A rare epidermoid cyst occurring in an young female: a case report and literature review

Abstract

Background Epidermoid cysts are very rare benign lesions of epithelial origin, slow growing extra-axial tumours and they accord for 1% of all intracranial tumours. They frequently occur at the cerebellopontine angle and parasellar regions insinuating brain structures. They are often associated with a high rate of residual tumor and recurrence. Clinical Case We present the case of a 18 year old patient who was admitted in the our clinic for secondary amenorrhea. The CT scan showed a large median mass with a mixed structure (calcareous and cystic) resembling a craniopharyngioma. Preoperatively the hormonal profile showed deficiency of all anterior pituitary hormones. Transsphenoidal surgery was performed and the histopathological exam established the diagnosis of sellar epidermoid cyst with parasellar extension. Postoperatively the patient developed iatrogenic Cushing syndrome (due to large amounts of dexamethasone given) and diabetes insipidus. Conclusion Epidermoid cysts are challenging tumours because of the extension along the subarachnoid spaces around delicate neurovascular structures therefore they are difficult to be completely resected. The particularity of this case stands in the rare occurrence of this types of tumours and the fact that although in these patients with hypopituitarism diabetes insipidus is present primarily our patient developed postoperatively.