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Child's Nervous System

, Volume 34, Issue 7, pp 1391–1396 | Cite as

An extraaxially localized intrasellar giant hydatid cyst with hypophyseal insufficiency

  • Gökhan Çavuş
  • Vedat Açik
  • Yeliz Çavuş
  • Emre Bilgin
  • Yurdal Gezercan
  • Ali Ihsan Ökten
Original Paper

Abstract

Purpose

A hydatid cyst is a parasitic illness that is caused by the larvae of Echinococcus granulosus. Hydatid cysts occur in the liver in 75% and in the lungs in 15% of cases. Central nervous system involvement is rare (perhaps as low as 1%), and the majority of such cases are observed in children. Headache and vomiting are the most frequently observed symptoms. In patients diagnosed with a hydatid cyst, imaging methods and serologic tests are very important for identifying cranial involvement. The most curative method is to remove the unruptured cyst using Dowling’s method and to then wash the resulting gap with sodium chloride.

Methods

The patient was a 16-year-old female with previous occasional headaches, progressive loss of vision, and general affective disorder.

Results

The patient presented at the emergency department with the above-mentioned complaints. She was hospitalized for a large cystic lesion in an extraaxially intrasellar location based on computerized tomography (CT) of the brain. The cyst was excised, and medical treatment was applied.

Conclusions

Hydatid cysts are rarely located in the central nervous system. Treatment involves surgical and medical interventions. In this article, we present the first published case of a giant hydatid cyst with an extraaxial intrasellar location. This is the first such case to be reported in the literature. The cyst caused somnolence, general affective disorder, panhypopituitarism, and progressive loss of vision.

Keywords

Intrasellar Hydatid cyst Panhypopituitarism Echinococcus 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Informed consent was obtained from all individual participants who were included in the study.

Ethical approval

All procedures performed in studies involving human participants were conducted in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

