Choroidal Fissure Cysts in Children-Dilemma in Follow Up

Background: Choroidal fissure cyst is a developmental variant that is characterised by a small cyst in the choroidal fissure. These are cysts that are specific to a specific location and can be neuroglial, neuroepithelial, or arachnoid in nature. In routine radiological cross-sectional imaging studies, these are considered incidental findings. There is dilemma in follow up of these cysts because of their asymptomatic nature or of some vague complaints and invites a lot of debate on their follow-up. Methods: Five children aged 10 to 16 years who presented to the outpatient department with a vague headache, vertigo, or unexplained seizures underwent non-contrast computerized tomography (NCCT) or magnetic resonance imaging (MRI) of the head to rule out any intracranial pathology. Results: Three of the cases had pure cysts in the brain, while the other two had tuberculomas of various sizes and types that resembled cystic appearances. One of the brain cyst cases involved a 14-year-old female, and NCCT head findings revealed a small cyst in the right choroid fissure. On multiplanar and multisectional plain MRI, this was later confirmed as a choroidal fissure cyst. The other two cystic pathologies were vesicular cysticercosis and posterior fossa arachnoid cyst. The other two were tuberculomas with ring enhancement, as confirmed by MR spectroscopy.

Conclusion: The case of the choroidal fissure cyst required special attention due to the patient's and clinician's concern for the follow-up. We reviewed the literature for the fate and follow up of these types of case