Incidental Pineal Cysts: Is Surveillance Necessary?

Nevins, Edward J, Das, Kumar, Bhojak, Maneesh, Pinto, Rohan S, Hoque, Mohammed N, Jenkinson, Michael D ORCID: 0000-0003-4587-2139 and Chavredakis, Emmanuel
(2016) Incidental Pineal Cysts: Is Surveillance Necessary? WORLD NEUROSURGERY, 90. pp. 96-102.

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<h4>Objective</h4>The natural history of incidental pineal cysts is poorly understood. Neurosurgeons and neuroradiologists are more frequently faced with this disease in the advent of higher-resolution magnetic resonance imaging (MRI) scanning. We aim to suggest a suitable surveillance strategy for these patients.<h4>Methods</h4>All patients who had MRI of the brain between June 2007 and January 2014 (n = 42,099) at The Walton Centre for Neurology and Neurosurgery were included. Radiologic reports containing the terms "pineal" and "cyst" were reviewed to identify patients.<h4>Results</h4>A total of 281 patients were identified with pineal cysts. The principal indication for head MRI was headache (50.2%), although no symptoms were deemed attributable to pineal disease. A total of 178 patients (63.3%) were female, and the age at diagnosis ranged from 16 to 84 years. The median size of pineal cyst at diagnosis was 10 mm. A total of 181 patients had subsequent follow-up at a median time of 6 months (range, 1-68). Eleven pineal cysts (6%) changed size during the follow-up period. Four patients had a reduction in cyst size; the median change was 2.5 mm. A further 7 pineal cysts increased in cyst size; the median change was 2 mm. No patients developed complications.<h4>Conclusions</h4>Incidental pineal cysts typically show a benign course. In the adult population, they do not require long-term neurosurgical follow-up, because pineal cysts tend to remain a stable size. In asymptomatic patients, we recommend a single follow-up MRI scan at 12 months to confirm diagnosis. The patient should then be discharged if the cyst remains stable.

Item Type: Article
Uncontrolled Keywords: Asymptomtic, Epidemiology, Follow-Up, Incidental, Pineal cyst, Surveillance
Depositing User: Symplectic Admin
Date Deposited: 28 Apr 2016 11:06
Last Modified: 12 Jul 2023 05:31
DOI: 10.1016/j.wneu.2016.02.092
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