Third ventricular xanthogranulomas clinically and radiologically mimicking colloid cysts

1994 ◽  
Vol 81 (4) ◽  
pp. 605-609 ◽  
Author(s):  
Stephen B. Tatter ◽  
Christopher S. Ogilvy ◽  
Jeffrey A. Golden ◽  
Robert G. Ojemann ◽  
David N. Louis
Keyword(s):  
Mr Imaging ◽  
Histopathological Examination ◽  
Third Ventricle ◽  
Contrast Material ◽  
Colloid Cyst ◽  
Mr Images ◽  
Intravenous Contrast ◽  
Content Type ◽  
Stereotactic Aspiration ◽  
Colloid Cysts

✓ Two cases are reported of third ventricle masses that were clinically and radiographically indistinguishable from pure colloid cysts. A 21- and a 36-year-old man presented with 5-year and 10-day histories of headache, respectively. Magnetic resonance (MR) imaging revealed smooth, homogeneous masses in the anterior third ventricle that were iso- to hyperintense on T1-weighted MR images and hyperintense on T2-weighted images. There was little enhancement with intravenous contrast material. In both patients, craniotomies were performed and histopathological examination revealed xanthogranulomas of the choroid plexus with only microscopic foci of colloid cyst-like structures. These cases illustrate that xanthogranulomas of the third ventricle may clinically and radiologically mimic pure colloid cysts, that a range of MR imaging signals can be seen, and that craniotomy rather than stereotactic aspiration is the indicated treatment.

Stereotactic management of colloid cysts: factors predicting success

1991 ◽  
Vol 75 (1) ◽  
pp. 45-51 ◽  
Author(s):  
Douglas Kondziolka ◽  
L. Dade Lunsford
Keyword(s):  
Third Ventricle ◽  
High Viscosity ◽  
Colloid Cyst ◽  
Ct Guided ◽  
Content Type ◽  
Stereotactic Aspiration ◽  
Preoperative Ct ◽  
Initial Procedure ◽  
Colloid Cysts ◽  
Fine Print

✓ Stereotactic aspiration is a valuable surgical alternative for colloid cysts when used alone or in conjunction with microsurgical resection. Since 1981, the authors have performed computerized tomography (CT)-guided stereotactic aspiration as the initial procedure in 22 patients with colloid cysts; stereotactic aspiration alone was successful in 11 patients (50%). Of the 11 patients in whom aspiration failed, stereotactic endoscopic resection was attempted in three and was successful in one. Seven patients required a craniotomy and microsurgical removal of the cyst performed via a transcortical approach. The preoperative CT appearance in eight cases of a hypodense or isodense cyst correlated favorably with successful aspiration of the cyst in six patients. A hyperdense appearance on the preoperative CT scan in 14 cases was associated with subtotal aspiration in 13 patients; five required craniotomy for removal. Preoperative magnetic resonance (MR) imaging in eight patients provided excellent anatomical definition of the cyst and its relationship to other structures of the third ventricle, but it was not possible to correlate successful aspiration with cyst appearance on MR images with short or long relaxation time sequences. The authors' 9-year experience suggests that preoperative CT studies accurately determine size, predict viscosity, and help to define a group of colloid cyst patients for whom stereotactic cyst aspiration will likely be successful. Unsuccessful stereotactic aspiration was related to two features: the high viscosity of the intracystic colloid material (nine patients), or deviation of the cyst away from the aspiration needle due to small cyst volume (two patients). Because of its simplicity and low risk, stereotactic surgery can be offered to selected patients as the initial procedure of choice. Craniotomy can be reserved for those whose imaging studies predict failure or for those whose cyst cannot be aspirated.

Endoscopic treatment of colloid cysts of the third ventricle

1998 ◽  
Vol 89 (6) ◽  
pp. 1062-1068 ◽  
Author(s):  
M. Samy Abdou ◽  
Alan R. Cohen
Keyword(s):  
Surgical Technique ◽  
Endoscopic Resection ◽  
Endoscopic Treatment ◽  
Third Ventricle ◽  
Content Type ◽  
Stereotactic Aspiration ◽  
The Third ◽  
Endoscopic Evacuation ◽  
Colloid Cysts ◽  
Fine Print

✓ The surgical technique for the endoscopic evacuation of colloid cysts of the third ventricle in 13 patients is described. The authors conclude that endoscopic resection of these lesions is a useful addition to the current surgical repertoire and a viable alternative to stereotactic aspiration or open craniotomy.

