Epidermoid cyst of the sphenoid sinus with extension into the sella turcica presenting as pituitary apoplexy: case report

Sani, Sepehr; Smith, Ashley A.; Leppla, David C.; Ilangovan, Saroja; Glick, Roberta P.

doi:10.1016/j.surneu.2004.02.039

Cited by 31 publications

(23 citation statements)

References 19 publications

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“…They most commonly arise as extradural lesions or as intracerebral masses in the region of the cerebellopontine angle, but they may also present in the sellar and parasellar region. 9,40,76,91,99,107 Epidermoid cysts often arise in a paramedian location, in contrast to typically midline dermoid cysts. 91 Sellar and parasellar epidermoid tumors make up only 0.2-0.7% of major trans sphenoidal series.…”

Section: Typical Histopathological Features Of Rccsmentioning

confidence: 99%

“…9,40,76,91,99,107 Epidermoid cysts often arise in a paramedian location, in contrast to typically midline dermoid cysts. 91 Sellar and parasellar epidermoid tumors make up only 0.2-0.7% of major trans sphenoidal series. 27,89 Epidermoid tumors typically present in middle-aged patients with symptoms of mass effect, such as headache and vision loss.…”

Section: Typical Histopathological Features Of Rccsmentioning

confidence: 99%

“…31,74,112 Some reports have also described an uncommon clinical presentation mimicking that of pituitary apoplexy. 91,104 The cyst contents of epidermoid cysts, and many other epithelial sellar region cysts, can be caustic to the surrounding tissue, often resulting in hypophysitis, meningitis, or neurological deficits. Standard MR imaging cannot be reliably used in all cases to definitively establish a diagnosis of epidermoid or dermoid tumors, on account of their nonspecific MR imaging features.…”

Section: Typical Histopathological Features Of Rccsmentioning

confidence: 99%

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Craniopharyngioma and other cystic epithelial lesions of the sellar region: a review of clinical, imaging, and histopathological relationships

Zada¹,

Lin²,

Ojerholm³

et al. 2010

FOC

232

182

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Object Cystic epithelial masses of the sellar and parasellar region may be difficult to differentiate on a clinical, imaging, or even histopathological basis. The authors review the developmental relationships and differentiating features of various epithelial lesions of the sellar region. Methods The authors performed a review of the literature to identify previous studies describing the etiological relationships and differentiating features of various cystic sellar lesions, including craniopharyngioma (CP), Rathke cleft cyst, xanthogranuloma, and dermoid and epidermoid cysts. Results There is significant evidence in the literature to support a common ectodermal origin of selected sellar and suprasellar cystic lesions, which may account for the overlap of features and transitional states observed in some cases. Research obtained from animal studies and reports of transitional cystic epithelial masses or lesions crossing over from typical to more aggressive pathological subtypes have collectively provided a solid foundation for this theory. Histological features that signify transitional entities beyond simple benign Rathke cleft cysts include squamous metaplasia, stratified squamous epithelium, and ciliated or mucinous goblet cells in squamous-papillary CPs. Several studies have identified key clinical, imaging, and histopathological features that can be used in the differentiation of these lesions. Conclusions The pattern of embryological formation of the hypothalamic-pituitary axis plays a major role in its propensity for developing cystic epithelial lesions. Subsequent inflammatory, metaplastic, and neoplastic processes may promote further progression along the pathological continuum, ranging from benign epithelial cysts to aggressive neoplastic cystic CPs. Selected clinical, imaging, and histopathological features can be used collectively to help differentiate these lesions and assign a formal diagnosis, thus accurately guiding further treatment.

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Section: Typical Histopathological Features Of Rccsmentioning

confidence: 99%

Section: Typical Histopathological Features Of Rccsmentioning

confidence: 99%

Section: Typical Histopathological Features Of Rccsmentioning

confidence: 99%

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Craniopharyngioma and other cystic epithelial lesions of the sellar region: a review of clinical, imaging, and histopathological relationships

Zada¹,

Lin²,

Ojerholm³

et al. 2010

FOC

232

182

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“…Clinical manifestation of this entity with symptoms of optic nerve compression has also not been previously described. Individual cases with lesser extent and isolated involvement of the sphenoid sinus have been previously reported [5,6]. A recently published case report shows an epidermoid cyst of the sphenoid sinus with extension into the sella turcica presenting as pituitary apoplexy [6].…”

Section: Discussionmentioning

confidence: 99%

“…Occipital or nasofrontal dermal sinus tracts are associated abnormalities [3] and malignant change is very rare [4]. Epidermoid cysts of the paranasal sinuses are rarely reported and, to our knowledge, only two cases have been described arising in the sphenoid sinus [5,6].…”

Section: Introductionmentioning

confidence: 99%

Sphenoid Sinus Epidermoid Cyst

Scheffel

Wassermann²,

Pangalu³

et al. 2006

Clin Neuroradiol

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We present an unusual case of an epidermoid cyst in the sphenoid sinus with extensive bony erosions and mass effect, compressing the optic nerve causing visual disturbances. Epidermoid cysts of the paranasal sinuses are extremely rare cases. They usually present as intradural, extraaxial, benign masses of the cerebellopontine angle but they should also be considered in the differential diagnosis of sphenoid sinus lesions. The typical imaging appearance of craniocerebral epidermoid cysts is demonstrated and pathophysiological considerations of formation in the paranasal sinuses are discussed. ZusammenfassungWir präsentieren einen Fall mit der ungewöhnlichen Lokalisation einer Epidermoidzyste im Sinus sphenoidalis mit ausgedehnten knöchernen Arosionen, Zeichen der Raumforderung und Kompression des Nervus opticus. Die Nasennebenhöhlen sind ein äußerst seltener Manifestationsort der Epidermoidzysten. Gewöhnlich zeigen sie sich als intradural und extraaxial gelegene benigne Raumforderungen des Kleinhirnbrückenwinkels. Sie sollten jedoch in die Differentialdiagnose der Läsi-onen des Sinus sphenoidalis eingeschlossen werden. Die charakteristische Bildgebung kraniozerebraler Epidermoidzysten wird demonstriert, und pathophysiologische Erklärungen zur Entstehung in den Nasennebenhöhlen werden diskutiert.

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Pituitary Apoplexy

Russell¹,

Miller²

Diagnosis and Management of Pituitary Disorders

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Epidermoid cyst of the sphenoid sinus with extension into the sella turcica presenting as pituitary apoplexy: case report

Cited by 31 publications

References 19 publications

Craniopharyngioma and other cystic epithelial lesions of the sellar region: a review of clinical, imaging, and histopathological relationships

Craniopharyngioma and other cystic epithelial lesions of the sellar region: a review of clinical, imaging, and histopathological relationships

Sphenoid Sinus Epidermoid Cyst

Pituitary Apoplexy

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