Purely endoscopic resection of colloid cysts.

Abstract

To further assess the safety and long-term efficacy of endoscopic resection of colloid cysts of the third ventricle. A retrospective review of a series of 35 consecutive patients (18 male, 17 female) with colloid cysts treated by endoscopic surgery was undertaken. The mean patient age was 32.4 years (range, 11-54 yr). Headache was the most common presenting symptom (22 patients). The average tumor size was 18 mm (range, 3-50 mm). The endoscopic technique could not be completed in six patients, necessitating conversion to an open craniotomy and a transcortical approach to the colloid cyst. All patients had histologically confirmed colloid cysts of the third ventricle, and complete resection of the lesion was confirmed macroscopically and radiologically in all patients. There were no deaths. Two patients developed aseptic meningitis without any permanent sequelae. One patient developed unilateral hydrocephalus attributable to obstruction of the foramen of Monro, which was treated with endoscopic septum pellucidotomy. The median follow-up period was 88 months (range, 10-132 mo). There was one asymptomatic radiological recurrence. No seizures occurred after surgery. The results of this study support the role of endoscopic resection in the treatment of patients with colloid cysts as a safe and effective modality. In some cases, conversion to an open procedure may be required. Additional follow-up will be required to continue to address the duration of lesion-free survival.