Colloid (Enterogenous) Cyst in the Frontal Lobe-Case Report-

Diagnostic Methods in Forensic Pathology: Autoptic Findings and Immunohistochemical Study in Cases of Sudden Death Due to a Colloid Cyst of the Third Ventricle

The colloid cyst is a non-malignant tumor growth made of a gelatinous material covered by a membrane of epithelial tissue. It is usually located posterior to the foramen of Monro, in the anterior aspect of the third ventricle of the brain. Due to its location, it can cause obstructive hydrocephalus, increased intracranial pressure, and sudden cardiac death, catecholamine-mediated, through hypothalamus compression. All the mechanisms are still controversial, but the role of catecholamine has been confirmed with histological findings that highlighted myocardial injury (coagulative myocytolysis and contraction band necrosis, CBN). This study presents a case of sudden death in a previously healthy 22-year-old male due to a colloid cyst of the third ventricle. A complete autopsy was performed, highlighting in the brain an abundant quantity of cerebrospinal fluid (CSF) and a 2 cm pale grayish-green rounded cyst formation partially filling and distending the third ventricle. The diagnosis was confirmed through immunohistochemical investigation: positivity for Periodic acid-Schiff (PAS) staining and CK7 expression. In cases such as the one reported here, a combined approach of autopsy, histology, and immunohistochemistry is mandatory in order to identify the neoformation's location and morpho-structural characteristics for a correct differential diagnosis, as well as to identify the cause of death.

Rare location of a colloid cyst - case presentation

Not only pituitary adenomas, but also a number of tumors may arise from within the sella presenting a diagnostic and therapeutic challenge at a multidisciplinary specialist level. This article presents a case of a colloid cyst located in sellar region, with overlapping symptoms of a nonfunctioning pituitary adenoma.

Full scope of options

OBJECTIVE

The purpose of Clinical Problem Solving articles is to present management challenges to give practicing neurosurgeons insight into how field leaders address these dilemmas. This illustration is accompanied by a brief review of the literature on the topic.

PRESENTATION

The case of a 16-year-old boy presenting with headaches is presented. The patient is found to have a typical colloid cyst at the foramen of Monro. Bilateral ventriculoperitoneal shunt placement had been performed as an initial treatment of the patient before presentation.

RESULTS

Surgeons experienced in open and endoscopic surgery discuss their individual approaches to colloid cysts, in the context of previous shunting, providing a varied perspective on the clinical challenges posed by these lesions.

CONCLUSION

Both open and endoscopic options remain viable for excision of a colloid cyst. Each has associated potential complications, as illustrated by the current case.

A rare case of a retroperitoneal enterogenous cyst with in-situ adenocarcinoma

Background

Retroperitoneal enterogenous cysts are uncommon and adenocarcinoma within such cysts is a rare complication.

Case presentation

We present the third described case of a retroperitoneal enterogenous cyst with adenocarcinomatous changes and only the second reported case whereby the cyst was not arising from any anatomical structure.

Conclusion

This case demonstrates the difficulties in making a diagnosis as well as the importance of a multi-disciplinary approach, and raises further questions regarding post-operative treatment with chemotherapy.

Colloid Cyst: Diffusion MR Imaging Findings

Colloid cysts usually have viscid gelatinous material or denser content. In an adult patient with a colloid cyst, diffusion magnetic resonance (MR) imaging was applied to detect its features with this sequence that if its viscous content may lead to a hyperintense appearance (decreased diffusion pattern) on b= 1000 sec/mm(2) images similar to epidermoids. The colloid cyst had hypointense signal on the b= 1000 sec/mm(2) image. The ADC map had more information that the ADC value of the cyst was 1.58 x 10(-3) mm(2)/sec. This value was apparently higher than that of normal cerebral parenchyma, and was apparently lower than that of CSF. These diffusion MR imaging features of the colloid cyst are consistent with an elevated diffusion pattern in contrast to epidermoids.