Huge colloid cyst: case report and review of unusual forms

Congenital colloid cyst with astigmatism in adult male patient: a rare case report

Introduction and importance

Colloid cysts are rare brain tumors that can cause headaches, memory problems, and vision issues. Early diagnosis and treatment are crucial to prevent complications.

Case presentation

The authors report a case of a patient in their 20s with a 2-year history of headaches and blurry vision. A computed tomography (CT) scan revealed a colloid cyst in the third ventricle. The patient was diagnosed with astigmatism and managed with corrective lenses and regular CT scans.

Clinical discussion

The patient's astigmatism may be linked to the colloid cyst, potentially due to migraines triggered by the cyst's location. Further research is needed to understand this relationship.

Conclusion

This case highlights the potential for colloid cysts to contribute to vision problems. Careful evaluation and individualized management are essential for patients with colloid cysts and vision disturbances.

Spontaneous dissolution of a cyst located within the septum pellucidum in a patient with sarcoidosis: a case report

Sarcoidosis is a granulomatous multisystem disease of unknown etiology. Typically, the disease affects the lungs, causing enlargement of the mediastinal lymph nodes, but other organs can be affected. Neurosarcoidosis is reported in 5-10% of the patients. This case represents a 39-year-old male patient diagnosed with lung sarcoidosis. Due to neurological symptoms, a contrast-enhanced cerebral magnetic resonance imaging was performed. Neurosarcoidosis was presented with meningeal enhancement adjacent to a cyst located within the cavum septum pellucidum. The cyst dissolved spontaneously within six months. The finding of a cyst located within the septum pellucidum is rare.

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.

Infected colloid cyst

INTRODUCTION

Colloid cysts are the most common pathologic lesions of the third ventricle. Although they are histologically benign, they may grow and can cause the hydrocephalus. A 5-year-old male patient underwent to surgery with the diagnosis of colloid cyst. In operation, after the anterior transcallosal approach, the cyst was punctured by syringe and obviously pus aspirated.

CONCLUSION

Colloid cysts mostly remain silent and detected incidentally. Although it is rarely defined, rhinorrhea, hypopituitarism, diabetes insipidus, spasmodic torticollis, drop attack, aseptic meningitis, and coexistence with neurocysticercosis have been reported, but this is the first reported case of an infected colloid cyst.

Imaging of spontaneous intraventricular rupture of a septum pellucidum colloid cyst: case report

Intraventricular rupture of a colloid cyst is a rare phenomenon and has been proposed as a mechanism for sudden death in patients with colloid cysts. Imaging of a colloid cyst during rupture has been described in only one other instance. The authors report a highly unusual case of a 53-year-old man who presented with acute onset headaches and imaging findings of hydrocephalus caused by a colloid cyst originating from the septum pellucidum and superior surface of the roof of the third ventricle. Interestingly, the colloid cyst revealed imaging signs of intraventricular rupture characterized by a tail-like drainage of cystic contents into the occipital horn of the lateral ventricle. The patient was surgically treated with a craniotomy and transcallosal approach to the colloid cyst, where it was noted that the cyst wall was spontaneously open. This rare case highlights unique imaging findings of a rare event in an infrequent pathology confirmed with intraoperative microscopy. The authors further document the process of cyst rupture and speculate on its pathomechanisms.

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.

Huge familial colloid cyst of the third ventricle: An extraordinary presentation

Background:

Since the use of computed tomography and magnetic resonance imaging, colloid cysts (CCs) are discovered more frequently and subsequently their true incidence exceeds the numbers previously estimated. In 1986, the first familial case was reported in two identical twin brothers. To date, a total of 17 of these cases have been reported, all differing in the pattern of affected family members.

Case Description:

Here, we describe a unique presentation of a familial case and review the relevant literature on CCs and their natural history to improve our understanding of these cases.

Conclusion:

Familial CC can present in various patterns, sizes, and forms. A genetic factor is likely to be responsible in these cases, and further research is warranted to clarify this phenomenon.

A rare case of pediatric colloid cysts in bilateral ventricles

Colloid cysts often arise in the third ventricle. It is quite rare for colloid cysts to arise from lateral ventricles. We describe a case of a patient with colloid cysts in the bilateral ventricles. The patient eventually underwent a surgical operation to alleviate the symptoms. Colloid cysts have the potential to be misdiagnosed in the clinical practice; therefore, magnetic resonance imaging and magnetic resonance spectroscopy would be effective for differential diagnosis.

Aneurysm of the distal anterior cerebral artery radiologically mimicking a ventricular mass

The ventricular system is a rare localization for intracranial aneurysms. Most ventricular aneurysms arise from a distal branch of the choroidal arteries and a major branch point of the circle of Willis. A 41-year-old-man suffering from dizziness of 2 weeks' duration was admitted to the clinic. On radiological examination, he had a well-circumscribed mass involving the frontal horn of the right lateral ventricle without radiological evidence of a prior or recent hemorrhage. Localization and radiological appearance were not typical of a ventricular mass and did not allow diagnosis. After cerebral angiography, an aneurysm arising from the distal anterior cerebral artery was incidentally found in an intraventricular location. This unruptured aneurysm was successfully treated via the endovascular route. The authors describe the unusual case of a distal anterior cerebral artery aneurysm with a dome extending into the right lateral ventricle, which appears to be the first such case in the literature. Angiography may be helpful to neurosurgeons in avoiding the disastrous complications of a biopsy procedure in such unusual cases.

Pediatric colloid cysts of the third ventricle: management considerations

PURPOSE

Pediatric colloid cysts (CC) have a congenital origin, and yet, there are very few studies focussing exclusively on their occurrence in the pediatric population. Pediatric CC has been associated with more aggressive clinical and radiological patterns than their adult counterparts. In this study, undertaken on children with anterior third ventricular CC, excised using the interhemispheric transcallosal approach, the characteristic clinicoradiological features and management options are studied.

METHODS

Five pediatric patients (aged 16 years or less; mean age 13.8 years; mean duration of symptoms:7.6 months) out of 38 patients with CC operated between 1995 to 2009 were included. The clinical manifestations included those of raised intracranial pressure (n = 4); exacerbation of occipital headache on reading (n = 1); secondary optic atrophy (n = 3); and, drop attacks (n = 1). On computed tomography scan, the cyst was hyperdense, enhancing in two patients and not enhancing in three patients. All had bilateral lateral ventricular dilatation with periventricular lucency. On magnetic resonance imaging (n = 3), the cyst was T1 hypointense and T2 isointense in one, hyperintense on both T1 and T2 with a hypointense capsule and nonenhancing on contrast in one (with a giant colloid cyst), and T1 hyperintense and T2 hypointense in one patient. An interhemispheric, transcallosal trajectory combined with transforminal approach (n = 3); combined transforminal and subchoroidal approaches (n = 1); and, interforniceal approach (n = 1) were used.

RESULTS

Total excision was performed in four patients. In one patient, a small part of capsule was left attached to thalamostriate vein. Symptoms of raised intracranial pressure showed improvement in all the patients with resolution of hydrocephalus. There was no tumor recurrence at follow-up.

CONCLUSIONS

Pediatric colloid cysts are rarer than their adult counterparts due to their late detection only after manifestations of raised intracranial pressure, visual or cognitive dysfunction or drop attacks occur. Their radiological appearance varies depending upon the amount of mucoid content, cholesterol, proteins, and water content. The fast development of clinical manifestations in children may be related to rapid enlargement of cyst due to higher water content within them. The transcallosal approach is the "gold standard" of surgery and usually ensures gratifying and lasting results.