Spontaneous Resolution of Asymptomatic Pediatric Suprasellar Arachnoid Cysts: Report of 2 Cases and Review of the Literature

Abstract

<b><i>Introduction:</i></b> Sellar/suprasellar arachnoid cysts are infrequent nonneoplastic cystic lesions that account for approximately 1% of all arachnoid cysts. While various surgical treatment options have been proposed for symptomatic lesions, treatment guidelines regarding the management of asymptomatic sellar/suprasellar arachnoid cysts remain to be elucidated. This case series aims to provide a better insight into the management and outcomes of such lesions. <b><i>Case Presentation:</i></b> We discuss 2 pediatric patients diagnosed with sellar/suprasellar arachnoid cysts who remained asymptomatic and demonstrated spontaneous gradual resolution of their arachnoid cysts on subsequent imaging studies. <b><i>Conclusion:</i></b> Review of the literature identified only a handful of previously reported cases of spontaneously disappearing suprasellar arachnoid cysts. There might be a role for conservative management of sellar/suprasellar arachnoid cysts in certain patients who remain asymptomatic.

Intracranial Arachnoid Cysts in Childhood: Pathogenesis, Clinical Features, and Management

“…[1,3,4,19,20,[29][30][31] The evolution of these cysts can be highly variable, and cases have been documented in which an increase, decrease, or even disappearance of lesions during follow-up has been observed. [3,29,36] Al-Holou et al [3] showed in their systematic review that most cases that underwent changes in their dimensions, a manifestation of symptoms, or need for surgical intervention were in patients younger than four years of age. Most cases have benign evolution, with no need for intervention.…”