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H & E staining showing the cyst containing eosinophilic material lined by a single layer of cuboidal cells and ciliated columnar cells.
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and impotance: Colloid cysts are rare intracerebral lesions that are preferentially encountered within the third ventricle. There are only a few reports in which colloid cysts are described in other locations such as the fourth ventricle, brainstem, cerebellum and suprasellar region.
Young female had presented with headache since one year and on ep...
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Citations
... 4 The multiple terms used to describe these cysts like colloid, endodermal, epithelial, paraphyseal, and neuroepithelial cyst. 1,2 As the cysts grow they obstruct the foramen of Monro producing hydrocephalus of the lateral ventricles leading to intermittent headache and features of raised Intracranial pressure. This can be acute and catastrophic because of the pedunculated nature of the tumor resulting in brain herniation and death. ...
Cysts occupying the third ventricle are rare lesions and may appear as an unusual cause of hydrocephalic crisis. A 40-year old woman with headache and one episode of fainting attack was diagnosed with a cystic lesion in the third ventricle after brain MRI study. She was operated with the pre-operative diagnosis of a colloid cyst. A yellowish, thick and mucoid cyst was observed intra-operatively. The total removal of the cyst was done along with the cyst wall. On histopathological evaluation, the cyst wall was lined by ciliated cuboidal to pseudostratified columnar epithelium resting on an eosinophilic basement membrane. The ultrastructural study showed the characteristic 9+2 pattern of cilia. Immunohistochemistry showed positive staining for epithelial membrane antigen (EMA), cytokeratin (CK), and negative staining for Glial fibrillary acidic protein (GFAP). Histopathological and ultrastructural findings confirm the diagnosis of a colloid cyst of third ventricles favoring the endodermal origin of the cyst.
... 1,2,3 They account for 0.5%-2% of all intracranial 1,2,3 and 15%-20% of all intraventricular tumors. 1 They may also be found in other locations such as the fourth ventricle, posterior fossa, brainstem or cerebellum. 2 Men are more affected than women, and they are diagnosed mostly in the third and fifth decades. 3 CCs generally range in size from 2-50mm in diameter, 1,3,4 and they may contain colloid material including cholesterol and fats. ...
... These may include things such as CCs, arachnoid cysts, craniopharyngioma, pituitary gland tumors, aneurysms, or Rathke cleft cysts. 2,6 There is no general agreement on the treatment of CCs, and the optimal management has been a debatable issue. Some of the treatment options include open and microsurgical resection, stereotactic aspiration, endoscopic removal, or simple shunt application. ...
A 29-year-old male presented to our emergency department with complaints of a left frontal headache, similar to his prior headaches. He also reported about 30 minutes of facial and tongue numbness, left arm weakness, slurred speech and changes in hearing that had resolved prior to his arrival. Despite the short duration of the other neurologic symptoms, he also endorsed persistent “dizziness.” Despite his history of recurrent headaches, he had never had any neuroimaging. This, as well as his reports of new neurological symptoms, prompted his care team to obtain a non-contrast brain computed tomography. The findings were consistent with a mass with mild hydrocephalus. Patient underwent neurosurgical resection of the mass at a tertiary center. He did well after surgery and was discharged on postop day 6 with a diagnosis of colloid cyst.
... Expression of CEA, Viamentin and S-100 varies. 7 Most reported cases occurred in the third to fifth decades of life with paucity of cases in early years. In majority of patients, colloid cysts are an incidental finding in an otherwise asymptomatic patient, coming in for neuroimaging of an unrelated reason. ...
