Neurosurgery Department, DFV Neuro, São Paulo, Brazil.
Hospital Sírio Libanês, São Paulo, Brazil.
Br J Neurosurg. 2024 Apr;38(2):361-366. doi: 10.1080/02688697.2021.1877610. Epub 2021 Feb 1.
Epidermoid cysts (EC) are lesions developing from neuroectodermal epithelial cells. They represent 1-2% of all intracranial tumors and are usually found in cerebellopontine angle and parasellar regions. To the best of our knowledge, only 27 cases have been reported of EC in sellar and suprasellar region. In 12 cases out of the 27, surgery was done by craniotomy means. The 7 most recent manuscripts (with 15 patients described) share in common the use of endoscopic endonasal approach (EEA) to perform surgical removal.
In this paper, we report the safe removal of epidermoid cysts arising from the pituitary using an EEA in two patients, which should be the sixth such description in literature. In both cases, resection and evolution was favourable.
Surgical resection is the treatment standard for epidermoid cysts, with total resection including the cyst wall to prevent recurrence when possible. The degree of resection obtained is limited by adherence to nearby neural and vascular structures. The advent of EEA approaches has allowed safe maximal resection especially in midline lesions nearby sellar and suprasellar compartiments.
表皮样囊肿（EC）是由神经外胚层上皮细胞发展而来的病变。它们占所有颅内肿瘤的 1-2%，通常在桥小脑角和鞍旁区域发现。据我们所知，只有 27 例报告发生在鞍上和鞍旁区域的 EC。在这 27 例中，有 12 例是通过开颅手术进行的。最近的 7 篇文献（描述了 15 例患者）共同之处在于使用经鼻内镜入路（EEA）进行手术切除。
在本文中，我们报告了使用 EEA 在两名患者中安全切除源自垂体的表皮样囊肿，这应该是文献中第六次这样的描述。在这两个病例中，切除和演变都是有利的。
手术切除是表皮样囊肿的治疗标准，尽可能完全切除包括囊肿壁，以防止复发。切除的程度受限于与邻近神经和血管结构的粘连程度。EEA 入路的出现使得在中线病变，尤其是在鞍上和鞍旁区域，能够安全地进行最大限度的切除。
