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Mansour MA, Khalil DF, Hamdi A, Bayoumi M, El-Salamoni MAF, Elsoulia A, Lasheen AA, Kamel AE, Nawara M, Ayad AA. Intraventricular sizeable colloid cyst with atypical radiological features: A case report and evidence-based review. Radiol Case Rep 2023; 18:3753-3758. [PMID: 37636536 PMCID: PMC10450352 DOI: 10.1016/j.radcr.2023.07.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 07/02/2023] [Accepted: 07/23/2023] [Indexed: 08/29/2023] Open
Abstract
Colloid cysts are benign intracranial lesions, typically located in the anterior portion of the third ventricle near the interventricular foramina of Monro. The cysts usually consist of an epithelial lining filled with viscous gelatinous material of various components. Colloid cysts are generally asymptomatic, but once symptomatic, they can present in a variety of ways, including headaches, vomiting, visual and memory problems, and vertigo. Colloid cysts present classically on imaging as a well-delineated hyperattenuating lesion on unenhanced radiological modalities. Herein, we report a case of a patient who presented with hydrocephalus caused by a sizeable colloid cyst which demonstrated atypical imaging findings in the form of hypodensity on CT and hyperintensity on T2WI, making them difficult to identify and easy to miss. Although this atypical imaging appearance is uncommon with yet unknown true incidence, it is prudent to be aware of it because early management of colloid cysts has a favorable outcome, in contrast to untreated cysts that are associated with higher rates of morbidity and mortality. Additionally, we provide a comprehensive, evidence-based review of the medical entity of intracranial colloid cysts with highlights of current postulated pathological theories and management algorithms.
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Affiliation(s)
- Moustafa A. Mansour
- Department of Neurology and Neurologic Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
- Department of Neurology and Neurologic Surgery, Mayo Clinic, Rochester, MN, USA
- Division of Neuro-Intensive Care, Dar Al-Fouad Medical Corporation, Cairo, Egypt
- Department of Emergency Medicine and Critical Care, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Dyana F. Khalil
- Department of Oncology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Abdou Hamdi
- Department of Neurology and Neurologic Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Mahmoud Bayoumi
- Department of Neurology and Neurologic Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | | | - Ali Elsoulia
- Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | | | | | - Mohamed Nawara
- Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Ahmad A. Ayad
- Department of Neurology and Neurologic Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
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2
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Otamendi-Lopez A, Marenco-Hillembrand LC, De Biase G, Snyman C, Quiñones-Hinojosa A. Disease characteristics and patterns of familial colloid cyst of the third ventricle: An international survey of the Colloid Cyst Survivors Group. J Clin Neurosci 2022; 106:49-54. [DOI: 10.1016/j.jocn.2022.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/18/2022] [Accepted: 09/28/2022] [Indexed: 11/15/2022]
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3
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Giantini-Larsen AM, Garton ALA, Villamater FN, Kuzan-Fischer CM, Savage NJ, Cunniff CM, Ross ME, Christos PJ, Stieg PE, Souweidane MM. Familial colloid cysts: not a chance occurrence. J Neurooncol 2022; 157:321-332. [PMID: 35243591 DOI: 10.1007/s11060-022-03966-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 02/04/2022] [Indexed: 01/19/2023]
Abstract
PURPOSE Colloid cysts are rare, benign brain tumors of the third ventricle with an estimated population prevalence of 1 in 5800. Sudden deterioration and death secondary to obstructive hydrocephalus are well-described presentations in patients with a colloid cyst. Although historically conceptualized as driven by sporadic genetic events, a growing body of literature supports the possibility of an inherited predisposition. METHODS A prospective registry of patients with colloid cysts was maintained between 1996 and 2021. Data pertaining to a family history of colloid cyst was collected retrospectively; self-reporting was validated in each case by medical record or imaging review. Frequency of patients with a documented first-degree family member with a colloid cyst based on self-reporting was calculated. The rate of familial co-occurrence within our series was then compared to a systematic literature review and aggregation of familial case studies, as well as population-based prevalence rates of sporadic colloid cysts. RESULTS Thirteen cases with affected first-degree relatives were identified in our series. Of the entire cohort, 19/26 were symptomatic from the lesion (73%), 12/26 (46.2%) underwent resection, and 2/26 (7.7%) had sudden death from presumed obstructive hydrocephalus. The majority of transmission patterns were between mother and child (9/13). Compared with the estimated prevalence of colloid cysts, our FCC rate of 13 cases in 383 (3.4%) estimates a greater-than-chance rate of co-occurrence. CONCLUSION Systematic screening for FCCs may facilitate early recognition and treatment of indolent cysts, thereby preventing the rapid deterioration that can occur with an unrecognized third ventricular tumor. Furthermore, identifying a transmission pattern may yield more insight into the molecular and genetic underpinnings of colloid cysts.
