Intrasellar epidermoid cyst

Case report

Restricted access

✓ The authors report the uncomplicated removal of an intrasellar epidermoid cyst that on presentation mimicked a pituitary adenoma. Current controversies regarding the differentiation of this cyst from other cystic lesions of the sellar region are reviewed.

Article Information

Address reprint requests to: James E. Boggan, M.D., c/o The Editorial Office, Department of Neurological Surgery, 350 Parnassus Avenue, Suite 807, San Francisco, California 94117-3690.

© AANS, except where prohibited by US copyright law.

Headings

Figures

  • View in gallery

    High-resolution computerized tomography scans showing that the sella turcica is enlarged, with an intrasellar region of decreased attenuation and slight suprasellar extension. Left: Coronal reformation. Right: Sagittal reformation.

  • View in gallery

    Photomicrograph showing stratified squamous epithelium with keratinization and a prickle-cell layer (arrows). H & E, × 250.

  • View in gallery

    Left: Photomicrograph of the cyst contents showing plates of keratin. H & E, × 250. Right: Photomicrograph showing an atrophic pituitary gland (arrows) adjacent to the layer of squamous epithelium. H & E, × 100.

References

  • 1.

    Alvarez-Garijo JAFroufé ATaboada Det al: Successful surgical treatment of an odontogenic ossified craniopharyngioma. Case report. J Neurosurg 55:8328351981Alvarez-Garijo JA Froufé A Taboada D et al: Successful surgical treatment of an odontogenic ossified craniopharyngioma. Case report. J Neurosurg 55:832–835 1981

    • Search Google Scholar
    • Export Citation
  • 2.

    Alvord EC Jr: Growth rates of epidermoid tumors. Ann Neurol 2:3673701977Alvord EC Jr: Growth rates of epidermoid tumors. Ann Neurol 2:367–370 1977

    • Search Google Scholar
    • Export Citation
  • 3.

    Burger PCVogel FS: Surgical Pathology of the Nervous System and Its Coverings. New York: John Wiley and Sons1976 pp 425437Burger PC Vogel FS: Surgical Pathology of the Nervous System and Its Coverings. New York: John Wiley and Sons 1976 pp 425–437

    • Search Google Scholar
    • Export Citation
  • 4.

    Cabezudo JMVaquero JAreitio Eet al: Craniopharyngiomas: a critical approach to treatment. J Neurosurg 55:3713751981Cabezudo JM Vaquero J Areitio E et al: Craniopharyngiomas: a critical approach to treatment. J Neurosurg 55:371–375 1981

    • Search Google Scholar
    • Export Citation
  • 5.

    Carmichael HT: Squamous epithelial rests in the hypophysis cerebri. Arch Neurol Psychiatry 26:9669751931Carmichael HT: Squamous epithelial rests in the hypophysis cerebri. Arch Neurol Psychiatry 26:966–975 1931

    • Search Google Scholar
    • Export Citation
  • 6.

    Choremis CEconomos DPapadatos Cet al: Intraspinal epidermoid tumours (cholesteatomas) in patients treated for tuberculous meningitis. Lancet 2:4374391956Choremis C Economos D Papadatos C et al: Intraspinal epidermoid tumours (cholesteatomas) in patients treated for tuberculous meningitis. Lancet 2:437–439 1956

    • Search Google Scholar
    • Export Citation
  • 7.

    Erdheim J: Über Hypophysengangsgeschwülste und Hirncholesteatome. Sitzungsb Akad Wissensch 113:5377261904Erdheim J: Über Hypophysengangsgeschwülste und Hirncholesteatome. Sitzungsb Akad Wissensch 113:537–726 1904

    • Search Google Scholar
    • Export Citation
  • 8.

    Fager CACarter H: Intrasellar epithelial cysts. J Neurosurg 24:77811966Fager CA Carter H: Intrasellar epithelial cysts. J Neurosurg 24:77–81 1966

    • Search Google Scholar
    • Export Citation
  • 9.

    Guidetti BGagliardi FM: Epidermoid and dermoid cysts. Clinical evaluation and late surgical results. J Neurosurg 47:12181977Guidetti B Gagliardi FM: Epidermoid and dermoid cysts. Clinical evaluation and late surgical results. J Neurosurg 47:12–18 1977

    • Search Google Scholar
    • Export Citation
  • 10.

    Hunter IJ: Squamous metaplasia of cells of the anterior pituitary gland. J Pathol Bacteriol 69:1411451955Hunter IJ: Squamous metaplasia of cells of the anterior pituitary gland. J Pathol Bacteriol 69:141–145 1955

    • Search Google Scholar
    • Export Citation
  • 11.

