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| {{distinguish|Choledochal cysts}} | | {{Short description|A type of brain cyst}} |
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| | name = Colloid cyst
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| | image = Colloid Cyst HE 40x.jpg
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| | caption = Histopathology of colloid cyst
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| [[File:Colloid Cyst Cat scan GIF.gif|thumb|[[X-ray computed tomography|CT scan]] of a 1 cm colloid cyst]]
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| A '''colloid cyst''' is a [[tumor]] 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]]. Colloid cysts represent 0.5–1.0% of intracranial tumors.<ref>{{Cite journal|last=Peeters|first=Sophie M.|last2=Daou|first2=Badih|last3=Jabbour|first3=Pascal|last4=Ladoux|first4=Alexandre|last5=Abi Lahoud|first5=Georges|date=2016-06-01|title=Spontaneous Regression of a Third Ventricle Colloid Cyst|journal=World Neurosurgery|volume=90|pages=704.e19–22|doi=10.1016/j.wneu.2016.02.116|issn=1878-8769|pmid=26968449}}</ref>
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| Symptoms can include [[headache]], [[Vertigo (medical)|vertigo]], [[memory deficit]]s, [[diplopia]], behavioral disturbances, and in extreme cases, sudden death. Intermittency of symptoms is characteristic of this lesion.<ref>{{cite journal|last1=Shaktawat|first1=Sameer S|last2=Salman|first2=Walid D|last3=Twaij|first3=Zuhair|last4=Al-Dawoud|first4=Abdul|title=Unexpected death after headache due to a colloid cyst of the third ventricle|journal=World Journal of Surgical Oncology|date=25 July 2006|volume=4|pages=47|doi=10.1186/1477-7819-4-47|issn=1477-7819|pmc=1550234|pmid=16867192}}</ref> Untreated pressure caused by these cysts can result in [[brain herniation]].<ref>{{cite web|last1=Schiff|first1=David|title=Cysts|url=http://www.abta.org/secure/resource-one-sheets/cysts.pdf|website=American Brain Tumor Association|publisher=American Brain Tumor Association|accessdate=26 October 2014|ref=1|archive-url=https://web.archive.org/web/20170516215546/http://www.abta.org/secure/resource-one-sheets/cysts.pdf|archive-date=16 May 2017|url-status=dead}}</ref> Colloid cyst symptoms have been associated with four variables: cyst size, cyst imaging characteristics, ventricular size, and patient age. Their 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.
| | A '''colloid cyst''' is a type of [[brain cyst]] that typically occurs in the [[third ventricle]] of the [[brain]]. These cysts are filled with a gelatinous substance and can cause [[obstructive hydrocephalus]] by blocking the flow of [[cerebrospinal fluid]] (CSF). Colloid cysts are considered benign, but their location can lead to serious complications if not treated. |
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| ==Symptoms== | | ==Pathophysiology== |
| 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.<ref>{{cite journal|last1=Pollock|first1=BE|last2=Schreiner|first2=SA|last3=Huston|first3=J 3rd|title=A theory on the natural history of colloid cysts of the third ventricle.|journal=Journal of Neurosurgery|date=May 2000|pmid=10807239|doi=10.1097/00006123-200005000-00010 |volume=46|pages=1077-81; discussion 1081-3}}</ref>
| | Colloid cysts are believed to originate from remnants of the [[neuroepithelium]] during embryonic development. They are usually located in the [[anterior]] part of the third ventricle, near the [[foramen of Monro]], which is a critical area for the flow of CSF between the [[lateral ventricles]] and the third ventricle. The cysts are filled with a thick, mucoid material that can vary in color from white to yellow or green. |
