A case of sellar epidermoid tumour with haemorrhage

Abstract

Introduction: Intracranial epidermoid cysts are congenital inclusion tumours. Cerebellopontine angle and parasellar locations are the common locations. This is a report of an intrasellar epidermoid cyst with haemorrhage, which is rare. Case report: A 70-year-old female presented with bifrontal headache, vertigo, and nasal discharge. Contrast-enhanced Magnetic resonance imaging[MRI] showed heterogeneously enhancing lesion in sella turcica. Internal hemorrhagic foci were seen. Computed tomography[CT] scan showed a slightly hyperdense tumour of sella. Transnasal transsphenoidal excision was done. Hemorrhagic and colloid material came out. Histopathological examination showed cyst lined by stratified squamous epithelium with keratohyalin granules and keratin flakes, suggestive of an epidermoid cyst. Discussion: Usually epidermoid cyst is hypodense in CT scan. But hyperdensity can occur due to calcification of keratinized debris, increased protein content, and recurrent haemorrhage. Enhancement with gadolinium in MRI is mild and in cyst wall. Haemorrhage and enhancement are probably due to foreign body granulation tissue developing from leakage.