J Korean Neurosurg Soc.  2016 Mar;59(2):168-171. 10.3340/jkns.2016.59.2.168.

Growing Hemorrhagic Choroidal Fissure Cyst

• Karatas A
• Gelal F
• Gurkan G
• Feran H

• KMID: 2192050
• DOI: http://doi.org/10.3340/jkns.2016.59.2.168

Abstract

Choroidal fissure cysts are often incidentally discovered. They are usually asymptomatic. The authors report a case of growing and hemorrhagic choroidal fissure cyst which was treated surgically. A 22-year-old female presented with headache. Cranial MRI showed a left-sided choroidal fissure cyst. Follow-up MRI showed that the size of the cyst had increased gradually. Twenty months later, the patient was admitted to our emergency department with severe headache. MRI and CT showed an intracystic hematoma. Although such cysts usually have a benign course without symptoms and progression, they may rarely present with intracystic hemorrhage, enlargement of the cyst and increasing symptomatology.

Keyword

Choroidal fissure; Cyst; Temporal lobe; Hemorrhage

MeSH Terms

Choroid*
Emergency Service, Hospital
Female
Follow-Up Studies
Headache
Hematoma
Hemorrhage
Humans
Magnetic Resonance Imaging
Temporal Lobe
Young Adult

Figure

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  Fig. 1 A small hemorrhagic choroidal fissure cyst (arrows) is noted on T2 weighted axial (A), sagittal (B) images MRI scan.

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  Fig. 2 MRI of growing hemorrhagic choroidal fissure cyst. T2 weighted (A), susceptibility weighted MRI axial (B) scans show hemorrhagic cyst with fluid-fluid levels. T1 weighted axial (C), T1 contrast axial (D), andT1 contrast coronal (E) images show no contrast enhancement.

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  Fig. 3 T2 weighted axial image (A) and CT scan (B) show large intracystic hemorrhage with surrounding edema.

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  Fig. 4 A : Thin cyst wall (arrows) was directly abuted the gliotic parenchyma (Haematoxylin & Eosin ×40). B : The cyst wall have no real epithelium. There is a minimal inflammatory cell infiltration on cyst wall (Haematoxylin & Eosin ×100). (C) Reactive gliozis around the cyst wall (Haematoxylin & Eosin ×100). D : The cyst wall was covered focally with real epithelium. The cyst have a low cuboidal lining (arrows) (Haematoxylin & Eosin ×200) (Permission from Turkan Rezanko).

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