Department of Neurological Surgery, CHI St. Vincent Arkansas Neuroscience Institute, Sherwood, Arkansas, USA.
Department of Neurological Surgery, CHI St. Vincent Arkansas Neuroscience Institute, Sherwood, Arkansas, USA.
World Neurosurg. 2021 Feb;146:26-30. doi: 10.1016/j.wneu.2020.09.030. Epub 2020 Sep 10.
Intracranial epidermoid cysts are congenital epidermal inclusion cysts derived from ectodermal origin with desquamated skin. The majority of these cysts occur in the cerebellopontine angle cistern. Epidermoid cyst of the pituitary stalk, however, is a rare location. To date, only 4 previous cases have been reported.
A 63-year-old male presented to our clinic with migraine headaches, dizziness, increased thirst, increased urinary frequency, and impotence. Magnetic resonance imaging of the brain demonstrated a rim-enhancing cystic mass with diffusion restriction on diffusion-weighted imaging located within the pituitary stalk. The patient underwent a pretemporal approach with gross total resection of the cyst. The patient's postoperative course was uneventful with no new deficits and/or endocrinopathies.
Epidermoid cyst of the pituitary stalk is an unusual and rare presentation. Four other cases treated via endoscopic approaches have been previously reported in the neurosurgical literature. To our knowledge this is the first case description of an infundibular epidermoid cyst pressing with isolated diabetes insipidus surgically treated via a transcranial pretemporal approach with gross total resection. The patient had a smooth and uneventful postoperative course with persistent diabetes insipidus.
颅内表皮样囊肿是一种先天性表皮包涵囊肿，来源于外胚层，伴有表皮脱落。这些囊肿大多数发生在桥小脑角池。然而，垂体柄表皮样囊肿是一种罕见的部位。迄今为止，仅报道过 4 例。
一名 63 岁男性因偏头痛、头晕、口渴增加、尿频和阳痿到我院就诊。脑部磁共振成像显示垂体柄内有一个边缘增强的囊性肿块，弥散加权成像上有弥散受限。患者接受了经颞前入路手术，对囊肿进行了大体全切除。患者术后恢复顺利，无新的缺陷和/或内分泌疾病。
垂体柄表皮样囊肿是一种不常见且罕见的表现。神经外科学文献中以前还报道过另外 4 例经内镜治疗的病例。据我们所知，这是首例经颅颞前入路大体全切除治疗孤立性尿崩症的漏斗部表皮样囊肿的病例描述。患者术后恢复顺利，持续存在尿崩症。
