Tumor cyst [Neurosurgery Wiki]

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=====Tumor cyst=====

[[Tumor]] cysts may be a nutrient reservoir for [[brain tumor]]s, securing tumor energy metabolism and synthesis of cell constituents. 

[[Serum]] is one likely source of cyst fluid nutrients. Nutrient levels in tumor cyst fluid are highly variable, which could differentially stimulate tumor growth. Cyst fluid [[glutamate]], [[lactate]], and phosphate may act as tumor growth factors; these compounds have previously been shown to stimulate tumor growth at concentrations found in tumor cyst fluid.
((Dahlberg D, Struys EA, Jansen EE, Mørkrid L, Midttun Ø, Hassel B. Cyst Fluid
From Cystic, Malignant Brain Tumors: A Reservoir of Nutrients, Including Growth
Factor-Like Nutrients, for Tumor Cells. Neurosurgery. 2017 Jun 1;80(6):917-924.
doi: 10.1093/neuros/nyw101. PubMed PMID: 28327992.
)).

see [[Cyst formation]].

====Types====

[[Cystic brain metastases]].

[[Epidermoid cyst]]

[[Cystic glioblastoma]]

[[Cystic meningioma]]

[[Cystic craniopharyngioma]]

[[Cystic prolactinoma]]

[[Cystic schwannoma]]

[[Cystic vestibular schwannoma]].

Cystic lesions in the [[atrium]] (trigone) of the lateral ventricle may become symptomatic due to obstruction of physiological CSF circulation and/or from mass effect on adjacent structures.

====Radiographic features====
The main challenge in discrimination between intracranial cystic lesions is to differentiate benign inflammatory cystic lesions (as cerebral abscess) from malignant cystic lesions (as [[cystic metastases]] and cystic glioma) which have totally different management.

CT
well defined intra-axial cystic lesion with peripheral ring enhancement
usually presents with mass effect.
mild perifocal oedema.
enhancing margin as well as the soft tissue component.
MRI
T1: homogeneously hypointense
T1 C+ (Gd) solid component usually enhances
T2: hyperintense
FLAIR: cystic areas show hyperintensity relative to CSF due to higher protein contents
DWI: no restriction for the cystic component; the solid component may show restriction according to the grade
MR spectroscopy: high Cho/Cr ratio
MR perfusion: no appreciable perfusion changes could be usually seen

====Differential diagnosis====

[[Cerebral abscess]].

[[Cystic metastases]]

intracranial hydatid cyst

other intra-axial cysts, e.g. intra-axial arachnoid cyst, neuroglial cyst, porencephalic cyst