The oldest presenting neurenteric cyst of the spinal cord

Background:Neurenteric cysts are rare congenital epithelium-lined cysts of the central nervous system. They are found predominantly in the spinal cord, with lower incidence in the intracranial compartment, and may be associated with various other congenital spinal anomalies. Seven patients with symptomatic intraspinal neurenteric cysts are presented.Materials and Methods:Seven patients with intraspinal neurenteric cysts aged from nine months to ten years treated at this hospital from May 2000 to July 2006 were reviewed. The clinical manifestations, imaging and surgical findings of patients were analyzed retrospectively. All patients underwent operation. One patient's cervical neurenteric cyst was resected using the lateral cervical approach, and the other six resections were performed with posterior approach.Results:All seven patients presented with neurological involvement. One patient had an intramedullary cyst, while the other six cysts were situated ventrally. Three patients' cysts occurred in the cervical region, two in the cervicothoracic region, one in the thoracic region and one in the lumbar region. One patient had bony anomalies, and one had a lumbar posterior occult spinal dysraphism. Five patients' symptoms improved rapidly after surgery.Conclusions:Intraspinal neurenteric cysts in children are rare and most occur ventral to the spinal cord. Magnetic resonance imaging (MRI) is the most effective imaging modality. Earlier diagnosis and surgical resection of spinal neurenteric cysts improves prognosis.

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Unusual split cord with neurenteric cyst and cerebellar heterotopia over spinal cord

Child s Nervous System ◽

10.1007/s00381-006-0211-7 ◽

2006 ◽

Vol 23 (2) ◽

pp. 243-247 ◽

Cited By ~ 7

Author(s):

Raj Kumar ◽

Mahesh Prakash

Keyword(s):

Spinal Cord ◽

Neurenteric Cyst

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Recurrent neurenteric cysts compressing the brainstem

Surgical Neurology International ◽

10.25259/sni_501_2019 ◽

2019 ◽

Vol 10 ◽

pp. 245

Author(s):

Angela N. Viaene ◽

Steven Brem

Keyword(s):

Spinal Cord ◽

Posterior Fossa ◽

Intraoperative Imaging ◽

Neurenteric Cyst ◽

Case Description ◽

Slow Growing

Background: Neurenteric cysts, also referred to as endodermal cysts and enterogenous cysts, are rare lesions of the neuroaxis occurring most frequently within the spinal cord and rarely intracranially. In the literature describing these lesions, examples of intraoperative imaging and cytology preparations are rare to non-existent. Case Description: Here, we describe a case of a recurrent posterior fossa neurenteric cyst compressing the brainstem in a 47-year-old female and causing incontinence and progressive quadriparesis. Intraoperative findings and cytologic and histologic features are presented. Conclusion: Neurenteric cysts are generally considered to be benign and slow-growing though recurrence is common. This case of a recurrent neurenteric cyst is illustrated by intraoperative macroscopic and cytologic images.

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A Recurrent Cervical Neurenteric Cyst Treated Anteriorly: Safe, Gross-Total Excision Facilitated by Prophylactic Unilateral Vertebral Artery Exposure, Microdissection, and Spinal Cord Monitoring—A Case Report and Technical Note

Case Reports in Orthopedics ◽

10.1155/2018/7620182 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Kazunobu Kida ◽

Toshikazu Tani ◽

Tateo Kawazoe ◽

Makoto Hiroi

Keyword(s):

Spinal Cord ◽

Vertebral Artery ◽

Evoked Potential ◽

Motor Evoked Potential ◽

Technical Note ◽

Neurenteric Cyst ◽

Spinal Cord Monitoring ◽

Cervical Cyst ◽

Cyst Cavity ◽

Brown Sequard Syndrome

This study reports on a 67-year-old woman with partial Brown-Séquard syndrome due to a recurrent cervical neurenteric cyst at C3 to C4. The myelopathic symptoms reappeared 22 years after a previous shunting operation performed posteriorly with a silicone tube connecting the intradural cervical cyst cavity to the subarachnoid space. We have now succeeded in removing the cyst nearly completely with the anterior approach. The surgical procedure consisted of right vertebral artery exposure at C3 and C4 and a subtotal corpectomy of C3 followed by microdissection of the cyst, duraplasty, and iliac strut graft fusion. Spinal cord monitoring with motor-evoked potential studies helped us safely dissect the cyst wall tightly adhering to the spinal cord. Duraplasty with Gore-Tex patch-grafting in conjunction with postoperative lumbar subarachnoid drainage worked well in preventing a spinal fluid fistula. At two years after surgery, the patient showed a nearly complete return of function without any recurrence of the cyst.

