# Sellar Lesions: Novel Aspects in Diagnosis and Management

## TL;DR

This review discusses new developments in diagnosing and treating sellar lesions, focusing on molecular biology and improved classification systems.

## Contribution

The paper highlights novel classification systems and molecular insights that enhance diagnosis and treatment of sellar lesions.

## Key findings

- The CNS5 WHO classification integrates genetic data with histopathology to better predict tumor behavior.
- Molecular alterations in sellar lesions serve as diagnostic and prognostic indicators for personalized treatment.
- Advances in molecular biology are leading to new therapeutic targets for aggressive sellar tumors.

## Abstract

Sellar lesions include a wide range of tumors and non-tumor conditions that can be difficult to diagnose and manage. Recent advances in molecular biology have increased our knowledge regarding the mechanisms underpinning pituitary tumorigenesis and proliferation, leading to the development of novel classification systems and diagnostic and treatment modalities. Integration of research data into clinical practice may lead to more accurate diagnosis, better knowledge of the biological behavior of sellar lesions and personalized treatment.

In this comprehensive review, we explore the evolving landscape of research and clinical practices in sellar lesions, emphasizing recent advancements in histopathology and molecular biology. Distinct lesions can arise from the sellar area, predominantly comprising different tumor types, inflammatory conditions, or systemic conditions. The recent CNS5 World Health Organization classification integrates genetic modifications into histopathological characteristics, enhancing the ability to predict the biological behavior and malignant potential of these lesions. Furthermore, the molecular alterations discovered in these tumors may act as valuable diagnostic and prognostic indicators, facilitating a tailored approach, especially for those demonstrating aggressive characteristics resistant to conventional treatments. The scope of the present review is to provide a comprehensive insight into the current understanding of sellar lesions with regard to emerging prognostic factors, like molecular alterations, to advances in clinical strategies, and to identification of potential new therapeutic targets within the oncology field.