Twenty Colloid Cysts - Comparison of Endoscopic and Microsurgical Management

Kehler, Uwe; Brunori, Andrea; Gliemroth, Jan; Nowak, G.; Delitala, Alberto; Chiappetta, F; Arnold, H

doi:10.1055/s-2001-18122

Cited by 68 publications

(54 citation statements)

References 8 publications

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“…Endoscopic procedures yield satisfactory results, but limited follow up is available for these cases. 12) In our case, no recurrence occurred for 2 years after total removal of the cyst.…”

Section: Ectopic Colloid Cyst Is Difficult To Differentiatementioning

confidence: 79%

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

Tanei

Fukui

Kato

et al. 2006

Neurol. Med. Chir.(Tokyo)

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A 60-year-old man presented with a left frontal mass lesion incidentally detected at a health check without apparent symptoms. Computed tomography revealed the lesion as homogeneous high density and magnetic resonance (MR) imaging showed the lesion as hyperintense on T 1 -weighted images, isointense on T 2 -weighted images, and hypointense on diffusion-weighted images. T 1 -weighted MR images with gadolinium showed no enhancement of the mass lesion. Cerebral angiography revealed an avascular area around the left frontal lesion. Total removal of the lesion was achieved through a craniotomy without complications. Histological, immunohistochemical, and electron microscopy examinations established the definite diagnosis of colloid cyst.

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“…Endoscopic procedures yield satisfactory results, but limited follow up is available for these cases. 12) In our case, no recurrence occurred for 2 years after total removal of the cyst.…”

Section: Ectopic Colloid Cyst Is Difficult To Differentiatementioning

confidence: 79%

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

Tanei

Fukui

Kato

et al. 2006

Neurol. Med. Chir.(Tokyo)

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“…However, microsurgical resection is associated with significant morbidity and prolonged post-operative hospital stays. 2,[20][21][22][23][24][25][26][27][28] More recently, some authors have reported less invasive microsurgical techniques with endoscopic assistance, 22 neuronavigation 29 and approaches through cylindrical retractors using stereotactic frames. 30,31 Although potentially less invasive, stereotactic aspiration is associated with recurrence rates of 30-80% [32][33][34] with recurrences occurring as early as two months in half of these.…”

mentioning

confidence: 99%

Endoscopic Versus Microsurgical Resection of Third Ventricle Colloid Cysts

Grondin

Hader

MacRae

et al. 2007

Can. j. neurol. sci.

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Colloid cysts of the third ventricle represent about 0.5-2 percent of intracranial tumors.1,2 Although uncommon, they are an important clinical entity because of their ability to cause cerebrospinal fluid (CSF) obstruction and sudden death. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] In one population-based study, one third of patients with symptomatic colloid cysts presented with acute neurological deterioration, underscoring the need for their treatment. There has been some debate over the optimal management of colloid cysts over the past few decades. Management options include CSF diversion procedures (e.g. ventriculo-peritoneal ABSTRACT: Objective: Endoscopic resection of colloid cysts has been performed as an alternative to microsurgical resection and stereotactic aspiration since 1982. To date, there are limited published studies comparing these procedures. In this study, we present the largest series of endoscopic resections published to date and compare outcomes to a cohort of microsurgical resections performed at the same institution. Methods: A retrospective chart review was conducted for all patients in the Calgary Health Region undergoing resection of a colloid cyst between 1991 and 2004. Comparison was made between patients treated with endoscopic resection versus microsurgical resection. Results: Twenty-five endoscopic and nine microsurgical procedures were performed. Complete resection was achieved in 24 of 25 procedures in the Endoscopic group, compared with all 9 procedures in the Microsurgical group. Patients in the Endoscopic group had a reduced operative time (mean 104 minutes versus 217 minutes) and reduced length of stay (3.8 days versus 8.4 days) compared to the Microsurgical group. One patient in the Endoscopic group had a complication (hemiparesis/pulmonary embolus). By contrast, 3 patients in the Microsurgical group had complications (seizure, ventriculitis/bone flap infection, and transient memory deficit). There was one recurrence in each group which both occurred at 5 years follow-up. The mean length of follow-up is 38 months in the Endoscopic group and 33 months in the Microsurgical group. Conclusion: Endoscopic resection of colloid cysts can be performed with significantly lower risk of complication than microsurgical resection and with equivalent surgical success. Operative time and length of hospital stay are both significantly reduced with endoscopic resection. RÉSUMÉ: Résection endoscopique versus microchirurgicale des kystes colloïdes du troisième ventricule.Objectif : La résection endoscopique des kystes colloïdes comme alternative à la résection microchirurgicale et à l'aspiration stéréotaxique est réalisée depuis 1982. À ce jour, peu d'études comparant ces interventions ont été publiées. Dans cette étude, nous présentons la plus grande série de résections endoscopiques publiée à ce jour et nous comparons les résultats à ceux d'une cohorte de patients ayant subi une résection microchirurgicale dans la même institution. Méthodes : Nous avons procédé à une ré...