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Affiliation(s)
- Alexandra M Giantini-Larsen
- Department of Neurological Surgery, Weill Cornell Medical College, New York-Presbyterian Hospital, 625 E 68th St; Starr 651, New York, NY, 10065, USA
- Department of Neurological Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Andrew L A Garton
- Department of Neurological Surgery, Weill Cornell Medical College, New York-Presbyterian Hospital, 625 E 68th St; Starr 651, New York, NY, 10065, USA
- Department of Neurological Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Francis N Villamater
- Department of Neurological Surgery, Weill Cornell Medical College, New York-Presbyterian Hospital, 625 E 68th St; Starr 651, New York, NY, 10065, USA
| | | | - Nicole J Savage
- Department of Neurological Surgery, Weill Cornell Medical College, New York-Presbyterian Hospital, 625 E 68th St; Starr 651, New York, NY, 10065, USA
| | - Christopher M Cunniff
- Department of Pediatrics, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA
| | - M Elizabeth Ross
- Feil Family Brain and Mind Research Institute, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA
| | - Paul J Christos
- Division of Biostatistics, Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, USA
| | - Philip E Stieg
- Department of Neurological Surgery, Weill Cornell Medical College, New York-Presbyterian Hospital, 625 E 68th St; Starr 651, New York, NY, 10065, USA
| | - Mark M Souweidane
- Department of Neurological Surgery, Weill Cornell Medical College, New York-Presbyterian Hospital, 625 E 68th St; Starr 651, New York, NY, 10065, USA.
- Department of Neurological Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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Lannon M, Mackenzie J, Reddy K. Genetics of Colloid Cyst in Monozygotic Twins: Case Report and Review of Literature. World Neurosurg 2020; 144:88-91. [PMID: 32889197 DOI: 10.1016/j.wneu.2020.08.176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 08/25/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Colloid cysts are rare developmental lesions, accounting for approximately 1% of intracranial tumors. Often, these benign lesions are asymptomatic, but they are associated with significant mortality as a result of acute hydrocephalus. This mortality in patients with vague or no symptoms dictates a need for better understanding of the etiology of colloid cysts to expedite diagnosis and management. We present a case of monozygotic twins with colloid cysts to propose a genetic etiology for colloid cyst. CASE DESCRIPTION Previously healthy male monozygotic twins presented 4 years apart with headache secondary to hydrocephalus as a result of colloid cysts. Both patients underwent multiple surgeries and were doing well at last follow-up. CONCLUSIONS The present case adds to a body of literature of familial colloid cysts, suggesting higher concordance in monozygotic compared with dizygotic twins. This may be due to high genetic load, shared intrauterine environment, epigenetic changes, or genetic mutation. This literature review suggests that given high morbidity and mortality of colloid cysts, screening may be beneficial. Even in the absence of a single, definitive genetic etiology, we recommend consideration of genetic screening or, at a minimum, screening with neuroimaging for monozygotic twins in cases where 1 twin is diagnosed with colloid cyst.
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Affiliation(s)
- Melissa Lannon
- Division of Neurosurgery, Department of Surgery, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada.
| | - Jennifer Mackenzie
- Division of Genetics, Department of Pediatrics, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Kesava Reddy
- Division of Neurosurgery, Department of Surgery, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
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Angelopoulou E, Koropouli E, Velonakis G, Koutsis G, Anagnostouli M, Tzartos I, Tzanetakos D, Stranjalis G, Kilidireas C, Evangelopoulos ME. Paroxysmal Lower Limb Tremor as a Rare Presentation of Colloid Cyst of the Third Ventricle: A Case Report and Literature Review. Open Neuroimag J 2020. [DOI: 10.2174/1874440002013010001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective:
Colloid cysts of the third ventricle are benign intracranial tumors. They are most commonly presented with signs of intracranial hypertension due to obstructive hydrocephalus, including headache, nausea/vomiting and vision disturbances, whereas extrapyramidal symptoms such as tremor are very rare. Sudden death, due to abruptly developed hydrocephalus, can be also observed. Although paroxysmal symptomatology attributed to the intermittent obstruction of the foramen of Monro is considered the “classical” clinical presentation, it is rather the exception in clinical practice.