References

  1. 1.
    Evliyaoglu C, Yuksel M, Gul B, Kaptanoglu E, Yaman M (1998) Growth rate of multiple intracranial hydatid cysts assessed by CT from the time of embolisation. Neuroradiology 40(6):387–389.  https://doi.org/10.1007/s002340050607 CrossRefPubMedGoogle Scholar
  2. 2.
    Iplikçioğlu AC, Ozer AF, Benli K, Işik N, Erbengi A (1989) Multiple cerebral hydatid cysts: report of two cases. Br J Neurosurg 3(2):217–219.  https://doi.org/10.3109/02688698909002797 CrossRefPubMedGoogle Scholar
  3. 3.
    Turgut AT, Altin L, Topçu S, Kiliçoğlu B, Aliinok T, Kaptanoğlu E et al (2007) Unusual imaging characteristics of complicated hydatid disease. Eur J Radiol 63(1):84–93.  https://doi.org/10.1016/j.ejrad.2007.01.001 CrossRefPubMedGoogle Scholar
  4. 4.
    Kammerer WS (1993) Echinococcosis affecting the central nervous system. Semin Neurol 13(02):144–147.  https://doi.org/10.1055/s-2008-1041118 CrossRefPubMedGoogle Scholar
  5. 5.
    Pedrosa I, Saíz A, Arrazola J, Ferreirós J, Pedrosa CS (2000) Hydatid disease: radiologic and pathologic features and complications. Radiographics 20(3):795–817.  https://doi.org/10.1148/radiographics.20.3.g00ma06795 CrossRefPubMedGoogle Scholar
  6. 6.
    Turgut M (2001) Intracranial hydatidosis in Turkey: its clinical presentation, diagnostic studies, surgical management, and outcome. A review of 276 cases. Neurosurg Rev 24(4-6):200–208.  https://doi.org/10.1007/s101430100168 CrossRefPubMedGoogle Scholar
  7. 7.
    Bükte Y, Kemaloğlu S, Nazaroğlu H, Özkan U, Ceviz A, Şimsek M (2004) Cerebral hydatid disease: CT and MR imaging findings. Swiss Med Wkly 134(31-32):459–467PubMedGoogle Scholar
  8. 8.
    Darwazah AK, Zaghari M, Eida M, Batrawy M (2013) Left ventricular endocardial ecchinococcosis associated with multiple intracranial hydatid cysts. J Cardiothorac Surg 8(1):104.  https://doi.org/10.1186/1749-8090-8-104 CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Karadağ O, Gürelik M, Özüm U, Göksel HM (2004) Primary multiple cerebral hydatid cysts with unusual features. Acta Neurochir 146:73–77; discussion 77CrossRefPubMedGoogle Scholar
  10. 10.
    Çakır D, Çelebi S, Gürpınar A, Ağın M, Bozdemir ŞE (2009) Evaluation of cases with hydatid diseases. J Pediatr Inf 3:104–108Google Scholar
  11. 11.
    King CH (2000) Echinococcosis. In: Mandell GL, Bennett JE, Dolin R (eds) Principles and practice of infectious disease. Churchill Livingston, New York, pp 2962–2963Google Scholar
  12. 12.
    Altıntaş N, Tınar R, Çoker A. Echinococcosis (1. baskı). In: AN, Tınar R, Çoker A (eds) Hidatoloji Derneği Yayın; 2004, pp 129–283.Google Scholar
  13. 13.
    Versaci A, Scuderi G, Rosato A, Angıo LG, Oliva G, Sfuncia G et al (2005) Rare localisation of echinococcosis: personal experience ANZ. J Surg 75:986–991Google Scholar
  14. 14.
    Blanton R (2007) Echinococcosis (Echinococcus granulosus and Echinococcus multilocularis). In: Behrman RE, Kliegman RM, Jenson HB, Stanton BF (eds) Nelson textbook of pediatrics, ed 18. WB Saunders, Philadelphia, pp 1516–1517Google Scholar
  15. 15.
    Boles DM (1981) Cerebral echinococciasis. Surg Neurol 16(4):280–282.  https://doi.org/10.1016/0090-3019(81)90057-4 CrossRefPubMedGoogle Scholar
  16. 16.
    Demir K, Karsli AF, Kaya T, Devrimci E, Alkan K (1991) Cerebral hydatid cysts: CT findings. Neuroradiology 33(1):22–24.  https://doi.org/10.1007/BF00593328 CrossRefPubMedGoogle Scholar
  17. 17.
    Paşaoğlu A, Orhon C, Akdemir H (1989) Multiple primary hydatid cysts of the brain. Turk J Pediatr 31(1):57–61PubMedGoogle Scholar
  18. 18.
    Altinörs N, Senveli E, Dönmez T, Bavbek M, Kars Z, Sanli M (1995) Management of problematic intracranial hydatid cysts. Infection 23(5):283–287.  https://doi.org/10.1007/BF01716287 CrossRefPubMedGoogle Scholar
  19. 19.
    Erşahin Y, Mutluer S, Güzelbağ E (1993) Intracranial hydatid cysts in children. Neurosurgery 33:219–224; discussion 224CrossRefPubMedGoogle Scholar
  20. 20.
    Ciurea AV, Fountas KN, Coman TC, Machinis TG, Kapsalaki EZ, Fezoulidis NI, Robinson JS (2006) Long-term surgical outcome in patients with intracranial hydatid cyst. Acta Neurochir 148(4):421–426.  https://doi.org/10.1007/s00701-005-0679-z CrossRefPubMedGoogle Scholar
  21. 21.
    Cataltepe O, Colak A, Ozcan OE, Ozgen T, Erbengi A (1992) Intracranial hydatid cysts: experience with surgical treatment in 120 patients. Neurochirurgia (Stuttg) 35(4):108–111Google Scholar
  22. 22.
    Kalaitzoglou I, Drevelengas A, Petridis A, Palladas P (1998) Albendazole treatment of cerebral hydatid disease: evaluation of results with CT and MRI. Neuroradiology 40(1):36–39.  https://doi.org/10.1007/s002340050535 CrossRefPubMedGoogle Scholar
  23. 23.
    Taş F, Gümüş C, Atalar M, Taş A, Eğilmez H, Bulut S (2002) Serebral kist Hidatiklerin Bilgisayarlı Tomografi Bulguları 24:113–118Google Scholar
  24. 24.
    Yüceer N, Güven MB, Yılmaz H (1998) Multiple hydatid cysts of the brain: a case report and review of literature. Neurosurgery 21:181–184Google Scholar
  25. 25.
    Arana-Iniquez R (1978) Echinococcus handbook of clinical neurology ınfections of the nervous system. North Holland Publishing Company, Amsterdam, pp 175–207Google Scholar
  26. 26.
    Arafah BM, Prunty D, Ybarra J, Hlavin ML, Selman WR (2000) The dominant role of increased intrasellar pressure in the pathogenesis of hypopituitarism, hyperprolactinemia, and headaches in patients with pituitary adenomas. J Clin Endocrinol Metab 85(5):1789–1793.  https://doi.org/10.1210/jcem.85.5.6611 PubMedGoogle Scholar
  27. 27.
    Zayour DH, Selman WR, Arafah BM (2004) Extreme elevation of intrasellar pressure in patients with pituitary tumor apoplexy: relation to pituitary function. J Clin Endocrinol Metab 89(11):5649–5654.  https://doi.org/10.1210/jc.2004-0884 CrossRefPubMedGoogle Scholar
  28. 28.
    Oruçkaptan H, Özcan OE. Pituiter apopleksi ve acil hipofiz cerrahisi. Editörler; Ziyal Mİ, Erbaş T. Hipofiz adenomla- rı, 1. In: Baskı, Hacettepe Üniversitesi Hastaneleri Basımevi (eds) 2008, pp 268–280.Google Scholar
  29. 29.
    Rajasekaran S, Vanderpump M, Baldeweg S, Drake W, Reddy N, Lanyon M, Markey A, Plant G, Powell M, Sinha S, Wass J (2011) UK guidelines for the management of pituitary apoplexy. Clin Endocrinol 74(1):9–20.  https://doi.org/10.1111/j.1365-2265.2010.03913.x CrossRefGoogle Scholar
  30. 30.
    Erbaş T (2006) Pituitary apoplexy. Turkiye Klinikleri. J Surg Med Sci 2:28–30Google Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of NeurosurgeryAdana Numune Training and Research HospitalYüreğir/AdanaTurkey
  2. 2.Department of RadiologyAdana Numune Training and Research HospitalAdanaTurkey

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