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Disseminated neurenteric cyst

Journal of Neurosurgery Spine ◽

10.3171/spi.2008.9.10.382 ◽

2008 ◽

Vol 9 (4) ◽

pp. 382-386 ◽

Cited By ~ 7

Author(s):

Muneyoshi Yasuda ◽

Hiroshi Nakagawa ◽

Hiroaki Ozawa ◽

Chikage Inukai ◽

Takeya Watabe ◽

...

Keyword(s):

Spinal Cord ◽

Japanese Woman ◽

Neurenteric Cyst ◽

Cerebrospinal Fluid Circulation ◽

Unsteady Gait ◽

Old Japanese ◽

History Of ◽

Cyst Membrane ◽

Upper Thoracic ◽

Cyst Fenestration

This case report presents the unusual holospinal dissemination of a neurenteric cyst, which was successfully treated by fenestration and placement of a subarachnoid-peritoneal (SP) shunt. The patient was a 46-year-old Japanese woman with a history of fourth ventricle neurenteric cysts, which were managed with cyst fenestration in 1996 and 2005. She had been doing well until January 2006, when she developed dizziness and an unsteady gait. A neurological examination revealed a disturbance in the deep sensation of the feet. A neuroimaging evaluation demonstrated multiple cystic lesions in the whole spinal canal, which significantly distorted the spinal cord. Because the spinal cord distortion was the most severe in the lower cervical to upper thoracic areas, a unilateral osteoplastic laminotomy with an endoscopic cyst fenestration was performed in these areas, followed by placement of an SP shunt. The pathological diagnosis was a disseminated neurenteric cyst. There was no malignancy, and the patient has been well, with an improved gait and no signs of peritoneal dissemination, for > 1 year. The present case showed a unique extent of dissemination, which was most likely a secondary characteristic. Neurenteric cysts are well known for their tendency to recur, and total removal is usually difficult because of adhesion of the cyst membrane to important structures. The lesion also compromises cerebrospinal fluid circulation. Cyst fenestration combined with SP shunt placement might be a treatment option in such a case.

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Spinal cord neurenteric cyst: clinical and diagnostic findings and long term follow-up in two dogs

Veterinary Quarterly ◽

10.1080/01652176.2018.1542515 ◽

2018 ◽

Vol 38 (1) ◽

pp. 106-111

Author(s):

Teresa Gagliardo ◽

Daniele Corlazzoli ◽

Marco Rosati ◽

Swan Specchi ◽

Luciano Pisoni ◽

...

Keyword(s):

Spinal Cord ◽

Neurenteric Cyst ◽

Long Term Follow Up

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Spectrum of Nonterminal Myelocystoceles

Neurosurgery ◽

10.1227/01.neu.0000197122.92954.82 ◽

2006 ◽

Vol 58 (3) ◽

pp. 509-515 ◽

Cited By ~ 39

Author(s):

