RESUMO
Symptomatic Rathke cleft cysts (RCC) are reported in the sellar and suprasellar regions, but no case of sphenoidal RCC has been reported. We report a case of sphenoidal RCC in a 41-year-old man. The lesion was revealed by headaches and diplopia. Symptoms disappeared transiently after a spontaneous rhinorrhea but relapsed 4 months later. MR imaging showed a cystic sphenoidal lesion, isointense on T1-weighted images (WI) with peripheral gadolinium enhancement and hyperintense on T2 WI. The patient underwent surgery through a transrhinoseptal approach. The wall of the sphenoid sinus was paper-thin. The cyst contained a motor-oil-like fluid and communicated widely with the nasal fossa. Its wall was partially extracted. Symptoms and signs ceased after surgery. MR imaging performed 1 year later showed the disappearance of the sphenoidal cyst. Embryological origin of RCCs is discussed. The hypothesis of a continuum between the different epithelial cystic lesions of the sellar and parasellar region is discussed. Imaging has an important impact on the diagnosis; nevertheless, the specific characterization remains difficult.
Assuntos
Cistos do Sistema Nervoso Central , Neoplasias dos Seios Paranasais , Seio Esfenoidal , Adulto , Cistos do Sistema Nervoso Central/diagnóstico , Cistos do Sistema Nervoso Central/cirurgia , Humanos , Imageamento por Ressonância Magnética , Masculino , Neoplasias dos Seios Paranasais/diagnóstico , Neoplasias dos Seios Paranasais/cirurgiaRESUMO
Intracranial epidermoid cysts are relatively rare tumors. These cysts are generally nearly isodense to CSF at CT and nearly isointense to CSF on T1W and T2W MR imaging. Spontaneously hyperdense epidermoid cysts are exceptional. We report the case of a 12-year-old girl with a spontaneously hyperdense epidermoid cyst of the posterior fossa presenting with focal neurological symptoms. The diagnosis was confirmed at histological examination.
