편측 시력 손실을 초래한 거대 안상 유피낭종의 수술적 치료

Surgical Management of a Giant Suprasellar Epidermoid Tumor with Unilateral Visual Loss

Suprasellar epidermoid tumor presenting with visual loss is rare. A 50-year-old woman was referred for treatment of a large well demarcated cystic mass at the suprasellar region. She had a history of left visual loss for several years. To preserve the vision of right side, we underwent VEP (visual evoked potential) preoperatively and monitored VEP during the surgery. During surgery, the right optic nerve was severely compressed by the tumor, and was successfully decompressed without damage to the optic nerve. The left optic nerve was more severely compressed by the fibrotic and calcified tumor capsule around the optic canal. The 6 cm sized multilobulated tumor was subtotally resected while preserving the visual functions of the right side. We report a case of giant epidermoid tumor with unilateral visual loss, for which surgical removal was aided by VEP monitoring to save the only remaining vision.