Variable Presentations of Lethal Colloid Cysts

Four cases of colloid cysts that led to death are reported to demonstrate their nonspecific and protean presentations at autopsy: a 27-year-old man with severe occipital headache, blurred vision, drowsiness and vomiting; a 44-year-old man with recent memory disturbance; a 54-year-old man with head and neck pains, tiredness, urinary incontinence, confusion, and drowsiness; and a 66-year-old man with severe frontal headache, gait disturbance, vomiting, and syncope with a previous episode of confusion and disorientation. Each death was due to an occult colloid cyst obstructing the foramen of Monro causing acute hydrocephalus. Nonspecific manifestations may mean that the diagnosis of colloid cyst is only made at the time of autopsy. The possibility of rare cases being familial may necessitate medical review of family members. Forensic evaluation should identify how a colloid cyst was related to the mechanism of death and whether there are any features that were associated with precipitate decline.