CASE 12432 Published on 05.02.2015

Colloid cyst of the third ventricle

Section

Neuroradiology

Case Type

Clinical Cases

Authors

Khnaba S, Moukine Billah M, Fikri M, Ech-Cherif El Kettani N, Elhassani MR, Jiddane M

CHU Avicenne;
Hopital des Spécialités
Avenue Souissi
11100 Rabat, Morocco;
Email:safae.khnaba@gmail.com
Patient

35 years, female

Categories
Area of Interest Head and neck ; Imaging Technique MR
Clinical History
A 41-year-old female patient presented with a long history of paroxysmal severe headaches.
Imaging Findings
MRI imaging detected unilocular rounded lesion at the roof of the 3rd ventricle, hyperintense at T1WI, hypointense at T2WI.
Discussion
Colloid cyst is a benign intraventricular lesion, usually located in the antero-superior third ventricle. It represents between 0.5% and 2% of brain tumours. [1] The mean age at diagnosis is the 3rd and 4th decade.
Collloid cyst may be asymptomatic and found accidentally, however, headaches are the most common symptoms. Patients most often complain of sudden onset of severe headache, possibly aggravated by a movement of the head, which may be due to a ball valve action of the tumour that intermittently obstructs the free flow of cerebrospinal fluid through the foramen of Monro. [2]
The obstruction of the foramen of Monro may cause acute hydrocephalus and can lead to sudden death. [3]
Imaging appearance is variable and dependent on the cholesterol and protein contents and not on the presence of paramagnetic minerals.
CT typically shows an oval or rounded hyperdense cyst, which varies in size from 3–40 mm in diameter but may be larger.
MRI findings differ, with Tl-weighted images varying from hyperintense, as in our patient, to isointense; T2-weighted images tend to be centrally hypointense with a hyperintense periphery.
The aim of MRI is to determine the relationship of the cyst with the foramen of Monro, the V3, but also with the internal cerebral veins and thalamostriatal vein.
The differential diagnosis includes large basilar artery tip aneurysms, meningiomas, cavernous haemangiomas, choroid plexus papillomas, craniopharyngiomas, xanthogranulomas, gliomas, and pituitary tumours. [4]
Differential Diagnosis List
Colloid cysts of the third ventricle
Large basilar artery tip aneurysm
Choroid plexus papilloma
Final Diagnosis
Colloid cysts of the third ventricle
Case information
URL: https://www.eurorad.org/case/12432
DOI: 10.1594/EURORAD/CASE.12432
ISSN: 1563-4086