Giant colloid cyst occupying a cavum septum pellucidum et vergae

Pryce, Mitchell L.; Huo, Cecilia W.; Dawes, Bryden; Chung, Kyu Jin

doi:10.1016/j.jocn.2020.08.008

Cited by 2 publications

(2 citation statements)

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“…The relationship of this interforniceal variant with cysts that develop within the cavum septum pellucidum remains unclear, although some have postulated how the two entities could lie on the same spectrum because their evolutions follow a superior pathway within loosely packed fibers. 2,9,[14][15][16][17] In the presence of cavum septi pellucidi, the surgical approach is simplified in that the cyst is dorsally surrounded by CSF; the fornices may be further distinctly separated and identified. [18][19][20][21][22] Because of their growth patterns, these cysts tend to have a larger average size at presentation, even though the likelihood that these cysts become symptomatic is similar to that of (smaller) transforaminal cysts.…”

Section: Discussionmentioning

confidence: 99%

Transseptal interforniceal endoscopic removal of superiorly recessed colloid cysts

Tosi

Uribe-Cardenas

Lara‐Reyna

et al. 2022

Journal of Neurosurgery

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OBJECTIVE Transforaminal endoscopic colloid cyst resection is well described. However, some anatomical colloid cyst variants may warrant a modified approach. Rarely, colloid cysts separate the forniceal columns and grow superiorly within the leaflets of the septum pellucidum. Thus, the authors’ goal was to characterize the imaging features, clinical presentation, surgical strategy, and outcomes of patients with this superiorly recessed colloid cyst variant. METHODS A retrospective evaluation of patients who underwent endoscopic resection of colloid cysts from 1999 to 2020 was performed. The patients were dichotomized depending on whether the cyst was located predominately below the forniceal columns or was superiorly recessed (forniceal column separation with variable intraseptal extension). This comparative cohort study focused on clinical presentation, imaging features, operative technique, and patient outcome. RESULTS In total, 182 patients were identified. Seventeen patients had colloid cysts that were defined as superiorly recessed and underwent transseptal interforniceal removal, and 165 patients underwent a standard transforaminal approach. Patients had similar demographic characteristics. However, transseptal cysts were on average larger (17.8 mm vs 11.4 mm, p < 0.0001), and these patients had a greater frontal-occipital horn ratio (0.45 vs 0.41, p = 0.012). They were also more likely to have undergone a previous resection (p = 0.02). The two cohorts had similar surgical outcomes, with no differences in extent of resection, recurrence, or complications. CONCLUSIONS Superiorly recessed intraseptal colloid cysts are larger and tend to splay the bodies of the fornix, thus requiring a parasagittal transseptal interforniceal endoscopic approach. This achieves complete removal with comparatively negligible morbidity or rare recurrence (5.9%).

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Section: Discussionmentioning

confidence: 99%

Transseptal interforniceal endoscopic removal of superiorly recessed colloid cysts

Tosi

Uribe-Cardenas

Lara‐Reyna

et al. 2022

Journal of Neurosurgery

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“… 1 Giant colloid cysts (GCCs) are defined as cysts greater than 30 mm in diameter. 2 These lesions often arise from the anterior part of the roof and grow downwards into the third ventricle. The lesion usually obstructs the foramen Monro and leads to obstructive hydrocephalus.…”

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confidence: 99%

Endoscopic resection of a giant colloid cyst in the velum interpositum: illustrative case

Arjipour¹,

Gharib²,

Eftekharian

2023

Journal of Neurosurgery: Case Lessons

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BACKGROUND Colloid cysts are an unusual differential diagnosis for lesions in the lateral ventricles. Microsurgery is usually recommended for the treatment of giant colloid cysts. This case is the largest reported colloid cyst in this unusual location treated with an endoscope. OBSERVATIONS A 39-year-old woman with a history of pulsing headaches presented with nausea, vomiting, vision blurring, and paresthesia of the left leg. On the brain computed tomography, a huge, well-defined homogeneous hyperdense intraventricular lesion with hydrocephalus was observed. Magnetic resonance imaging showed a spherical lesion over the third ventricle inside the lateral ventricles, obstructing the Sylvius aqueduct. There was no enhancement and no diffusion restriction on diffusion-weighted images. Endoscopic third ventriculostomy was undertaken for hydrocephalus treatment. Then the lesion was resected grossly. The cyst wall was resected as much as it was safe. There was no clot or bloody product inside the lesion. LESSONS Colloid cyst is rarely encountered in the velum interpositum and lateral ventricles, but the authors’ giant colloid cyst case along with similar cases led to considering it out of the third ventricle. According to their experience, endoscopic removal is a safe and efficient method for colloid cyst surgery, even in giant cases.

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Giant colloid cyst occupying a cavum septum pellucidum et vergae

Cited by 2 publications

References 20 publications

Transseptal interforniceal endoscopic removal of superiorly recessed colloid cysts

Transseptal interforniceal endoscopic removal of superiorly recessed colloid cysts

Endoscopic resection of a giant colloid cyst in the velum interpositum: illustrative case

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