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:01:33Z","timestamp":1790726493000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/12\/13\/article-CASE26610.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,28]]},"references-count":16,"journal-issue":{"issue":"13"},"URL":"https:\/\/doi.org\/10.3171\/case26610","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,28]]}}}