SAT-LB312 Central Diabetes Insipidus as Presenting Manifestation of Suprasellar Epidermoid Cyst

Abstract

Back Ground: Epidermoid cysts (ECs) result from the inclusion of squamous epithelial elements during neural tube closure. ECs are tumors constituting 02-1.8% of all brain tumors. ECs are typically found in cerebellopontine angle, but occasionally develop in sellar region. ECs are usually clinically silent, but may produce signs of mass effect as headaches, visual field defects. ECs presenting with Central Diabetes insipidus is reported but rare. Only two cases were reported in literature (Ref: 1).Here we report a case of sellar Epidermoid cyst presenting with Diabetes insipidus. Case Description: 49-year male presented with one-month history of polyuria, polydipsia and weight loss. The initial work up identified normal blood glucose, serum calcium and renal function. The water deprivation test confirmed the diagnosis of central Diabetes insipidus. Further pituitary hormonal assessment revealed panhypopituitarism along with diabetes insipidus. The MRI of brain showed evidence of large sellar supracellar cystic mass with a differential diagnosis of craniopharyngioma, Rathkeys cyst. Surgery performed in order to remove the tumor. The pathological report confirmed the tumor as epidermoid cyst. He did well through hospital stay. DI and along with panhypopituitarism persisted post operatively and treated with hormonal replacement. Conclusion: ECs of sellar region vary in presentation depending upon their location, and extension into surrounding areas producing mass effects. Diabetes Insipidus is a rare presentation in these rare tumors.