Extra-dural epidermoid cyst of the parasellar region: A rare case report

Introduction: Intracranial epidermoid cysts (IECs) comprise less than 1 % of intracranial tumors. IECs begin forming at birth and slowly grows in size. Cerebellopontine angle is the most common location reported. Brain magnetic resonance imaging (MRI) plays crucial role in diagnosis. Gross total resection is the ideal management but adhesion to adjacent structures is often challenging. Case presentation: We presented a case of 57-year-old female with vertigo and chronic abnormal sensation in her left side of the face. Brain MRI suggested an IEC located in the left parasellar region, which compressed the left trigeminal nerve. Resection was performed through a pterional approach. Gross total resection was successful without injuring nearby structures. Histopathological examination confirmed the diagnosis of epidermoid cyst. Post-operative care was uneventful and patient was discharged 3 days after surgery. Discussion: Less commonly located IEC in the parasellar region, instead of the cerebellopontine angle, results in compression of the trigeminal nerve. Surgery is appropriate for symptomatic cases. Surgical resection through a pterional approach provided access to the deeply located lesion in the parasellar region. Gross total resection should always be attempted while considering the risk of injuring nearby structures. Conclusion: Despite IECs being rare intracranial lesions with frequent adhesion and high rate of recurrence, gross total resection should always be attempted. Pterional approach provided great access for intracranial mass located in the parasellar region. Longer follow-up is suggested to monitor clinical outcome and also recurrence.