Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA.
Department of Pathology, Baylor College of Medicine, Houston, Texas, USA.
World Neurosurg. 2019 Oct;130:110-114. doi: 10.1016/j.wneu.2019.06.205. Epub 2019 Jul 5.
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.
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.
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.
颅内表皮样囊肿是良性、先天性、角化、鳞状上皮衬里的囊肿，充满角蛋白。它们并不常见，由于与周围结构的粘连，往往给手术带来挑战。它们通常位于桥小脑角或鞍旁区域，与 Rathke 囊的异常发育有关；垂体柄受累很少见。
检索了患者的电子健康记录以获取相关数据。使用专门的检索词对漏斗部表皮样囊肿的病例进行了文献系统回顾。我们报告了一个独特的病例，一名 55 岁男性因视力改变就诊，发现鞍旁有局限于垂体柄的表皮样囊肿。患者接受了经蝶窦内镜切除术，实现了大体全切除。患者术后发生可能的化学性脑膜炎和全垂体功能减退症，病情显著。术后患者的视力主观上有所改善。
尽管另外 3 例涉及垂体柄的表皮样囊肿病例已被确定，但我们患者的肿瘤是独特的，因为它局限于垂体柄。我们患者的病例突出了一种治疗鞍旁表皮样囊肿的手术方法及其相关的可能并发症。
