Pineal gland cyst

Last updated
Pineal gland cyst
Verkalkte Corpus pineale Zyste sagittal.jpg
Calcified cyst of pineal gland in CT. Sagittal MPR.

A pineal gland cyst is a usually benign (non-malignant) cyst in the pineal gland, a small endocrine gland in the brain. Historically, these fluid-filled bodies appeared on 1-4% of magnetic resonance imaging (MRI) brain scans, but were more frequently diagnosed at death, seen in 4-11% of autopsies. [1] A 2007 study by Pu et al. found a frequency of 23% in brain scans (with a mean diameter of 4.3 mm). [1]

Contents


The National Organization for Rare Disorders states that pineal cysts larger than 5.0 mm are "rare findings" and are possibly symptomatic. If narrowing of the cerebral aqueduct occurs, many neurological symptoms may exist, including headaches, vertigo, nausea, muscle fasciculations, eye sensitivity, and ataxia. Continued monitoring of the cyst might be recommended to monitor its growth, and surgery may be necessary. [2]

Treatment

Rhomberg, T., & Schroeder, H. W. (2024). Microsurgical Resection of a Pineal Cyst via a Paramedian Supracerebellar Infratentorial Approach. World Neurosurgery, 185, 113. https://doi.org/10.1016/j.wneu.2024.02.049

Pineal gland cysts typically require treatment only if they are symptomatic. They can be removed either endoscopically [3] or through a conventional open approach, such as a supracerebellar infratentorial approach [4] .


Additional images

Related Research Articles

<span class="mw-page-title-main">Brain tumor</span> Neoplasm in the brain

A brain tumor occurs when a group of cells within the brain turn cancerous and grow out of control, creating a mass. There are two main types of tumors: malignant (cancerous) tumors and benign (non-cancerous) tumors. These can be further classified as primary tumors, which start within the brain, and secondary tumors, which most commonly have spread from tumors located outside the brain, known as brain metastasis tumors. All types of brain tumors may produce symptoms that vary depending on the size of the tumor and the part of the brain that is involved. Where symptoms exist, they may include headaches, seizures, problems with vision, vomiting and mental changes. Other symptoms may include difficulty walking, speaking, with sensations, or unconsciousness.

<span class="mw-page-title-main">Cyst</span> Closed sac growth on the body

A cyst is a closed sac, having a distinct envelope and division compared with the nearby tissue. Hence, it is a cluster of cells that have grouped together to form a sac ; however, the distinguishing aspect of a cyst is that the cells forming the "shell" of such a sac are distinctly abnormal when compared with all surrounding cells for that given location. A cyst may contain air, fluids, or semi-solid material. A collection of pus is called an abscess, not a cyst. Once formed, a cyst may resolve on its own. When a cyst fails to resolve, it may need to be removed surgically, but that would depend upon its type and location.

<span class="mw-page-title-main">Pineal gland</span> Endocrine gland in the brain of most vertebrates

The pineal gland is a small endocrine gland in the brain of most vertebrates. It produces melatonin, a serotonin-derived hormone, which modulates sleep patterns following the diurnal cycles. The shape of the gland resembles a pine cone, which gives it its name. The pineal gland is located in the epithalamus, near the center of the brain, between the two hemispheres, tucked in a groove where the two halves of the thalamus join. It is one of the neuroendocrine secretory circumventricular organs in which capillaries are mostly permeable to solutes in the blood.

<span class="mw-page-title-main">Craniopharyngioma</span> Brain tumor of pituitary gland embryonic tissue

A craniopharyngioma is a rare type of brain tumor derived from pituitary gland embryonic tissue that occurs most commonly in children, but also affects adults. It may present at any age, even in the prenatal and neonatal periods, but peak incidence rates are childhood-onset at 5–14 years and adult-onset at 50–74 years. People may present with bitemporal inferior quadrantanopia leading to bitemporal hemianopsia, as the tumor may compress the optic chiasm. It has a point prevalence around two per 1,000,000. Craniopharyngiomas are distinct from Rathke's cleft tumours and intrasellar arachnoid cysts.

