case_images: PMC10301739_01
case_images: Preoperative MRI scan of the patient. T1-weighted images revealed a well-defined hypointense lesion at the right side of the saddle (A). T2-weighted sequences showed a small cystic and homogeneous hyperintense lesion, measuring approximately 1.0 cm x 1.2 cm (B). Cranial neuroimaging revealed a dumbbell-shaped cystic shadow on the right side of the saddle, suggesting a potential small cyst of the right oculomotor nerve root sheath (C).
case_images: fendo-14-1153263-g001.jpg
case_images: PMC10301739_01_fendo-14-1153263-g001.jpg
case_images: f1
case_images: T1-weighted images and a small cystic and homogeneous hyperintense lesion on T2-weighted sequences, measuring approximately 1.0 cm x 1.2 cm ( Figures 1A, B ), with a potential mass effect on the right oculomotor nerve. This lesion was associated with an abnormal light reflex. She also underwent cranial neuroimaging ( Figure 1C ), which demonstrated a dumbbell-shaped cystic shadow on the right side of the saddle, suggesting a potential small cyst on the right oculomotor nerve root sheath.
case_images: Postoperative MRI scan of the patient. T2-weighted imaging (B, D) showed an inhomogeneous signal on the right side of the pituitary gland, a nodular-like lesion that was hyperintense, measuring approximately 0.7 cm x 0.7 cm. On T1-weighted imaging (C), it was hypointense, without enhancement after the intravenous administration of the extracellular contrast agent on postcontrast axial T1-weighted imaging (A). (E) shows the gross specimen that was resected during the operation.
case_images: fendo-14-1153263-g002.jpg
case_images: PMC10301739_01_fendo-14-1153263-g002.jpg
case_images: f2
case_images: Figure 2E ). Furthermore, a 0.5 cm x 0.5 cm white okara-like tissue at the right oculomotor nerve in the orbit, which is not adherent to the surrounding tissues and with an intact capsule, was observed. T2-weighted imaging ( Figures 2B, D ), measuring 0.7 cm x 0.7 cm, and was hypointense on T1-weighted imaging ( Figure 2C ), without enhancement after the intravenous administration of the extracellular contrast agent on postcontrast axial T1-weighted imaging ( Figure 2A ). The patient was discharged on the 12th postoperative day.
case_images: Specimens sent for pathological diagnosis revealed keratin debris without a squamous epithelial lining. Considering the intraoperative findings of this case, a definite diagnosis of an epidermoid cyst was established.
case_images: fendo-14-1153263-g003.jpg
case_images: PMC10301739_01_fendo-14-1153263-g003.jpg
case_images: f3
case_images: Considering the intraoperative findings, a definite diagnosis of an epidermoid cyst was established ( Figure 3 ).