Third ventricular colloid cysts in children-a series of eight cases and review of literature

Abstract

AIm: Colloid cysts are uncommon lesions, which most commonly occur in the fourth through seventh decade. The authors hereby report a series of colloid cysts in the pediatric age group. mAterIAl and methOds: A retrospective study was conducted on all patients of colloid cyst that underwent surgery at our institute over a period of seven years (2005 to 2011). Patients above the age of 20 were excluded from the study.results: All eight patients presented with the features of raised intracranial pressure. All these patients had the characteristic radiological features of a colloid cyst. Of these eight pediatric patients, endoscopic removal was attempted in four. In one of these four, the colloid cyst could not be removed endoscopically and had to be converted into transcortical transventricular excision. In one more patient, transcortical transventricular excision was used, while transcallosal approach was performed in three patients. Of the three patients who underwent endoscopy, one patient additionally underwent septostomy and one patient additionally underwent septostomy along with third ventriculostomy. One of the patients succumbed to ventriculitis.COnClusIOn: Colloid cysts in the young are thought to be more aggressive clinically and radiologically and therefore, early surgical intervention is indicated. BulGulAr: Sekiz hastanın tümü artmış intrakraniyal basınç bulgularıyla gelmişlerdir. Tüm hastalarda kolloid kistin karakteristik radyolojik özellikleri saptanmıştır. Bu sekiz pediatrik hastanın dördünde kist endoskopik olarak çıkarılmaya çalışılmıştır. Bu dört hastanın birinde kolloid kist endoskopik olarak çıkarılamamış ve transkortikal transventriküler eksizyona dönülmek zorunda kalınmıştır.Bir hastada transkortikal transventriküler eksizyon, üç hastada transkallosal yaklaşım kullanılmıştır. Endoskopi yapılan üç hasta içinde bir hastaya ayrıca septostomi yapılmış ve bir hastaya ayrıca septostomi ve üçüncü ventrikülostomi yapılmıştır. Bir hasta ventrikülit nedeniyle kaybedilmiştir. sOnuÇ: Çocuklarda kolloid kistlerin klinik ve radyolojik olarak daha agresif olduğu düşünülür ve bu nedenle erken cerrahi girişim gereklidir.

Occipital Lobe Infarction due to Acute Hydrocephalus Secondary to Third Ventricle Colloid Cyst in a Child

“…Colloid cysts of the brain are rarely seen in children and only approximately 100 cases have been reported in English literature till date (►Table 1). 4 Mathiesen et al reported 37 cases of colloid cyst, 5 of which were found to occur in children. 1 Alnaghmoosh and Alkhani reported 7 cases of colloid cyst in children in a series of 43 cases.…”

“…3 Most of the series describing colloid cyst in pediatric patients report male predominance. 4,[10][11][12][13] The cyst may range in size from 3 to 40 mm; giant cysts above 30 mm are uncommon. 11 The rate of cyst growth is uncertain and whether all the cysts eventually manifest with symptoms is unclear.…”

“…11 The rate of cyst growth is uncertain and whether all the cysts eventually manifest with symptoms is unclear. 3,4 Macdonald et al reported that younger patients with colloid cyst are more likely to become symptomatic.…”

“…1,2 These benign tumors are generally seen in the anterosuperior portion of the third ventricle and are by far the most common of the intraventricular masses here. 3,4 Colloid cysts are of endodermal (foregut) origin and are lined by pseudostratified, cuboidal, or columnar epithelial cells. Cysts may range in size from 3 to 40 mm and contain viscous, gelatinous contents with some cellular debris.…”

“…Cysts may range in size from 3 to 40 mm and contain viscous, gelatinous contents with some cellular debris. [1][2][3][4] Colloid cysts of the third ventricle are rare in children. [5][6][7][8] Obstruction of the foramen of Monro by the colloid cyst in the anterosuperior portion of third ventricle may result in noncommunicating hydrocephalus, which may be complicated by central transtentorial herniation manifesting with brainstem compression and posterior cerebral artery infarction.…”