Surgical Resection of Pineal Epidermoid Cyst Contributed to Relieving Schizophrenia Symptoms

Jiang, Xiaobing; Chen, Yinsheng; Zhou, Zhihuan; Luo, Liping; Hu, Wanming; Zheng, Huirong; Zhu, Zhe; Wang, Jian; Chen, Zhongping

doi:10.1016/j.wneu.2018.02.151

Cited by 6 publications

(7 citation statements)

References 16 publications

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“…Symptoms associated to sellar EC can be related to a slow growing mass effect, and include focal neurologic deficits or nonlocalizing signs such as headache, visual alterations, and pituitary dysfunction. 15,[18][19][20][21][22] Epidermoid cysts tend to surround adjacent structures, and its rupture can produces chronic inflammation of the leptomeninges or ependyma. 15,[18][19][20][21] Sellar/suprasellar ECs can determine disturbances in the release and/or production of hormones, because the compressive effect of the process may affect the physiology of the pituitary gland or even determine hypothalamic disorders.…”

Section: Discussionmentioning

confidence: 99%

“…1,4,6,10,15,17,19,20 On gross, sellar ECs are a pale-gray, uniloculated, translucent lesion, which can measure from a few millimeters to over 4 cm in diameter. 1,4,6,9,15,16,21,22 At microscopy, ECs are covered by a mature keratinizing squamous epithelium, and the lumen is occupied by lamellae of keratin. No evidence of atypias can be found and the wall is constituted by connective tissue.…”

Section: Discussionmentioning

confidence: 99%

“…Dermoid Cyst (DM) exhibit a thick wall and contain adnexal structures, such as hair follicles and sebaceous glands. [4][5][6]10,13,[20][21][22] Adamantinomatous craniopharyngioma exhibits a thick, complex, palisaded epithelium, while papillary craniopharyngioma shows a thick epithelium disposed in irregular papillae with fibrovascular core. Papillary craniopharyngioma lacks keratohyalin granules and anucleate squames.…”

Section: Discussionmentioning

confidence: 99%

“…Mature teratoma are more frequently solid masses constituted by cartilaginous tissue, sebaceous gland, and mature dermis and epidermis. [4][5][6]10,15,21,24,25 The curative treatment for sellar ECs is gross total surgical removal by transsphenoidal approach, but the presence ofdense adherence of the lesion to the adjacent structures can limit the complete resection of the cyst. [2][3][4]8,16,25 The most common postoperative complications are diabetes insipidus, endocrine disturbances, and chemical meningitis, due to leakage of keratin into the cerebral spinal fluid (CSF) pathways.…”

Section: Discussionmentioning

confidence: 99%

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Physiopathological Aspects of Sellar Epidermoid Cyst Determining Endocrine Disturbances: A Case Report

et al. 2019

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Epidermoid cysts (ECs) of the central nervous system (CNS) constitute benign circumscribed lesions that are more common in lateral than in midline sites. Epidermoid cysts of the CNS arise more frequently in the cerebellopontine angle, around the pons, near the sella, within the temporal lobe, in the diploe, and in the spinal canal. Most common tumoral lesion of sellar region is pituitary adenoma, and sellar cystic epithelial masses may be difficult to differentiate based only on clinical and imaging findings. Epidermoid cysts are covered by keratinized squamous epithelium and are usually filled with keratin lamellae. The process is, for the most part, maldevelopmental in origin, presumably arising from trapped surface ectodermal elements in association with the developing CNS during the closure of the neural groove or formation of the secondary cerebral vesicles. In the present study, the authors describe a case of sellar epidermoid cyst producing endocrine alterations and visual disturbance in a 35 years woman, and review the physiopathological and diagnostic criteria of this lesion.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Physiopathological Aspects of Sellar Epidermoid Cyst Determining Endocrine Disturbances: A Case Report

et al. 2019

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“…The significance of pineal cyst findings in patients with SSDs is unclear. One case report describing an improvement of psychotic symptoms after resection of a pineal epidermoid cyst in a 23-year-old male patient [56] indicates that such incidental findings might be of clinical relevance at least in some patients. Thus, whether there is a pathophysiological association between pineal cysts and psychosis should be investigated in future studies.…”

Section: Instrument-based Diagnosticsmentioning

confidence: 99%

Diagnosing Organic Causes of Schizophrenia Spectrum Disorders: Findings from a One-Year Cohort of the Freiburg Diagnostic Protocol in Psychosis (FDPP)

et al. 2020

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Introduction: Secondary schizophrenia spectrum disorders (SSDs) have clearly identifiable causes. The Department for Psychiatry and Psychotherapy at the University Hospital Freiburg has continued to expand its screening practices to clarify the organic causes of SSDs. This retrospective analysis was carried out to analyze whether a comprehensive organic diagnostic procedure could be informative in patients with SSDs. Methods and Participants: The “Freiburg Diagnostic Protocol in Psychosis” (FDPP) included basic laboratory analyses (e.g., thyroid hormones), metabolic markers, pathogens, vitamin status, different serological autoantibodies, rheumatic/immunological markers (e.g., complement factors), cerebrospinal fluid (CSF) basic and antineuronal antibody analyses, as well as cranial magnetic resonance imaging (cMRI) and electroencephalography (EEG). The findings of 76 consecutive patients with SSDs (55 with paranoid–hallucinatory; 14 with schizoaffective; 4 with hebephrenic; and 1 each with catatonic, acute polymorphic psychotic, and substance-induced psychotic syndromes) were analyzed. Results: Overall, vitamin and trace element deficiency was identified in 92%. Complement factor analyses detected reduced C3 levels in 11%. Immunological laboratory alterations were detected in 76%. CSF analysis revealed general alterations in 54% of the patients, mostly with signs of blood–brain barrier dysfunction. cMRI analyses showed chronic inflammatory lesions in 4%. Combination of EEG, cMRI, and CSF revealed alterations in 76% of the patients. In three patients, autoimmune psychosis was suspected (4%). Discussion: On the basis of these findings, we conclude that a comprehensive diagnostic procedure according to the FDPP in patients with SSD is worthwhile, considering the detection of secondary, organic forms of SSDs, as well as alterations in “modulating factors” of the disease course, such as vitamin deficiency. Larger studies using comprehensive diagnostic protocols are warranted to further validate this approach.

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Cognitive Impairment in CNS-Related Cancer Therapy: Focus on Immunotherapy

Safarzadeh,

Ghorbaninezhad,

Soleimani

et al. 2024

Interdisciplinary Cancer Research

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Surgical Resection of Pineal Epidermoid Cyst Contributed to Relieving Schizophrenia Symptoms

Cited by 6 publications

References 16 publications

Physiopathological Aspects of Sellar Epidermoid Cyst Determining Endocrine Disturbances: A Case Report

Physiopathological Aspects of Sellar Epidermoid Cyst Determining Endocrine Disturbances: A Case Report

Diagnosing Organic Causes of Schizophrenia Spectrum Disorders: Findings from a One-Year Cohort of the Freiburg Diagnostic Protocol in Psychosis (FDPP)

Cognitive Impairment in CNS-Related Cancer Therapy: Focus on Immunotherapy

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