Giant petroclival endodermal cyst with xanthogranulomatous changes

Abstract

<jats:p>Endodermal cyst is a rare developmental cyst of the CNS, such as a Rathke cleft and colloid cyst lined by columnar epithelium of presumed endodermal origin. Intracranial endodermal cysts are rare, and most are found in the posterior fossa. The authors report a case of petroclival endodermal cyst with extensive bone destruction. A 12-year-old boy presented with transient facial weakness and headache. Imaging revealed a 3 × 3 × 4–cm, partial rim, enhanced cystic lesion in the petroclival area that was isointense on T1-weighted imaging and hyperintense in T2-weighted imaging. The cyst wall was partially removed and the cyst was obliterated using a lateral approach. Histological examination revealed ciliated, simple-to-pseudostratified cuboidal epithelium with a basement membrane that was consistent with an endodermal cyst, with the rare finding of xanthogranulomatous changes.</jats:p>

Supratentorial endodermal cysts - Report of two cases

“…[6] Diagnosis of an EC is confirmed on histology. [8] It is difficult to differentiate these various subtypes of ECs under a light microscope. Immunohistochemistry is a useful adjunct in these cases.…”

Endodermal cyst in pineal region: Rare location

“…In general, lack of contrast enhancement of the cyst wall, and of bone destruction is useful for distinguishing endodermal cysts from other cystic lesions such as schwannomas or cystic meningiomas. [ 4 6 ] In retrospect, the concomitant presence of a small interhemispheric lipoma, and an additional small posterior falx possible meningioma could have raised the possible diagnosis of a developmental lesion. There are no histopathological or immunohistochemical criteria for a clear distinction between Rathke cleft cyst, colloid cyst, and endodermal cyst.…”

“…The intracranial locations reported are more frequently within posterior fossa in fourth ventricle, cerebellopontine angle, ambient and quadrigeminal cistern, around brainstem, and less frequently in supratentorial compartment. [ 1 2 3 4 5 9 11 ] The embryogenesis of endodermal cyst is not well-understood, and, like Rathke cleft and colloid cysts, they all are considered the result of failed separation between notochord and neurenteric canal. [ 6 ]…”