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Persisting Embryonal Infundibular Recess Masquerading as a Nasal Mass.

Shejoy Joshua1, Shyamsundar Sreedhar1, Vineeth Viswam2

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Asian Journal of Neurosurgery
|November 22, 2018
PubMed
Summary

Persisting embryonal infundibular recess (PEIR), a rare posterior pituitary anomaly, can present as a nasal mass. This case highlights PEIR extending to the nasal cavity, successfully treated via endoscopic endonasal surgery.

Keywords:
Encephalocoelenasal masspersisting embryonal infundibular recess

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Area of Science:

  • Neuroscience
  • Developmental Biology
  • Otorhinolaryngology

Background:

  • Persisting embryonal infundibular recess (PEIR) is a rare developmental anomaly of the posterior pituitary, characterized by a defect in the third ventricular floor.
  • Previous reports documented PEIR descending only to the sella turcica.

Observation:

  • A 35-year-old female presented with hyposmia and a pulsatile nasal mass identified via diagnostic nasal endoscopy.
  • Magnetic resonance imaging revealed a cystic lesion extending from the third ventricular floor into the nasal cavity.

Findings:

  • This is the first reported case of PEIR presenting as a pulsatile nasal mass.
  • The lesion extended significantly further than previously described, reaching the nasal cavity.

Implications:

  • This case expands the known clinical spectrum of PEIR.
  • Endoscopic endonasal transsphenoidal approach is an effective surgical management for PEIR presenting as a nasal mass.
  • Highlights the importance of considering rare pituitary developmental anomalies in the differential diagnosis of nasal masses.