An extraaxially localized intrasellar giant hydatid cyst with hypophyseal insufficiency

Childs Nerv Syst. 2018 Jul;34(7):1391-1396. doi: 10.1007/s00381-017-3715-4. Epub 2018 Jan 5.

Abstract

Purpose: A hydatid cyst is a parasitic illness that is caused by the larvae of Echinococcus granulosus. Hydatid cysts occur in the liver in 75% and in the lungs in 15% of cases. Central nervous system involvement is rare (perhaps as low as 1%), and the majority of such cases are observed in children. Headache and vomiting are the most frequently observed symptoms. In patients diagnosed with a hydatid cyst, imaging methods and serologic tests are very important for identifying cranial involvement. The most curative method is to remove the unruptured cyst using Dowling's method and to then wash the resulting gap with sodium chloride.

Methods: The patient was a 16-year-old female with previous occasional headaches, progressive loss of vision, and general affective disorder.

Results: The patient presented at the emergency department with the above-mentioned complaints. She was hospitalized for a large cystic lesion in an extraaxially intrasellar location based on computerized tomography (CT) of the brain. The cyst was excised, and medical treatment was applied.

Conclusions: Hydatid cysts are rarely located in the central nervous system. Treatment involves surgical and medical interventions. In this article, we present the first published case of a giant hydatid cyst with an extraaxial intrasellar location. This is the first such case to be reported in the literature. The cyst caused somnolence, general affective disorder, panhypopituitarism, and progressive loss of vision.

Keywords: Echinococcus; Hydatid cyst; Intrasellar; Panhypopituitarism.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Echinococcosis / surgery*
  • Fatal Outcome
  • Female
  • Humans
  • Neurosurgical Procedures / adverse effects
  • Neurosurgical Procedures / methods
  • Pituitary Diseases / surgery*