Infected colloid cyst
Mustafa Emrah Kaya
Received: 12 May 2017 /Accepted: 16 May 2017 /Published online: 3 June 2017
Springer-Verlag Berlin Heidelberg 2017
Introduction Colloid cysts are the most common pathologic
lesions of the third ventricle. Although they are histologically
benign, they may grow and can cause the hydrocephalus.
Case summary A 5-year-old male patient underwent to sur-
gery with the diagnosis of colloid cyst. In operation, after the
anterior transcallosal approach, the cyst was punctured by
syringe and obviously pus aspirated.
Conclusion Colloid cysts mostly remain silent and detected
incidentally. Although it is rarely defined, rhinorrhea, hypopi-
tuitarism, diabetes insipidus, spasmodic torticollis, drop attack,
aseptic meningitis, and coexistence with neurocysticercosis
have been reported, but this is the first reported case of an
infected colloid cyst.
Pure third ventricle lesions seem rare. They can be originated
by congenital or acquired reasons, such as choroid plexus
papilloma or cysts, lymphoma, cavum veli interpositi cyst,
enterogenous cyst, ependymal cyst colloid cyst (CC), and
neoplasms [1, 2].
They can produce various clinical findings depending on
their location. The lesions of the anterior recesses or floor may
cause hormonal dysfunctions related to hypothalamic–
pituitary gland axis pathologies, and the lesions of the poste-
rior wall may cause to non-communican hydrocephalus.
CCs form 55% of pure third ventricular lesions [3–5]. On
magnetic resonance imaging (MRI) in T1-weighted imaging
mostly seems as hyperintense or isointense lesion and in T2-
weighted imaging mostly seems hypointense. The most obvi-
ous difference from other mass lesions is typically round, well
circumscribed, and hyperintense appearance with peripheral
contrast enhancement. CCs almost always appear in the third
ventricle, and more than 99% are placed in the foramen
Monro. They are usually placed in the anterior and antero-
superior part of the third ventricle [6–12].
The cyst content is frequently formed by the gelatinous or
mucoid material [13–15]. They may remain asymptomatic, or
they can be presented with paroxysmal headache, gait distur-
bance, nausea, vomiting, impaired memory, hydrocephalus,
andevensuddendeath[6, 11, 14, 16].
We want to report on a patient infected CC, who was suc-
cessfully surgically treated.
A 5-year-old male patient with no previous health problems
admitted to our outpatient clinic with intermittent headache
complaint. Neurologic examination revealed left-sided trem-
or, and fundoscopy revealed bilateral papilledema.
MRI diagnosis revealed a markedly enlarged triventricular
hydrocephalus with a rounded and well-circumscribed third
ventricular lesion. The lesion diameter was approximately
40 mm, and it was slight hypointense on T1- and hyperintense
on T2-weighted images with peripheral contrast enhancement
(Figs. 1 and 2).
Complete blood cell count, erythrocyte sedimentation rate,
and C-reactive protein tests were within normal ranges.
* Atilla Yilmaz
Neurosurgery Department, Mustafa Kemal University, Hatay, Turkey
Childs Nerv Syst (2017) 33:1599–1602