Colloid cyst
Colloid cyst | |
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Histopathology of colloid cyst |
A colloid cyst is a non-malignant
Symptoms can include
Symptoms
Patients with third-ventricular colloid cysts become symptomatic when the tumor enlarges rapidly, causing cerebrospinal fluid (CSF) obstruction, ventriculomegaly, and increased intracranial pressure. Some cysts enlarge more gradually, however, allowing the patient to accommodate the enlarging mass without disruption of CSF flow, and the patient remains asymptomatic. In these cases, if the cyst stops growing, the patient can maintain a steady state between CSF production and absorption and may not require neurosurgical intervention.[4]
Diagnosis
Colloid cysts can be diagnosed by symptoms presented. Additional testing is required and the colloid cyst symptoms can resemble those of other diseases. MRI and CT scans are often used to confirm diagnosis.[5]
Treatment
There are various management options depending on the severity of symptoms and their effects on the patient. The main management options are observation, craniotomy for microsurgical resection, neuroendoscopic removal, stereotactic drainage, and CSF diversion with bilateral ventriculoperitoneal shunting placement.[6][7]
Surgical resection
Multiple studies have discussed how to remove a colloid cyst. One option is an endoscopic removal. An endoscope is inserted into the brain via a small incision and then moved toward the tumor in the ventricular compartment. The tumor is hit with an electric current. The interior of the cyst is removed followed by the cyst wall. The electric current is then used to kill the remaining pieces of the cyst. This whole process, including closing of the incision and removal of the scope, is completed within 45 minutes to an hour. The patients are able to leave the hospital after 1 or 2 days.[8] Quality of life is found to be better following endoscopic excision than microsurgery, with cysts smaller than 18 mm showing better cognitive outcome.[9] Another study found that ventriculomegaly may not be a contraindication for endoscopic removal, as the condition has comparable complication rates.[10] Another study experimented with a smaller retractor tube, 12 mm instead of 16–22 mm. The surgery was successful in removing the cyst; the smaller retractor tube minimized resection injury.
Neuroendoscopic third ventriculostomy during surgery can be used to prevent further postoperative hydrocephalus. This removes the need for insertion of bilateral shunts.[6][7]
Patients who have had a colloid cyst removed from the third ventricle sometimes experience some difficulty with day‐to‐day memory. Mammillary body atrophy in patients with surgical removal of colloid cysts indicates that this atrophy is partly due to a loss of temporal lobe projections in the fornix.[11]
References
- PMID 26968449.
- PMID 16867192.
- ^ Schiff, David. "Cysts" (PDF). American Brain Tumor Association. Archived from the original (PDF) on 16 May 2017. Retrieved 26 October 2014.
- PMID 10807239.
- PMID 23078815.
- ^ PMID 20559107.
- ^ PMID 32542676.
- ^ Colloid Cyst – New York Presbyterian Hospital Archived 22 June 2015 at the Wayback Machine. Nyp.org. Retrieved on 2013-08-15.
- S2CID 237524281.
- S2CID 6383791.
- PMID 19164441.
Further reading
- Hamlat, A.; Casallo-Quiliano, C.; Saikali, S.; Adn, M.; Brassier, G. (2004). "Huge colloid cyst: Case report and review of unusual forms". S2CID 21210149.
- Beems, Tjemme; Menovsky, Tomas; Lammens, M. (2006). "Hemorrhagic colloid cyst". Surgical Neurology. 65 (1): 84–6. PMID 16378869.
- Spears, Roderick C. (2004). "Colloid cyst headache". Current Pain and Headache Reports. 8 (4): 297–300. S2CID 37231525.
- Benoiton L.A.; Correia J.; Kamat A.S.; Wickremesekera A. (2014). "Familial colloid cyst". Journal of Clinical Neuroscience. 21 (3): 533–535. S2CID 206317368.
- Melbourne Neurosurgery