Cholesteatoma in the Sellar Region Presenting as Hypopituitarism and Diabetes Insipidus

Kong, Xiangyi; Wu, Huanwen; Ma, Wenbin; Li, Yongning; Xing, Bing; Kong, Yanguo; Wang, Renzhi

doi:10.1097/md.0000000000002938

Cited by 6 publications

(6 citation statements)

References 14 publications

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“…It could be embryologic origin and has an intact tympanic membrane. A cholesteatoma usually occurred in middle ear cavity or mastoid region, sometimes in external auditory canal [1][2][3]. Cholesteatomas can be classified into acquired or congenital.…”

Section: Introductionmentioning

confidence: 99%

A Tympanic Membrane Cholesteatoma: A Case Report and Literature Review

Lee¹,

Chao²,

Wang³

2019

SCR

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Keywords: Cholesteatoma tympanic membrane hearing loss acquired A B S T R A C T A 45-year-old female complained of right hearing loss with fullness in recent months. She underwent right tympanoplasty type I about 4 years ago. On physical and otoscopic examination, a pearl-like mass about 3 x 4 mm in size over central part of right ear drum was noted. Pure tone audiometry test showed 35 decibel (dB) average hearing loss of right ear, and 20 dB of left ear. Tympanogram test showed bilateral type A. Computed tomography with thin cuts of the temporal bone revealed a 3 x 4 mm soft tissue mass over central part of right ear drum. Excision of the mass under microscope was smoothly done. A cholesteatoma was confirmed by pathology. She was uneventful during a regular follow-up. Cholesteatomas are benign collections of keratinized squamous epithelium within the middle ear. A cholesteatoma usually occurred in middle ear cavity or mastoid region, sometimes in external auditory canal. Tympanic membrane cholesteatomas were seldom reported.

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Section: Introductionmentioning

confidence: 99%

A Tympanic Membrane Cholesteatoma: A Case Report and Literature Review

Lee¹,

Chao²,

Wang³

2019

SCR

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“…To the best of our knowledge, there have been only 3 case reports of sphenoid sinus cholesteatoma with cephalad extension to the sellar or clivus region. 10,11,13 One showed lateral extension to temporal lobe. 12 All the cases had successful marsupialization surgery by sphenoidotomy without report of complications.…”

Section: Discussionmentioning

confidence: 99%

“…To date, there are 4 cases reported. 10-13 Three cases describing as sphenoid sinus cholesteatoma, extended to the sellar or clivus region. 10,11,13 Most presented with headache, diplopia, and cranial nerve involvement.…”

Section: Introductionmentioning

confidence: 99%

Sphenoid Sinus Cholesteatoma—Complications and Skull Base Osteomyelitis: Case Report and Review of Literature

Kanjanawasee

Chaowanapanja

Keelawat

et al. 2019

Clin Med Insights Case Rep

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Introduction: Cholesteatoma of the paranasal sinuses is uncommon. Its clinical characteristics are an expanding growth of the affected paranasal sinuses consisting of keratinizing squamous epithelium with bony wall destruction. Among involved paranasal sinuses, sphenoid sinus cholesteatoma is the least common. Case presentation: An 82-year-old female diabetic patient presented with subacute onset of fever after experiencing chronic progressive headaches for more than 20 years. Nasal endoscopy found purulent discharge from left sphenoethmoidal recess. Computed tomography (CT) scan of the paranasal sinus showed soft tissue lesions that totally filled the left sphenoid sinus with posterior and inferior wall destruction. There was no evidence of connection to the left mastoid cavity. Management and outcome: Left sphenoidotomy was performed. Histopathology revealed cholesteatoma. Two months after surgery, she became worse and CT showed extensive skull base destruction. The patient underwent bilateral sphenoidectomy and craniotomy with surgical debridement of osteomyelitis of the skull base. She received long-term intravenous ertapenam and sitafloxacin for treating drug-resistant Klebsiella infection. The osteomyelitis could not be controlled, and she died. Discussion: Progressive headache can be caused by an uncommon disease such as sphenoid sinus cholesteatoma, which is a surgical condition. Complicating osteomyelitis of the skull base requires extensive debridement surgery and should be anticipated.

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“…Epidermoid cysts, also known as primary cholesteatomas (8), are currently thought to arise from ectodermal remnants that fail to degenerate after neuroembryonic development in the fifth week of gestation (2). Intracranial epidermoid cysts are uncommon, accounting for approximately 0.2%-1.8% of intracranial tumors and are usually located in the cerebellopontine angle, prepontine cistern, and middle cranial fossa (7,9).…”

Section: Discussionmentioning

confidence: 99%

Endoscopic endonasal resection of an epidermoid cyst in the cavernous sinus: A case report and literature review

Gao

et al. 2022

Front. Oncol.

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BackgroundEpidermoid cysts of cavernous sinus (CS) are rare congenital neoplasms of the central nervous system. In previous literature reports, the treatment for CS epidermoid cysts was mainly microsurgical resection, and the surgical methods included simple microsurgery and endoscope-assisted microsurgery. The present case report demonstrates the first case of complete resection of a CS epidermoid cyst by a simple endoscopic endonasal transcavernous (EET) approach.Case presentationA 54-year-old woman presented with chronic persistent headaches and occasional syncope. Brain MRI demonstrated a space-occupying lesion of the left CS, and digital substruction angiography (DSA) showed a small aneurysm at the beginning of the left ophthalmic artery. Thrombotic therapy of carotid–ophthalmic aneurysms was performed first, and the patient underwent resection of the CS lesion secondary. Considering the location of the lesion and the neuroendoscopy technology and experience of the doctor, we made bold innovations and used an EET approach to achieve complete resection of the lesion. The postoperative pathological results were consistent with the characteristics of epidermoid cyst. During the 1-year follow up, the patient showed no apparent signs of recurrence on head MRI.ConclusionEpidermoid cyst of cavernous sinus is a rare benign occupying lesion in cavernous sinus. Reviewing the previous literature, the main treatment is microneurosurgery, and neuroendoscopy is only used as an auxiliary equipment. We present the first case of complete endoscopic resection of CS epidermoid cyst by EET approach according to CARE guidelines, aiming to share the new surgical plan for CS epidermoid cyst and provide more surgical options for this disease for neurosurgery colleagues.

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Cholesteatoma in the Sellar Region Presenting as Hypopituitarism and Diabetes Insipidus

Cited by 6 publications

References 14 publications

A Tympanic Membrane Cholesteatoma: A Case Report and Literature Review

A Tympanic Membrane Cholesteatoma: A Case Report and Literature Review

Sphenoid Sinus Cholesteatoma—Complications and Skull Base Osteomyelitis: Case Report and Review of Literature

Endoscopic endonasal resection of an epidermoid cyst in the cavernous sinus: A case report and literature review

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