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. 2020 Dec;36(12):2927-2938.
doi: 10.1007/s00381-020-04792-3. Epub 2020 Jul 20.

Systematic review of pineal cysts surgery in pediatric patients

Joham Choque-Velasquez  1   2 , Roberto Colasanti  3   4 , Szymon Baluszek  5   6 , Julio Resendiz-Nieves  7 , Sajjad Muhammad  7   8 , Christopher Ludtka  9 , Juha Hernesniemi  7   10
Affiliations

Systematic review of pineal cysts surgery in pediatric patients

Joham Choque-Velasquez et al. Childs Nerv Syst. 2020 Dec.

Abstract

Introduction: We present a consecutive case series and a systematic review of surgically treated pediatric PCs. We hypothesized that the symptomatic PC is a progressive disease with hydrocephalus at its last stage. We also propose that PC microsurgery is associated with better postoperative outcomes compared to other treatments.

Methods: The systematic review was conducted in PubMed and Scopus. No clinical study on pediatric PC patients was available. We performed a comprehensive evaluation of the available individual patient data of 43 (22 case reports and 21 observational series) articles.

Results: The review included 109 patients (72% females). Ten-year-old or younger patients harbored smaller PC sizes compared to older patients (p < 0.01). The pediatric PCs operated on appeared to represent a progressive disease, which started with unspecific symptoms with a mean cyst diameter of 14.5 mm, and progressed to visual impairment with a mean cyst diameter of 17.8 mm, and hydrocephalus with a mean cyst diameter of 23.5 mm in the final stages of disease (p < 0.001). Additionally, 96% of patients saw an improvement in their symptoms or became asymptomatic after surgery. PC microsurgery linked with superior gross total resection compared to endoscopic and stereotactic procedures (p < 0.001).

Conclusions: Surgically treated pediatric PCs appear to behave as a progressive disease, which starts with cyst diameters of approximately 15 mm and develops with acute or progressive hydrocephalus at the final stage. PC microneurosurgery appears to be associated with a more complete surgical resection compared to other procedures.

Keywords: Microneurosurgery; Pineal cysts; Sitting position; Supracerebellar infratentorial approach.

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Conflict of interest statement

Prof. Juha Hernesniemi is an Aesculap counselor. The authors have no personal financial or institutional interest in any of the drugs, materials, and devices described in this article.

Figures

Fig. 1
Fig. 1
Comprehensive search of the literature and study selection for the surgically treated pineal cysts in pediatric population
Fig. 2
Fig. 2
Pineal cysts diameters across the age groups controlled by gender
Fig. 3
Fig. 3
Pineal cysts diameters across the gender groups controlled by age
Fig. 4
Fig. 4
Pineal cysts diameters across the surgical criteria groups (a), controlled by age (b), and controlled by gender (c)
See this image and copyright information in PMC

References

    1. Mamourian AC, Towfighi J. Pineal cysts: MR imaging. AJNRAmerican journal of neuroradiology. 1986;7:1081–1086. - PMC - PubMed
    1. Al-Holou WN, Garton HJ, Muraszko KM, et al. Prevalence of pineal cysts in children and young adults. Clinical article. Journal of neurosurgeryPediatrics. 2009;4:230–236. doi: 10.3171/2009.4.PEDS0951. - DOI - PubMed
    1. Al-Holou WN, Terman SW, Kilburg C, et al. Prevalence and natural history of pineal cysts in adults. Journal of Neurosurgery. 2011;115:1106–1114. doi: 10.3171/2011.6.JNS11506. - DOI - PubMed
    1. Cauley KA, Linnell GJ, Braff SP, Filippi CG. Serial follow-up MRI of indeterminate cystic lesions of the pineal region: experience at a rural tertiary care referral center. AJRAmerican journal of roentgenology. 2009;193:533–537. doi: 10.2214/AJR.08.1906. - DOI - PubMed
    1. Lacroix-Boudhrioua V, Linglart A, Ancel PY, et al. Pineal cysts in children. Insights into imaging. 2011;2:671–678. doi: 10.1007/s13244-011-0117-0. - DOI - PMC - PubMed

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