Hypopituitarism Secondary to an Arachnoid Cyst — Case Report

Abstract

Arachnoid cysts (ACs) are a rare condition of mass effect injury and are usually found in the Sylvian fissure. However, rarely, they can appear in the sellar area, causing symptoms of compression. Due to the mass effect, the sellar arachnoid cyst (SAC) may cause headaches, visual disturbances, hypopituitarism, precocious puberty, and the “bobble-head doll” syndrome.

We present the case of JNS, 61 years old, male. The patient presented with hypotestosteronism, hypothyroidism, hypocortisolism and bitemporal hemianopsia. The magnetic resonance imaging scans revealed a mass above the pituitary gland, compatible with a SAC. A surgical excision was performed with removal of the capsule and fenestration within the subarachnoid spaces for emptying the cyst. After the procedure, the patient presented great clinical improvement. The rarity of the case calls attention to the fact that SACs should be thought of as a differential diagnosis in cases of hypopituitarism.

Resumo

Cistos aracnoides são uma condição rara de lesão de efeito de massa e que comumente aparecem na região da fissura silviana. No entanto, raramente, podem aparecer na região selar, ocasionando sintomas de compressão. Devido ao efeito de massa, podem causar dores de cabeça, distúrbios visuais, hipopituitarismo, puberdade precoce e síndrome da “bobble-head doll. ”

Apresentamos o caso de JNS, 61 anos, do sexo masculino. Paciente com hipotestosteronismo, hipotiroidismo, hipocortisolismo e hemianopsia bitemporal. As imagens de ressonância magnética (RM) revelaram uma massa acima da hipófise, mostrando um cisto aracnoide selar. O paciente foi submetido a excisão cirúrgica com fenestração dentro dos espaços subaracnoides para esvaziamento do cisto e apresentou grande melhora clínica após o procedimento. A raridade deste caso chama atenção para o fato de que o cisto aracnoide selar deve ser considerado como um diagnóstico diferencial em casos de hipopituitarismo.

Keywords

arachnoid cysts - hypopituitarism - sellar

Palavras-chave

cistos aracnoides - hipopituitarismo - selar

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