Among skull base chordomas, a pure intrasellar chordoma is uncommon and is thought to have originated from an ectopic embryological notochord in the Sella turcica. Considering its unique case and vague side effects, clinicians may misdiagnose intrasellar chordoma as pituitary adenoma in view of preoperative radiographic pictures. In this report, we present an intrasellar chordoma that clinically mirrored pituitary macroadenoma with hyper prolactinemia and hypopituitarism and was effectively resected by endoscopic endonasal transsphenoidal medical procedure. The radiographic characteristics of this case suggest chordoma in sellar lesions. While the high signal on T2-weighted images and heterogeneous enhancement typically suggested chordoma, the enlarged sellar with thinned remodeled bone and no clival destruction was the first thing that came to mind. This uncommon diagnosis must be taken into account when evaluating sellar lesions before surgery because it can affect how the neurosurgeon prepares for surgery and the goals of the surgery. A 60-year-old woman presented with a progressive visual disturbance that lasted for two years. Although a blood test reveals elevated prolactin and decreased free thyroxin levels, the patient exhibited no symptoms or signs related to pituitary hormone. A huge, cavernous, partially thrombosed right carotid aneurysm compressed the sella turcica significantly, according to neuroimaging. The right cervical internal carotid artery was ligated using double anastomoses of the right superficial temporal artery and middle cerebral artery to treat the aneurysm. On postoperative day 6, when aneurysmal mass effects were temporarily increased on neuroimages and associated with hypocortisolism and hyponatremia, the patient experienced headache, general fatigue, chills, and hypoactivity. The aneurysm shrank and pituitary hormone values were normalized, with the exception of prolactin, eight months after surgery, which led to the tapering off of hydrocortisone, which improved the symptoms. ICA aneurysm-associated hypopituitarism is uncommon. Only seven of the 4087 hypopituitary patients had ICA aneurysms that extended to the sellar region. The destruction or mechanical compression of the adenohypophysis, hypothalamus, or pituitary stalk by an expanding mass lesion and/or the disruption of the microvascular blood supply to the pituitary gland are thought to be the causes of pituitary endocrine derangement. ICA aneurysms in the parasellum. Systemic organs are affected by immune checkpoint inhibitor-related adverse events; Endocrine disorders are thought to affect 3.8–29% of people. However, the prevalence of pituitary disorders is lower than that of thyroid disorders. A 42-year-old male patient with recurrent oropharyngeal squamous cell carcinoma began receiving treatment with nivolumab. He experienced severe malaise after four months, and blood tests revealed decreased levels of cortisol and adrenocorticotropic hormone. Pituitary-adrenal insufficiency was diagnosed based on the aforementioned findings, and glucocorticoid replacement therapy was started. The symptoms immediately improved as a result. Glucocorticoid replacement therapy is still being used to treat the patient right now. All cancer patients experience malaise as a symptom; since it is not a typical symptom of endocrine disorders, we typically disregard it. However, the onset of endocrine disorders is always suspected when an ICI is used, and hormone tests should be quickly added if necessary. Even if anti-tumor efficacy with continued ICI treatment is poor, accurate diagnosis of immune-related adverse events and prompt treatment initiation are beneficial to the patient. Occipital neuralgia is a difficult condition influencing the back scalp in the dispersions of the more prominent occipital nerve, lesser occipital nerve, third occipital nerve or a mix of the three. Scalp masses that originate from neural components can cause occipital neuralgia, but their incidence is low and preoperative diagnosis may be challenging. There is a class of benign tumors of the peripheral nerves that derive from Schwann cells. We describe a rare occipital neuralgia-causing GON schwannoma. A 52-year-old Chinese woman presented with no other symptoms and six months of daily headaches, mostly in the left occipital region

With Regards,
Sara Giselle
Associate Managing Editor
 Journal of Medical Physics and Applied Sciences