Colloid cysts of the third ventricle are rare, benign lesions that can lead to acute cerebrospinal fluid obstruction, rapid neurological deterioration, and sudden death. This study aimed to evaluate the clinical presentation, imaging characteristics, and postoperative outcomes of surgically treated third-ventricle colloid cysts, with emphasis on imaging correlates and age-related patterns of clinical presentation. We retrospectively analyzed 25 consecutive patients who underwent microscopic interhemispheric transcallosal excision of third-ventricle colloid cysts between 2008 and 2023, assessing demographic, clinical, imaging, and postoperative variables, including magnetic resonance imaging characteristics, ventricular parameters, and Colloid Cyst Risk Score (CCRS) classification. The median age was 35 years (interquartile range, 22-46), and 96% of patients were symptomatic, most commonly presenting with headache (92%). All cysts were located in CCRS risk zone I, and all patients had CCRS scores ≥4. Fluid-attenuated inversion recovery hyperintensity was observed in 72% of cases, and ventricular asymmetry in 48%. Patients aged ≥40 years exhibited significantly longer symptom duration and larger cyst diameter, with a moderate positive correlation between age and cyst diameter (P = 0.015). Gross total resection was achieved in all cases. Postoperative shunt dependency occurred in 8%, complications in 8%, and reoperation due to imaging-confirmed recurrence in 4%. Median postoperative follow-up was 13 months (interquartile range, 8-70). Microscopic interhemispheric transcallosal excision appears to provide safe and effective management of third-ventricle colloid cysts, with high rates of complete resection and low morbidity in this single-center series. Preoperative risk assessment supported by CCRS and magnetic resonance imaging findings may help contextualize symptomatic risk and guide clinical decision-making.

Intradural spinal metastases are rare but clinically significant manifestations of systemic malignancies. Their management remains controversial, and evidence guiding surgical outcomes is limited. The aim of recent study is to evaluate the clinical features, surgical outcomes, and prognostic factors with intradural spinal metastases treated surgically at a single center. A retrospective review of 14 patients who underwent surgical resection for intradural extra- or intramedullary spinal metastases between 2014 and 2025 was conducted. Neurological outcomes were assessed using the McCormick scale. Overall survival and postoperative survival were analyzed using Kaplan-Meier and Cox regression models. Lung cancer was the predominant primary tumor (80%), with thoracic spine being the most involved site (64.3%). Gross total resection (GTR) was achieved in 71.4% of the cases. Neurological function improved in 28.6% of the cases, remained stable in 42.9%, and worsened in the 28.6% postoperatively. Median postoperative survival was 9.5 months, and overall survival from primary diagnosis was 31.8 months. Subtotal resection and intramedullary involvement were associated with worse outcomes, though not statistically significant. Surgical resection of intradural spinal metastases can offer meaningful neurological improvement and symptom relief in selected patients. GTR is associated with better outcomes, and careful preoperative selection is critical. Multidisciplinary approaches remain essential for optimizing patient care.

Background: The synchronous occurrence of pathologically distinct primary intracranial tumors is an exceptionally rare clinical entity. The coexistence of an isocitrate dehydrogenase (IDH)-wild-type glioblastoma (GBM) and a pituitary adenoma poses significant diagnostic and therapeutic challenges, with only six previously reported cases in the medical literature; seven, including the present patient. Case Description: We report a 45-year-old man who presented with progressive visual decline and headache. Magnetic resonance imaging demonstrated two separate, distinct lesions: A sellar mass consistent with a pituitary macroadenoma and a left frontal intra-axial lesion suspicious for high-grade glioma. The patient underwent staged surgical management consisting of an endoscopic endonasal transsphenoidal resection of the sellar lesion, followed by a frontal craniotomy for the intra-axial mass. Histopathological examination confirmed a pituitary transcription factor 1-lineage densely granulated lactotroph adenoma (pituitary neuroendocrine tumor) and an IDH-wildtype GBM (World Health Organization grade 4). Adjuvant radiotherapy and temozolomide chemotherapy were administered. GBM recurrence was detected 12 months after surgery, and the patient died 20 months after the initial diagnosis. Conclusion: The coexistence of GBM and pituitary adenoma is exceedingly rare. Including the present patient, only seven cases have been reported to date. Further clinical and molecular investigations are required to clarify whether this association represents a coincidental occurrence or reflects an underlying biological relationship.

Background: Atypical meningiomas (CNS WHO grade 2) are biologically heterogeneous, and reliable preoperative imaging correlates of tumor biology remain incompletely defined. This study investigated associations between routinely acquired conventional MRI features and histopathological markers of biological aggressiveness within this tumor grade. Methods: We retrospectively analyzed 90 consecutive patients who underwent surgical resection for histologically defined atypical meningiomas between January 2016 and March 2025. Histopathological specimens were re-reviewed according to the 2021 WHO Classification. Conventional MRI features and apparent diffusion coefficient (ADC) values were evaluated in relation to the Ki-67 labeling index (LI), mitotic count, hypercellularity, spontaneous necrosis, pathological brain invasion, and progesterone receptor expression. Ki-67 LI and ADC were analyzed primarily as continuous variables. A literature-informed Ki-67 threshold of ≥8% was used for secondary categorical analysis, with ≥4% and ≥10% retained as sensitivity analyses. Benjamini–Hochberg false-discovery-rate correction was applied to exploratory categorical comparisons. Results: The median age was 59 years, and 56 patients (62.2%) were female. The median Ki-67 LI was 10% (IQR, 5–15), and the median ADC was 0.78 × 10⁻³ mm²/s (IQR, 0.73–0.88). ADC showed a weak inverse correlation with Ki-67 LI (ρ = −0.255; 95% CI, −0.44 to −0.05; p = 0.015) but was not significantly correlated with mitotic count (ρ = −0.124; p = 0.244). In the adjusted continuous model, the association between ADC and Ki-67 was not statistically significant (Ki-67 ratio per 0.1 × 10⁻³ mm²/s increase in ADC, 0.95; 95% CI, 0.87–1.04; p = 0.264). Similarly, the secondary analysis using Ki-67 ≥ 8% yielded an imprecise association with ADC (OR, 0.865; 95% CI, 0.713–1.002; p = 0.054). Among 96 exploratory categorical comparisons, only the association between radiological and pathological brain invasion remained significant after false-discovery-rate correction (q = 0.003). Conclusions: Conventional MRI features showed weak and largely exploratory associations with histopathological markers of biological aggressiveness in histologically defined atypical meningiomas. Lower ADC was weakly correlated with higher Ki-67 LI, but this association was not robust after adjustment. Radiological brain invasion was strongly associated with pathological brain invasion. These findings should be considered hypothesis-generating and require prospective multicenter validation incorporating standardized imaging, molecular profiling, and clinically relevant outcomes before clinical application.