PMC7586049_01
NECT of the brain: Midline third ventricular well-circumscribed hyperdense giant colloid cyst contributing to obstructive hydrocephalus.. NECT: Non-enhanced computed tomography, Ax: Axial, Cor: coronal.
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Monro contributing to obstructive hydrocephalus (Fig. 1). MRI analysis of the lesion revealed a heterogeneous appearance of non-enhancing low T2 and intermediate T1 signal intensity with associated central T2 dark signal intensity areas in the inferior aspect of the cyst that depicts hypointense T1 signal and blooming artifacts on SWI sequence suggestive of blood products (Fig. 2).
MRI of the brain: Giant colloid cyst obstructing the foramen of Monro and causing obstructive hydrocephalus shows predominant non-enhancing low T2 and intermediateT1 signal intensity with dark T2 signal areas in the inferior aspect of the cyst that depicts hypointense T1 signal and blooming artifacts on SWI sequence suggestive of associated blood products.. Ax: Axial, SWI: susceptibility weighted images, Sag: Sagittal, Cor: Coronal, +C: Contrast enhanced.
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Monro contributing to obstructive hydrocephalus (Fig. 1). MRI analysis of the lesion revealed a heterogeneous appearance of non-enhancing low T2 and intermediate T1 signal intensity with associated central T2 dark signal intensity areas in the inferior aspect of the cyst that depicts hypointense T1 signal and blooming artifacts on SWI sequence suggestive of blood products (Fig. 2).
Axial CT brain scan without contrast after transcortical endoscopic transventricular approach showed full excision of a third ventricular cyst and the insertion of external ventricular drain (EVD) with mild pneumocephalus in the left frontal horn of the lateral ventricle.
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The patient was subjected to transcortical endoscopic transventricular excision of a third ventricular cyst and the insertion of external ventricular drain (EVD) (Fig. 3).
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Non contrast axial CT brain image showed midline, ill defined, heterogeneous mass at the foramen of monro causing obstructive hydrocephalus and suggestive of colloid cyst.
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NECT of the brain revealed a midline ill-defined heterogeneous hyperdense lesion anterior midline third ventricular lesion at the level of the foramen of monro suggestive of colloid cyst, measuring 2 x 1.4 x 1.6 cm in maximum dimensions and causing obstructive hydrocephalus (Fig. 4).
MRI of the brain: Irregular walled heterogeneous T1 high and T2 low signal intensity anterior midline third ventricular colloid cyst that contributes to acute ongoing hydrocephalous. Noted central dark T2 and T1 signal intensity changes which showed blooming artifacts on SWI images (not shown) consistent with hemosiderin staining likely related to prior intra-cystic haemorrhage. No abnormal contrast enhancement was detected.
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No abnormal contrast enhancement was detected (Fig. 5).
Histopathology of case 2 showed cystic lesion lined by columnar epithelium with subepithelial extensive xanthogranulomatous reaction in the form of cholesterol crystals, foamy histiocytes, fibrosis, hemosiderin-laden macrophages and multinucleated giant cells.
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Histopathology of the examined material showed cystic lesion lined by columnar epithelium with subepithelial extensive xanthogranulomatous reaction in the form of cholesterol crystals, foamy histiocytes, fibrosis, hemosiderin-laden macrophages and multinucleated giant cells (Fig. 6).