Case Report:
A 42-year-old woman with no medical history was admitted to the neurology department as suffering from a potential demyelinating disease due to episodes of paroxysmal tremor of her right lower limb and persistent mild gait instability, which presented 15 days prior to her arrival. She also complained of episodes of partially position-dependent bilateral headache over the last 10 years, as well as episodes of vertigo over the last 4 years. On arrival, her gait was shuffling and mildly wide-based and an intermittent tremor of her right lower limb was observed in supine and sitting positions, but not in a prone position. Brain magnetic resonance imaging (MRI) demonstrated a round cystic lesion of the third ventricle, accompanied by hydrocephalus with enlargement of lateral ventricles. MRI findings were highly indicative of a colloid cyst. The patient underwent resection of the mass and the tremor resolved after surgery.
Conclusion:
Given the greatly heterogeneous clinical presentation of colloid cysts, our case highlights the significance of the prompt diagnosis of this rare but potentially fatal cause of paroxysmal limb tremor.
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Calderón C, Fernandez-de Thomas RJ, De Jesus O. Familial Colloid Cysts of the Third Ventricle: Case Report and Literature Review. Asian J Neurosurg 2020; 15:414-417. [PMID: 32656143 PMCID: PMC7335152 DOI: 10.4103/ajns.ajns_332_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 12/21/2019] [Accepted: 02/18/2020] [Indexed: 11/23/2022] Open
Abstract
Colloid cysts of the third ventricle are rare lesions. To our knowledge, only 23 familial cases of colloid cysts have been reported in the literature. The country of origin of the patients with familial cases had not been previously studied as a group. A 49-year-old female patient from Puerto Rico and her 21-year-old daughter underwent surgical resection for colloid cysts within a period of 5 years. The daughter presented with symptomatic hydrocephalus, while the mother only had mild chronic headaches. The occurrence of a colloid cyst in this family prompted us to perform a literature review and tabulate all the familial cases. This report presents the 24th case of a familial colloid cyst, and the fourth involving a mother and daughter. Australia is the country with the largest amount of reported cases. For smaller countries such as Sweden and Finland, two cases had been reported for each of them. Due to the unlikely probability of familial colloid cyst occurring at random, a genetic component is likely to be involved. The occurrence of several reports from patients from Australia, Finland, Sweden, and Puerto Rico where the population is smaller or more segregated may also suggest a genetic inheritance. Screening of first-degree-related subjects is recommended for families in which two or more members are affected. The presence of a colloid cyst in a twin mandates neuroimaging in the other twin, as there are five familial cases in twins reported in the literature.
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Affiliation(s)
- Carlos Calderón
- Department of Surgery, Section of Neurosurgery, School of Medicine, University of Puerto Rico, San Juan, PR
| | | | - Orlando De Jesus
- Department of Surgery, Section of Neurosurgery, School of Medicine, University of Puerto Rico, San Juan, PR
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Muscas G, Battista F, Serra C, Boschi A, Noubari BA, Della Puppa A. Are familial colloid cysts of the third ventricle associated with a worse clinical course than sporadic forms? Case illustration and systematic literature review. J Neurosurg Sci 2020; 66:258-263. [PMID: 32043846 DOI: 10.23736/s0390-5616.20.04860-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The incidence of asymptomatic colloid cysts is increasing due to the widespread use of neuroimaging tools. According to previous works, familial forms (within first-degree relatives) represent 5-25% of the cases, and it is not clear whether they display specific features influencing the clinical behavior of the disease. METHODS We reviewed the literature to extract data from papers dealing with familial colloid cysts. For comparison, previous series dealing with the natural history of sporadic cases were identified. Also, we present two more cases of familiar colloid cysts from our experience. RESULTS Fifty-one patients (23 reports, plus our cases) were analyzed. Familial cases showed a younger age at diagnosis (p=0.02) and fewer asymptomatic cases (p<0.001) compared to non- familial colloid cysts. The odds ratio and relative risk of needing surgery with a positive family history for surgical cyst removal were respectively 17.5 (CI: 1.6 - 197.4) and 1.9 (CI: 0.71 - 5.1). Screening of other family members identified further colloid cysts in 4% of families. CONCLUSIONS Familial colloid cysts show a higher percentage of younger and symptomatic patients compared to non-familiar forms. A positive family history for surgical evacuation is a predictor for a similar outcome. This could indicate a predisposition to an earlier formation and faster growth, and the need for a stricter follow-up in asymptomatic patients. If confirmed in the future, this could suggest a review of the criteria for cyst treatment and extend the surgical indication to asymptomatic familial cases.