Neuroepithelial (colloid) cyst of the third ventricle in identical twins

1986 ◽  
Vol 65 (3) ◽  
pp. 401-403 ◽  
Author(s):  
Abdel Wahab M. Ibrahim ◽  
Hisham Farag ◽  
Mohammed Naguib ◽  
Ezzeldin Ibrahim
Keyword(s):  
Cerebrospinal Fluid ◽  
Obstructive Hydrocephalus ◽  
Third Ventricle ◽  
Colloid Cyst ◽  
Content Type ◽  
The Third ◽  
Colloid Cysts ◽  
Fluid Pathway ◽  
Ocular Signs ◽  
Fine Print

✓ Colloid cysts of the third ventricle are described in middle-aged twin brothers. One of them presented with recurrent attacks of headache. In this patient the cyst had reached a size large enough to obstruct the cerebrospinal fluid pathway, resulting in hydrocephalus. The twin brother, although asymptomatic, was suspected of the anomaly and investigated because of the similarity of his ocular signs. The diagnosis was confirmed by computerized tomography in both the patient and his brother. The latter proved to have a smaller colloid cyst situated anteriorly in the third ventricle with no obstructive hydrocephalus. The patient was successfully operated on, while the brother is still under observation. Both brothers have had bilateral cataracts, retinal detachments, and left lateral rectus palsies. The familial occurrence of colloid cysts and their association with these ocular findings have apparently not been described before.

Migratory neurocysticercosis mimicking a third ventricular colloid cyst

2001 ◽  
Vol 95 (1) ◽  
pp. 122-123 ◽  
Author(s):  
Steven D. Wray ◽  
Thomas L. Ellis ◽  
Sabatino Bianco
Keyword(s):  
Preoperative Diagnosis ◽  
Histopathological Examination ◽  
Third Ventricle ◽  
Colloid Cyst ◽  
Foramen Of Monro ◽  
Radiographic Findings ◽  
Content Type ◽  
Intracranial Lesions ◽  
Microsurgical Approach ◽  
Mental Decline

✓ The authors report on a case of solitary neurocysticercosis located in the anterior third ventricle of a 21-year-old Hispanic man who presented with progressive headache, nausea, and mental decline. The appearance of the lesion on computerized tomography and magnetic resonance studies was typical of that of a colloid cyst, which was the presumptive preoperative diagnosis. A transcortical-transventricular microsurgical approach was used, and inspection of the anterior third ventricle via the ipsilateral foramen of Monro revealed no lesion. Inspection of the floor of the ipsilateral lateral ventricle revealed the intact cyst, which had migrated since the preoperative studies had been obtained. The lesion was removed intact, and histopathological examination confirmed the diagnosis of neurocysticercosis. The authors review the radiographic findings in this case and further illustrate the potential for neurocysticercosis to masquerade as other intracranial lesions.

Third ventricle colloid cysts: a consecutive 12-year series

1997 ◽  
Vol 86 (1) ◽  
pp. 5-12 ◽  
Author(s):  
Tiit Mathiesen ◽  
Per Grane ◽  
Lars Lindgren ◽  
Christer Lindquist
Keyword(s):  
Third Ventricle ◽  
Colloid Cyst ◽  
Memory Deficit ◽  
Individual Treatment ◽  
Content Type ◽  
Colloid Cysts ◽  
Permanent Morbidity ◽  
Radiological Studies ◽  
Fine Print

