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Three cases with a pituitary cystic mass that spontaneously disappeared were discussed. Common characteristics of these 3 cases were presence of headache, cystic mass, spontaneous disappearance, and no recurrence. Based on clinical course, MRI findings such as cystic mass with ring enhancement, no calcification, and displacement posteriorly of the normal pituitary gland, and previous reports, these 3 cases were diagnosed as an equivocal Rathke's cleft cyst. We suggested that operative indication in an equivocal Rathke's cleft cyst, even though it was symptomatic, should be decided after sufficient follow-up, because there may be a possibility of spontaneous reduction or disappearance like our cases.

Lateral thoracic meningocele is an uncommon disorder known to occur with high frequency in patients with neurofibromatosis. We report a case not accompanied by neurofibromatosis and describe the operative technique utilizing a posterolateral extradural approach. A 41-year-old man was referred to our cardiologic clinic for severe anterior chest pain. Plain chest X-ray demonstrated an oval mass lesion in the right 9th to 10th thoracic paravertebral region. Magnetic resonance imaging revealed a cystic mass at the 10th thoracic intervetebral foramen without distortion of the spinal cord. Signal intensity of the cystic mass was the same as the cerebrospinal fluid around the spinal cord. In the prone position, laminotomy of the 10th vertebral only was carried out. A pulsatile round mass in continuity with the dura mater was exposed. The wall of the sac, which was thickened with CSF, was identified. The neck of the menigocele was ligated with the help of an aneurysm needle. The patient's severe chest pain disappeared postoperatively.

Thymoma with extrathoracic metastasis is very rare, especially to the central nervous system. As far as we know, this is the 15th reported case of cerebral metastasis from malignant thymoma. The prognosis is very poor and almost all of them die in one to one and half years. We have experienced such a case, who is 56 years old man, presenting Gerstmann's syndrome and right-hemiparesis 8 months later after thoracotomy for removal of thymoma. At the admission time in this hospital, CT findings proved the tumor in the left temporoparietal area, left ventricle deformity and slight midline shift to right side. The average of CT density in the low density area was 20. Peripheral region of the tumor was enhanced by contrast CT. Left carotid angiography showed the ACA shift to the right side and abnormal vascularity of peripheral branches of angular artery (arterial phase) and also tumor strain in late artery (arterial phase) and also tumor strain in late arterial phase. Brain scintigram revealed accumulation in the left parietal region. The rt-hemiparesis was rapidly going to be rt-hemiplegia. Therefore, we have performed needle puncture to prevent rt-hemiplegia at the first time. In the course of needle puncture, 90 ml of dark and red fluid was gained at 3.0 cm depth from the cerebral surface. Immediately, the above two symptoms have improved remarkably. Post operative CT showed the reduction of tumor and improvement of the midline shift. The radical operation have been done 2 days after the needle puncture. The tumor was elastic-soft and hemorrhagic and appeared dark-red.(ABSTRACT TRUNCATED AT 250 WORDS)