Recurrent intrasellar arachnoid cyst.

A 48-year-old man presented with complaints of decreased visual acuity persisting for 6 weeks in December 1997. Neurological examination demonstrated defects in the superior bitemporal visual field and bilateral optic atrophy. Computed tomography and magnetic resonance (MR) imaging showed an intrasellar cystic lesion. The cyst wall was excised via a transsphenoidal approach. The diagnosis was intrasellar arachnoid cyst. The sellar floor was reconstructed after packing fat in the sellar turcica. The visual complaint improved, but he was lost to follow up. Four years later, he was re-admitted complaining of decreased visual acuity. Superior bilateral field defects were found. MR imaging revealed recurrence of the intrasellar arachnoid cyst. The cyst wall was excised through a craniotomy. The visual acuity and the visual field defects gradually improved. Intrasellar arachnoid cyst may recur after transsphenoidal surgery, so long-term follow up is necessary after excision of the intrasellar cyst wall.