<span class="mw-page-title-main">Arachnoid cyst</span> Medical condition

Arachnoid cysts are cerebrospinal fluid covered by arachnoidal cells and collagen that may develop between the surface of the brain and the cranial base or on the arachnoid membrane, one of the three meningeal layers that cover the brain and the spinal cord. Primary arachnoid cysts are a congenital disorder whereas secondary arachnoid cysts are the result of head injury or trauma. Most cases of primary cysts begin during infancy; however, onset may be delayed until adolescence.

<span class="mw-page-title-main">Corpora arenacea</span> Small mineral concentrations in the brain

Corpora arenacea are calcified structures in the pineal gland and other areas of the brain such as the choroid plexus. Older organisms have numerous corpora arenacea, whose function, if any, is unknown. Concentrations of "brain sand" increase with age, so the pineal gland becomes increasingly visible on X-rays over time, usually by the third or fourth decade. They are sometimes used as anatomical landmarks in radiological examinations.

<span class="mw-page-title-main">Colloid cyst</span> Medical condition

A colloid cyst is a non-malignant tumor in the brain. It consists of a gelatinous material contained within a membrane of epithelial tissue. It is almost always found just posterior to the foramen of Monro in the anterior aspect of the third ventricle, originating from the roof of the ventricle. Because of its location, it can cause obstructive hydrocephalus and increased intracranial pressure. Colloid cysts represent 0.5–1.0% of intracranial tumors.

Endoscopic third ventriculostomy (ETV) is a surgical procedure for treatment of hydrocephalus in which an opening is created in the floor of the third ventricle using an endoscope placed within the ventricular system through a burr hole. This allows the cerebrospinal fluid to flow directly to the basal cisterns, bypassing the obstruction. Specifically, the opening is created in the translucent tuber cinereum on the third ventricular floor.

<span class="mw-page-title-main">Pineocytoma</span> Benign tumor of the pineal gland

Pineocytoma, is a rare, benign, slowly growing tumor of the pineal gland. The pineal gland is a small endocrine gland close to the center of the brain that secretes melatonin into the bloodstream. Pineocytomas can cause pressure and fluid build-up in the brain. They are more common in adults. Symptoms include vision problems, nausea, vomiting, memory problems, and headaches.

<span class="mw-page-title-main">Central nervous system cyst</span> Medical condition

A central nervous system cyst is a type of cyst that presents and affects part of the central nervous system (CNS). They are usually benign and filled with either cerebrospinal fluid, blood, or tumor cells. CNS cysts are classified into two categories: cysts that originate from non-central nervous system tissue, migrate to, and form on a portion of the CNS, and cysts that originate within central nervous system tissue itself. Within these two categories, there are many types of CNS cysts that have been identified from previous studies.

<span class="mw-page-title-main">Pineoblastoma</span> Cancerous tumor of the pineal gland

Pineoblastoma is a malignant tumor of the pineal gland. A pineoblastoma is a supratentorial midline primitive neuroectodermal tumor. Pineoblastoma can present at any age, but is most common in young children. They account for 0.001% of all primary CNS neoplasms.

Piezoelectric bone surgery is a process that utilizes piezoelectric vibrations in the application of cutting bone tissue. The process was patented by Fernando Bianchetti, Domenico Vercellotti, and Tomaso Vercellotti. It was first used clinically in 1988. It is indicated for use in oral, maxillofacial, cranial and spinal procedures; but is mainly used in orthodontics and craniofacial surgery.

Pediatric ependymomas are similar in nature to the adult form of ependymoma in that they are thought to arise from radial glial cells lining the ventricular system. However, they differ from adult ependymomas in which genes and chromosomes are most often affected, the region of the brain they are most frequently found in, and the prognosis of the patients. Children with certain hereditary diseases, such as neurofibromatosis type II (NF2), have been found to be more frequently afflicted with this class of tumors, but a firm genetic link remains to be established. Symptoms associated with the development of pediatric ependymomas are varied, much like symptoms for a number of other pediatric brain tumors including vomiting, headache, irritability, lethargy, and changes in gait. Although younger children and children with invasive tumor types generally experience less favorable outcomes, total removal of the tumors is the most conspicuous prognostic factor for both survival and relapse.

