Recurrent Intrasellar Arachnoid Cyst-Case Report-

Abstract

A 48-year-old man presented with complaints of decreased visual acuity persisting for 6 weeks in December 1997. Neurological examination demonstrated defects in the superior bitemporal visual field and bilateral optic atrophy. Computed tomography and magnetic resonance (MR) imaging showed an intrasellar cystic lesion. The cyst wall was excised via a transsphenoidal approach. The diagnosis was intrasellar arachnoid cyst. The sellar floor was reconstructed after packing fat in the sellar turcica. The visual complaint improved, but he was lost to follow up. Four years later, he was re-admitted complaining of decreased visual acuity. Superior bilateral field defects were found. MR imaging revealed recurrence of the intrasellar arachnoid cyst. The cyst wall was excised through a craniotomy. The visual acuity and the visual field defects gradually improved. Intrasellar arachnoid cyst may recur after transsphenoidal surgery, so long-term follow up is necessary after excision of the intrasellar cyst wall.

Endonasal management of sellar arachnoid cysts: simple cyst obliteration technique

“…6,26 Early on, some cases were addressed through a transcranial approach. 2,17,24,25 However, the majority of more recent symptomatic ACs have been fenestrated via the transsphenoidal route (Table 3). Although fenestration of the anterior cyst membrane is an essential initial entry point using the transsphenoidal approach, the subsequent intrasellar management of these ACs has been inconsistent among case reports and even within series.…”

“…1,5,6,12,14,16,17,[22][23][24][25][26][27][28][32][33][34] Dietemann and colleagues 5 first described the use of the endoscope to explore the cystic cavity, which lead to the finding of a communication between the cyst and the suprasellar SAS in one of their cases. More recently, Cavallo and colleagues 4 in a multicenter study recognized the role of the endoscope in the transsphenoidal management of sellar cystic lesions.…”

Hypopituitarism Secondary to an Arachnoid Cyst — Case Report

“…Arachnoid cysts can expand in the space between the pia-mater and the arachnoid membrane (subarachnoid space). 1 They correspond to 1% of all intracranial lesions (with mass effect) in adults and 3% in children, with an occurrence of 5 in 1,000 autopsies. 2 In most cases, ACs are present at birth (congenital); therefore, they are sometimes also called primary.…”

“…Approximately half of the cases occur in the Sylvian fissure area, and 9% of the cysts are located in the sellar and suprasellar regions. 1,2 Arachnoid cysts, for the most part, are asymptomatic and are usually found during imaging tests. However, due to their mass effect, they can cause headaches, visual disturbances, hypopituitarism, precocious puberty and "bobble-head doll" syndrome.…”

Giant Intrasellar Arachnoid Cyst Manifesting as Adrenal Insufficiency Due to Hypothalamic Dysfunction-Case Report-

“…6,7) Intrasellar arachnoid cyst is rare, [2][3][4][5][6]8,10,11,13,17,19,20) and it is important, although difficult, to differentiate this type of cyst from other cystic lesions such as Rathke's cleft cyst, pituitary cyst (parenchymal or adenomatous), craniopharyngioma, pars intermedia cyst, and other miscellaneous cysts (epidermoid cyst, cysticercosis cyst) when considering the prognosis. 9,14) Hypothalamic dysfunction due to an intrasellar arachnoid cyst is extremely rare.…”