✓ A continuous follow-up review of colloid cysts including aspects of natural history and evaluation of treatment options is necessary to optimize individual treatment. Thirty-seven consecutive patients with colloid cyst of the third ventricle seen at Karolinska Hospital between 1984 and 1995 were reviewed. Five patients were admitted in a comatose state, and two died despite emergency ventriculostomy. Three had recurrent cysts following previous aspiration procedure. During the study period, patients underwent a total of 10 ventriculostomies, 10 aspirations, 26 microsurgical operations, and two shunt operations. Twenty-four of 26 microsurgical operations were transcallosal and two were transcortical. Twenty-four operations (22 transcallosal and two transfrontal approaches) without permanent morbidity were performed by four surgeons. Transient memory deficit from forniceal traction was noted in 26%. The remaining two transcallosal operations, which led to permanent morbidity or mortality, were performed by two different surgeons. Aspiration of cysts performed by four different surgeons carried a 40% risk of transient memory deficit (10% permanent) and an 80% recurrence rate. One patient was found to be cured on radiological studies obtained at the 5-year follow-up review. Seven cysts were followed by means of radiological studies with no treatment for 6 to 37 months. Five of these cysts grew, indicating that younger patients with colloid cysts will probably need surgical treatment. The main causes of unfavorable results were: 1) failure to investigate symptoms that proved fatal; 2) subtotal resection; and 3) surgical complications. Transcallosal microsurgery produced excellent results when performed by experienced surgeons. A colloid cyst of the foramen of Monro is a disease that should be detected before permanent neurological damage has occurred. Permanent morbidity or mortality should not be accepted in modern series of third ventricle colloid cysts.

Empty sella secondary to suprasellar colloid cyst of foregut (respiratory) origin

1979 ◽  
Vol 51 (1) ◽  
pp. 114-117 ◽  
Author(s):  
Dwight C. Evans ◽  
Martin G. Netsky ◽  
Verne E. Allen ◽  
Vira Kasantikul
Keyword(s):  
Cerebrospinal Fluid ◽  
Third Ventricle ◽  
Sella Turcica ◽  
Colloid Cyst ◽  
Empty Sella ◽  
Content Type ◽  
The Third ◽  
Colloid Cysts ◽  
Third Ventricular Cyst ◽  
Fine Print

✓ An enlarged sella turcica was discovered in a 40-year-old man who had bitemporal headaches. A pneumoencephalograph revealed a third ventricular cyst, dilated lateral ventricles, and an empty sella. The colloid cyst was lined by foregut epithelium, probably originating in the respiratory tract, and dense connective tissue. This case is the first instance of an empty sella associated with a colloid cyst of the third ventricle. It is proposed that enlargement of the mass in the third ventricle caused increased pulsation pressure of the cerebrospinal fluid, and that in the presence of an incompetent diaphragma sellae the subarachnoid space expanded into the sella. The origin of third ventricle cysts is reconsidered. It is concluded that suprasellar colloid cysts may arise from endoderm, ectoderm, neuroepithelium, or a combination of these epithelia.

High recurrence rate following aspiration of colloid cysts in the third ventricle

1993 ◽  
Vol 78 (5) ◽  
pp. 748-752 ◽  
Author(s):  
Tiit Mathiesen ◽  
Per Grane ◽  
Christer Lindquist ◽  
Hans von Holst
Keyword(s):  
Third Ventricle ◽  
High Recurrence Rate ◽  
Term Outcome ◽  
Foramen Of Monro ◽  
Repeat Surgery ◽  
Long Term Outcome ◽  
Content Type ◽  
Stereotactic Aspiration ◽  
The Third ◽  
Colloid Cysts

✓ Sixteen patients treated between 1969 and 1989 for a colloid cyst of the foramen of Monro by stereotactically guided aspiration (not stereotactic extirpation) were evaluated to assess the long-term outcome of the procedure. Thirteen of these patients required reoperation due to an acute comatose state, failure to achieve permanent reduction of the cyst, or symptomatic hydrocephalus. Of these 13, six were treated twice and two were treated three times by stereotactic aspiration. Five patients underwent microsurgical extirpation and three had a shunt placed following a failed aspiration. Failure of the first procedure was detected within the first 2 months after treatment in eight patients and after more than 6 years in seven. Following stereotactic aspiration, three patients experienced a temporary memory deficit and confusion and one patient suffered a central pain syndrome. Eleven of the 26 procedures were followed by a recurrence 6 to 15 years after treatment; seven recurrent cysts were detected after more than 8 years. Of the patients with recurrences, three did not undergo repeat surgery but showed an increase in cyst size at the latest follow-up examination. It is suggested that radical removal by open or stereotactically guided microsurgery is the method of choice since stereotactic aspiration fails to offer a radical or permanent treatment for colloid cysts of the third ventricle.

