Hemorrhagic colloid cyst in a 9-year-old girl

Colloid cysts of the third ventricle are benign intracranial tumors that usually become symptomatic in adults, rather than in children. Rare hemorrhages in these cysts can cause acute obstructive hydrocephalus and sudden death. We report a novel pediatric case of hemorrhagic colloid cyst in a 9-year-old girl who presented with headaches, nausea, and had sudden deterioration of her mental status. The patient underwent emergent ventriculostomy and then craniotomy to resect the colloid cyst; she had an excellent recovery.     

Hemorrhagic colloid cyst of the third ventricle: A rare cause of colloid cyst growth and progressive hydrocephalus. Case report

IntroductionAcute spontaneous bleeding within a colloid cyst of the third ventricle is extremely rare. Accordingly, is difficult to establish reliable prognostic factors, risk factors for obstructive hydrocephalus remain poorly defined, and there are no standard management strategies.Case presentation19-Year-old man with a colloid cyst of the third ventricle causing obstructive hydrocephalus is described, initially treated with partial endoscopic removal and ventriculo-peritoneal shunt placement. Serial neuroimaging follow-up showed gradual growth of the cyst due to clinically silent intracystic recurrent hemorrhage. Microsurgical transcallosal approach was performed and the cyst was totally resected. Pathological examination demonstrated hemorrhages of varying ages within the tumor.ConclusionBleeding within a colloid cyst must be considered when neuroimaging follow-up shows cyst growth, even with no clinical events associated. Hemorrhagic changes within the colloid cyst should be considered in the surgical indication and approach.     

Olfactory colloid cyst

Colloid cysts are rare intracerebral lesions that are predominantly located in the third ventricle. Extraventricular colloid cysts have only rarely been reported but so far there are no reports of a colloid cyst residing in the olfactory groove. A 74-year-old patient underwent a brain computed tomography scan for a mild head trauma that incidentally revealed a space-occupying lesion near the olfactory groove. Brain magnetic resonance imaging that ensued demonstrated a hyperintense lesion in T₁, T₂, and FLAIR sequences, without evidence of surrounding brain edema. To evaluate the metabolic status of the lesion, brain single-photon emission computed tomography with ^99mTc-Tetrofosmin was then performed, revealing no tracer uptake, a finding consistent with benignity. Due to the diagnostic uncertainty the excision of the lesion was proposed. The patient underwent surgery and intraoperative a cyst was revealed. Furthermore the cyst seemed to erode the dura and due to its location there was an imminent danger for cerebrospinal fluid leak. Therefore a repair of the dura was performed and the cyst was excised totally. Histology verified the presence of a colloid cyst. Colloid cysts should be included in the differential diagnosis of lesions in the anterior fossa and although benign they may have an aggressive presentation by eroding the dura and producing CSF leak.     

Familial colloid cyst

Colloid cysts of the third ventricle are rare benign tumours that can present as symptomatic hydrocephalus or be an incidental finding on imaging. This report presents familial colloid cysts found in a mother and daughter. Prior examples of familial colloid cysts are also reviewed and suggestions regarding the mode of inheritance and screening strategy are proposed.     

Solid-calcified colloid cyst of the third ventricle

We report a 65-year-old female with a solid-calcified colloid cyst in the third ventricle that was demonstrated on computed tomography scan and magnetic resonance images. The lesion was surgically excised using the anterior transcallosal-transforaminal approach. Complete preservation of the surrounding neural and vascular structures was achieved.     

Origin of colloid cyst: immunoperoxidase study

Despite their consistent anatomic location and histological features, the histogenesis of colloid cysts has remained obscure. We report immunohistochemical data on surgically excised cysts in attempt to define the origin of the lining epithelial cells. Paraffin-embedded tissues from colloidal cysts (7 in the 3rd ventricle and one in the sella) and two similar epithelial cysts (one in the cerebellopontine angle and one in the sella) were investigated. After examination by conventional stains, immunoperoxidase studies were carried out using primary antisera against epithelial membrane antigen (EMA), tissue polypeptide antigen (TPA), epidermal keratin (EK) and S-100 protein. The apical plasma membrane, surface microstructures were consistently EMA positive. Columnar cells demonstrated cytoplasmic staining for TPA. Basal cells of lining epithelia expressed EK. All epithelia studied were negative for S-100 protein. These findings suggest an endodermal origin of colloid cysts.     

Xanthogranulomatous colloid cyst of the third ventricle

Summary This is a case report of a xanthogranulomatous colloid cyst of the 3rd ventricle. Posible etiologies for this rare entiry, along with the clinical problems that may be associated with it, and the differential diagnosis are discussed.     

