Giant Intrasellar Arachnoid Cyst Manifesting as Adrenal Insufficiency Due to Hypothalamic Dysfunction-Case Report-

Yasuda, Katsuhiro; Saitoh, Youichi; Okita, Keisuke; Morris, Shayne; Moriwaki, Masamitsu; Miyagawa, Jun‐ichiro; Yoshimine, Toshiki

doi:10.2176/nmc.45.164

Cited by 10 publications

(3 citation statements)

References 15 publications

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“…1,5,6,12,14,16,17,[22][23][24][25][26][27][28][32][33][34] Dietemann and colleagues 5 first described the use of the endoscope to explore the cystic cavity, which lead to the finding of a communication between the cyst and the suprasellar SAS in one of their cases. More recently, Cavallo and colleagues 4 in a multicenter study recognized the role of the endoscope in the transsphenoidal management of sellar cystic lesions.…”

Section: Surgical Management Of Intrasellar Acsmentioning

confidence: 99%

Endonasal management of sellar arachnoid cysts: simple cyst obliteration technique

McLaughlin

Vandergrift

Filho

et al. 2012

JNS

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Sellar ACs can be effectively treated using endonasal fenestration and obliteration with fat with resultant reversal of presenting symptoms in the majority of patients. This simplified technique of AC cavity obliteration without enlarging communication to the SAS has a low risk of CSF leakage, and in most cases appears to effectively disrupt cyst progression, although longer follow-up is required to monitor for cyst recurrence.

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Section: Surgical Management Of Intrasellar Acsmentioning

confidence: 99%

Endonasal management of sellar arachnoid cysts: simple cyst obliteration technique

McLaughlin

Vandergrift

Filho

et al. 2012

JNS

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“…1,2,8,11 Most authors have found that endocrine disorders do not regress postoperatively. 2,11,15 The occurrence of SIADH in association with an SAC in the pediatric population has not been previously described. Hyponatremia has been seen in association with a Rathke cleft cyst; however, it is typically seen with other endocrine disturbances such as hypothalamic dysfunction and precocious puberty.…”

Section: Discussionmentioning

confidence: 99%

Suprasellar arachnoid cyst resulting in the syndrome of inappropriate antidiuretic hormone secretion

Beier

Cheshier

Chakraborty

et al. 2010

PED

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The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is occasionally seen after hypothalamic injury or dysfunction, although it typically occurs in association with other endocrine disturbances. It is has never been described as a presenting feature of a suprasellar arachnoid cyst (SAC) in the pediatric population. The authors describe the case of an enlarging SAC resulting in SIADH as the only presenting feature, with an otherwise normal hypothalamic-pituitary axis. An SAC was diagnosed in utero in this 5-month-old girl who had a normal functioning hypothalamic-pituitary axis on presentation. Because of cyst enlargement and hydrocephalus, the patient was scheduled for surgery; however, preoperative labs revealed SIADH. After stabilizing the serum sodium concentration with fluid restriction and the administration of 3% sodium chloride, the patient underwent endoscopic cyst fenestration. Postoperatively, she had complete resolution of the SIADH. Syndrome of inappropriate antidiuretic hormone secretion as the presenting symptom of an SAC has not been previously described. In the aforementioned patient, the proposed mechanism for SIADH was enlargement of the suprasellar arachnoid cyst causing compression of the supraoptic and paraventricular nuclei and thus overstimulating the secretion of arginine vasopressin, which resulted in SIADH. The association of SIADH with an SAC is reportable, as is the resolution of the SIADH via cyst fenestration. The authors suggest that SIADH is an uncommon presenting feature of SACs and that syndrome resolution is possible with cyst decompression.

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“…[33] e clinical presentation of 128 cases with sellar/suprasellar ACs is summarized in Table 2. [4][5][6][7]9,[11][12][13][14]16,21,22,[25][26][27][28][31][32][33][34]37,38,[40][41][42]44,45,[47][48][49] e 50 males and 66 females were aged 16-80. Headache 44 patients and visual disturbance 78 patients were the complaints of most patients.…”

Section: Improved Visual Acuitymentioning

confidence: 99%

Endoscopic transnasal transsphenoidal management of sellar/suprasellar arachnoid cyst: A case report and literature review

Matmusaev

Watanabe

Iwami

et al. 2023

Surgical Neurology International

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Background: Arachnoid cysts (ACs) are collections of cerebrospinal fluids (CSFs) that develop within the arachnoid layer of the meninges. Sellar ACs are comparatively rare. In general, ACs account for approximately 1% of all intracranial mass lesions, and sellar ACs are 3% of all intracranial ACs. An endoscopic transnasal transsphenoidal approach for the treatment of ACs by fenestrating the cyst’s wall and connecting with the subarachnoid space is the most optimal option. Case Description: A 74-year-old woman whose sellar AC was diagnosed on magnetic resonance imaging a year ago was admitted to our hospital with complaints of bitemporal hemianopia and diminished visual acuity in the past 2 months. Sellar AC was diagnosed based on the clinical history and presentation, as well as neurologic, endocrinologic, and ophthalmologic examinations, including visual acuity and visual field examination, and additional imaging findings. The patient with a sellar/suprasellar AC was treated by an endoscopic transnasal transsphenoidal approach with cyst drainage and perforation of the lamina terminalis. Postoperatively, the visual disturbances improved markedly. No surgery-related complications occurred. Conclusion: The endoscopic transnasal transsphenoidal approach remains a minimally invasive and preferred approach for the treatment of sellar/suprasellar ACs. Hermetically reconstructing the sellar floor is an effective method to prevent CSF leakage.

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Giant Intrasellar Arachnoid Cyst Manifesting as Adrenal Insufficiency Due to Hypothalamic Dysfunction-Case Report-

Cited by 10 publications

References 15 publications

Endonasal management of sellar arachnoid cysts: simple cyst obliteration technique

Endonasal management of sellar arachnoid cysts: simple cyst obliteration technique

Suprasellar arachnoid cyst resulting in the syndrome of inappropriate antidiuretic hormone secretion

Endoscopic transnasal transsphenoidal management of sellar/suprasellar arachnoid cyst: A case report and literature review

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