What are the other Names for this Condition? (Also known as/Symptoms)

• GEC (Glioependymal Cyst)
• Glioependymal Cyst (GEC)
• Neuroepithelial Cyst

What is Neuroglial Cyst? (Definition/Background Information)

• Neuroglial Cysts are highly uncommon and benign lesions having a congenital origin. These cysts are also known as Glioependymal Cysts (GECs) and are sometimes observed in children, but more commonly in adults
• Many Neuroglial Cysts are observed in the brain (intracranial cysts), affecting the frontal lobes. Usually there is no communication between these and the cerebrospinal fluid-containing ventricular cavities. Some cysts are occasionally seen in the spinal cord (intraspinal cysts)
• The cause of formation of a Neuroglial Cyst is unknown. Also, presently, the risk factors for the same are not well-established. These lesions are believed to develop during pregnancy (embryogenesis) from neural tube structures
• Generally, Neuroglial Cysts are not known to not present any significant signs and symptoms. However, large tumors may cause headaches, seizures, back pain, numbness, and weakness of the lower extremities, depending on the location of the tumor
• Most of these cystic tumors are diagnosed incidentally during adulthood. The treatment of a Neuroglial Cyst may involve surgery, if necessary. In a vast majority of cases, the prognosis is excellent with appropriate treatment, since it is a benign cyst

Who gets Neuroglial Cyst? (Age and Sex Distribution)

• Neuroglial Cysts are highly uncommon tumors that represent much less than 1% of all intracranial cystic tumors
• Even though the cyst origin is during the fetal stage, the signs and symptoms are mostly manifested only during adulthood. Some are known to present symptoms during childhood
• Both males and females are affected
• No specific racial or ethnic group predilection is noted

What are the Risk Factors for Neuroglial Cyst? (Predisposing Factors)

• Currently, no definite risk factors have been identified for Neuroglial Cyst

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Neuroglial Cyst? (Etiology)

The cause of development of Neuroglial Cyst is generally unknown.

• The cyst is usually present in the brain tissue (intraparenchymal lesion) without an epithelial tissue lining, and reportedly has a neuroectodermal origin
• Neuroglial Cyst is typically a congenital lesion that develops during pregnancy (embryogenesis). It is not caused by what the expectant mother does or does not do, either prior to or during pregnancy

Note: A subtype of Neuroglial Cyst called ependymal cyst is often present near the ventricular system. This cyst is lined by simple epithelium.

What are the Signs and Symptoms of Neuroglial Cyst?

The signs and symptoms of Neuroglial Cyst can vary from one individual to another and depends on the size and location of the cystic tumor. In many individuals, these cysts grow slowly and remain asymptomatic, and are only diagnosed during certain radiological imaging studies of the head and neck region, performed for unrelated health conditions.

Neuroglial Cysts may be found anywhere within the brain. However, the frontal lobe is the most common location. Most of the tumors are intracranial, while few are intraspinal (involving the spinal cord).

In general, most tumors are asymptomatic and no significant symptoms are observed. Infrequently, the signs and symptoms of a large Neuroglial Cyst may include:

• Headaches
• Nausea and vomiting
• Numbness and tingling sensation
• Sensory disturbances, depending on the tumor location
• Speech impairment
• Muscle weakness; ataxia
• Seizures
• Dizziness
• If the spinal cord is involved, it may occasionally lead to:
  • Back pain and/or chest pain
  • Pain in the arms and legs, depending on the nerves that are compressed by the tumor
  • Severe cases may result in loss of bowel and bladder control

How is Neuroglial Cyst Diagnosed?

Neuroglial Cysts are typically incidental findings, when the healthcare provider is evaluating for other conditions/procedures. In many cases, they are diagnosed through a process of exclusion; tissue biopsies are rarely recommended.

