Endoscopic treatment of colloid cysts of the third ventricle: long-term results in a series of 6 consecutive cases.
OBJECTIVE
Colloid cysts of the third ventricle represent 0.5-2% of all intracranial tumors. Several surgical approaches have been proposed for the treatment of these lesions and endoscopy is the most recent one, but the best treatment still remains controversial. We decided to treat colloid cysts with endoscopic approach since 1999. In this paper we present our results in 6 consecutive cases admitted at our institution from 1999 to 2004.


METHODS
There were 4 males and 2 females. The mean age was 51.6 (range 29-77). All the cysts were symptomatic. The presenting symptom was headache in 4 patients, gait disturbance in 2, altered vision in 2, mental status change in 2, urinary incontinence in 2, loss of consciousness in 2 and short-term memory loss in 1 patient. All the endoscopic procedures were performed via a right precoronal burr hole, with a rigid endoscope.


RESULTS
The removal was radiologically complete in 4 cases and incomplete in 2. Overall outcome was good in all cases, with an improvement of colloid cyst-related hydrocephalus in all the patients. There was no surgical mortality. The mean follow-up period was 52.5 months. No tumor recurrences were observed. Complications occurred in only one patient: a septic ventriculitis, venous thrombosis of the right leg and pulmonary embolism developed, but completely resolved during the hospitalization time.


CONCLUSIONS
The endoscopic approach for the removal of colloid cysts of the third ventricle represents a safe procedure, and can be considered a very good option for the treatment of these lesions.
Acerbi
F
F
Neurosurgery, Department of Neurological Sciences, University of Milan, Fondazione IRCCS, Ospedale Maggiore, Policlinico Mangiagalli e Regina Elena, Milan, Italy. f.acerbi@sssup.it
Rampini
P
P
Egidi
M
M
Locatelli
M
M
Borsa
S
S
Gaini
S M
SM
D000328:Adult; D000368:Aged; D020863:Central Nervous System Cysts / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D002551:Cerebral Ventricle Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D003102:Colloids; D003244:Consciousness Disorders / Q000209:etiology; D004660:Encephalitis / Q000209:etiology; D004724:Endoscopy / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006261:Headache; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008569:Memory Disorders / Q000209:etiology; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology; D020542:Third Ventricle / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology; D020246:Venous Thrombosis / Q000150:complications; D015354:Vision, Low / Q000209:etiology
D003102:Colloids