Persisting Embryonal Infundibular Recess: Case Report and Imaging Findings

World Neurosurg. 2018 Sep:117:11-14. doi: 10.1016/j.wneu.2018.05.228. Epub 2018 Jun 7.

Abstract

Background: Persisting embryonal infundibular recess (PEIR) is a rare anomaly of the third ventricular floor, with only 10 cases having been reported to date. Accurate imaging diagnosis of this entity is essential to avoid unnecessary surgery and its associated morbidity. The following case is presented to emphasize its recognition in the differential diagnosis of pituitary cystic lesions.

Case description: A 38-year-old woman was referred for evaluation of a pituitary cystic mass. Magnetic resonance imaging (MRI) revealed a 10.2-mm cystic mass in an enlarged sella turcica. Three-dimensional high-resolution MRI using constructive interference in steady-state sequence clearly delineated a communicating tract between the third ventricle and the sellar cyst through pituitary stalk. A final diagnosis of PEIR was made. The patient was managed successfully with conservative treatment, and the lesion was in a stationary condition over a 5-year follow-up period.

Conclusions: This is the first case report demonstrating imaging features of PEIR in 3-dimensional high-resolution MRI. Although PEIR is a rare anomaly, imaging diagnosis of this entity is important because confusion with other pituitary cystic lesions and the attempt of surgical removal may lead to serious complications.

Keywords: 3D CISS MRI; Developmental anomaly; Persisting embryonal infundibular recess; Sellar cyst; Third ventricle.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Conservative Treatment
  • Cysts / diagnostic imaging
  • Diagnosis, Differential
  • Female
  • Humans
  • Imaging, Three-Dimensional
  • Magnetic Resonance Imaging
  • Pituitary Diseases / diagnostic imaging*
  • Pituitary Gland / diagnostic imaging
  • Sella Turcica / diagnostic imaging
  • Third Ventricle / abnormalities*
  • Third Ventricle / diagnostic imaging*