Rate of recurrence following stereotactic aspiration of colloid cysts of the third ventricle

Abstract

Background: The rate of recurrence following stereotactic aspiration of colloid cysts is not defined in the literature.

Aims: To study the long-term imaging and clinical outcome in patients who had stereotactic aspiration of colloid cysts of the third ventricle.

Methods: Between 1987 and 1994, computerized tomography-guided stereotactic aspiration was attempted in 26 consecutive patients with colloid cysts of the third ventricle.

Results: There was no mortality or permanent morbidity. A complete aspiration of the cyst was possible in 17 patients, a partial aspiration of the cyst was achieved in 6 and the aspiration failed in 3 patients. On long-term follow-up, symptomatic recurrence was noted in 5/6 patients after partial aspiration and 4/17 patients after complete aspiration (mean follow-up 84.8 months). Kaplan-Meier analysis revealed that after complete aspiration of the cyst, median time to recurrence on imaging is 42 months (95% CI 23.0-60.9 months) but median time to symptomatic recurrence is much later at 184 months (95% CI 88.2-279.7 months).

Conclusions: Stereotactic aspiration of colloid cysts remains a valid surgical option as complete aspiration leads to a good long-term outcome in several patients. Partial aspiration of the cyst should be followed by excision of the cyst, due to the high rate of symptomatic recurrence. However, periodic follow-up imaging is mandatory even after complete aspiration as delayed recurrences are possible.