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“…15,20,28,32 Several series of patients affected by third ventricle colloid cysts have reported an average rate of recurrence higher in cases in which the cyst wall was partially resected compared with those in which the capsule was entirely removed (6.87% vs 0.71%, respectively). 2,4,5,9,[14][15][16]20,21,23,29,31,32 Based on these data, we attempted to achieve a complete resection of the colloid cyst in all patients. However, the endoscopic approach to the third ventricle, usually performed through the foramen of Monro, does not provide an adequate view of the cyst's attachment to the tela choroidea, necessitating that the cyst capsule be stripped away from the roof of the third ventricle in a "blinded" fashion, especially when attachment of the lesion is very posterior.…”

Section: Discussionmentioning

confidence: 99%

“…2,15,20,24,26,29 The rate of recurrence varies among the different series, ranging from 0% to 11.47%. 2,4,5,9,[14][15][16]18,20,21,23,26,29,31,32 Complete resection of third ventricle colloid cysts, including their attachment to the tela choroidea, is important to reduce the risk of recurrence. However, stripping away the cyst wall from its insertion in the roof of the third ventricle may result in severe hemorrhage if the internal cerebral veins are injured.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4]6,[8][9][10]12,14,16,17,[19][20][21]23,28,29,31,32 Several series have demonstrated the efficacy and safety of endoscopic resection of colloid cysts with shorter operating times, shorter hospitalization, and fewer complications compared with open surgery. 5,18,26,29 Although the endoscopic treatment of third ventricle colloid cyst has progressively increased in recent years, its surgical results are still discussed because the rate of residual and recurrent cysts is higher than that of microsurgery.…”

Section: Discussionmentioning

confidence: 99%

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Combined endoscopic transforaminal-transchoroidal approach for the treatment of third ventricle colloid cysts

Iacoangeli¹,

Somma²,

Rienzo³

et al. 2014

JNS

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Colloid cysts are histologically benign lesions whose primary goal of treatment should be complete resection to avoid recurrence and sudden death. Open surgery is traditionally considered the standard approach, but, recently, the endoscopic technique has been recognized as a viable and safe alternative to microsurgery. The endoscopic approach to colloid cysts of the third ventricle is usually performed through the foramen of Monro. However, this route does not provide adequate visualization of the cyst attachment on the tela choroidea. The combined endoscopic transforaminal-transchoroidal approach (ETTA), providing exposure of the entire cyst and a better visualization of the tela choroidea, could increase the chances of achieving a complete cyst resection. Between April 2005 and February 2011, 19 patients with symptomatic colloid cyst of the third ventricle underwent an endoscopic transfrontal-transforaminal approach. Five of these patients, harboring a cyst firmly adherent to the tela choroidea or attached to the middle/posterior roof of the third ventricle, required a combined ETTA. Postoperative MRI documented a gross-total resection in all 5 cases. There were no major complications and only 1 patient experienced a transient worsening of the memory deficit. To date, no cyst recurrence has been observed. An ETTA is a minimally invasive procedure that can allow for a safe and complete resection of third ventricle colloid cysts, even in cases in which the lesions are firmly attached to the tela choroidea or located in the middle/posterior roof of the third ventricle.

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Twenty Colloid Cysts - Comparison of Endoscopic and Microsurgical Management

Cited by 68 publications

References 8 publications

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

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

Endoscopic Versus Microsurgical Resection of Third Ventricle Colloid Cysts

Combined endoscopic transforaminal-transchoroidal approach for the treatment of third ventricle colloid cysts

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