Pediatric third ventricular glioependymal cyst: A case report

Abstract

Background: Glioependymal cysts are rare lesions, especially in children.

Case description: The authors treated a well-developed 12-year-old male who presented with 1 week of acute-onset headache. Magnetic resonance imaging revealed a thin-walled third ventricular cyst obstructing the foramen of Monro. Endoscopic fenestration of the cyst with biopsy and endoscopic third ventriculostomy was performed. Histopathologic examination revealed a glioependymal cyst. At 13-month follow-up, the patient is asymptomatic without evidence of recurrence.

Conclusion: This case represents the first glioependymal cyst reported in an adolescent.

Keywords: Endoscopic third ventriculostomy; Glioependymal cyst; Intracranial cyst; Neuroepithelial cyst; Third ventricle.

Figure 1:

(a) Preoperative sagittal T2-weighted magnetic resonance (MR) imaging obtained in the patient demonstrating a cyst that is isointense to cerebrospinal fluid within the third ventricle, causing dilation of the lateral ventricles. (b) Postoperative sagittal T2-weighted MR imaging demonstrating cyst resolution. (c) Axial preoperative view. (d) Axial postoperative view.

Figure 2:

Intraventricular endoscopic view of the glioependymal cyst membrane through foramen of Monro.

Figure 3:

(Left) Light microscopy of cyst wall by hematoxylin and eosin staining demonstrating minute fragments of neuroepithelial tissue without significant presence of intact innermost cuboidal cell lining. (Right) Immunohistochemical staining for glial fibrillary acidic protein highlighting the diffuse distribution of glial cells. Samples did not stain positive for neuronal markers (NeuN and Synaptophysin).