INTRASELLAR DERMOID CYST: CASE REPORT OF A RARE LESION AND SYSTEMATIC LITERATURE REVIEW COMPARING INTRASELLAR, SUPRASELLAR AND PARASELLAR LOCATIONS.

Abstract

OBJECTIVE:

Intracranial dermoid cyst (DC) is a rare benign, slow-growing lesion, most commonly arising along the midline. They can occur in the supratentorial compartment, very rarely involve the sellar region and only exceptionally are intrasellar. The aim of our study is to address the challenges in the diagnosis and management of sellar DCs.

METHODS:

We performed a systematic review of sellar DCs, in keeping with the PRISMA guidelines, and described an intrasellar DC in a 32-year-old female who presented with bilateral blurring vision.

RESULTS:

The review identified 4 intrasellar, 29 suprasellar and 28 parasellar cases. Intrasellar DCs more likely present with progressive visual impairment and pituitary hormone dysfunctions during the fifth decade of life. Suprasellar and parasellar DCs are typically diagnosed during the third decade of life because of diplopia, ptosis, trigeminal hypo-/para-aesthesia or cyst's rupture. Sellar DCs are typically hypodense on CT-scans and contain calcifications. MRI features include T1 hyperintensity, T2 heterogeneous intensity, no restriction on diffusion-weighted images and no contrast enhancement. Surgery is the treatment of choice. Gross total resection is achieved in 60.0% of intrasellar and 61.9% of suprasellar and parasellar DCs. Early postoperative complications are reported in 40.0%, 16.7%, and 23.8% of intrasellar, suprasellar and parasellar DCs, respectively.

CONCLUSIONS:

Intrasellar DCs are rare lesions. Its diagnosis typically occurs later than that of suprasellar and parasellar DCs due to their different clinical presentations. However, they should be considered in the differential diagnosis of cystic lesions of the sella, including epidermoid cysts, craniopharyngiomas, Rathke's cleft cysts and teratomas.

• Authors: Carmine Antonio Donofrio, Giacomo Bertazzoni, Lucia Riccio, Aurora Pinacoli, Luca Pianta, Daniele Generali, Marco Ungari, Franco Servadei, Federico Roncaroli, Antonio Fioravanti
• Journal: World neurosurgery (World Neurosurg) (Nov 21 2023) ISSN: 1878-8769 [Electronic] United States
• PMID: 37995988 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2023 Elsevier Inc. All rights reserved.