Endoscopic management of an unusual and large suprasellar arachnoid cyst extending into the adjacent temporal lobe

Abstract

In this paper, we comment on a 4 year-old boy with a complex and large suprasellar arachnoid cyst extending to the adjacent temporal lobe. Its successful decompression using a unilateral endoscopic approach (confirmed on post-operative imaging) and excellent clinical recovery, highlights this as a useful technique to manage such cases.

Keywords:

• arachnoid cyst
• suprasellar
• endoscopic fenestration
• Neurosurgery

Public Interest Statement

This case report demonstrates an unusual presentation of a relatively uncommon neurosurgical problem. As can be seen in the imaging of the patient’s head, there is a large mass, representing fluid, that has extended significantly. Indeed, on close inspection, you can see it distorting some of the surrounding structures, including where the optic nerves cross. The case demonstrates successful management endoscopically (essentially “keyhole” neurosurgery) with restoration of the flow of the fluid and reduced distortion of surrounding structures. There are multiple different approaches to this type of problem and this once again supports existing literature that the endoscopic management is effective and well tolerated.

Competing interests

The authors declare no competing interest.

Additional information

Notes on contributors

O. MacCormac

Oscar MacCormac is currently a neurosurgery registrar at St Mary’s Hospital in Paddington, London, UK. He undertook his first year as a junior doctor at Queen’s Medical Centre, Nottingham, UK. Here he met Mr Natalwala and Prof Vloeberghs. Following working with these colleagues, this case was encountered and it was deemed pertinent to the literature to (1) highlight the effectiveness of endoscopic management and also the unusual size and presentation of the arachnoid cyst. Prof Vloeberghs operates using this method on similar cases with excellent results.