Papers of the Week

Introduction Colloid cysts are relatively uncommon lesions in the pediatric population. The xanthogranulomatous (XG) variant is a very rare with less than 30 reported cases. Case Report In this report the patient was a 13-year-old boy who presented with transient epsiodes of headache with blurring of vision. His MRI brain showed a T2 hyperintense well-defined cystic lesion, with an eccentrically located T2 hypointense partially enhancing nodule, at the foramen of Monro. He underwent middle frontal gyrus transcortial, transchoroidal gross total excision of the cyst. The histopathology of the lesion revealed a XG colloid cyst. Patient recovered well from the procedure and was relieved of the symptoms. Conclusion XG colloid cyst may present with altered radiological features compared to the normal variant. This can pose a diagnostic dilemma and it is important to differentiate it from a craniopharyngioma or a parasitic cyst, as in our case. When considered pre-operatively, surgeons should be conscious to review their surgical strategies. Stereotactic aspiration of the XG cyst should be avoided as contents are thicker and heterogenous than the usual. The spillage of cyst contents should be prevented. Also, the XG cysts are likely to have a poor cyst-fornix or -choroid plexus interface due to inflammation limiting complete resection.