Colloid cysts of the third ventricle

1974 ◽  
Vol 40 (2) ◽  
pp. 230-235 ◽  
Author(s):  
John R. Little ◽  
Collin S. MacCarty
Keyword(s):  
Third Ventricle ◽  
Normal Pressure ◽  
Colloid Cyst ◽  
Cerebral Vein ◽  
Diagnostic Study ◽  
Progressive Dementia ◽  
Foramen Of Monro ◽  
Content Type ◽  
The Third ◽  
Colloid Cysts

✓ Thirty-eight cases of colloid cyst of the third ventricle are reviewed. Headache was the most frequent complaint but a strong positional relationship, supposedly a pathognomonic feature of this tumor, was seldom seen. A combination of progressive dementia and gait disturbance without evidence of papilledema, resembling the clinical picture in “normal-pressure” hydrocephalus, was present in eight patients. Sudden deterioration and death occurred in four cases; two other deaths were precipitated by lumbar puncture and pneumoencephalography. Ventriculography was the most reliable diagnostic study. Both the demonstration of dilatation of the lateral ventricles and an upward convexity in the initial segment of the internal cerebral vein in five of the 10 angiograms performed were highly suggestive of tumor. Removal of the colloid cyst through a cortical incision in the non-dominant hemisphere was carried out in 21 cases; in six it was necessary to enlarge the foramen of Monro by dividing the ipsilateral anterior column of the fornix. There were three deaths in the early and two in the late postoperative period. The main complication associated with the transventricular approach was the development of seizures.

Intrapontomesencephalic colloid cyst: an unusual location

2001 ◽  
Vol 94 (1) ◽  
pp. 118-121 ◽  
Author(s):  
Servet Inci ◽  
Nidal Al-Rousan ◽  
Figen Söylemezoglu ◽  
Özdemir Gurçay
Keyword(s):  
Histopathological Examination ◽  
Third Ventricle ◽  
Colloid Cyst ◽  
Cystic Mass ◽  
Surgical Removal ◽  
Content Type ◽  
Transsylvian Approach ◽  
First Case ◽  
Nerve Paresis ◽  
Fine Print

✓ Colloid cysts appear most commonly in the third ventricle; the occurrence of a colloid cyst in the brainstem is very unusual. The authors report on a patient with an intrapontomesencephalic colloid cyst. This 15-year-old girl complained of a headache associated with diplopia. Her neurological examination revealed right-sided sixth nerve paresis and a mild left hemiparesis. Radiological investigations revealed an intraparenchymal pontomesencephalic cystic mass. Surgical removal of the lesion was achieved via the pterional transsylvian approach and the patient experienced an excellent recovery. Histopathological examination revealed that the lesion was a typical colloid cyst. To the best of the authors' knowledge, this is the first case in which an intraparenchymal upper brainstem colloid cyst was surgically excised totally. In addition to describing this case, the authors also review other brainstem neuroepithelial cysts described in the literature and briefly discuss the concept of their origin.

Colloid cyst of the third ventricle

1982 ◽  
Vol 57 (1) ◽  
pp. 108-113 ◽  
Author(s):  
Richard W. Leech ◽  
Thomas Freeman ◽  
Robert Johnson
Keyword(s):  
Third Ventricle ◽  
Morphological Diversity ◽  
Cell Types ◽  
Colloid Cyst ◽  
Ciliated Cells ◽  
Content Type ◽  
Additional Dimension ◽  
The Third ◽  
Colloid Cysts ◽  
Abnormal Cilia

✓ Three colloid cysts of the third ventricle were examined by both transmission (TEM) and scanning electron microscopy (SEM). There was morphological diversity of the cyst surface on SEM, with ciliated and non-ciliated cells present. In some areas, the non-ciliated cells were more numerous and extended above the surface. Individual non-ciliated cells show a wrinkled cell surface and bleb-like structures. The TEM findings correlated well with SEM, revealing two cell types. The non-ciliated cells appeared to have both exocrine and apocrine activity. In ciliated cells, abnormal cilia were related to abnormal centrioles; also present were highly abnormal microvilli. The appearance of the surface was similar to a normal ventricular surface. By allowing a greater assessment of cell types and their distribution, SEM has added one additional dimension in the evaluation of colloid cysts and their possible derivation.

Sign in / Sign up

Export Citation Format

Share Document