There are a variety of tests that may be employed to diagnose a Neuroglial Cyst. These may include:

• Physical examination and complete medical history screening
• Assessment of the presenting signs and symptoms
• Neurological, motor skills, and cognitive assessment:
  • Checking intellectual ability, memory, mental health and function, language skills, judgment and reasoning, coordination and balance, reflexes, and sensory perceptions (space, sight, hearing, touch, etc.)
  • The healthcare provider/neurologist may use the Karnofsky Performance Scale in order to assess the neurological functioning of the individual’s central nervous system (CNS)
• Electroencephalography (EEG)
• Electromyography with nerve conductivity tests
• Imaging studies that may be performed include:
  • X-ray of head and neck region or vertebral column
  • Computerized tomography (CT) scan of the head and neck region/vertebral column; CT with contrast
  • Magnetic resonance imaging (MRI) scan of the central nervous system (brain and spine); MRI with contrast agents such as gadolinium
  • Cerebral angiographic studies or MR angiography: An angiogram involves injecting dye into the bloodstream, which makes the blood vessels to appear visually on X-rays. The X-ray may show a tumor in the brain or the blood vessels leading into the tumor
  • Magnetic resonance spectroscopy: This radiological technique is used to study the chemical profile of the tumor. It is often performed with and compared to corresponding MRI scan images of the affected region
• Cerebrospinal fluid analysis, where a spinal tap or lumbar puncture procedure may be performed: This diagnostic test is used to remove a sample of cerebrospinal fluid (CSF) from the spaces in and around the brain and spinal cord. The sample is removed from the lower spinal cord using a thin needle, and it is then checked for the presence of cancer cells
• Molecular studies, if necessary

Tissue biopsy: A biopsy of the affected region (brain or spinal cord) is performed and sent to a laboratory for a pathological examination. A pathologist examines the biopsy sample under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. Examination of the biopsy sample under a microscope by a pathologist is considered to be gold standard in arriving at a conclusive diagnosis.

A differential diagnosis to eliminate other conditions or tumor types may be considered, before arriving at a definitive diagnosis. The radiological differential diagnosis may include:

• Arachnoid cyst
• Cerebral hydatid cyst
• Enlarged perivascular spaces
• Ependymal cyst
• Intracranial epidermoid cyst
• Neurocysticercosis
• Porencephalic cyst

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Neuroglial Cyst?

The complications of Neuroglial Cyst may include the following:

• Stress and anxiety due to fear of an intracranial tumor
• Large tumor masses may get secondarily infected with bacteria or fungus
• Tumor rupture and torsion: Usually, larger tumors are more prone for torsion
• Tumor can rarely rupture and cause a form of meningitis
• Occasionally, recurrence of the cyst following its incomplete surgical removal
• Damage to the muscles, vital nerves, and blood vessels, during surgery
• Post-surgical infection at the wound site

How is Neuroglial Cyst Treated?

The treatment of Neuroglial Cyst may involve the following:

• In most cases of small-sized cysts and considering their slow-growing rates, the healthcare provider may propose conservative ‘wait and watch’ measures, instead of immediately recommending surgery to remove them
• In individuals who are symptomatic due to fluid drainage or rupture of the cyst (fenestration), treatment may be required
• Based on the healthcare provider’s assessment and individual circumstances, surgery may be necessary. Rarely, a complete surgical excision may be performed

Follow-up care with regular screening and check-ups are important and encouraged.

How can Neuroglial Cyst be Prevented?

Currently, there are no known methods to prevent the development of Neuroglial Cyst.

What is the Prognosis of Neuroglial Cyst? (Outcome/Resolutions)

The prognosis of Neuroglial Cyst is usually excellent with appropriate treatment, since it is a benign and mostly asymptomatic cystic tumor.

Typically, the prognosis depends on several factors that include:

• Size of the cyst
• Location of the cyst
• Combination and severity of the signs and symptoms

Additional and Relevant Useful Information for Neuroglial Cyst:

The following article link will help you understand other cancers and benign tumors:

http://www.dovemed.com/diseases-conditions/cancer/