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Affiliation(s)
- Giovanni Muscas
- Department of Neurosurgery Clinic, Department of Neuroscience, Psychology, Pharmacology and Child Health, Careggi Hospital, University of Florence, Florence, Italy -
| | - Francesca Battista
- Department of Neurosurgery Clinic, Department of Neuroscience, Psychology, Pharmacology and Child Health, Careggi Hospital, University of Florence, Florence, Italy
| | - Carlo Serra
- Department of Neurosurgery, Zurich University Hospital, Zurich, Switzerland
| | - Andrea Boschi
- Department of Neurosurgery Clinic, Department of Neuroscience, Psychology, Pharmacology and Child Health, Careggi Hospital, University of Florence, Florence, Italy
| | - Bahman A Noubari
- Department of Neurosurgery Clinic, Department of Neuroscience, Psychology, Pharmacology and Child Health, Careggi Hospital, University of Florence, Florence, Italy
| | - Alessandro Della Puppa
- Department of Neurosurgery Clinic, Department of Neuroscience, Psychology, Pharmacology and Child Health, Careggi Hospital, University of Florence, Florence, Italy
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8
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Al-Sharydah AM, Al-Suhibani SS, Al-Abdulwahhab AH, Al-Aftan MS, Gashgari AF. A unique finding of cavum velum interpositum colloid-like cyst and literature review of a commonplace lesion in an uncommon place. Int J Gen Med 2018; 11:301-305. [PMID: 30038515 PMCID: PMC6052918 DOI: 10.2147/ijgm.s169018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Colloid cysts typically reside within the area of the anterior third ventricle, in the proximity of the foramen of Monro. Although they are considered to commonly localize in various parts of the cerebrum, they are exceedingly rare outside the ventricular system and rarely occur within the velum interpositum. We have reported here a rare case of a velum interpositum colloid-like cyst in a 23-year-old man, who presented to our clinic with temporary binocular strabismus, which he had been experiencing for the previous year. In addition, we have briefly reviewed evidence regarding the generation, anatomy, and pathogenesis of colloid cysts, as well as the management options for such rare cases. The present report is only the third to describe a colloid-like cyst located within the velum interpositum, providing additional data that may aid in elucidating the pathogenesis of these neoplasms.
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Affiliation(s)
- Abdulaziz Mohammad Al-Sharydah
- Diagnostic and Interventional Radiology Department, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province, Saudi Arabia,
| | - Sari Saleh Al-Suhibani
- Diagnostic and Interventional Radiology Department, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province, Saudi Arabia,
| | - Abdulrahman Hamad Al-Abdulwahhab
- Diagnostic and Interventional Radiology Department, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province, Saudi Arabia,
| | - Mohammad Saad Al-Aftan
- Diagnostic and Interventional Radiology Department, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province, Saudi Arabia,
| | - Ahmad Fouad Gashgari
- Diagnostic Radiology Department, Dammam Central Hospital, Dammam, Eastern Province, Saudi Arabia
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9
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Connolly ID, Johnson E, Lamsam L, Veeravagu A, Ratliff J, Li G. Microsurgical vs. Endoscopic Excision of Colloid Cysts: An Analysis of Complications and Costs Using a Longitudinal Administrative Database. Front Neurol 2017; 8:259. [PMID: 28649225 PMCID: PMC5465269 DOI: 10.3389/fneur.2017.00259] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 05/22/2017] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Open microsurgical and endoscopic approaches are the two main surgical options for excision of colloid cysts. Controversy remains as to which is superior. Previous studies consist of small cohort sizes. This topic has not been investigated using national administrative claims data which benefits from larger patient numbers. METHODS Current Procedural Terminology (CPT) and International Classification of Disease version 9 (ICD-9) coding at inpatient visit was used to select for index surgical procedures corresponding to microsurgical or endoscopic excision of colloid cysts. Comorbidities, costs, and complications were collected. RESULTS We identified a total of 483 patients. In all, 240 were from the microsurgical cohort and 243 were from the endoscopic cohort. The two groups displayed similar demographic and comorbidity profiles. Thirty-day post-operative complications were also similar between groups with the exception of seizures and thirty-day readmissions, both higher in the open surgical cohort. The seizure rates were 14.7 and 5.4% in the microsurgical and endoscopic cohorts, respectively (p = 0.0011). The thirty-day readmission rates were 17.3 and 9.6% in the microsurgical and endoscopic cohorts, respectively (p = 0.0149). Index admission costs and 90-day post discharge payments were higher in patients receiving microsurgical excision. CONCLUSION An analysis of administrative claims data revealed few differences in surgical complications following colloid cyst excision via microsurgical and endoscopic approaches. Post-operative seizures and thirty-day readmissions were seen at higher frequency in patients who underwent microsurgical resection. Despite similar complication profiles, patients undergoing microsurgical excision experienced higher index admission costs and 90-day aggregated costs suggesting that complications may have been more severe in this group.
