Pineal cyst in bipolar patient with normolithiaemia and positive fibromyalgic tender points
Pineal cysts are benign, nonneoplastic lesions of the pineal gland, often identified incidentally on MRI scans. Although these cysts are usually asymptomatic, they can occasionally enlarge and compress adjacent structures, leading to neurological complications such as obstructive hydrocephalus and P...
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Elsevier
2025-03-01
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| Series: | Radiology Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1930043324012949 |
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| author | Salvatore Marrone, MD Antonio Alessandro Biancardino, MD Evier Andrea Giovannini, MD Federica Paolini, MD Benedetta Maria Campisi, MD Jaime Mandelli, MD Domenico Santangelo, MD Salvatore Fanara, MD Giuseppe Vaccaro, MD Michele Vecchio, MD Domenico Gerardo Iacopino, MD, PhD Luigi Basile, MD |
| author_facet | Salvatore Marrone, MD Antonio Alessandro Biancardino, MD Evier Andrea Giovannini, MD Federica Paolini, MD Benedetta Maria Campisi, MD Jaime Mandelli, MD Domenico Santangelo, MD Salvatore Fanara, MD Giuseppe Vaccaro, MD Michele Vecchio, MD Domenico Gerardo Iacopino, MD, PhD Luigi Basile, MD |
| author_sort | Salvatore Marrone, MD |
| collection | DOAJ |
| description | Pineal cysts are benign, nonneoplastic lesions of the pineal gland, often identified incidentally on MRI scans. Although these cysts are usually asymptomatic, they can occasionally enlarge and compress adjacent structures, leading to neurological complications such as obstructive hydrocephalus and Parinaud's syndrome. The underlying mechanisms of pineal cyst development remain largely unclear, although inflammation - common in rheumatological conditions such as fibromyalgia - and mechanical stress have been suggested as contributing factors. In addition, the incomplete blood-brain barrier of the pineal gland raises the possibility that chronic lithium therapy, commonly used for psychiatric disorders and also known for its hyperplastic effects, could facilitate cysts formation through lithium accumulation and epithelial stimulation.We report the case of a 49-year-old woman with bipolar disorder on long-term lithium treatment who presented with a pineal cyst and clinical symptoms consistent with fibromyalgia. A review of the literature highlights possible links between pineal cyst formation, systemic inflammation associated with rheumatological disorders and prolonged lithium exposure.Although the hyperplastic properties of lithium in glandular tissue are well documented, there is no conclusive evidence directly linking lithium use to the development of pineal cysts in humans. The possibility of cystic growth driven by the pro-inflammatory environment of fibromyalgia remains plausible and warrants further investigation of the complex interactions between lithium therapy, systemic inflammation and pineal cystogenesis, particularly in patients with coexisting rheumatological and psychiatric disorders. |
| format | Article |
| id | doaj-art-ce17c40a61bd4628ba9e15e1f1d40f24 |
| institution | Kabale University |
| issn | 1930-0433 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Radiology Case Reports |
| spelling | doaj-art-ce17c40a61bd4628ba9e15e1f1d40f242025-01-18T05:03:51ZengElsevierRadiology Case Reports1930-04332025-03-0120313171322Pineal cyst in bipolar patient with normolithiaemia and positive fibromyalgic tender pointsSalvatore Marrone, MD0Antonio Alessandro Biancardino, MD1Evier Andrea Giovannini, MD2Federica Paolini, MD3Benedetta Maria Campisi, MD4Jaime Mandelli, MD5Domenico Santangelo, MD6Salvatore Fanara, MD7Giuseppe Vaccaro, MD8Michele Vecchio, MD9Domenico Gerardo Iacopino, MD, PhD10Luigi Basile, MD11Unit of Neurosurgery, Sant'Elia Hospital, via Luigi Russo n° 6, Caltanissetta, ItalyNeurosurgical Clinic, AOUP “Paolo Giaccone”, Post Graduate Residency Program in Neurologic Surgery, Department of Biomedicine Neurosciences and Advanced Diagnostics, School of Medicine, University of Palermo, Palermo, Italy; Corresponding author.Unit of Neurosurgery, Sant'Elia Hospital, via Luigi Russo n° 6, Caltanissetta, Italy; Neurosurgical Clinic, AOUP “Paolo Giaccone”, Post Graduate Residency Program in Neurologic Surgery, Department of Biomedicine Neurosciences and Advanced Diagnostics, School of Medicine, University of Palermo, Palermo, ItalyUnit of Neurosurgery, Sant'Elia