Massachusetts General Hospital

Empty Sella Syndrome

What is empty sella syndrome?

Empty sella syndrome (ESS) is characterized by an enlarged bony structure (sella turcica) that houses the pituitary gland at the base of the brain. The pituitary gland may initially appear to be missing when imaging tests of the area are done. In primary ESS, the pituitary gland is usually flattened down along the contours of the sella turcica. It is associated with obesity and high blood pressure in women. Primary ESS may also be associated with a buildup of fluid in the brain. In secondary ESS, the pituitary may be small due to injury, radiation therapy, or surgery.

What are the symptoms of empty sella syndrome?

There may not be any symptoms of empty sella syndrome. Symptoms that may occur include impotence, reduced sexual desire, and irregular menstruation. Symptoms vary from person to person and depend on age and what caused the syndrome.

How is empty sella syndrome diagnosed?

In addition to a complete medical history and medical examination, diagnostic procedures for empty sella syndrome may include:

• Computed tomography (CT or CAT scan). A noninvasive diagnostic procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images of the body to detect any abnormalities that may not show up on an ordinary X-ray.

• Magnetic resonance imaging (MRI). A noninvasive procedure that produces two-dimensional views of an internal organ or structure, especially the brain or spinal cord.

The symptoms of empty sella syndrome may resemble other conditions or medical problems. Always consult your doctor for a diagnosis.

What is the treatment for empty sella syndrome?

Specific treatment for empty sella syndrome will be determined by your doctor based on:

• Your age, overall health, and medical history

• Extent of the disease

• Your tolerance for specific medications, procedures, or therapies

• Expectations for the course of the disease

• Your opinion or preference

If there are no other symptoms, and if the pituitary gland is not enlarged, treatment may not be necessary for empty sella syndrome itself. Attendant hormone deficiencies can be treated with hormone replacement.