Tiing Yee Siow1, Chi-Cheng Chuang2, Cheng Hong Toh3, Mauricio Castillo4. 1. Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan. 2. Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan. 3. Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan. Electronic address: eldomtoh@hotmail.com. 4. Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
Abstract
BACKGROUND: Persisting embryonal infundibular recess (PEIR) is a rare anomaly of the third ventricular floor, with only 10 cases having been reported to date. Accurate imaging diagnosis of this entity is essential to avoid unnecessary surgery and its associated morbidity. The following case is presented to emphasize its recognition in the differential diagnosis of pituitary cystic lesions. CASE DESCRIPTION: A 38-year-old woman was referred for evaluation of a pituitary cystic mass. Magnetic resonance imaging (MRI) revealed a 10.2-mm cystic mass in an enlarged sella turcica. Three-dimensional high-resolution MRI using constructive interference in steady-state sequence clearly delineated a communicating tract between the third ventricle and the sellar cyst through pituitary stalk. A final diagnosis of PEIR was made. The patient was managed successfully with conservative treatment, and the lesion was in a stationary condition over a 5-year follow-up period. CONCLUSIONS: This is the first case report demonstrating imaging features of PEIR in 3-dimensional high-resolution MRI. Although PEIR is a rare anomaly, imaging diagnosis of this entity is important because confusion with other pituitary cystic lesions and the attempt of surgical removal may lead to serious complications.
BACKGROUND: Persisting embryonal infundibular recess (PEIR) is a rare anomaly of the third ventricular floor, with only 10 cases having been reported to date. Accurate imaging diagnosis of this entity is essential to avoid unnecessary surgery and its associated morbidity. The following case is presented to emphasize its recognition in the differential diagnosis of pituitary cystic lesions. CASE DESCRIPTION: A 38-year-old woman was referred for evaluation of a pituitary cystic mass. Magnetic resonance imaging (MRI) revealed a 10.2-mm cystic mass in an enlarged sella turcica. Three-dimensional high-resolution MRI using constructive interference in steady-state sequence clearly delineated a communicating tract between the third ventricle and the sellar cyst through pituitary stalk. A final diagnosis of PEIR was made. The patient was managed successfully with conservative treatment, and the lesion was in a stationary condition over a 5-year follow-up period. CONCLUSIONS: This is the first case report demonstrating imaging features of PEIR in 3-dimensional high-resolution MRI. Although PEIR is a rare anomaly, imaging diagnosis of this entity is important because confusion with other pituitary cystic lesions and the attempt of surgical removal may lead to serious complications.
Authors: Waleed A Azab; Luigi Maria Cavallo; Waleed Yousef; Tufail Khan; Domenico Solari; Paolo Cappabianca Journal: Childs Nerv Syst Date: 2022-02-22 Impact factor: 1.532