Intra-Infundibular Epidermoid Cysts: A Distinct and Rare Entity

Area of Science:

• Neurosurgery
• Endocrinology
• Pathology

Background:

• Intra-infundibular epidermoid cysts (IECs) are exceptionally rare, with only 7 prior cases reported.
• This study details institutional experience with IEC resection and reviews existing literature.

Purpose of the Study:

• To describe the clinical features, radiological findings, and surgical outcomes of intra-infundibular epidermoid cysts.
• To highlight distinguishing features and operative nuances of IECs compared to other infundibular lesions.

Main Methods:

• Retrospective analysis of 3 consecutive IEC cases.
• Systematic literature search of PubMed and EMBASE for IEC case reports.
• Analysis of clinical, radiological, and operative data from a total of 10 cases.

Main Results:

• Median age at diagnosis was 53.5 years; 60% were male.
• Despite small size (1.62 cm³), 80% had visual disturbances, 78% pituitary hormone deficiency, and 40% diabetes insipidus.
• Cyst adhesion to the stalk/hypothalamus occurred in 50%, leading to residual tumor; postoperative complications included meningitis and abscess.

Conclusions:

• Intra-infundibular epidermoid cysts are rare and frequently misdiagnosed preoperatively.
• IECs present distinct postoperative morbidity profiles compared to other infundibular cystic lesions.
• Recognition of IECs as a distinct entity is vital for appropriate management and surgical planning.