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Recurrent Glioependymal Cyst of the
Posterior Fossa: An Unusual Entity Containing Mixed Glial Elements. Case report
James Frazier, Ira Garonzik, Tarik Tihan, Alessandro
Olivi
Department
of Neurosurgery (J.F., I.G., A.O), Department of Pathology (T.T.), Johns Hopkins University School of Medicine,
Baltimore, MD, USA
Reports of glioependymal cysts in the posterior fossa are uncommon.
There are only a few documented cases of posterior fossa glioependymal cysts
and, to our knowledge, this is the first documented case of a recurrent
posterior fossa glioependymal cyst.
We discuss the clinical presentation, pathological features, and treatment
options for this lesion.
A 55-year-old woman with a 10-year history of a recurrent cytic lesion in the
left cerebellar hemisphere, which required two operations, presented with
diplopia, dizziness, and ataxia.
Magnetic resonance imaging revealed a multiloculted cytic lesion in the left
cerebellar hemisphere.
Resection, through a suboccipital craniectomy, resulted in improvement of the
patient's neurologic status.
Microscopic examination of a surgical specimen revealed complex cysts lined by a
single layer of ependyma-like cells and underlying gliotic parenchyma with
florid reactive changes.
Glioependymal cysts of the posterior fossa may present with symptoms of
increased intracranial pressure and compression of local structures.
Recurrence in this case may be partly explained by subtotal resection in the
previous two operations and may also be associated with a florid, proliferative
ependymal element.
Definitive diagnosis is by microscopic examination of surgically resected
specimens.
Total extirpation of these cystic lesions is recommended.
Keywords:
glioependymal cyst, neuroependymal cyst, recurrent cyst, posterior fossa
Copyright
©
2004 Kluwer Academic Publishers.
All rights reserved
Source: http://journals.kluweronline.com/article.asp?PIPS=5138406
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