Hospital, via Luigi Russo n° 6, Caltanissetta, Italy; Neurosurgical Clinic, AOUP “Paolo Giaccone”, Post Graduate Residency Program in Neurologic Surgery, Department of Biomedicine Neurosciences and Advanced Diagnostics, School of Medicine, University of Palermo, Palermo, ItalyNeurosurgical Clinic, AOUP “Paolo Giaccone”, Post Graduate Residency Program in Neurologic Surgery, Department of Biomedicine Neurosciences and Advanced Diagnostics, School of Medicine, University of Palermo, Palermo, ItalyUnit of Neurosurgery, Sant'Elia Hospital, via Luigi Russo n° 6, Caltanissetta, ItalyUnit of Neurology, Sant'Elia Hospital, via Luigi Russo n° 6, Caltanissetta, ItalyUnit of Neurology, Sant'Elia Hospital, via Luigi Russo n° 6, Caltanissetta, ItalyUnit of Neuroradiology, Sant'Elia Hospital, via Luigi Russo n° 6, Caltanissetta, ItalyUnit of Neurology, Sant'Elia Hospital, via Luigi Russo n° 6, Caltanissetta, ItalyNeurosurgical Clinic, AOUP “Paolo Giaccone”, Post Graduate Residency Program in Neurologic Surgery, Department of Biomedicine Neurosciences and Advanced Diagnostics, School of Medicine, University of Palermo, Palermo, ItalyUnit of Neurosurgery, Sant'Elia Hospital, via Luigi Russo n° 6, Caltanissetta, ItalyPineal cysts are benign, nonneoplastic lesions of the pineal gland, often identified incidentally on MRI scans. Although these cysts are usually asymptomatic, they can occasionally enlarge and compress adjacent structures, leading to neurological complications such as obstructive hydrocephalus and Parinaud's syndrome. The underlying mechanisms of pineal cyst development remain largely unclear, although inflammation - common in rheumatological conditions such as fibromyalgia - and mechanical stress have been suggested as contributing factors. In addition, the incomplete blood-brain barrier of the pineal gland raises the possibility that chronic lithium therapy, commonly used for psychiatric disorders and also known for its hyperplastic effects, could facilitate cysts formation through lithium accumulation and epithelial stimulation.We report the case of a 49-year-old woman with bipolar disorder on long-term lithium treatment who presented with a pineal cyst and clinical symptoms consistent with fibromyalgia. A review of the literature highlights possible links between pineal cyst formation, systemic inflammation associated with rheumatological disorders and prolonged lithium exposure.Although the hyperplastic properties of lithium in glandular tissue are well documented, there is no conclusive evidence directly linking lithium use to the development of pineal cysts in humans. The possibility of cystic growth driven by the pro-inflammatory environment of fibromyalgia remains plausible and warrants further investigation of the complex interactions between lithium therapy, systemic inflammation and pineal cystogenesis, particularly in patients with coexisting rheumatological and psychiatric disorders.http://www.sciencedirect.com/science/article/pii/S1930043324012949Pineal cystBipolar disorderFibromyalgiaSystemic inflammationLithium therapy |
| spellingShingle | Salvatore Marrone, MD Antonio Alessandro Biancardino, MD Evier Andrea Giovannini, MD Federica Paolini, MD Benedetta Maria Campisi, MD Jaime Mandelli, MD Domenico Santangelo, MD Salvatore Fanara, MD Giuseppe Vaccaro, MD Michele Vecchio, MD Domenico Gerardo Iacopino, MD, PhD Luigi Basile, MD Pineal cyst in bipolar patient with normolithiaemia and positive fibromyalgic tender points Radiology Case Reports Pineal cyst Bipolar disorder Fibromyalgia Systemic inflammation Lithium therapy |
| title | Pineal cyst in bipolar patient with normolithiaemia and positive fibromyalgic tender points |
| title_full | Pineal cyst in bipolar patient with normolithiaemia and positive fibromyalgic tender points |
| title_fullStr | Pineal cyst in bipolar patient with normolithiaemia and positive fibromyalgic tender points |
| title_full_unstemmed | Pineal cyst in bipolar patient with normolithiaemia and positive fibromyalgic tender points |
| title_short | Pineal cyst in bipolar patient with normolithiaemia and positive fibromyalgic tender points |
| title_sort | pineal cyst in bipolar patient with normolithiaemia and positive fibromyalgic tender points |
| topic | Pineal cyst Bipolar disorder Fibromyalgia Systemic inflammation Lithium therapy |
| url | http://www.sciencedirect.com/science/article/pii/S1930043324012949 |
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