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Endoscopic ultrasonic aspirator–assisted removal of a third ventricular colloid cyst

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Abstract

Background

Colloid cysts are benign tumors usually located on the roof of the third ventricle. Cyst removal is the treatment of choice. It can be accomplished microsurgically through a transcortical- or transcallosal approach, or endoscopically. There is a lack of consensus regarding the best strategy for cyst removal. One of the challenges of the traditional endoscopic technique is dealing with the cyst content density. Hyperdensity on computed tomography scan and low signal on T2-weighted magnetic resonance imaging (MRI) cyst are correlated with high viscosity cystic content.

Case reports

We present a case of a colloid cyst of the third ventricle in a 15-year-old boy removed through a pure endoscopic transventricular approach. The cyst presented a low signal on T2 MRI; nevertheless, it was easily removed with the help of an endoscopic ultrasonic aspirator.

Discussion and conclusion

The colloid cyst of the third ventricle can be safely treated by a purely endoscopic approach. The rationale of the use of the ultrasonic aspirator relies on the facilitation of aspiration of the content even when the consistency is extremely firm.

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Authors and Affiliations

  1. Department of Neurosciences, Unit of Neurosurgery, Santobono-Pausilipon Children’s Hospital, Via Mario Fiore 6, 80121, Naples, Italy

    Pietro Spennato, Marianna Di Costanzo, Francesca Vitulli, Claudio Ruggiero, Giuliana Di Martino & Giuseppe Cinalli

  2. Department of Medicine and Surgery, University of Milan Bicocca, Milan, Italy

    Maria Allegra Cinalli

  3. Neurosurgery Department, Ospedale San Gerardo, Monza, Italy

    Maria Allegra Cinalli

  4. Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università Degli Studi di Napoli “Federico II”, Naples, Italy

    Marianna Di Costanzo & Francesca Vitulli

Authors
  1. Pietro Spennato
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  2. Maria Allegra Cinalli
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  3. Marianna Di Costanzo
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  4. Francesca Vitulli
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  5. Claudio Ruggiero
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  6. Giuliana Di Martino
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  7. Giuseppe Cinalli
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Contributions

Primary surgeon: Spennato; assistant surgeon/supervisor: Cinalli G.; editing and drafting the video and manuscript: Spennato, Cinalli MA, Di Costanzo, Ruggiero, Di Martino; critically revising the work: Cinalli G., Spennato; approved the final version of the work on behalf of all authors: Spennato; supervision: Cinalli G. All authors reviewed the manuscript.

Corresponding author

Correspondence to Pietro Spennato.

Ethics declarations

Ethics approval and consent to participate

All procedures performed in the studies involving human participants conformed to the ethical standards of the institutional and/or national research committee and the 1964 Declaration of Helsinki and its subsequent amendments or comparable ethical standards. Written informed consent was obtained from the parents for publication of the details of the medical case and associated images. Because this was a retrospective case report and all procedures performed were part of routine care, the study was exempt from ethical approval by the Institutional Review Board.

Conflict of interest

The authors declare no competing interests.

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Supplementary Information

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Supplementary file1 Video 1: Operative video of the case in Figs. 1 and 2 (MP4 786685 KB)

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Spennato, P., Cinalli, M.A., Di Costanzo, M. et al. Endoscopic ultrasonic aspirator–assisted removal of a third ventricular colloid cyst. Childs Nerv Syst 39, 3391–3395 (2023). https://doi.org/10.1007/s00381-023-05994-1

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  • DOI: https://doi.org/10.1007/s00381-023-05994-1

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