Intrasellar epidermoid cyst

Boggan, James E.; Davis, Richard L.; Zorman, Greg; Wilson, Charles B.

doi:10.3171/jns.1983.58.3.0411

Cited by 20 publications

(7 citation statements)

References 26 publications

(5 reference statements)

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“…They most commonly arise as extradural lesions or as intracerebral masses in the region of the cerebellopontine angle, but they may also present in the sellar and parasellar region. 9,40,76,91,99,107 Epidermoid cysts often arise in a paramedian location, in contrast to typically midline dermoid cysts. 91 Sellar and parasellar epidermoid tumors make up only 0.2-0.7% of major trans sphenoidal series.…”

Section: Typical Histopathological Features Of Rccsmentioning

confidence: 99%

Craniopharyngioma and other cystic epithelial lesions of the sellar region: a review of clinical, imaging, and histopathological relationships

Zada¹,

Lin²,

Ojerholm³

et al. 2010

FOC

229

182

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Object Cystic epithelial masses of the sellar and parasellar region may be difficult to differentiate on a clinical, imaging, or even histopathological basis. The authors review the developmental relationships and differentiating features of various epithelial lesions of the sellar region. Methods The authors performed a review of the literature to identify previous studies describing the etiological relationships and differentiating features of various cystic sellar lesions, including craniopharyngioma (CP), Rathke cleft cyst, xanthogranuloma, and dermoid and epidermoid cysts. Results There is significant evidence in the literature to support a common ectodermal origin of selected sellar and suprasellar cystic lesions, which may account for the overlap of features and transitional states observed in some cases. Research obtained from animal studies and reports of transitional cystic epithelial masses or lesions crossing over from typical to more aggressive pathological subtypes have collectively provided a solid foundation for this theory. Histological features that signify transitional entities beyond simple benign Rathke cleft cysts include squamous metaplasia, stratified squamous epithelium, and ciliated or mucinous goblet cells in squamous-papillary CPs. Several studies have identified key clinical, imaging, and histopathological features that can be used in the differentiation of these lesions. Conclusions The pattern of embryological formation of the hypothalamic-pituitary axis plays a major role in its propensity for developing cystic epithelial lesions. Subsequent inflammatory, metaplastic, and neoplastic processes may promote further progression along the pathological continuum, ranging from benign epithelial cysts to aggressive neoplastic cystic CPs. Selected clinical, imaging, and histopathological features can be used collectively to help differentiate these lesions and assign a formal diagnosis, thus accurately guiding further treatment.

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Section: Typical Histopathological Features Of Rccsmentioning

confidence: 99%

Craniopharyngioma and other cystic epithelial lesions of the sellar region: a review of clinical, imaging, and histopathological relationships

Zada¹,

Lin²,

Ojerholm³

et al. 2010

FOC

229

182

View full text Add to dashboard Cite

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“…Mature teratoma are more frequently solid masses constituted by cartilaginous tissue, sebaceous gland, and mature dermis and epidermis. [4][5][6]10,15,21,24,25 The curative treatment for sellar ECs is gross total surgical removal by transsphenoidal approach, but the presence ofdense adherence of the lesion to the adjacent structures can limit the complete resection of the cyst. [2][3][4]8,16,25 The most common postoperative complications are diabetes insipidus, endocrine disturbances, and chemical meningitis, due to leakage of keratin into the cerebral spinal fluid (CSF) pathways.…”

Section: Discussionmentioning

confidence: 99%

Physiopathological Aspects of Sellar Epidermoid Cyst Determining Endocrine Disturbances: A Case Report

et al. 2019

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Epidermoid cysts (ECs) of the central nervous system (CNS) constitute benign circumscribed lesions that are more common in lateral than in midline sites. Epidermoid cysts of the CNS arise more frequently in the cerebellopontine angle, around the pons, near the sella, within the temporal lobe, in the diploe, and in the spinal canal. Most common tumoral lesion of sellar region is pituitary adenoma, and sellar cystic epithelial masses may be difficult to differentiate based only on clinical and imaging findings. Epidermoid cysts are covered by keratinized squamous epithelium and are usually filled with keratin lamellae. The process is, for the most part, maldevelopmental in origin, presumably arising from trapped surface ectodermal elements in association with the developing CNS during the closure of the neural groove or formation of the secondary cerebral vesicles. In the present study, the authors describe a case of sellar epidermoid cyst producing endocrine alterations and visual disturbance in a 35 years woman, and review the physiopathological and diagnostic criteria of this lesion.

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“…Some of these rests present with cornification and keratohyalin typical of epidermoid tumors and metaplasia of anterior hypophyseal cell is very likely to be the source. 7 …”

Section: Discussionmentioning

confidence: 99%

Cholesteatoma in the Sellar Region Presenting as Hypopituitarism and Diabetes Insipidus

Kong

et al. 2016

Medicine

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Clinically significant sellar cysts unrelated to pituitary adenomas are uncommon. Intracranial cholesteatomas are also rare and are most common in the middle ear and mastoid region. We report an even rarer case of cholesteatoma in the sellar region—a challenging diagnosis guided by clinical presentations, radiological signs, and biopsy, aiming at emphasize the importance of considering cholesteatoma when making differential diagnoses of sellar lesions.We present a case of cholesteatoma in the sellar region in a 56-year-old man with hypopituitarism, diabetes insipidus, and cystic imaging findings. It was difficult to make an accurate diagnosis before surgery. We present detailed analysis of the patient's disease course and review pertinent literature.The patient underwent a surgical exploration and tumor resection through a transsphenoidal approach. Pathologic results revealed a cholesteatoma. The patient's symptoms improved a lot after surgery, and the postoperative period was uneventful. Taken together, the lesion's imaging appearance, pathological characteristics, and clinical features were all unique features that lead to a diagnosis of cholesteatoma.As we did not see such reports by Pubmed and EMBASE, we believe this is the first reported case of sellar cholesteatoma presenting in this manner. This article emphasized that cholesteatomas, although rare, should be considered part of the differential diagnosis of sellar lesions.

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Intrasellar epidermoid cyst

Abstract: ~/ The authors report the uncomplicated removal of an intrasellar epidermoid cyst that on presentation mimicked a pituitary adenoma. Current controversies regarding the differentiation of this cyst from other cystic lesions of the sellar region are reviewed.

Cited by 20 publications

References 26 publications

Craniopharyngioma and other cystic epithelial lesions of the sellar region: a review of clinical, imaging, and histopathological relationships

Craniopharyngioma and other cystic epithelial lesions of the sellar region: a review of clinical, imaging, and histopathological relationships

Physiopathological Aspects of Sellar Epidermoid Cyst Determining Endocrine Disturbances: A Case Report

Cholesteatoma in the Sellar Region Presenting as Hypopituitarism and Diabetes Insipidus

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