Jonathan Roth, Tel Aviv Sourasky Medical Center
Yurii Perekopaiko, Tel Aviv Sourasky Medical Center
Danil A. Kozyrev, Tel Aviv Sourasky Medical Center
Shlomi Constantini, Tel Aviv Sourasky Medical Center
Hannah E. Myers, Children's Healthcare of Atlanta
Benjamin L. Chern, Children's Healthcare of Atlanta
Andrew Reisner, Children's Healthcare of Atlanta
Jose Hinojosa Mena-Bernal, Hospital Sant Joan de Déu Barcelona
Andrea Bartoli, Hôpitaux Universitaires de Genève
Luca Paun, Hôpitaux Universitaires de Genève
Saqib Kamran Bakhshi, The Aga Khan University Hospital
M. Shahzad Shamim, The Aga Khan University Hospital
Giuseppe Talamonti, ASST Niguarda
R. Michael Scott, Children's Hospital Boston
Nir Shimony, Geisinger Commonwealth School of Medicine
Ahmed El Damaty, Universitätsklinikum Heidelberg
Rodrigo Mierez, Hospital de Niños Víctor J. Vilela
José Silva, Hospital de Niños Víctor J. Vilela
Gustavo Sánchez, Hospital de Niños Víctor J. Vilela
Andrea Di Rita, Azienda Ospedaliero-Universitaria Meyer
Lorenzo Genitori, Azienda Ospedaliero-Universitaria Meyer
Barbara Spacca, Azienda Ospedaliero-Universitaria Meyer
Yacine Felissi, Mohamed Lamine Debaghine University Hospital
Abdelhalim Morsli, Mohamed Lamine Debaghine University Hospital
Dhaval Shukla, National Institute of Mental Health and Neuro Sciences
Dwarakanath Srinivas, National Institute of Mental Health and Neuro Sciences
Kevin Jude Sudevan, National Institute of Mental Health and Neuro Sciences
Meriem Amarouche, Oxford University Hospitals NHS Foundation Trust
J. André Grotenhuis, Radboud University Medical Center

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Journal of Neurosurgery: Pediatrics





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OBJECTIVE Colloid cysts (CCs) are rare at all ages, and particularly among children. The current literature on pediatric CC is limited, and often included in mixed adult/pediatric series. The goal of this multinational, multicenter study was to combine forces among centers and investigate the clinical course of pediatric CCs. METHODS A multinational, multicenter retrospective study was performed to attain a large sample size, focusing on CC diagnosis in patients younger than 18 years of age. Collected data included clinical presentation, radiological characteristics, treatment, and outcome. RESULTS One hundred thirty-four children with CCs were included. Patient age at diagnosis ranged from 2.4 to 18 years (mean 12.8 ± 3.4 years, median 13.2 years, interquartile range 10.3–15.4 years; 22% were < 10 years of age). Twenty-two cases (16%) were diagnosed incidentally, including 48% of those younger than 10 years of age. Most of the other patients had symptoms related to increased intracranial pressure and hydrocephalus. The average follow-up duration for the entire group was 49.5 ± 45.8 months. Fifty-nine patients were initially followed, of whom 28 were eventually operated on at a mean of 19 ± 32 months later due to cyst growth, increasing hydrocephalus, and/or new symptoms. There was a clear correlation between larger cysts and symptomatology, acuteness of symptoms, hydrocephalus, and need for surgery. Older age was also associated with the need for surgery. One hundred three children (77%) underwent cyst resection, 60% using a purely endoscopic approach. There was 1 death related to acute hydrocephalus at presentation. Ten percent of operated patients had some form of complication, and 7.7% of operated cases required a shunt at some point during follow-up. Functional outcome was good; however, the need for immediate surgery was associated with educational limitations. Twenty operated cases (20%) experienced a recurrence of their CC at a mean of 38 ± 46 months after the primary surgery. The CC recurrence rate was 24% following endoscopic resection and 15% following open resections (p = 0.28). CONCLUSIONS CCs may present in all pediatric age groups, although most that are symptomatic present after the age of 10 years. Incidentally discovered cysts should be closely followed, as many may grow, leading to hydrocephalus and other new symptoms. Presentation of CC may be acute and may cause life-threatening conditions related to hydrocephalus, necessitating urgent treatment. The outcome of treated children with CCs is favorable.