Infundibular Epidermoid Cyst: Case Report and Systematic Review

World Neurosurg. 2019 Oct:130:110-114. doi: 10.1016/j.wneu.2019.06.205. Epub 2019 Jul 5.

Abstract

Background: Intracranial epidermoid cysts are benign, congenital, keratinizing, squamous epithelial-lined cysts filled with keratin. They are uncommon and often pose a surgical challenge owing to the adherence to surrounding structures. They are typically found at the cerebellopontine angle or in the parasellar region, where they are associated with abnormal development of the Rathke pouch; involvement of the pituitary stalk is rare.

Case description: The patient's electronic health record was queried for relevant data. A systematic review of the literature using dedicated search terms for cases of infundibular epidermoid cysts was conducted. We present a unique case of a 55-year-old male who presented with vision changes and was found to have a parasellar epidermoid cyst confined to the pituitary stalk. The patient underwent endoscopic transsphenoidal resection, and gross total resection was achieved. The patient's postoperative course was significant for possible chemical meningitis and the development of panhypopituitarism. The patient's vision subjectively improved after surgery.

Conclusions: Although 3 other cases of epidermoid cysts involving the pituitary stalk were identified, our patient's tumor was unique in that it was confined to the stalk. Our patient's case highlights a surgical approach to parasellar epidermoid cysts and the possible complications associated therewith.

Keywords: Cystic epithelial tumor; Intracranial epidermoid cyst; Pituitary tumor.

Publication types

  • Case Reports
  • Systematic Review

MeSH terms

  • Epidermal Cyst / diagnostic imaging*
  • Epidermal Cyst / surgery*
  • Humans
  • Male
  • Middle Aged
  • Pituitary Gland / diagnostic imaging*
  • Pituitary Gland / surgery*