Suprasellar dermoid cyst associated with colloid cyst of the third ventricle: Disordered embryogenesis or a mere coincidence?
A 22-year-old male patient presented with on and off frontal headaches and occasional blurring of vision for 1 year. Patient was operated initially for suprasellar dermoid cyst 5 years back. Bifrontal craniotomy and partial excision of dermoid cyst was performed during previous surgery. Patient was asymptomatic 4 years after first surgery. Clinical examination was normal with visual acuity of 6/6 in both eyes without evidence of any field defects on perimetry. Routine hematological and biochemical investigations were normal. Hormone status of the patient was normal. Magnetic resonance imaging (MRI) revealed mainly cystic lesion in the suprasellar region with small solid component anteriorly which was hyperintense on T1-weighted sequences without any contrast enhancement. Cyst wall did not show any enhancement on contrast. Simultaneously a colloid cyst of 1.2 × 1.5 cm was seen at the foramen of Monro, mainly occupying third ventricle with evidence of mild hydrocephalus []. An old bifrontal craniotomy was re-explored and complete excision of suprasellar dermoid cyst was achieved through bilateral subfrontal approach along with transcortical transventricular excision of colloid cyst in the same setting. Intraoperatively, suprasellar cyst was containing a whitish fluid with fat globules with small solid vascularized fatty nodule. Post-operative scans showed complete excision of both the lesions []. Histopathological findings confirmed the diagnosis [].