Prolonged Postoperative Pyrexia and Transient Nonnephrogenic Vasopressin-Analogue-Resistant Polyuria following Endoscopic Transsphenoidal Resection of an Infundibular Epidermoid Cyst

Figure 2

The intercavernous sinus has been cut after cauterization (a). A Y-shaped dural incision is made (a). The cyst wall is found above the pituitary gland (b). Vascular streaks are found on the cyst wall, indicating the pituitary stalk is tumorized (b). The cyst is displacing the optic chiasm (c). The cyst contents are aspirated via a long needle (d). After the aspiration (d), the cyst is shrunken so that the working space in this tumor resection is secured. An indentation is observed in the inferior surface of the decompressed optic chiasm (e). The solid cyst contents appeared as tissue debris, keratin, solid cholesterol, and their mixtures, which were meticulously removed (f). Since the cyst wall is the tumorized pituitary stalk, the cyst was gross-totally removed from the intrasellar part to the infundibular part (g). The opened skull base (h) is reconstructed with a fat-on-fascia graft plug [8].

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