背景:松果体囊肿是一种罕见的松果体病变。松果体囊肿是良性病变,一般无症状,通常是对其他问题进行MRI的偶然发现。儿童松果体囊肿的管理仍然是一个有争议的问题。这里,我们报告了经过手术治疗的回顾性儿科病例,并回顾了有关该主题的儿科文献.
方法:这是一项单中心回顾性研究。包括2000年至2021年由高级作者(CM)为良性松果体囊肿手术的所有患者。排除所有其他松果体区囊性病变。从医院医疗数据库中提取医疗和手术数据。
结果:纳入12例患者。临床症状以7名患者头痛为特征,两名患者的视力问题,一名患者性早熟,两名患者的颅内高压征象,一名患者的癫痫发作与头痛有关,和另一个病人的行为问题相关的头痛。在此系列中未观察到重大的术后并发症。要注意的是,进行手术是因为怀疑了真正的松果体实质肿瘤。组织病理学研究回来诊断为松果体囊肿。
结论:松果体囊肿是罕见的。如果放射学诊断明确,除与脑积水和快速生长相关的病例外,不提倡手术。如果怀疑真正的松果体实质肿瘤,可能需要手术来确认诊断。最后,我们强调,只有松果体本身的囊性病变才应被视为松果体囊肿。
BACKGROUND: Pineal cysts are a rare lesion of the
pineal gland. Pineal cysts are benign lesions, generally asymptomatic, and are usually an incidental discovery on MRI performed for other problems. The management of
pineal cysts in children remains a matter for debate. Here, we report our own retrospective paediatric cases that have been surgically treated and review the paediatric literature on this topic.
METHODS: This is a retrospective monocentric study. All patients operated by the senior author (CM) for a benign pineal cyst from 2000 to 2021 were included. All other
pineal region cystic lesions were excluded. Medical and surgical data were extracted from the hospital medical database.
RESULTS: Twelve patients were included. The clinical symptomatology was characterized by headaches in seven patients, visual troubles in two patients, precocious puberty in one patient, signs of intracranial hypertension in two patients, seizures associated with headache in one patient, and headaches associated with behavioural troubles in another patient. No major post-operative complications were observed in this series. It is to noted that surgery was performed because a suspicion of a true pineal parenchymal tumour has been made. Histopathological study came back with the diagnosis of pineal cyst.
CONCLUSIONS: Pineal cyst is rare. If the radiological diagnosis is clear, no surgery is advocated except in cases associated with hydrocephalus and rapid growth. In case of a suspicion of a true pineal parenchymal tumour, a surgery may be needed to confirm the diagnosis. Lastly, we stress that only cystic lesions of the
pineal gland itself should be considered as
pineal cyst.