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| | ==Clinical Presentation== |
| | Patients with a colloid cyst may present with a variety of symptoms, depending on the size of the cyst and the degree of obstruction it causes. Common symptoms include: |
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| | * [[Headache]] |
| | * [[Nausea]] and [[vomiting]] |
| | * [[Memory loss]] |
| | * [[Gait disturbances]] |
| | * [[Vision problems]] |
| | * [[Sudden death]] in rare cases due to acute hydrocephalus |
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| | The symptoms are often positional, worsening when the patient is lying down or changing positions. |
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| ==Diagnosis== | | ==Diagnosis== |
| [[File:Colloid Cyst.svg|thumb|This is an image of a regular brain and a brain with a colloid cyst.]] | | Colloid cysts are typically diagnosed using [[neuroimaging]] techniques. [[Magnetic resonance imaging]] (MRI) is the preferred method, as it provides detailed images of the brain and can clearly show the cyst and any associated hydrocephalus. [[Computed tomography]] (CT) scans can also be used, especially in emergency situations. |
| 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.<ref>{{Cite journal|last=Turillazzi|first=Emanuela|last2=Bello|first2=Stefania|last3=Neri|first3=Margherita|last4=Riezzo|first4=Irene|last5=Fineschi|first5=Vittorio|date=2012-01-01|title=Colloid cyst of the third ventricle, hypothalamus, and heart: a dangerous link for sudden death|journal=Diagnostic Pathology|volume=7|pages=144|doi=10.1186/1746-1596-7-144|issn=1746-1596|pmc=3502434|pmid=23078815}}</ref>
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| == Treatment == | | ==Treatment== |
| Various management options exist 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.<ref name="pmid20559107">{{cite journal|last1=G. Hadjipanayis|first1=Costas|last2=Schuette|first2=Albert J.|last3=Nicholas|first3=Boulis|last4=Charlie|first4=Hao|last5=Daniel L.|first5=Barrow|last6=Charlie|first6=Teo|title=Full Scope of Options|journal=Journal of Neurosurgery|date=July 2010|volume=67|issue=1|pages=197–205|pmid=20559107|pmc=2888508|doi=10.1227/01.neu.0000370602.15820.e4}}</ref>
| | The treatment of colloid cysts depends on the size of the cyst and the severity of symptoms. Options include: |
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| ===Surgical resection===
| | * '''Observation''': Small, asymptomatic cysts may be monitored with regular imaging studies. |
| 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.<ref>[http://nyp.org/health/colloid-cyst.html Colloid Cyst – New York Presbyterian Hospital]. Nyp.org. Retrieved on 2013-08-15.</ref> Another study found that [[ventriculomegaly]] may not be a contraindication for endoscopic removal, as the condition has comparable complication rates.<ref>{{Cite journal | last1 = Wait | first1 = S. D. | last2 = Gazzeri | first2 = R. | last3 = Wilson | first3 = D. A. | last4 = Abla | first4 = A. A. | last5 = Nakaji | first5 = P. | last6 = Teo | first6 = C. | title = Endoscopic Colloid Cyst Resection in the Absence of Ventriculomegaly | doi = 10.1227/NEU.0b013e3182870980 | journal = Neurosurgery | pages = 1 | year = 2013 | pmid = 23334281 | pmc = | volume=73 | issue=1 Suppl Operative}}</ref> 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.
