Colloid cyst of the third ventricle

Case contributed by Abanindu Thakur
Diagnosis almost certain

Presentation

Headache, giddiness

Patient Data

Age: 40 years
Gender: Female

The MRI sequences demonstrate a well-defined ovoid lesion (23 x 19 x 21 mm) in the roof of third ventricle. It is isointense to white matter on T1WI and hyperintense on T2 and FLAIR, with no restricted diffusion. It is not fat suppressed. It shows no post contrast enhancement. Inferior aspect of lesion shows tiny foci of calcification. No significant dilatation of the lateral ventricles seen.

Case Discussion

MRI features of the ovoid lesion in midline are consistent with of the colloid cyst of the third ventricle. 

Colloid cysts are unilocular, mucin-containing 3rd ventricular cyst1.

In MR Imaging of colloid cyst, T1WI signal correlates with cholesterol concentration, which is hyperintense in 2/3 rd & isointense in 1/3 rd cases (like in this case). T2WI signal is more variable and reflects water content. Cysts are not suppressed on FLAIR, not restricted on DWI, and usually show no enhancement1.

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