Rate of Recurrence following Stereotactic Aspiration of Colloid Cysts of the Third Ventricle

Abstract

Background: The rate of recurrence following stereotactic aspiration of colloid cysts is not defined in the literature. Aims: To study the long-term imaging and clinical outcome in patients who had stereotactic aspiration of colloid cysts of the third ventricle. Methods: Between 1987 and 1994, computerized tomography-guided stereotactic aspiration was attempted in 26 consecutive patients with colloid cysts of the third ventricle. Results: There was no mortality or permanent morbidity. A complete aspiration of the cyst was possible in 17 patients, a partial aspiration of the cyst was achieved in 6 and the aspiration failed in 3 patients. On long-term follow-up, symptomatic recurrence was noted in 5/6 patients after partial aspiration and 4/17 patients after complete aspiration (mean follow-up 84.8 months). Kaplan-Meier analysis revealed that after complete aspiration of the cyst, median time to recurrence on imaging is 42 months (95% CI 23.0–60.9 months) but median time to symptomatic recurrence is much later at 184 months (95% CI 88.2–279.7 months). Conclusions: Stereotactic aspiration of colloid cysts remains a valid surgical option as complete aspiration leads to a good long-term outcome in several patients. Partial aspiration of the cyst should be followed by excision of the cyst, due to the high rate of symptomatic recurrence. However, periodic follow-up imaging is mandatory even after complete aspiration as delayed recurrences are possible.

Çocukluk Döneminde Üçüncü Ventrikül Kolloid Kiste Bağlı Gelişen Akut Hidrosefali

“…Yüksek rekürrens oranı olmasına rağmen stereotaktik aspirasyon faydalı olabilir (17). Hidrosefaliye neden olmayan 1 cm'den küçük asemptomatik KK'ler seri görüntüleme yön-temleri ile takip edilebilirler.…”

Symptomatic colloid cysts in the third ventricle of monozygotic twins

“…They carry different risks, with epilepsy and memory deficits being the most severe, respectively. In recent years, less invasive techniques have been introduced, including endoscopic removal ( 24 ) as well as stereotactic aspiration ( 25 ) and cyst wall rupture ( 26 ). It still has to be proven though whether or not these innovations are preferable to micro-neurosurgical removal.…”

Management of pineal and colloid cysts

“…Frame-based stereotactic aspiration of colloid cysts has fallen out of favour in recent years due to the relatively high rates of failure (10%), incomplete aspiration (23%) and recurrence (40%) and consequent need for long-term follow-up. 38 …”