    Kernohan JWSayre GP: Tumors of the Pituitary Gland and Infundibulum. Atlas of Tumor Pathology Section X Fascicle 36. Washington, DC: Armed Forces Institute of Pathology1956 pp 5877Kernohan JW Sayre GP: Tumors of the Pituitary Gland and Infundibulum. Atlas of Tumor Pathology Section X Fascicle 36. Washington DC: Armed Forces Institute of Pathology 1956 pp 58–77

    • Search Google Scholar
    • Export Citation
  • 12.

    Kiyono H: Über des Vorkommen von Plattenepithelherden in der Hypophyse. Virchows Arch (Pathol Anat) 252:1181451924Kiyono H: Über des Vorkommen von Plattenepithelherden in der Hypophyse. Virchows Arch (Pathol Anat) 252:118–145 1924

    • Search Google Scholar
    • Export Citation
  • 13.

    Kline LBGalbraith JG: Parasellar epidermoid tumor presenting as painful ophthalmoplegia. Case report. J Neurosurg 54:1131171981Kline LB Galbraith JG: Parasellar epidermoid tumor presenting as painful ophthalmoplegia. Case report. J Neurosurg 54:113–117 1981

    • Search Google Scholar
    • Export Citation
  • 14.

    Landolt AM: Ultrastructure of human sella tumors. Correlations of clinical findings and morphology. Acta Neurochir Suppl 22:1041191975Landolt AM: Ultrastructure of human sella tumors. Correlations of clinical findings and morphology. Acta Neurochir Suppl 22:104–119 1975

    • Search Google Scholar
    • Export Citation
  • 15.

    Laws ER Jr: Transsphenoidal microsurgery in the management of craniopharyngioma. J Neurosurg 52:6616661980Laws ER Jr: Transsphenoidal microsurgery in the management of craniopharyngioma. J Neurosurg 52:661–666 1980

    • Search Google Scholar
    • Export Citation
  • 16.

    Lemire RJLoeser JDLeach RWet al: Normal and Abnormal Development of the Human Nervous System. Hagerstown: Harper and Row1975 pp 370372Lemire RJ Loeser JD Leach RW et al: Normal and Abnormal Development of the Human Nervous System. Hagerstown: Harper and Row 1975 pp 370–372

    • Search Google Scholar
    • Export Citation
  • 17.

    Lever WFSchaumburg-Lever G: Histopathology of the Skined 5. Philadelphia/Toronto: JB Lippincott1975 p 461Lever WF Schaumburg-Lever G: Histopathology of the Skin ed 5. Philadelphia/Toronto: JB Lippincott 1975 p 461

    • Search Google Scholar
    • Export Citation
  • 18.

    Liszczak TRichardson EP JrPhillips JPet al: Morphological, biochemical, ultrastructural, tissue culture and clinical observations of typical and aggressive craniopharyngiomas. Acta Neuropathol 43:1912031978Liszczak T Richardson EP Jr Phillips JP et al: Morphological biochemical ultrastructural tissue culture and clinical observations of typical and aggressive craniopharyngiomas. Acta Neuropathol 43:191–203 1978

    • Search Google Scholar
    • Export Citation
  • 19.

    MacCarty CSLeavens MELove JGet al: Dermoid and epidermoid tumors in the central nervous system of adults. Surg Gynecol Obstet 108:1911981959MacCarty CS Leavens ME Love JG et al: Dermoid and epidermoid tumors in the central nervous system of adults. Surg Gynecol Obstet 108:191–198 1959

    • Search Google Scholar
    • Export Citation
  • 20.

    Matsushima TFukui MOhta Met al: Ciliated and goblet cells in craniopharyngioma. Light and electron microscopic studies at surgery and autopsy. Acta Neuropathol 50:1992051980Matsushima T Fukui M Ohta M et al: Ciliated and goblet cells in craniopharyngioma. Light and electron microscopic studies at surgery and autopsy. Acta Neuropathol 50:199–205 1980

    • Search Google Scholar
    • Export Citation
  • 21.

    Olivecrona H: On suprasellar cholesteatomas. Brain 55:1221341932Olivecrona H: On suprasellar cholesteatomas. Brain 55:122–134 1932

    • Search Google Scholar
    • Export Citation
  • 22.

    Petito CKDeGirolami UEarle KM: Craniopharyngiomas. A clinical and pathological review. Cancer 37:194419521976Petito CK DeGirolami U Earle KM: Craniopharyngiomas. A clinical and pathological review. Cancer 37:1944–1952 1976

    • Search Google Scholar
    • Export Citation
  • 23.

    Raskind RBrown HAMathis J: Recurrent cyst of the pituitary: 26-year follow-up from first decompression. Case report. J Neurosurg 28:5955991968Raskind R Brown HA Mathis J: Recurrent cyst of the pituitary: 26-year follow-up from first decompression. Case report. J Neurosurg 28:595–599 1968

    • Search Google Scholar
    • Export Citation
  • 24.

