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The colloid cyst of the third ventricle - a potential life threatening benign tumour

The colloid cyst of the third ventricle is a rare lesion, extremely interesting for forensic experts due to its potential in causing sudden death. Although not malignant in nature, this lesion may be life threatening as it can cause acute hydrocephalus by obstructing cerebrospinal fluid flow. Although the clinical, radiological and histological characteristics of colloid cysts are well known, their etiology and physiopathology continue to be a subject of debate. Further on, we present the case of a young woman who had a sudden death, on her admission to the hospital. She had had a several-year history of episodic headaches, but no CT scans performed prior to her death. The forensic pathology and microscopic examination revealed a colloid cyst of the third ventricle, resulting in a hydrocephalus involving the lateral ventricles and a massive pulmonary edema. The fulminant neurogenic pulmonary edema, following the increased intracranial pressure and the complete obstruction of the cerebrospinal fluid flow triggered death. This case report emphasizes that, although a rare disease, colloid cysts should also be taken into account when trying to establish the diagnosis of apparently harmless headaches in young adults. Furthermore, it stresses the importance of early diagnosis, generally done by computed tomography or magnetic resonance imaging.