Suprasellar Epidermoid Cyst Originating from the Infundibulum: Case Report and Literature Review

Abstract

Epidermoid cysts account for a small fraction of intracranial brain tumors, most commonly found in the cerebellopontine angle and parasellar cisterns. Here we present a rare case of an epidermoid cyst located in the suprasellar region, specifically originating from the infundibulum. Only one additional case with an epidermoid cyst originating within the pituitary stalk has been previously reported in the literature. The patient in this case presented with headaches, diplopia and blurred vision without any endocrinopathy. The patient’s pre-operative evaluation was significant for pseudotumor cerebri, hyponatremia, obesity, and a history of smoking; post-operative course was significant for neurogenic diabetes insipidus.

Suprasellar epidermoid cyst in an adult female, presenting as amnesia and somnolence: A rare case report

“…Firm adhesion of the cyst to the underlying pia matter or leptomeninges around cranial nerves are examples of situations in which gross versus subtotal resection would have to be weighed. The clinical decision to reach for total resection is surgeon and patient dependent; the risks and benefits of operating near key vascular structures must be included in the pre-operative discussion, with expectations should complications occur clearly outlined before surgery [ 4 ]. Despite better outcome has been reported by C.W.…”

“…They frequently occur at the cerebellopontine angles and parasellar regions, insinuating between brain structures [ 3 ]. The slow growth of these tumors often results in them remaining asymptomatic until their size is large enough to compress surrounding structures [ 4 ]. Symptoms depend on their location and include hearing loss, dizziness, gait disturbance, trigeminal neuralgia, tinnitus, diplopia, visual impairment, apathy, headache, and gait ataxia [ 2 ].…”

Prolonged Postoperative Pyrexia and Transient Nonnephrogenic Vasopressin-Analogue-Resistant Polyuria following Endoscopic Transsphenoidal Resection of an Infundibular Epidermoid Cyst

“…From this case, we have found two things that the previous reports did not refer to [10][11][12][13][14][15]; the first is postoperative prolonged pyrexia (PPP), and the second is postoperative transient vasopressin-analogue-resistant polyuria (VARP).…”

“…Only six cases of infundibular epidermoid cysts were reported prior to this report (Table 1) [10][11][12][13][14][15]. In fact, infundibular epidermoid cysts are rare, and surgical experiences are valued.…”

“…us, gross total resection is the primary treatment goal of an intracranial epidermoid, if possible. Among the previous reports of infundibular epidermoid cysts [10][11][12][13][14][15], not all epidermoid cysts were resected gross-totally. Based on the recurrence rate of 21% in subtotal resection of epidermoid [32], careful and long-term follow-up is necessary even after subtotal resection.…”