Pineal cysts as a cause of central nervous system symptoms

Introduction
Nonneoplasmatic pineal cyst changes are quite often found during brain MRI of pediatric patients. Usually, they are asymptomatic; however, clinical signs such as headache, sight disorders, dizziness or hydrocephalia may occur.

Objective
Epidemiological and clinical evaluation of the occurrence of pineal cysts in children treated in a single oncological ward over a period of 7 years.

Methods
Retrospective analysis of the patients hospitalized in the Department of Pediatrics, Hematology and Oncology in Bydgoszcz and diagnosed for pineal cyst by MRI.

Results
The incidence of pineal cysts in patients who underwent MRI for various reasons was 5.2%. In 52% of the patients, MRI examination was performed to check their reported headache. The size of the cysts in MRI varied from 3 mm to 21 mm. Control MRI was performed in 64% of the children after 1-12 months. In 2 of them, little reduction of the size of the cyst was observed; in one case, slight enlargement was observed, and in the remaining, the size was stable. None of the patients required neurosurgical intervention. Conclusions:

Conclusions
Pineal cysts were diagnosed in 5.2% of the children with central nervous system disorder symptoms. In half of the cases, headache was the reason for starting the diagnostic procedures. Size of the pineal cysts observed in the population of pediatric patients usually does not exceed 10 mm. Most of the pineal cysts have mild clinical character but always require excluding the presence of malignant process. No clinical progression was observed within 6-12 month observation in any of the patients.