Cystic lesion of the sella turcica: interesting case report and review of literature
Keywords:Sellar cystic lesion, Arachnoid cyst, Transsphenoidal approach
Intrasellar arachnoid cysts are rare entities. High index of suspicion and precise radiological evaluation are the cornerstone for appropriate diagnosis and treatment. We present a symptomatic case of a sellar cystic lesion in a 52-year-old lady, who had complaints of decreased vision associated with diplopia of three months duration. Clinical evaluation showed bitemporal hemianopia. Magnetic Resonance Imaging (MRI) of brain revealed features of sellar arachnoid cyst with the intracystic component similar to cerebrospinal fluid (CSF). She underwent endoscopic transnasal transsphenoidal excision of lesion. Her visual symptoms improved well on subsequent follow up.However infrequent, sellar arachnoid cyst should be borne in mind as differential diagnosis for any cystic sellar lesions, as they can mimic pituitary adenomas, either by impairment of pituitary hormonal function or by exerting pressure effects on optic chiasma. Evaluation modalities, therapeutic challenges and literature review are presented in this case report.
Starkman SP, Brown TC, Linell EA. Cerebral arachnoid cysts. J Neuropathol Exp Neurol. 1958;17(3):484-500.
Guduk M, Hamit AM, Sav A, Berkman Z. Intrasellar arachnoid cyst: A case report and review of the literature. Int J Surg Case Rep. 2016;23:105-8.
Rengachary SS, Watanabe I. Ultrastructure and pathogenesis of intracranial arachnoid cysts. J Neuropathol Exp Neurol. 1981;40(1):61-83.
Dubuisson AS, Stevenaert A, Martin DH, Flandroy PP. Intrasellar arachnoid cysts. Neurosurgery. 2007;61(3):505-13.
Benedetti A, Carbonin C, Colombo F. Possible aetiopathogenetic correlation between primary empty sella and arachnoid cyst. Acta Neurochir. 1977;38(3):269-78.
Miyamoto T, Ebisudani D, Kitamura K, Ohshima T, Horiguchi H, Nagahiro S. Surgical management of symptomatic intrasellar arachnoid cysts-two case reports. Neurol Med Chir. 1999;39(13):941-5.
Mangussi GJ, Gentil AF, Filippi RZ, Momesso RA, Handfas BW, Radvany J, et al. Sellar and suprasellar arachnoid cyst. Einstein. 2019;17(1):4269.
Prayson RA. Neuropathology Review. 2nd ed. Human Press; 2001: 230.
Murakami M, Okumura H, Kakita K. Recurrent intrasellar arachnoid cyst. Neurol Med Chir. 2003;43(6):312-5.