Conservative and surgical treatment of patients with pineal cysts: A prospective case series of 110 patients.

Conservative and surgical treatment of patients with pineal cysts: A prospective case series of 110 patients.

World Neurosurg. 2017 Jun 02;:

Authors: Májovský M, Netuka D, Beneš V

Abstract
BACKGROUND: A pineal cyst is a relatively common benign condition of the pineal gland. The clinical management of patients with a pineal cyst remains controversial, especially when patients present with non-specific symptoms.
METHODS: We performed a prospective study between 2000 and 2016. All patients with a pineal cyst larger than 7 mm were included. Epidemiological data, presenting symptoms, surgical results and radiographic and clinical follow-up were documented.
RESULTS: A total of 110 patients were enrolled in the present study. The most common presenting symptoms were tension headache (62.7%), vertigo (16.4%), migraine (12.7%), syncope (10.9%), nausea (8.2%) and diplopia (8.2%). Symptoms worsened during the follow-up period in 16 patients (14.6%), improved in 13 patients (11.8%) and remained stable in 81 patients (73.6%). The mean follow-up was 79.2 months. A pineal cyst increased in size during the follow-up in 6 patients (5.5%) and decreased in size in 9 patients (8.2%). Twenty-one patients underwent pineal cyst resection; 20 patients (95.2%) reported some improvement in their presenting symptoms and 10 patients (47.6%) were symptom free after the surgery.
CONCLUSION: We present the largest clinical series of patients with pineal cysts. Surgery, if indicated properly, is a legitimate treatment modality for symptomatic patients with satisfactory results. Relief of symptoms, even non-specific ones, is achieved in the majority of cases. Simple growth of the cyst in the first decades of life is a part of the natural course and should not be considered as an indication for surgery.

PMID: 28583453 [PubMed - as supplied by publisher]

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