Colloid cysts are relatively rare benign intracranial lesions preferentially located within the third ventricle. There are only a few reports in which they have been found to be ectopic, such as in the fourth ventricle. A young female presented on with spontaneous non-traumatic cerebrospinal fluid (CSF) rhinorrhoea for three months which was positional in nature, relieved temporarily by neck flexion. Magnetic resonance imaging (MRI) scan showed a focal well-defined rounded cystic lesion along the fourth ventricle, showing subtle peripheral rim enhancement. Significant hydrocephalus was also noted. A suboccipital craniotomy and total excision of the lesion was done. Postoperatively, the patient recovered quickly with no neurological deficits. Her rhinorrhoea was completely cured. Histopathology was consistent with a colloid cyst. Colloid cyst is rarely found in infratentorial location. However, such a rare diagnosis has to be considered in the differential diagnosis in patients who present with an infratentorial cystic lesion associated with spontaneous CSF rhinorrhoea.
Benign cysts within the pure aqueductal region are a rare entity. Their critical location within the ventricular system presents a risk of potentially catastrophic outcomes. We present a case of a 68-year-old female who was transferred to our unit with an acute obstructive triventricular hydrocephalus caused by a benign cyst within the cerebral aqueduct. She became unconscious and had an urgent endoscopic third ventriculostomy (ETV). Post-operatively, the patient was recovering well but then developed a sudden onset severe headache accompanied by vomiting. Imaging revealed intracystic haemorrhage with expansion of lesion but there was no obstructive hydrocephalus due to CSF diversion performed 9 d prior. She was treated conservatively and continued to improve.
Background
Colloid cysts (CCs) are rare cystic lesions derived from the endoderm of the central nervous system. Although they appear most commonly in the anterior roof of the third ventricle, there are only a few reports of CCs located in the suprasellar region. Although CCs are considered to be slow-growing benign tumors, their developmental process remains unclear.
Case Description
A 6-year-old boy was referred to our hospital for a mild head injury. Head computed tomography scan revealed a round, hyperdense suprasellar lesion, while magnetic resonance imaging depicted the mass as an isointense lesion with multiple highly hypointense spots on T2-weighted imaging. Although this lesion had been managed conservatively with annual magnetic resonance imaging follow-up, its size gradually increased, resulting in an increase in diameter by a factor of 1.5 over an 11-year period. The doubling time of this tumor was estimated to be approximately 7 years. Despite its asymptomatic nature, the cystic lesion was totally resected when the patient was 17 years of age using an endoscopic endonasal approach to make a definitive histologic diagnosis and prevent the occurrence of neurologic symptoms. The postoperative course was uneventful, and the histologic diagnosis of the surgical specimen was consistent with CC.
Conclusions
This case suggests that CC may be one of several possible diagnoses in patients who present with suprasellar cystic lesions. Even if CCs in the suprasellar region remain asymptomatic, radiological follow-up is required due to possible progressive enlargement of the cyst.
Background:
Colloid cysts (CC) are rarely found in the sellar-suprasellar region. Differential diagnosis of CC is more challenging in this region because many other cystic lesions may locate or invade sellar or suprasellar structures. We present a large and unusual case of sellar-suprasellar colloid cyst with extension into the suprasellar, interpedincular and prepontine cisterns. This is the first case of sellar-suprasellar colloid cyst treated with endoscopic transsphenoidal approach.
Case description:
A 33-year-old woman presented with a 1-year history of recurrent headaches. Her headaches had been unresponsive to medical treatment for the last two weeks. She had normal neurological and ophthalmological examinations. Neuroradiological studies showed a large cystic sellar lesion with extension into the suprasellar, interpedincular and prepontine cisterns. The lesion did not show any enhancement, not even in the cyst wall. Her hormonal status was also normal. The cystic lesion was totally resected via a purely endoscopic endonasal approach. There were no complications, and the patient was recovered completely with improvement of her headache. Pathology was consistent with a colloid cyst. At 6- month of follow-up, magnetic resonance imaging did not show any evidence of the residual or recurrent lesion.
Conclusion:
Although rarely found in this location, CC should be considered in the differential diagnosis in patients who present with a sellar-suprasellar cystic lesion. Additionally, sellar-suprasellar CC would be a good candidate for the endoscopic endonasal approach.
