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. 2016:23:105-8.
doi: 10.1016/j.ijscr.2016.03.033. Epub 2016 Mar 26.

Intrasellar arachnoid cyst: A case report and review of the literature

Mustafa Güdük  1 , Murat HamitAytar  2 , Aydın Sav  3 , Zafer Berkman  2
Affiliations

Intrasellar arachnoid cyst: A case report and review of the literature

Mustafa Güdük et al. Int J Surg Case Rep. 2016.

Abstract

Introduction: Arachnoid cysts (ACs) are frequently found on intracranial imaging studies but intrasellar arachnoid cysts are rarely encountered.

Presentation of case: We present a 49-year old patient who had headaches for 6 months and cystic sellar mass was found in his cranial imaging. We operated him by transnasal transsphenoidal route. Our intraoperative diagnosis was an arachnoid cyst and pathologic studies verified our observation. He did well postoperatively and after a 1year follow-up he was left free from future follow-ups.

Discussion: As common cystic lesions occupying the sellar region can simulate ACs both clinically and radiologically, neurosurgeon can fail to include ACs in making the initial diagnosis preoperatively.

Conclusion: Although a rare entity, arachnoid cysts should be considered in the differential diagnosis of sellar region.

Keywords: Arachnoid cyst; Case report; Sellar arachnoid cyst; Sellar cysts.

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Figures

Fig. 1
Fig. 1
Preoperative MRI and CT images showing a cystic sellar lesion. A: Coronal T1 weighted MRI image, B: T2 weighted MRI image, C: Coronal Dynamic contrast enhanced T1 weighted MRI image, D: Sagittal dynamic contrast enhanced MRI image; E and F Coronal and sagittal contrast enhanced CT images.
Fig. 2
Fig. 2
Postoperative Day 1 coronal MRI images showing cyst excised and the normal hypophysis. A: T1 weighted, B: T2 weighted and C: Dynamic contrast enhanced studies.
Fig. 3
Fig. 3
Histopathology and immunohistochemistry. A: Flattened arachnoid cells lined on thin basement membrane (H&E, x59.7). B: Basement membrane rich in reticulin fibers in cyst wall (Gomori’s reticulum stain, x113.2). C: Cyst wall overlined by flattened arachnoidal cells reacting with EMA (arrow) (Biotinylated streptavidin complement, EMA, x127.5) D: Anterior pituitary cell cluster in close neighbourhood of cyst wall (Biotinylated streptavidin complement, Synaptophysin, x61.0).
See this image and copyright information in PMC

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