Coexistence of colloid cyst and neuroglial heterotopia

Introduction Colloid cyst is a rare intracranial tumor in childhood. This is the first report on the coexistence of a colloid cyst and the neuroglial heterotopia.Discussion A 3-year-old boy presented with a 10-day history of headache. Radiological findings revealed a cyst in the third ventricle and a solid mass protruding into the lateral ventricle causing obstructive hydrocephalus. The cyst was attached to the solid mass. Endoscopic aspiration and removal of the cyst followed by biopsy of the protruding mass was performed. Headache and vomiting then disappeared and the patient returned to normal life.Conclusion The pathologic diagnosis was a colloid cyst associated with neuroglial heterotopia. We experienced a case of coexistent colloid cyst and neuroglial heterotopia, which have different embryonal origins.     

Familial colloid cyst of the third ventricle

We describe the cases of a mother and son who presented one year apart with a colloid cyst of the third ventricle. The mother was symptomatic and had complete resolution of her symptoms after surgical intervention. Her son was asymptomatic. There have been several reported instances of a familial association of colloid cysts of the third ventricle. The probability of a colloid cyst occurring in the same family coincidentally is possible, but highly unlikely (1 x 10(10)). The increasing number of reports of the familial incidence of colloid cysts would suggest the possibility of an autosomal dominant inheritance pattern, but to date, a familial pattern of inheritance has not been recognised. If there is a potential genetic link, then screening of asymptomatic relatives may be indicated. With non-invasive imaging techniques, such as computed tomography and magnetic resonance imaging scanning, accurate diagnosis and effective elective treatment is possible. This may result in preventing future complications as a result of hydrocephalus or sudden unexpected death, and also reduce morbidity as surgery can be done electively rather than as an emergency procedure.     

Giant,calcified colloid cyst of the lateral ventricle

We report a patient with a giant, calcified colloid cyst in the left lateral ventricle. Colloid cysts are slow growing, benign lesions, commonly originating in the roof of the anterior third ventricle near the foramen of Monro. Many colloid cysts are small lesions which are either discovered incidentally or cause headache, visual changes, memory deficits, and/or syncope. Giant colloid cysts are rare. A 40-year-old man presented with a month long history of worsening headaches and was found to have a multiloculated 5 cm intraventricular mass with an anterior hyperdensity, suggestive of calcification, arising within the lateral ventricles. He underwent an interhemispheric transcallosal approach for resection of the mass. The pathology was consistent with a giant colloid cyst with calcification in the anterior cyst wall. Giant, calcified mass is a rare presentation of colloid cyst. Although rare, this diagnosis remains an important consideration in the differential diagnosis of any calcified, cystic intraventricular mass.     

Intraventricular colloid cyst, hydrocephalus and neurogenic stunned myocardium

OBJECTIVE: To report the occurrence of neurogenic stunned myocardium in the context of a hydrocephalus due to a third ventricle colloid cyst. DESIGN: Case report. SETTING: Neurocritical care unit of a university hospital. PATIENT: The case of a 33-year-old woman with an intraventricular cerebral colloid cyst who developed hydrocephalus, cardiac arrest and survived is presented. Workup was consistent with neurogenic stunned myocardium in the context of acute hydrocephalus due to an intraventricular colloid cyst. RESULTS: The patient had decreased left ventricular ejection fraction, apex-sparing areas of hypokinesis and akinesis, wall motion abnormalities not matching a particular vascular territories, the peak troponin T level of 0.09 ng/ml and had normal coronary arteries at angiography. Seven days after the initial event the cardiac function recovered. Tumor resection was successfully performed. At 10 months after discharge, the only complaint was mild memory disturbance, she was completely functional with no evidence of seizures or of cardiac dysfunction. CONCLUSION: The sudden elevation of intracranial pressure, with the subsequent decreased cerebral perfusion pressure induces a vigorous cerebro-protective neuroendocrine system activation that can lead to the neurogenic stunned myocardium. Sudden death in patients with colloid cysts may be related to acute neurogenic cardiac dysfunction, and not necessarily cerebral herniation(s), as previously thought.     

Inheritance of nasal dermoid sinus cyst and evidence for association with third ventricle colloid cyst

Purpose  

The purpose of this paper is to study the possible inheritance of nasal dermoid sinus cyst in the Finnish population.     

Ultrastructural observation on a colloid cyst of the third ventricle

Summary The case involves a colloid cyst of the third ventricle in a 20-year-old man. The lining epithelia of the cyst were composed of two different types of epithelial cells; stratified squamous cells and mucincontaining columnar cells. The presence of both squamous and glandular cells in the cyst wall supports the contention that the colloid cyst in the present case derived from an non-neuroepithelial source. The clinico-pathology of this cystic tumor is compared here with other epithelial cysts of the central nervous system (CNS), especially Rathke's cyst.     

Giant colloid cyst occupying a cavum septum pellucidum et vergae

Colloid cysts are uncommon, intracranial lesions frequently arising from the anterior aspect of the third ventricle. Rarely a cyst presents greater than 30 mm diameter as a giant colloid cyst. This case reports a patient with a giant colloid cyst occupying a cavum septum pellucidum et vergae. The clinical and operative significance of this anatomical variation is discussed and the giant colloid cyst literature reviewed.