PMC7749933_01
Preoperative magnetic resonance imaging (MRI) showed cystic image in the sellar and suprasellar region (i.e., 17 x 20 x 22 mm) hyperintense on T2 sequence and hypointense on T1 with no capsule enhancement on the contrast study, causing upward displacement and compression of the optic chiasm. Postoperative MRI reveals resection of the cyst with liberation of the sellar and interpeduncular arachnoid space.
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F1
Brain magnetic resonance (MR) showed a cystic image in the sellar and suprasellar region (i.e., 17 x 20 x 22 mm) hyperintense on T2 sequence and hypointense on T1 with no capsule enhancement on the contrast study, causing upward displacement and compression of the optic chiasm [Figure 1].
(a) Planning the approach taking into account the anatomical landmarks (supraorbital nerve and artery, frontal branch of the facial nerve, zygomatic arch, and supraorbital notch). (b-d) Single frontobasal burr hole was made posterior to the temporal line, thereafter, a "c"-shaped line is cut from the medial border of the frontobasal cut, thus creating a bone flap with a width of 2 x 3 cm. (e) Surgical field where is observed the internal carotid artery, optic nerve, and the cyst. (f and h) Once the cystic portion was resected, we identified a nodular portion compatible with the scolex. (g) Free carotid optic space due to total cyst resection.
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F2
This was performed utilizing microscopic visualization and we identified a cyst with a firm avascular capsule, clear liquid content, with lax adhesions to the chiasm, optic nerves and to a small area of thickened arachnoid and diaphragm sellae, without arterial compromise that was fully resected without complications or incidents [Figure 2].
Microscopic image demonstrating the scolex and the parasitic wall with wavy, dense cuticle, and focal globular structure, surrounding inflammatory, mononuclear lymphocytic reaction with plasma cells. (H and E) (x40 and x100).
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F3
Histological examination revealed a parasitic wall characterized by wavy, dense cuticle, and focal globular structure, surrounding inflammatory, mononuclear lymphocytic reaction with plasma cells [Figure 3].