Surgical treatment of a patient with a giant choroidal fissure cyst: a case report

Childs Nerv Syst. 2023 Apr;39(4):1097-1100. doi: 10.1007/s00381-022-05753-8. Epub 2022 Nov 17.

Abstract

Introduction: Choroidal fissure cysts (CFC) are usually an incidental finding on imaging and lead to morbidity only in rare cases. The aim of this study was to present the case of a patient with a giant CFC and its treatment.

Case report: The patient was a male infant of 9 days of life that presented with symptoms of intracranial hypertension. A CFC measuring 56 × 70 × 86 mm was diagnosed. Endoscopic fenestration of the cyst was performed; however, the communication closed thereafter. A reservoir catheter was inserted, which subsequently became infected and was then replaced by a ventriculoperitoneal shunt.

Discussion: The choroidal fissure is a C-shaped cleft located between the fornix and the thalamus separated from the temporal horn by the layer of tela choroidea. The pathophysiology of CFC is still unclear. In our case, initial endoscopic treatment was decided on to avoid shunt-related complications. Currently, there are no guidelines for the best surgical treatment for CFC.

Conclusion: We describe an atypical case of CFC and analyze the surgical treatment performed. Although endoscopic treatment is recommended for CFC, currently no guidelines exist regarding the best management of the entity.

Keywords: Choroidal fissure; Cyst; Endoscopy; Hydrocephalus.

Publication types

  • Case Reports

MeSH terms

  • Arachnoid Cysts* / surgery
  • Choroid Plexus / surgery
  • Cysts* / complications
  • Cysts* / diagnostic imaging
  • Cysts* / surgery
  • Endoscopy / methods
  • Humans
  • Infant
  • Lateral Ventricles / surgery
  • Magnetic Resonance Imaging
  • Male
  • Ventriculoperitoneal Shunt