Colloid Cyst

Findings:
T1 and T2WI demonstrate a small mass in the region of the left Foramen of Monro which is hyperintense on T1 and hypointense on T2. Moderate ventricular asymmetry is present, consistent with obstructive hydrocephalus.

Differential Diagnosis:
Few lesions other than colloid cyst exhibit these signal characteristics, and probably shouldn't be considered. Other lesions in this region include subependymal giant cell astrocytoma, central neurocytoma, and subependymoma.

Discussion:
Colloid cyst comprises 1-3% of all intracranial tumors and is almost always located in the anterior superior third ventricle. It is the most common intraventricular neuroepithelial cyst, and is histologically similar to a Rathke's cleft cyst. Clinically, the patient may present with positional headaches. The lesion may obstruct the foramen of Monro acutely and could cause sudden death.  Imaging appearance is variable, with most lesions hyperdense on CT, hyper T1/hypo T2. The lesions do not calcify. 40% show rim enhancement, with rare solid enhancement.
 

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