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Affiliation(s)
- Ian David Connolly
- Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Eli Johnson
- Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Layton Lamsam
- Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Anand Veeravagu
- Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, CA, United States
| | - John Ratliff
- Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Gordon Li
- Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, CA, United States
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Niknejad HR, Samii A, Shen SH, Samii M. Huge familial colloid cyst of the third ventricle: An extraordinary presentation. Surg Neurol Int 2015; 6:S349-53. [PMID: 26236556 PMCID: PMC4521314 DOI: 10.4103/2152-7806.161416] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 06/06/2015] [Indexed: 11/10/2022] Open
Abstract
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.
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Affiliation(s)
| | - Amir Samii
- Department of Neurosurgery, International Neuroscience Institute, D-30625 Hannover, Germany
| | - Shang-Hang Shen
- Department of Neurosurgery, International Neuroscience Institute, D-30625 Hannover, Germany
| | - Majid Samii
- Department of Neurosurgery, International Neuroscience Institute, D-30625 Hannover, Germany
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Abstract
In this case report we describe colloid cysts in the third ventricles of monozygotic twin sisters. They were 26 years old when their condition was discovered. One woman was admitted to us on an emergency basis, with signs of high intracranial pressure such as unconsciousness and extension posturing. Her sister was also brought to the hospital since she had a history of attacks of headache. They were both operated with removal of the colloid cysts, and the clinical courses are described in the case report. In reviewing the literature another 30 familial cases were found. Of these were two pairs of monozygotic and one pair of dizygotic twins.
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Affiliation(s)
| | - Edith Popek
- Department of Neurology, Örebro University Hospital, Örebro, Sweden
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12
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Benoiton LA, Correia J, Kamat AS, Wickremesekera A. Familial colloid cyst. J Clin Neurosci 2013; 21:533-5. [PMID: 24308955 DOI: 10.1016/j.jocn.2013.08.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2013] [Revised: 08/04/2013] [Accepted: 08/07/2013] [Indexed: 11/27/2022]
Abstract
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.
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Affiliation(s)
- L A Benoiton
- Neurosurgery Department, Wellington Hospital, Capital and Coast District Health Board, Riddiford Street, Newtown, Wellington 6021, New Zealand.
| | - J Correia
- Neurosurgery Department, Starship Hospital, Auckland, New Zealand
| | - A S Kamat
- Neurosurgery Department, Wellington Hospital, Capital and Coast District Health Board, Riddiford Street, Newtown, Wellington 6021, New Zealand
| | - A Wickremesekera
- Neurosurgery Department, Wellington Hospital, Capital and Coast District Health Board, Riddiford Street, Newtown, Wellington 6021, New Zealand
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13
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Algin O, Ozmen E, Arslan H. Radiologic Manifestations of Colloid Cysts: A Pictorial Essay. Can Assoc Radiol J 2013; 64:56-60. [DOI: 10.1016/j.carj.2011.12.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2011] [Revised: 10/17/2011] [Accepted: 12/19/2011] [Indexed: 11/25/2022] Open
Abstract
Colloid cysts are among rare benign tumours of the third ventricle. Although the most frequent symptoms are headache and syncope, arrest hydrocephalus or sudden death could appear with colloid cysts. The aim of this pictorial essay was to increase awareness of the clinical presentation, computed tomography (CT) and magnetic resonance (MR) imaging spectrum, and treatment options of the colloid cysts. The data of 11 patients with histopathologically and/or clinically proven colloid cyst were analysed, retrospectively; and the neuroradiologic appearances of the cysts were evaluated. The CT and MR appearance of colloid cysts may change, depending on the viscosity or the cholesterol content of the cysts. However, the cystic content is the most important factor that could affect the success of treatment. Cysts that are especially rich in protein and cholesterol tend to be hyperdense on CT, hypointense on T2-weighted sequences and hyperintense on T1-weighted sequences. These cysts are viscous, and the success of aspiration is significantly low. In the diagnosis and evaluation of small-sized cysts that have an ingredient similar to cerebrospinal fluid, 3-dimensional sequences might be useful. The radiologic appearances of colloid cysts could play an important role in directing these patients to alternative surgical modalities, including resection.
