Extracellular Vesicle-Mediated Communication in Sellar Tumors: A Conceptual and Translational Framework.

Sellar tumors, including pituitary neuroendocrine tumors (PitNETs), craniopharyngiomas, and rare malignant entities, represent a heterogeneous group of lesions characterized by complex interactions within the tumor microenvironment (TME). In recent years, extracellular vesicles (EVs) have emerged as key mediators of intercellular communication, playing a crucial role in tumor progression, invasion, and therapeutic resistance across multiple cancer types. Despite growing interest in EV biology, their role in sellar tumors remains poorly defined due to limited direct experimental evidence. This review provides a conceptual and translational framework for understanding EV-mediated communication in the context of sellar region tumors. We summarize current knowledge on EVs biogenesis, molecular cargo, and mechanisms of uptake, and discuss how these vesicles may influence tumor behavior through modulation of proliferation, angiogenesis, extracellular matrix (ECM) remodeling, and immune responses. Particular attention is given to PitNETs and craniopharyngiomas, integrating available evidence with insights derived from related tumor models. We further explore the potential of EVs as minimally invasive biomarkers and therapeutic tools and highlight the major technical and biological challenges that currently limit clinical translation. By identifying key knowledge gaps and future research directions, this review aims to guide further investigation into the role of EVs in sellar tumor biology.