Colloid cyst (recurrent)
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Headaches. Abnormal CT Brain.
There is a well-defined lobulated mass lesion occupying and expanding the third ventricle and the Monro foramen on the right, without causing convincing obstructive hydrocephalus. It has an intrinsic T1 signal without enhancement, low T2, bright FLAIR, and facilitated diffusion.
This patient had the lesion resected by a transcallosal approach:
MACROSCOPIC DESCRIPTION: 1. "Colloid cyst": A strip of soft white tissue 12x1x1mm. A1. 2. "Colloid cyst": A strip of soft white tissue 8x1x1mm. A1.
MICROSCOPIC DESCRIPTION: 1,2. The sections show a cyst, which is lined by a layer of cuboidal to columnar epithelium. Some goblet cells are noted. The wall is fibrous. No evidence of malignancy is seen. The features are those of a colloid cyst.
MRI Brain (5 years later)
Defect in the body of the corpus callosum, to the right of the midline in keeping with the previous resection. Non enhancing T1 and FLAIR hyperintense intraventricular lesion in the region of the foramen of Munro measures approximately 18 x 15 x 17 mm (ML x AP x SI). The ventricular and sulcal pattern is otherwise within normal limits with no evidence of hydrocephalus. No other abnormal parenchymal signal.
This case illustrates colloid cyst recurrence 5 years after its resection.