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Enlarging subependymal cyst: case report
C H Rabb1, M L Levy, J G McComb
1Division of Neurosurgery, Children's Hospital Los Angeles, California, USA.
Insights
A rare cystic lesion in an infant with Dandy-Walker malformation progressively enlarged over a year. Biopsies ruled out neoplasia, marking the first reported case of such a growing cyst.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Developmental Neurobiology
Background:
- Dandy-Walker malformation is a congenital brain defect.
- Hydrocephalus is a common complication requiring intervention.
- Ventriculoperitoneal shunts are used to treat hydrocephalus.
Observation:
- A 1-month-old infant with Dandy-Walker malformation presented with hydrocephalus.
- A subependymal cystic lesion was identified in the right caudate nucleus.
- The lesion showed significant enlargement from 1 cm to 3 cm over one year.
Findings:
- Despite biopsy during fenestration, no neoplastic cells were identified.
- This represents the first documented case of a spontaneously enlarging subependymal cyst in this location.
- The cyst's progressive growth in the absence of neoplasia is a unique finding.
Implications:
- This case highlights the importance of monitoring unexpected cystic lesions in infants with congenital brain anomalies.
- Further research may be needed to understand the etiology and behavior of such non-neoplastic, growing cysts.
- This finding could influence diagnostic and management strategies for similar pediatric neurological cases.
Abstract:
A 1-month-old infant with a Dandy-Walker malformation underwent the placement of a ventriculoperitoneal shunt to treat progressive hydrocephalus. On the initial computed tomographic scan, a subependymal cystic lesion larger than 1 cm in diameter was noted in the head of the right caudate nucleus, which enlarged to 3 cm in diameter on follow-up imaging studies over the course of a year. Biopsies taken at the time of fenestration failed to show the presence of neoplasia. This appears to be the first reported case of a cyst of this nature to show progressive enlargement.