    Richmond ILWara WMWilson CB: Role of radiation therapy in the management of craniopharyngiomas in children. Neurosurgery 6:5135171980Richmond IL Wara WM Wilson CB: Role of radiation therapy in the management of craniopharyngiomas in children. Neurosurgery 6:513–517 1980

    • Search Google Scholar
    • Export Citation
  • 25.

    Rubinstein LJ: Tumors of the Central Nervous System. Atlas of Tumor Pathology Series 2 Fascicle 6. Washington, DC: Armed Forces Institute of Pathology1972 pp 288294Rubinstein LJ: Tumors of the Central Nervous System. Atlas of Tumor Pathology Series 2 Fascicle 6. Washington DC: Armed Forces Institute of Pathology 1972 pp 288–294

    • Search Google Scholar
    • Export Citation
  • 26.

    Russell DSRubinstein LJ: Pathology of Tumours of the Nervous Systemed 4. Baltimore: Williams and Wilkins1977 pp 2837Russell DS Rubinstein LJ: Pathology of Tumours of the Nervous System ed 4. Baltimore: Williams and Wilkins 1977 pp 28–37

    • Search Google Scholar
    • Export Citation
  • 27.

    Seemayer TABlundell JSWiglesworth FW: Pituitary craniopharyngioma with tooth formation. Cancer 29:4234301972Seemayer TA Blundell JS Wiglesworth FW: Pituitary craniopharyngioma with tooth formation. Cancer 29:423–430 1972

    • Search Google Scholar
    • Export Citation
  • 28.

    Shuangshoti SNetsky MGNashold BS Jr: Epithelial cyst related to sella turcica. Proposed origin from neuroepithelium. Arch Pathol 90:4444501970Shuangshoti S Netsky MG Nashold BS Jr: Epithelial cyst related to sella turcica. Proposed origin from neuroepithelium. Arch Pathol 90:444–450 1970

    • Search Google Scholar
    • Export Citation
  • 29.

    Spaziante Rde Divitis EStella Let al: Benign intrasellar cysts. Surg Neurol 15:2742821981Spaziante R de Divitis E Stella L et al: Benign intrasellar cysts. Surg Neurol 15:274–282 1981

    • Search Google Scholar
    • Export Citation
  • 30.

    Steinberg GKKoenig GHGolden JB: Symptomatic Rathke's cleft cysts. Report of two cases. J Neurosurg 56:2902951982Steinberg GK Koenig GH Golden JB: Symptomatic Rathke's cleft cysts. Report of two cases. J Neurosurg 56:290–295 1982

    • Search Google Scholar
    • Export Citation
  • 31.

    Toglia JUNetsky MGAlexander E Jr: Epithelial (epidermoid) tumors of the cranium. Their common nature and pathogenesis. J Neurosurg 23:3843931965Toglia JU Netsky MG Alexander E Jr: Epithelial (epidermoid) tumors of the cranium. Their common nature and pathogenesis. J Neurosurg 23:384–393 1965

    • Search Google Scholar
    • Export Citation
  • 32.

    Tytus JSPennybacker J: Pearly tumours in relation to the central nervous system. J Neurol Neurosurg Psychiatry 19:2412591956Tytus JS Pennybacker J: Pearly tumours in relation to the central nervous system. J Neurol Neurosurg Psychiatry 19:241–259 1956

    • Search Google Scholar
    • Export Citation
  • 33.

    Ulrich J: Intracranial epidermoids. A study of their distribution and spread. J Neurosurg 21:105110581964Ulrich J: Intracranial epidermoids. A study of their distribution and spread. J Neurosurg 21:1051–1058 1964

    • Search Google Scholar
    • Export Citation
  • 34.

    Weber ELVogel FSOdom GL: Cysts of the sella turcica. J Neurosurg 33:48531970Weber EL Vogel FS Odom GL: Cysts of the sella turcica. J Neurosurg 33:48–53 1970

    • Search Google Scholar
    • Export Citation
  • 35.

    Yoshida JKobayashi TKageyama Net al: Symptomatic Rathke's cleft cyst. Morphological study with light and electron microscopy and tissue culture. J Neurosurg 47:4514581977Yoshida J Kobayashi T Kageyama N et al: Symptomatic Rathke's cleft cyst. Morphological study with light and electron microscopy and tissue culture. J Neurosurg 47:451–458 1977

    • Search Google Scholar
    • Export Citation
  • 36.

    Zülch KJ: Brain Tumors: Their Biology and Pathologyed 2. New York: Springer-Verlag1965 pp 228233Zülch KJ: Brain Tumors: Their Biology and Pathology ed 2. New York: Springer-Verlag 1965 pp 228–233

    • Search Google Scholar
    • Export Citation

Metrics

Metrics

All Time Past Year Past 30 Days
Abstract Views 118 118 9
Full Text Views 184 184 0
PDF Downloads 144 144 0
EPUB Downloads 0 0 0

PubMed

Google Scholar