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Natural course of pineal cysts—a radiographic study

BACKGROUND: Pineal cysts (PCs) are a benign lesion of the pineal gland that have been known to the medical community for a long time. With a prevalence rate of approximately 1% in the general population, PC is often a reason for medical counseling. The natural course of PC morphology has not been we...

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Autores principales: Majovsky, Martin, Benes, Vladimir
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7398253/
https://www.ncbi.nlm.nih.gov/pubmed/32922893
http://dx.doi.org/10.1186/s41016-018-0142-7
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author Majovsky, Martin
Benes, Vladimir
author_facet Majovsky, Martin
Benes, Vladimir
author_sort Majovsky, Martin
collection PubMed
description BACKGROUND: Pineal cysts (PCs) are a benign lesion of the pineal gland that have been known to the medical community for a long time. With a prevalence rate of approximately 1% in the general population, PC is often a reason for medical counseling. The natural course of PC morphology has not been well described. In this study, we present a longitudinal magnetic resonance imaging (MRI) study of patients with PCs, with special focus on those who showed an increase or decrease in PC size. METHODS: We enrolled all patients with a PC who were referred to our department between January 2000 and January 2018. Each patient underwent a clinical examination, and the patient’s age, sex, and presenting signs and symptoms were noted. MRI was performed during periodic examinations, and a clinical and radiological course was reassessed. RESULTS: In total, 133 patients (99 women, 34 men) were enrolled. The mean maximum diameter was 12.7 ± 5.2 mm (range 7–35 mm). PCs increased in size during the follow-up in seven patients (5.3%) and decreased in size in 10 (7.5%). The remaining cysts (n = 116, 87.2%) were stable over the follow-up period. Analyzing patients according to cyst size change, we found a significant difference in the mean age between the PC progression group and PC regression group (p = 0.01). The mean size of the PCs at the time of diagnosis did not differ significantly between the two groups (p = 0.81). We diagnosed two cases of pineal apoplexy. CONCLUSION: We found that PCs are a dynamic structure that may change in size during the patient’s lifetime. Patients with an increase in PC size were significantly younger than patients with a decrease in size. Therefore, PC growth in the first, second, and third decennium is normal and does not justify medical intervention. Surgery is indicated in cases of hydrocephalus and Parinaud’s syndrome or in atypical cysts when neoplasia is suspected. The size of a PC does not predict PC behavior in terms of a future increase or decrease in size.
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spelling pubmed-73982532020-09-10 Natural course of pineal cysts—a radiographic study Majovsky, Martin Benes, Vladimir Chin Neurosurg J Research BACKGROUND: Pineal cysts (PCs) are a benign lesion of the pineal gland that have been known to the medical community for a long time. With a prevalence rate of approximately 1% in the general population, PC is often a reason for medical counseling. The natural course of PC morphology has not been well described. In this study, we present a longitudinal magnetic resonance imaging (MRI) study of patients with PCs, with special focus on those who showed an increase or decrease in PC size. METHODS: We enrolled all patients with a PC who were referred to our department between January 2000 and January 2018. Each patient underwent a clinical examination, and the patient’s age, sex, and presenting signs and symptoms were noted. MRI was performed during periodic examinations, and a clinical and radiological course was reassessed. RESULTS: In total, 133 patients (99 women, 34 men) were enrolled. The mean maximum diameter was 12.7 ± 5.2 mm (range 7–35 mm). PCs increased in size during the follow-up in seven patients (5.3%) and decreased in size in 10 (7.5%). The remaining cysts (n = 116, 87.2%) were stable over the follow-up period. Analyzing patients according to cyst size change, we found a significant difference in the mean age between the PC progression group and PC regression group (p = 0.01). The mean size of the PCs at the time of diagnosis did not differ significantly between the two groups (p = 0.81). We diagnosed two cases of pineal apoplexy. CONCLUSION: We found that PCs are a dynamic structure that may change in size during the patient’s lifetime. Patients with an increase in PC size were significantly younger than patients with a decrease in size. Therefore, PC growth in the first, second, and third decennium is normal and does not justify medical intervention. Surgery is indicated in cases of hydrocephalus and Parinaud’s syndrome or in atypical cysts when neoplasia is suspected. The size of a PC does not predict PC behavior in terms of a future increase or decrease in size. BioMed Central 2018-12-11 /pmc/articles/PMC7398253/ /pubmed/32922893 http://dx.doi.org/10.1186/s41016-018-0142-7 Text en © The Author(s) 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Majovsky, Martin
Benes, Vladimir
Natural course of pineal cysts—a radiographic study
title Natural course of pineal cysts—a radiographic study
title_full Natural course of pineal cysts—a radiographic study
title_fullStr Natural course of pineal cysts—a radiographic study
title_full_unstemmed Natural course of pineal cysts—a radiographic study
title_short Natural course of pineal cysts—a radiographic study
title_sort natural course of pineal cysts—a radiographic study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7398253/
https://www.ncbi.nlm.nih.gov/pubmed/32922893
http://dx.doi.org/10.1186/s41016-018-0142-7
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