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Affiliation(s)
- Oktay Algin
- Department of Radiology, Ataturk Training and Research Hospital, Bilkent, Ankara, Turkey
| | - Evrim Ozmen
- Department of Radiology, Ataturk Training and Research Hospital, Bilkent, Ankara, Turkey
| | - Halil Arslan
- Department of Radiology, Ataturk Training and Research Hospital, Bilkent, Ankara, Turkey
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14
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Salaud C, Hamel O, Buffenoir-Billet K, Nguyen JP. [Familial colloid cyst of the third ventricle: case report and review of the literature]. Neurochirurgie 2012; 59:81-4. [PMID: 23148858 DOI: 10.1016/j.neuchi.2012.09.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2011] [Revised: 09/30/2012] [Accepted: 09/30/2012] [Indexed: 11/25/2022]
Abstract
Colloid cysts of the third ventricle are rare benign lesions. We report here an exceptional familial case defined by the evidence of two colloid cysts in two relatives of the first degree, a mother and her daughter in our description. Only 15 cases are reported in the literature. The main differences compared with sporadic cases are an earlier age of discovery and a female predominance. In case of familial colloid cyst, we have to recover a brain MRI screening of all the relatives of the first degree.
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Affiliation(s)
- C Salaud
- Clinique universitaire de neurochirurgie, hôpital Laënnec, CHU de Nantes, boulevard Jacques-Monod, 44800 Saint-Herblain, France.
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15
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Colloid Cyst: A Case Report and Literature Review of a Rare But Deadly Condition. J Emerg Med 2011; 40:e5-9. [DOI: 10.1016/j.jemermed.2007.11.110] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2007] [Revised: 10/31/2007] [Accepted: 11/29/2007] [Indexed: 11/15/2022]
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16
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Kumar V, Behari S, Kumar Singh R, Jain M, Jaiswal AK, Jain VK. Pediatric colloid cysts of the third ventricle: management considerations. Acta Neurochir (Wien) 2010; 152:451-61. [PMID: 19856141 DOI: 10.1007/s00701-009-0531-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2009] [Accepted: 09/23/2009] [Indexed: 10/20/2022]
Abstract
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.
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Demirci S, Dogan KH, Erkol Z, Gulmen MK. Sudden death due to a colloid cyst of the third ventricle: Report of three cases with a special sign at autopsy. Forensic Sci Int 2009; 189:e33-6. [DOI: 10.1016/j.forsciint.2009.04.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2008] [Revised: 04/02/2009] [Accepted: 04/14/2009] [Indexed: 10/20/2022]
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Colloid cyst of third ventricle presenting as pseudoeclampsia. Arch Gynecol Obstet 2009; 280:1019-21. [DOI: 10.1007/s00404-009-1047-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2009] [Accepted: 03/09/2009] [Indexed: 11/30/2022]
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Romani R, Niemelä M, Korja M, Hernesniemi JA. Dizygotic twins with a colloid cyst of the third ventricle: case report. Neurosurgery 2008; 63:E1003; discussion E1003. [PMID: 19005365 DOI: 10.1227/01.neu.0000330388.91098.89] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE AND IMPORTANCE Colloid cysts of the third ventricle are rare benign tumors of endodermal origin accounting for 1% of all intracranial tumors. Interestingly, a few familial cases have been reported previously. We present the first case of dizygotic twins with a symptomatic colloid cyst of the third ventricle. CLINICAL PRESENTATION A 10-year-old boy was admitted to a local hospital in 1993 because of severe progressive headache. Computed tomographic and magnetic resonance imaging scans revealed acute obstructive hydrocephalus attributable to a third ventricular colloid cyst, which was removed after emergent ventricular drainage. Fourteen years later, a nonidentical twin brother complained of continuous headache with nausea and vomiting. A magnetic resonance imaging scan showed obstructive hydrocephalus and a third ventricle colloid cyst, which was removed by use of the transcallosal approach. INTERVENTION Both twins underwent complete removal of the cyst by the interhemispheric transcallosal approach without postoperative complications. CONCLUSION On the basis of a literature review, 2 cases of colloid cysts of the third ventricle in monozygotic twins and a few familial cases have been reported. Our case is the first in dizygotic twin brothers. These findings suggest that the prevalence of colloid cyst may be higher in twins than in the general population. We believe that the presence of this lesion in a twin necessitates magnetic resonance imaging of the other twin, and a clinical follow-up would be recommended in all other first-degree relatives.
