An unusual case of intradural intramedullary dorsal bronchogenic cyst in spine

Abstract

Bronchogenic cysts are congenital malformations derived from anomalous budding of the embryonic foregut. Intraspinal bronchogenic cysts are extremely rare and most of them are extramedullary. There has been only one case of intramedullary spinal bronchogenic cyst reported. We present an 18-year-old male patient with spastic paraparesis and bowel and bladder involvement. MRI revealed a 2 cm diameter intradural and intramedullary lesion at D2-D3 level which was hyperintense on T1 and hypointense on T2 imaging. Histopathological examination after surgical excision of the lesion revealed a bronchogenic cyst. To our knowledge this is the first case reporting an intramedullary bronchogenic cyst at the upper dorsal level and overall second reported case of intramedullary spinal bronchogenic cyst.

Large intramedullary bronchogenic cyst of the cervical spine: illustrative case

“…Of the 27 published cases of primary spinal bronchogenic cysts, only 3 were intramedullary lesions ( Table 1 ). 1 , 17 , 18 We present our case of a large intradural intramedullary spinal bronchogenic cyst causing syrinx formation as well as cord compression.…”

“…Bronchogenic cysts are formed as a result of abnormal budding of the bronchial tree and characterized by ciliated, pseudostratified columnar epithelial lining of the cyst walls. 1 , 2 These developmental cysts are typically located in the lung or mediastinum. Spinal bronchogenic cysts are rare, with fewer than 30 cases published and the vast majority being extramedullary lesions ( Table 1 ).…”

“… 2–16 Three prior accounts described intramedullary bronchogenic cysts ( Table 1 ). 1 , 17 , 18 We present our experience with a large intramedullary bronchogenic cyst located in the cervical spine.…”

Bilobed intramedullary and extramedullary bronchogenic cyst of the conus medullaris: illustrative case

“…However, it is noteworthy that surgeons in all three cases of intramedullary bronchogenic cysts in our literature review, as well as our own novel case, encountered difficulty in achieving complete extirpation of intramedullary components. 18,22,23 Hematoxylin and eosin stain demonstrating at low power (Â4 power) a partially disrupted cyst with a pseudostratified epithelial lining that forms tufts into the cyst lumen (C). Higher magnification (Â20 power) shows the cyst lining to have prominent cilia (D).…”

“…However, it is noteworthy that surgeons in all three cases of intramedullary bronchogenic cysts in our literature review, as well as our own novel case, encountered difficulty in achieving complete extirpation of intramedullary components. 18 , 22 , 23 This is due largely to the tendency for these cysts to have a tightly adherent wall to the spinal cord, precluding a clear dissection plane.…”