Abstract
Objective and Importance:: Epidermoid cysts are fairly uncommon lesions that have a maldevelopmental origin and are thought to arise from trapped surface ectodermal elements. These cysts are usually located in the subarachnoid spaces, typically in the cerebellopontine angle. Many unusual locations have been reported; however, to our knowledge this is the first described case of an epidermoid cyst arising in the pituitary stalk. Clinical Presentation:: The patient is a 27-year-old woman with a 2-year history of amenorrhea, galactorrhea, and secondary polyuria and polydipsia. A preoperative magnetic resonance imaging study showed a lesion extending from the upper part of the sella to the suprasellar region (up to the chiasm) with inhomogenous signals in both T1 and T2 images. Intervention:: The cyst was partially resected through an endonasal trans-sphenoidal extended endoscopic approach by a multidisciplinary team [neurosurgeons and ear nose throat (ENT) surgeons]. The postoperative course was uneventful. The histologic examination disclosed a squamous epithelium and the presence of dry keratinous debris, establishing the epidermoid nature of the lesion. Conclusions:: Surgical removal is the treatment of choice of symptomatic epidermoid cysts. In this unusual presentation (intrasellar/suprasellar) the authors preferred an endonasal trans-sphenoidal extended endoscopic approach. However, as in almost every case of epidermoid cyst, the adherence between the capsule of the lesion and neurovascular structures made complete removal of the cyst walls impossible.
| Original language | English |
|---|---|
| Pages (from-to) | 108-111 |
| Number of pages | 4 |
| Journal | Neurosurgery Quarterly |
| Volume | 23 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - May 2013 |
Fingerprint
Keywords
- Cyst
- Endoscopy
- Epidermoid tumor
- Pituitary dysfunction
- Pituitary stalk
ASJC Scopus subject areas
- Clinical Neurology
- Surgery
Cite this
Epidermoid cyst of the pituitary stalk : Case report and review of the literature. / Costa, Francesco; Fornari, Maurizio; Felisati, Giovanni; Maccari, Alberto; Bauer, Dario; Lasio, Giovanni.
In: Neurosurgery Quarterly, Vol. 23, No. 2, 05.2013, p. 108-111.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Epidermoid cyst of the pituitary stalk
T2 - Case report and review of the literature
AU - Costa, Francesco
AU - Fornari, Maurizio
AU - Felisati, Giovanni
AU - Maccari, Alberto
AU - Bauer, Dario
AU - Lasio, Giovanni
PY - 2013/5
Y1 - 2013/5
N2 - Objective and Importance:: Epidermoid cysts are fairly uncommon lesions that have a maldevelopmental origin and are thought to arise from trapped surface ectodermal elements. These cysts are usually located in the subarachnoid spaces, typically in the cerebellopontine angle. Many unusual locations have been reported; however, to our knowledge this is the first described case of an epidermoid cyst arising in the pituitary stalk. Clinical Presentation:: The patient is a 27-year-old woman with a 2-year history of amenorrhea, galactorrhea, and secondary polyuria and polydipsia. A preoperative magnetic resonance imaging study showed a lesion extending from the upper part of the sella to the suprasellar region (up to the chiasm) with inhomogenous signals in both T1 and T2 images. Intervention:: The cyst was partially resected through an endonasal trans-sphenoidal extended endoscopic approach by a multidisciplinary team [neurosurgeons and ear nose throat (ENT) surgeons]. The postoperative course was uneventful. The histologic examination disclosed a squamous epithelium and the presence of dry keratinous debris, establishing the epidermoid nature of the lesion. Conclusions:: Surgical removal is the treatment of choice of symptomatic epidermoid cysts. In this unusual presentation (intrasellar/suprasellar) the authors preferred an endonasal trans-sphenoidal extended endoscopic approach. However, as in almost every case of epidermoid cyst, the adherence between the capsule of the lesion and neurovascular structures made complete removal of the cyst walls impossible.
AB - Objective and Importance:: Epidermoid cysts are fairly uncommon lesions that have a maldevelopmental origin and are thought to arise from trapped surface ectodermal elements. These cysts are usually located in the subarachnoid spaces, typically in the cerebellopontine angle. Many unusual locations have been reported; however, to our knowledge this is the first described case of an epidermoid cyst arising in the pituitary stalk. Clinical Presentation:: The patient is a 27-year-old woman with a 2-year history of amenorrhea, galactorrhea, and secondary polyuria and polydipsia. A preoperative magnetic resonance imaging study showed a lesion extending from the upper part of the sella to the suprasellar region (up to the chiasm) with inhomogenous signals in both T1 and T2 images. Intervention:: The cyst was partially resected through an endonasal trans-sphenoidal extended endoscopic approach by a multidisciplinary team [neurosurgeons and ear nose throat (ENT) surgeons]. The postoperative course was uneventful. The histologic examination disclosed a squamous epithelium and the presence of dry keratinous debris, establishing the epidermoid nature of the lesion. Conclusions:: Surgical removal is the treatment of choice of symptomatic epidermoid cysts. In this unusual presentation (intrasellar/suprasellar) the authors preferred an endonasal trans-sphenoidal extended endoscopic approach. However, as in almost every case of epidermoid cyst, the adherence between the capsule of the lesion and neurovascular structures made complete removal of the cyst walls impossible.
KW - Cyst
KW - Endoscopy
KW - Epidermoid tumor
KW - Pituitary dysfunction
KW - Pituitary stalk
UR - http://www.scopus.com/inward/record.url?scp=84877727134&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84877727134&partnerID=8YFLogxK
U2 - 10.1097/WNQ.0b013e318266c267
DO - 10.1097/WNQ.0b013e318266c267
M3 - Article
VL - 23
SP - 108
EP - 111
JO - Neurosurgery Quarterly
JF - Neurosurgery Quarterly
SN - 1050-6438
IS - 2
ER -