A Hemorrhagic Pineal Cyst with a Bacterial Meningitis-like Manifestation and Benign Outcome

Yamamoto, Kanji; Omodaka, Toshikazu; Watanabe, Rie; Kodaira, Minori

doi:10.2169/internalmedicine.52.0451

Cited by 6 publications

(6 citation statements)

References 21 publications

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“…The etiological mechanism behind hemorrhage into RCCs is obscure, but usually there is no identified antecedent traumatic or other inciting event. Also of note is the fact that, since the time of Paulus et al , numerous parallel examples of hemorrhage into other types of benign cysts such as arachnoid cysts , colloid cysts or even epidermoid or developmental cysts have been reported. Some of these bleeds have been linked to trauma, but many have been spontaneous events.…”

Section: Introductionsupporting

confidence: 87%

Review of xanthomatous lesions of the sella

Kleinschmidt‐DeMasters

Lillehei

Hankinson

2017

Brain Pathology

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Xanthomatous lesions of the sellar region have traditionally been divided into two separate categories, xanthomatous hypophysitis (XH) and xanthogranuloma (XG) of the sellar region. The seminal article on XH, a condition typified by foamy histiocytes and lymphoplasmacytic infiltrates in the pituitary gland/sellar region, but usually little or no hemosiderin pigment, detailed three patients. However, most reports since that time have been single cases, making understanding of the entity difficult. In contrast, the seminal report on XG, characterized by sellar region cholesterol clefts, lymphoplasmacytic infiltrates, marked hemosiderin deposits, fibrosis, multinucleated giant cells around cholesterol clefts, eosinophilic granular necrotic debris, and accumulation of macrophages, included 37 patients, allowing more insights into etiology. Few examples could be linked to adamantinomatous craniopharyngioma, and although ciliated epithelium similar to that of Rathke cleft cyst (RCC) was identified up to 35% of the 37 cases, it could not be proven that XG was related to hemorrhage into RCC. Case reports since that time, however, occasionally linked XG to RCC when an etiology could be identified at all, and a few recognized that a spectrum exists in xanthomatous lesions of the sella. They review literature, adding 23 cases from our own experience, to confirm that overlap occurs between XH and XG, and that the majority-but not all-can be linked to RCC leakage/rupture/hemorrhage. It was suggested that progressive accumulation of hemosiderin pigment in the lesion, possibly caused by the multiple episodes of bleeding, could account for the transition of at least some cases of XH to XG.

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Section: Introductionsupporting

confidence: 87%

Review of xanthomatous lesions of the sella

Kleinschmidt‐DeMasters

Lillehei

Hankinson

2017

Brain Pathology

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“…In contrast, conservatively managing PC apoplexies lacks sufficient evidence because the rarity of PC apoplexies has limited opportunities to develop a robust management guideline. To some success, only five case reports have managed pineal apoplexy conservatively [6 , 20 , 22 , 30 , 31] . One case even reported apoplexy resolved spontaneously, supporting the conservative management of PC apoplexies [20] .…”

Section: Discussionmentioning

confidence: 99%

Pineal cyst apoplexy and memory loss: a novel complication

Shafqat

AlGethami²,

Shafqat

et al. 2022

Radiology Case Reports

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“…Large cysts typically exert the mass effect on the cerebral aqueduct, surrounding venous structures, and the dorsal midbrain. Symptomatic PCs were classified into three distinct syndromes: 1) paroxysmal headache and gaze palsy; 2) chronic headache, papilledema, gaze paresis, hydrocephalus; and 3) pineal apoplexy with acute hydrocephalus [10]. Of these neurological features, apoplexy is the rarest but most dangerous form.…”

Section: Discussionmentioning

confidence: 99%

“…On gross examination, hemorrhagic PCs were smooth surfaced, soft, and opaque to yellow or chocolate-brown. The cyst contents have been reported to be clear yellow, cloudy milky, or coffee to amber in the case of older hemorrhages [10].…”

mentioning

confidence: 99%

Pineal Cyst Apoplexy: A Rare Complication of Common Entity

Kim

Kwon

2020

Brain Tumor Res Treat

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Pineal cysts (PCs) are often encountered as incidental findings in intracranial images. The vast majority of cysts are normally asymptomatic and clinically benign. Bleeding into the cysts, which leads to neurological symptoms and signs, is considered to be quite rare. The authors illustrate a newly identified complication of PC in a 56-year-old woman who characterized by headache of sudden onset and vomiting. MRI disclosed a small hemorrhagic PC without narrowing of the cerebral aqueduct. The patient was managed conservatively without any surgical interventions, and she remained symptom-free over a period of 15-year follow-up. The description of this case adds to the limited literature on the series in which nonsurgical treatments had a role in the care for patients with PC complicated by intracystic hemorrhage.

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A Hemorrhagic Pineal Cyst with a Bacterial Meningitis-like Manifestation and Benign Outcome

Cited by 6 publications

References 21 publications

Review of xanthomatous lesions of the sella

Review of xanthomatous lesions of the sella

Pineal cyst apoplexy and memory loss: a novel complication

Pineal Cyst Apoplexy: A Rare Complication of Common Entity

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