Inflamed symptomatic sellar arachnoid cyst: case report

Area of Science:

• Neuroendocrinology
• Neurosurgery
• Pathology

Background:

• Sellar arachnoid cysts are uncommon, and infected sellar arachnoid cysts are exceptionally rare, with only one prior reported case.
• The patient, a 53-year-old female with a history of chronic sinusitis, presented with headache, polyuria, polydipsia, and abnormal vaginal bleeding.

Purpose of the Study:

• To report a case of an infected or inflamed sellar arachnoid cyst.
• To describe the successful treatment of this rare condition using transsphenoidal surgery (TSA).

Main Methods:

• Magnetic resonance imaging (MRI) was used to identify a sellar cystic mass with a thickened pituitary stalk.
• A water-deprivation test confirmed central diabetes insipidus.
• Transsphenoidal surgery (TSA) was performed for diagnosis and treatment.

Main Results:

• Intraoperative findings revealed turbid intracystic contents, though microorganisms were not identified on culture.
• Pathological examination of the cyst wall confirmed inflamed meningoepithelial lining cells, consistent with an arachnoid cyst.
• The patient's symptoms were successfully managed post-operatively.

Conclusions:

• Infected or inflamed sellar arachnoid cysts, though extremely rare, can be effectively treated with transsphenoidal surgery.
• This case adds to the limited literature on infected sellar arachnoid cysts and highlights the importance of considering this diagnosis.
• Transsphenoidal surgery is a viable option for managing symptomatic sellar arachnoid cysts, even in rare infectious or inflammatory presentations.