Andrea Rossi ◽

Gianluca Piatelli ◽

Carlo Gandolfo ◽

Marco Pavanello ◽

Chen Hoffmann ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Spinal Cord ◽

Magnetic Resonance ◽

Normal Skin ◽

Subcutaneous Fat ◽

Clinical Findings ◽

Neurenteric Cyst ◽

Imaging Features ◽

Resonance Imaging ◽

Clinical Records

Abstract OBJECTIVE: To present the magnetic resonance imaging features, clinical findings, and possible embryologic bases for nonterminal myelocystoceles, a distinct subset of closed spinal dysraphisms. METHODS: We retrospectively analyzed imaging series and clinical records from five newborns and one older child with skin-covered soft tissue masses along the posterior midline spine. Spinal (6 patients) and brain (5 patients) magnetic resonance imaging was performed before surgical repair and compared with clinical findings, observations at surgery, and final lesion histology. RESULTS: The lesions affected the cervical (n = 3), thoracic (n = 2), and lumbar (n = 1) regions. In each case, the dome of the mass was covered by thickened, dystrophic epithelium with no subcutaneous fat, whereas the base and lateral walls of the mass were covered by normal skin. All patients were neurologically intact at presentation. In three cases, a stalk emanated from the dorsal normal spinal cord, crossed a narrow posterior bony spina bifida, and coursed through a posterior meningocele to attach to the inner aspect of its dome. The other three cases showed dissection of a hydromyelic cavity into the stalk, converting it into a second "cyst" within the meningocele. Concurrent anomalies included focal hydromyelia immediately cranial to the origin of the posterior stalk (n = 2), mild Chiari II malformation (n = 3), triventricular hydrocephalus from aqueductal stenosis (n = 1), filar lipoma (n = 1), and presumed neurenteric cyst (n = 1). At surgery, the sac was resected in all cases, but intradural exploration and untethering was performed in only three children. Embryologic considerations indicate that the spectrum of these lesions likely arises from partial limited closure of the neural tube, failed disjunction of the cutaneous ectoderm, and variable degrees of hydromyelia. CONCLUSION: The nonterminal myelocystocele is a distinct form of closed spinal dysraphism characterized by a skin-covered meningocele, which is either crossed by a fibroneurovascular stalk that extends from the dorsal aspect of the spinal cord to attach to the dome of the meningocele (abortive form, or myelocystocele manqué) or contains a hydromyelic cavity that is continuous with the ependymal canal of the spinal cord (complete form).

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Delayed Myelopathy After Trivial Neck Injury in a Patient With a Cervical Neurenteric Cyst

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100040269 ◽

1995 ◽

Vol 22 (2) ◽

pp. 168-171 ◽

Cited By ~ 9

Author(s):

Rajiv Midha ◽

Bruce Gray ◽

Laurence Becker ◽

James Drake

Keyword(s):

Spinal Cord ◽

Spinal Pain ◽

Neurenteric Cyst ◽

Cyst Size ◽

Cyst Excision ◽

Congenital Origin ◽

Spinal Movement ◽

History Of ◽

High Cervical ◽

Spinal Cord Dysfunction

AbstractBackground:Neurenteric cysts are rare spinal lesions of congenital origin. They usually present insidiously with a long history of local spinal pain, radiculopathy and myelopathy. We report a 14-year-old male with a high cervical neurenteric cyst who developed a progressive myelopathy after minor neck trauma. Full recovery followed a partial cyst excision and decompressive procedure.Significance and conclusion:The possible pathogenic mechanisms for this unusual presentation include hemorrhage into the cyst, sudden mechanical compression from abnormal spinal movement of a chronically distorted and compressed spinal cord, or an increase in the size of the cyst secondary to accumulation of cyst fluid. In this case a small increase in the cyst size may have resulted in increased mechanical distortion and spinal cord dysfunction on a compressive and ischemic basis.

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Tethered Cord Syndrome Secondary to the Unusual Constellation of a Split Cord Malformation, Lumbar Myelomeningocele, and Coexisting Neurenteric Cyst

Case Reports in Neurological Medicine ◽

10.1155/2012/635029 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

Humphrey Okechi ◽

A. Leland Albright ◽

Ancent Nzioka

Keyword(s):

Spinal Cord ◽

Tethered Cord ◽

Tethered Cord Syndrome ◽

Prophylactic Surgery ◽

Split Cord Malformation ◽

Pathological Examination ◽

Neurenteric Cyst ◽

History Of ◽

Spinal Mri ◽

Large Bone

We describe a seminal case report of a child with a tethered cord syndrome secondary to the unusual constellation of a split cord malformation, lumbar myelomeningocele, and coexisting neurenteric cyst. A 17-year-old adolescent girl with a several-month history of myelopathy and urinary incontinence was examined whose spinal MRI scan demonstrated a type II split cord malformation with a large bone spur and an intradural neurenteric cyst in addition to lumbar myelomeningocele. Untethering of the spinal cord was achieved via a lumbar laminectomy. Pathological examination confirmed the intradural cyst to be a neurenteric cyst. Postoperatively there was stabilization of the neurological symptoms. Prophylactic surgery with total resection of the neurenteric cyst when feasible and spinal cord un-tethering appears to be associated with excellent outcomes.

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