Colloid cyst

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Not to be confused with Choledochal cysts.
Colloid cyst

Histopathology of colloid cyst

Classification and external resources
eMedicine med/2906 radio/96
[edit on Wikidata]

CT scan of a 1 cm colloid cyst

A colloid cyst is a cyst containing gelatinous material in the brain. It is almost always found just
posterior to the foramen of Monro in the anterior aspect of the third ventricle, originating from
the roof of the ventricle. Because of its location, it can cause obstructive hydrocephalus and
increased intracranial pressure. A Colloid cysts represent 0.5%-1% of intracranial tumors.[1]

Symptoms can include headache, vertigo, memory deficits, diplopia, behavioral disturbances and
in extreme cases, sudden death. Intermittency of symptoms is characteristic of this lesion.[2]
Untreated pressure caused by these cysts can result in brain herniation.[3] Colloid cyst symptoms
have been associated with 4 variables: cyst size, cyst imaging characteristics, ventricular size,
and patient age. The developmental origin is unclear, though they may be of endodermal origin,
which would explain the mucin-producing, ciliated cell type. These cysts can be surgically
resected, and opinion is divided about the advisability of this.

Contents
1 Colloid cyst diagnosis
2 Colloid Cyst Need for Surgery
3 Colloid cyst resection
4 References
5 External links

Colloid cyst diagnosis

Colloid cysts can be diagnosed by symptoms presented. Additional testing will be required and
the colloid cyst symptoms can resemble those of other diseases. MRI and CT scans are often
used to confirm diagnosis.[4]

Colloid Cyst Need for Surgery

Patients with third ventricular colloid cysts become symptomatic when the tumor enlarges
rapidly, causing 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.[5] Various management options exist depending
on the severity of symptoms and their effect on the patient. The main management options are:
observation, craniotomy for microsurgical resection, neuroendoscopic removal, stereotactic
drainage, and cerebrospinal fluid diversion with bilateral ventriculoperitoneal shunting
placement.[6]

Colloid cyst resection

Multiple studies have been found on how to remove a colloid cyst. One is an endoscopic
removal. To remove the cyst, make a small incision. The endoscope is inserted into the brain 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.[7] A case was done with the absence of ventriculomegaly that
has been contraindication in an endoscopic removal. The study found that with normal-sized
ventricles are not a contraindication. They actually have comparable or less complication rates.[8]
Another study experimented with a smaller retractor tube, 12 mm instead of 1622 mm. The
study found that using a 12 mm tube on a 10 mm colloid cyst. The surgery was successful in
removing the cyst with a smaller retractor tube for resection while minimizing injury. The
surgery had potential for improving outcomes.

Neuroendoscopic third ventriculostomy during surgery can be used to prevent further

hydrocephalus post op. This removes the need for insertion of bilateral shunts.[6]

References
1.

Peeters, Sophie M.; Daou, Badih; Jabbour, Pascal; Ladoux, Alexandre; Abi Lahoud, Georges
(2016-06-01). "Spontaneous Regression of a Third Ventricle Colloid Cyst". World Neurosurgery.
90: 704.e1922. doi:10.1016/j.wneu.2016.02.116. ISSN 1878-8769. PMID 26968449.
Shaktawat, Sameer S; Salman, Walid D; Twaij, Zuhair; Al-Dawoud, Abdul (25 July 2006).
"Unexpected death after headache due to a colloid cyst of the third ventricle". World Journal of
Surgical Oncology. 4: 47. doi:10.1186/1477-7819-4-47. ISSN 1477-7819. PMC 1550234 .
PMID 16867192.
Schiff, David. "Cysts" (PDF). American Brain Tumor Association. American Brain Tumor
Association. Retrieved 26 October 2014.
Turillazzi, Emanuela; Bello, Stefania; Neri, Margherita; Riezzo, Irene; Fineschi, Vittorio
(2012-01-01). "Colloid cyst of the third ventricle, hypothalamus, and heart: a dangerous link for
sudden death". Diagnostic Pathology. 7: 144. doi:10.1186/1746-1596-7-144. ISSN 1746-1596.
PMC 3502434 . PMID 23078815.
Pollock, BE; Schreiner, SA; Huston, J 3rd (May 2000). "A theory on the natural history of
colloid cysts of the third ventricle.". Journal of Neurosurgery. 46: 107781; discussion 10813.
doi:10.1097/00006123-200005000-00010. PMID 10807239.
G. Hadjipanayis, Costas; Schuette, Albert J.; Nicholas, Boulis; Charlie, Hao; Daniel L.,
Barrow; Charlie, Teo (July 2010). "Full Scope of Options". Journal of Neurosurgery. 67 (1):
197205. doi:10.1227/01.neu.0000370602.15820.e4. PMC 2888508 . PMID 20559107.
Colloid Cyst New York Presbyterian Hospital. Nyp.org. Retrieved on 2013-08-15.

8. Wait, S. D.; Gazzeri, R.; Wilson, D. A.; Abla, A. A.; Nakaji, P.; Teo, C. (2013).
"Endoscopic Colloid Cyst Resection in the Absence of Ventriculomegaly". Neurosurgery.
73 (1 Suppl Operative): 1. doi:10.1227/NEU.0b013e3182870980. PMID 23334281.

External links
Images of Colloid Cyst from MedPix
UCLA Neurosurgery: Colloid cysts (with video of removal procedure)
Hamlat, A.; Casallo-Quiliano, C.; Saikali, S.; Adn, M.; Brassier, G. (2004). "Huge
colloid cyst: Case report and review of unusual forms". Acta Neurochirurgica. 146 (4):
397401; discussion 401. doi:10.1007/s00701-004-0221-8. PMID 15057535.
Beems, Tjemme; Menovsky, Tomas; Lammens, M. (2006). "Hemorrhagic colloid cyst".
Surgical Neurology. 65 (1): 846. doi:10.1016/j.surneu.2005.03.034. PMID 16378869.
 Spears, Roderick C. (2004). "Colloid cyst headache". Current Pain and Headache
Reports. 8 (4): 297300. doi:10.1007/s11916-004-0011-2. PMID 15228889.
Benoiton L.A.; Correia J.; Kamat A.S.; Wickremesekera A. (2014). "Familial colloid
cyst". Journal of Clinical Neuroscience. 21 (3): 533535.
doi:10.1016/j.jocn.2013.08.012.
Melbourne Neurosurgery

Categories:

Central nervous system disorders

Rare diseases

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