Endoscopic resection of colloid cysts: indications, technique, and results during a 13-year period

Questions of recurrence and inadequacy of follow-up length persist regarding endoscopic treatment of colloid cysts. In this retrospective review, we report our long-term follow-up during a 13-year period in 35 patients who underwent endoscopic resection of colloid cysts.

The 19 males and 16 females (age range 14 to 58 years, mean 35.9 years) who had symptomatic colloid cysts that ranged in size from 5 mm to 4 cm underwent endoscopic resection in the period from 1991 to 2004.

Of 2 patients who developed recurrences at 5.9 years and 4.3 years (1 and 6 mm, respectively) both remain asymptomatic. The rate of late asymptomatic recurrence in this series is 6.3%. Three endoscopic resections were converted to an open craniotomy. Three operative complications occurred (i.e., introducer tract hemorrhage, thalamic stroke secondary to thermal injury, epidural hematoma that required evacuation). Four patients noted minimal short-term memory loss without interference in daily living. Of 3 patients with shunts preoperatively, all have no evidence of hydrocephalus after shunt removal. Two patients have asymptomatic ventriculomegaly. Prophylactic anticonvulsants were not prescribed and no seizures were reported. No infections were recorded with antibiotic administration preoperatively, and 24 hours postoperatively.

Our series represents the longest follow-up (mean of 7.8 years) of colloid cysts after endoscopic resection. We now use this technique as the first line of treatment for colloid cysts. The risk of recurrence is minimal with gross total resection and/or coagulation of the cyst wall.