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Affiliation(s)
- Rossana Romani
- Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland.
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Bavil MS, Vahedi P. Familial colloid cyst of the third ventricle in non-twin sisters: case report, review of the literature, controversies, and screening strategies. Clin Neurol Neurosurg 2007; 109:597-601. [PMID: 17561340 DOI: 10.1016/j.clineuro.2007.04.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2007] [Revised: 03/25/2007] [Accepted: 04/10/2007] [Indexed: 11/17/2022]
Abstract
Colloid cyst of the third ventricle is a known primary brain tumor. The familial occurrence of this cyst and associated conditions has been rarely discussed in the literature. To our knowledge only 10 affected families have been previously reported in the literature. We report the 11th family with this potentially life-threatening tumor and discuss the associated conditions and, existing controversies and plan screening strategies.
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Affiliation(s)
- Moslem Shakeri Bavil
- Department of Neurological Surgery, Tabriz University of Medical Sciences, Tabriz, Iran.
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Abstract
We review the current state of knowledge regarding headache and brain tumors. The epidemiology of this clinically relevant area is highlighted along with general clinical features of headache disorders seen in brain tumor patients. Some rarer clinical presentations are noted, particularly in relationship to the newly described trigeminal autonomic cephalalgias, as well as the relationships of headache to pituitary tumors and paroxysmal and positional headaches. Headaches as a result of brain tumor therapy are noted, as is the important area of treatment of headaches in patients with central nervous system neoplasms of a primary or secondary nature.
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Affiliation(s)
- Sarah Kirby
- Department of Medicine, Division of Neurology, QEII Health Sciences Centre, Dalhousie University, 1278 Tower Road, Halifax, Nova Scotia B3H 2Y9, Canada
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Shaktawat SS, Salman WD, Twaij Z, Al-Dawoud A. Unexpected death after headache due to a colloid cyst of the third ventricle. World J Surg Oncol 2006; 4:47. [PMID: 16867192 PMCID: PMC1550234 DOI: 10.1186/1477-7819-4-47] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2005] [Accepted: 07/25/2006] [Indexed: 11/10/2022] Open
Abstract
Background Colloid cysts of the third ventricle are rare benign intracranial non-neoplastic cysts. Headache is the most common symptom. We present a case of sudden death due to colloid cyst in a 17 year old female who had symptoms of intermittent headaches. Case presentation A 17 year old female presented with intermittent mild headaches for a period of two years. She complained of severe headache in the night and was found unresponsive the next morning. Resuscitation team was called on site but the patient was already dead. At post mortem examination a dilated ventricular system was found with a colloid cyst of the third ventricle. Conclusion This report highlights the difficulty in the diagnosis and importance of recognizing colloid cyst of the third ventricle which should be in the differential diagnosis of headaches in children and young adults and of hydrocephalus at autopsy
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Affiliation(s)
- Sameer S Shaktawat
- Department of Cellular Pathology, Blackpool Victoria Hospital, Blackpool, Lancashire, UK
| | - Walid D Salman
- Department of Histopathology, Burnley General Hospital, Burnley, Lancashire, UK
| | - Zuhair Twaij
- Department of Histopathology, Burnley General Hospital, Burnley, Lancashire, UK
| | - Abdul Al-Dawoud
- Department of Histopathology, Burnley General Hospital, Burnley, Lancashire, UK
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