<span class="mw-page-title-main">Papillary tumors of the pineal region</span> Type of brain tumor

Papillary tumors of the pineal region were first described by A. Jouvet et al. in 2003 and were introduced in the World Health Organization (WHO) classification of central nervous system in 2007. Papillary Tumors of the Pineal Region are located on the pineal gland which is located in the center of the brain. The pineal gland is located on roof of the diencephalon. It is a cone-shaped structure dorsal to the midbrain tectum. The tumor appears to be derived from the specialized ependymal cells of the subcommissural organ. Papillary tumors of the central nervous system and particularly of the pineal region are very rare and so diagnosing them is extremely difficult.

<span class="mw-page-title-main">Aqueductal stenosis</span> Narrowing of the aqueduct of Sylvius

Aqueductal stenosis is a narrowing of the aqueduct of Sylvius which blocks the flow of cerebrospinal fluid (CSF) in the ventricular system. Blockage of the aqueduct can lead to hydrocephalus, specifically as a common cause of congenital and/or obstructive hydrocephalus.

Endoscopic endonasal surgery is a minimally invasive technique used mainly in neurosurgery and otolaryngology. A neurosurgeon or an otolaryngologist, using an endoscope that is entered through the nose, fixes or removes brain defects or tumors in the anterior skull base. Normally an otolaryngologist performs the initial stage of surgery through the nasal cavity and sphenoid bone; a neurosurgeon performs the rest of the surgery involving drilling into any cavities containing a neural organ such as the pituitary gland. The use of endoscope was first introduced in Transsphenoidal Pituitary Surgery by R Jankowsky, J Auque, C Simon et al. in 1992 G.

The Dextroscope is a medical equipment system that creates a virtual reality (VR) environment in which surgeons can plan neurosurgical and other surgical procedures.

<span class="mw-page-title-main">William Couldwell</span>

William T. Couldwell is a Canadian neurosurgeon who is professor and Chairman of the Department of Neurosurgery at the University of Utah, a position he assumed in 2001.

Pancreatic mucinous cystic neoplasm (MCN) is a type of cystic lesion that occurs in the pancreas. Amongst individuals undergoing surgical resection of a pancreatic cyst, about 23 percent were mucinous cystic neoplasms. These lesions are benign, though there is a high rate of progression to cancer. As such, surgery should be pursued when feasible. The rate of malignancy present in MCN is about 10 percent. If resection is performed before invasive malignancy develops, prognosis is excellent. The extent of invasion is the single most important prognostic factor in predicting survival.

Thalamic gliomas are very rare, deep-seated, generally high-grade glial neoplasms that form in the thalamus, representing 1–5% of all pediatric brain tumors. Because of their difficult to reach position, they are a unique and difficult challenge for neuro-oncologists and neurosurgeons.

References

  1. 1 2 Pu, Y.; Mahankali, S.; Hou, J.; Li, J.; Lancaster, J.L.; Gao, J.-H.; Appelbaum, D.E.; Fox, P.T. (2007). "High Prevalence of Pineal Cysts in Healthy Adults Demonstrated by High-Resolution, Noncontrast Brain MR Imaging". American Journal of Neuroradiology. 28 (9): 1706–9. doi: 10.3174/ajnr.A0656 . PMC   8134222 . PMID   17885233.
  2. Pineal Cysts, Symptomatic, National Organization for Rare Disorders [ page needed ]
  3. Shahinian, Hrayr; Ra, Yoon (2013). "Fully Endoscopic Resection of Pineal Region Tumors". Journal of Neurological Surgery Part B: Skull Base. 74 (3): 114–7. doi:10.1055/s-0033-1338165. PMC   3712663 . PMID   24436899.
  4. Rhomberg, Thomas; Schroeder, Henry WS (2024). "Microsurgical Resection of a Pineal Cyst via a Paramedian Supracerebellar Infratentorial Approach". World Neurosurgery. 185: 113. doi:10.1016/j.wneu.2024.02.049. PMID   38369105.

Further reading