Surgical Treatment in a Case of Concomittant Frontal Gemistocytic Astrocytoma and Colloid Cyst

Abstract

More than one tumors in central nervous system (CNS) rarely contain different pathologies. In literature, colloid cyst and glial tumor coexisting in the same patient have been reported only in two cases. Also, there is no previous reports of concomittant existence of Gemistocytic astroctyoma and colloid cyst. Here, we report on a case of coexisting frontal gemistocytic astrocytoma and intraventricular colloid cyst and discuss the surgical treatment. A 50 year-old-man presented at our emergency room generalized epileptic seizures accompanying as recent history of throbbing headache and nausea. His radiological evaluation revealed a right frontal tumor with no contrast enhancement attributable to a glial tumor as well as a colloid cyst inside the third ventricle. Frontal midline shift and a collapsed frontal horn of the right lateral ventricle were noted due the mass effect of the tumor. The patient was informed about both lesions and the surgical treament was planned. A right frontal craniotomy was performed and frontal tumor was removed. Frozen section study confirmed the low-grade glial tumor diagnosis and the surgical procedure was continued. Right ventricle was accessed through the natural openening which developed in the wall of the frontal horn during tumor removal. Foramen Monro was accessed by a frontal transcortical anterior angle and the colloid cyst totally removed. Total excision was accived for both leisons in a single surgical session. Permanent histopathological diagnosis was gemistocytic astrocytoma and colloid cyst. Postoperative recovery was uneventful and patient reported relief of both seizures and headache.