Background: The Sellar and parasellar region being small, but is an anatomically complex area which encloses many vital structures and can get involved by diverse pathological lesions such as neoplastic, inflammatory, infectious, developmental and vascular abnormalities. All of them clinically presenting as mass lesions occupying the sellar and/parasellar areas. Unfortunately, many of these tumors lack characteristic imaging features thereby making the histological diagnosis crucial in the management of the patient. This study was done with the aim of knowing the incidence, age group affected and the varied spectrum of conditions which can present as sellar and/ parasellar lesions and to review the cases with respect to latest WHO 2016 classification and to eliminate the differentials. Methods: A 5 year retrospective study was conducted in the Department of Neuropathology, Institute of Neurosurgery/Neurology from January 2014 to December 2018 and CT confirmed cases of sellar and/ parasellar masses were compiled. Results: A total of 158 cases were identified during the study duration which presented as sellar and/ parasellar mass lesions, with a slight female preponderance. The commonest being Pituitary adenoma 92 cases (58.23%) followed by Craniopharyngioma 28 cases (17.72%). The other lesions encountered are: Meningioma, Glial tumors, Pituitary carcinoma and secondary deposits. Of which extremely rare lesions like Pleomorphic xanthoastrocytoma and recurrent pituitary adenoma was also encountered. Non neoplastic lesions such as abscess, Rathke cleft cyst and Xanthogranuloma of sellar region. Conclusion: A wide spectrum of neoplastic and non-neoplastic lesions can present as mass lesions occupying the sellar and parasellar regions knowledge of which is essential. Even rare lesions are possible in these anatomically complex areas. The commonest lesion encountered was Pituitary adenoma followed by non-adenomatous tumors like Craniopharyngioma and Meningioma. Hence one should have a differential of all these lesions while approaching sellar and/ parasellar mass.

Keywords: Sellar; Parasellar; Pituitary adenoma.