Parasellar neurenteric cyst : Unusual site and histology : Case report. Commentaries

OBJECTIVE AND IMPORTANCE: Intracranial neurenteric cyst is an exceedingly rare, congenital, benign, space-occupying lesion, and only a few reports of intracranial neurenteric cysts have been documented. We report a case of parasellar neurenteric cyst, a site not previously reported in the literature. A further rarity was the presence of smooth muscle as part of the cyst wall. This feature provides support for an endodermal origin of the cyst. CLINICAL PRESENTATION: A 27-year-old man presented with recurrent episodes of headache, vomiting, and left ptosis. Magnetic resonance imaging disclosed a cystic lesion in the parasellar region. INTERVENTION: A well-circumscribed cystic lesion was resected through a left frontotemporal craniotomy. At follow-up examination, persistent cranial nerve deficits were present. CONCLUSION: Hitherto unreported, a parasellar location of a well-encapsulated neurenteric cyst is described. The presence of a subepithelial smooth muscle layer, reminiscent of bronchiolar/intestinal muscularis mucosa, provides strong evidence for an endodermal origin of this cystic lesion.