| | * '''Surgical removal''': Symptomatic cysts or those causing significant hydrocephalus are typically removed surgically. Approaches include: |
| | * '''Endoscopic surgery''': A minimally invasive technique that uses an endoscope to remove the cyst. |
| | * '''Microsurgical resection''': A more traditional approach that involves opening the skull to access and remove the cyst. |
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| Neuroendoscopic third [[ventriculostomy]] during surgery can be used to prevent further postoperative hydrocephalus. This removes the need for insertion of bilateral shunts.<ref name="pmid20559107" />
| | ==Prognosis== |
| | The prognosis for patients with a colloid cyst is generally good, especially if the cyst is detected and treated before significant complications arise. Surgical removal of the cyst often results in the resolution of symptoms and a return to normal function. |
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| ==References== | | ==Related pages== |
| {{reflist}}
| | * [[Hydrocephalus]] |
| | * [[Ventricular system]] |
| | * [[Neurosurgery]] |
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| ==Further reading==
| | [[Category:Neurosurgery]] |
| *{{cite journal |pmid=15057535 |doi=10.1007/s00701-004-0221-8 |title=Huge colloid cyst: Case report and review of unusual forms |year=2004 |last1=Hamlat |first1=A. |last2=Casallo-Quiliano |first2=C. |last3=Saikali |first3=S. |last4=Adn |first4=M. |last5=Brassier |first5=G. |journal=[[Acta Neurochirurgica]] |volume=146 |issue=4 |pages=397–401; discussion 401 }}
| | [[Category:Brain disorders]] |
| *{{cite journal |pmid=16378869 |doi=10.1016/j.surneu.2005.03.034 |title=Hemorrhagic colloid cyst |year=2006 |last1=Beems |first1=Tjemme |last2=Menovsky |first2=Tomas |last3=Lammens |first3=M. |journal=Surgical Neurology |volume=65 |pages=84–6 |issue=1 }}
| | [[Category:Congenital disorders]] |
| *{{cite journal |doi=10.1007/s11916-004-0011-2 |title=Colloid cyst headache |year=2004 |last1=Spears |first1=Roderick C. |journal=Current Pain and Headache Reports |volume=8 |issue=4 |pages=297–300 |pmid=15228889 }}
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| * {{cite journal |author1=Benoiton L.A. |author2=Correia J. |author3=Kamat A.S. |author4=Wickremesekera A. | year = 2014 | title = Familial colloid cyst | doi = 10.1016/j.jocn.2013.08.012 | journal = Journal of Clinical Neuroscience | volume = 21 | issue = 3| pages = 533–535 }}
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| * [http://www.neurosurgery.com.au/pdfs/ILLNESS/colloidcystpdf.pdf Melbourne Neurosurgery]
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| == External links ==
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| {{Medical resources
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| | DiseasesDB =
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| | ICD10 = {{ICD10|Q04.6}}
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| | eMedicineSubj = med
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| | eMedicineTopic = 2906
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| | eMedicine_mult = {{eMedicine2|radio|96}}
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| [[Category:Central nervous system disorders]] | |
| [[Category:Rare diseases]] | |
A type of brain cyst
A colloid cyst is a type of brain cyst that typically occurs in the third ventricle of the brain. These cysts are filled with a gelatinous substance and can cause obstructive hydrocephalus by blocking the flow of cerebrospinal fluid (CSF). Colloid cysts are considered benign, but their location can lead to serious complications if not treated.
Pathophysiology
Colloid cysts are believed to originate from remnants of the neuroepithelium during embryonic development. They are usually located in the anterior part of the third ventricle, near the foramen of Monro, which is a critical area for the flow of CSF between the lateral ventricles and the third ventricle. The cysts are filled with a thick, mucoid material that can vary in color from white to yellow or green.
Clinical Presentation
Patients with a colloid cyst may present with a variety of symptoms, depending on the size of the cyst and the degree of obstruction it causes. Common symptoms include:
The symptoms are often positional, worsening when the patient is lying down or changing positions.
Diagnosis
Colloid cysts are typically diagnosed using neuroimaging techniques. Magnetic resonance imaging (MRI) is the preferred method, as it provides detailed images of the brain and can clearly show the cyst and any associated hydrocephalus. Computed tomography (CT) scans can also be used, especially in emergency situations.
Treatment
The treatment of colloid cysts depends on the size of the cyst and the severity of symptoms. Options include:
- Observation: Small, asymptomatic cysts may be monitored with regular imaging studies.
- Surgical removal: Symptomatic cysts or those causing significant hydrocephalus are typically removed surgically. Approaches include:
* Endoscopic surgery: A minimally invasive technique that uses an endoscope to remove the cyst.
* Microsurgical resection: A more traditional approach that involves opening the skull to access and remove the cyst.
Prognosis
The prognosis for patients with a colloid cyst is generally good, especially if the cyst is detected and treated before significant complications arise. Surgical removal of the cyst often results in the resolution of symptoms and a return to normal function.
Related pages
