Neurenteric Cyst Located Dorsal to the Cervical Spine: Case Report

Macdonald, Rachel; Schwartz, Michael L.; Lewis, Anthony

doi:10.1227/00006123-199104000-00017

Cited by 50 publications

(18 citation statements)

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“…8,12,18) Persistence of the entire primitive neurenteric canal results in vertebral anomalies and dysraphic syndromes. 1,12,14,15,17,18,[22][23][24][25] Persistence of only part of the tract results in isolated intraspinal or intracranial cyst.…”

Section: Discussionmentioning

confidence: 99%

“…14) Most cases of neurenteric cyst occur in the spinal canal at the cervical or upper thoracic levels, with a predilection for ventral localization. 1,2,5,12,14,15,18,20) Neurenteric cysts in lumbosacral locations are uncommon and even more unusual in intracranial locations. 12) Intracranial neurenteric cysts occur mainly in the posterior fossa such as the craniovertebral junction, prepontine cistern, cerebellopontine angle, and juxta-jugular foramen, and rarely in supratentorial regions like the suprasellar regions, septum pellucidum, and cerebral convexity.…”

Section: Introductionmentioning

confidence: 99%

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Multiple Neurenteric Cysts in the Posterior Fossa and Cervical Spinal Canal-Case Report-

Oyama

Ikeda

Inoue

et al. 2004

Neurol. Med. Chir.(Tokyo)

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A 46-year-old woman presented with multiple neurenteric cysts in the posterior fossa and spinal canal. Neuroimaging demonstrated neurenteric cysts in the interspace between the left cerebellar hemisphere and vermis, the lateral side of the right cerebellar hemisphere, and the ventral side of the spinal cord at the C-2 and C-4 levels. Total resection of the paravermian cyst and partial removal of the spinal cyst at the C-4 level were performed. Histological examination showed the cyst wall consisted of single or multiple layers of columnar epithelial cells with secretory granules, with mucin secretion verified by periodic acid-Schiff staining. Immunohistochemical staining showed the walls were positive for the cytokeratin, epithelial membrane antigen, and carcinoembryonic antigen, and negative for glial fibrillary acidic protein and S-100 protein. These findings confirmed the endodermal origin. The diagnosis was neurenteric cyst. The paravermian cyst disappeared, but the spinal cyst at the C-4 level recurred 8 months later. Reoperation became necessary 16 months later. The other two cysts also showed enlargement at 6 or 15 months. Total removal of neurenteric cyst is recommended if possible.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Multiple Neurenteric Cysts in the Posterior Fossa and Cervical Spinal Canal-Case Report-

Oyama

Ikeda

Inoue

et al. 2004

Neurol. Med. Chir.(Tokyo)

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“…In our series the location and position of the neurenteric cysts differed from the preferred location (that is, in the cervical spine with an anterior relationship to the cord) that has been previously reported by many authors. 15,30,31,38,54 …”

Section: Cyst Locationmentioning

confidence: 99%

Spinal neurenteric cysts and their relation to more common aspects of occult spinal dysraphism

Rauzzino¹,

Tubbs²,

Alexander³

et al. 2001

FOC

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Object Neurenteric cysts are infrequently reported congenital abnormalities believed to be derived from an abnormal connection between the primitive endoderm and ectoderm. The authors report a series of 13 patients treated over a 50-year period. Methods Of the 13 patients, seven were female and six were male. Their ages at presentation ranged widely from 5 weeks to 52 years of age. Children presented more commonly with cutaneous stigmata of occult spinal dysraphism (OSD) whereas adults presented primarily with pain. Neurological deficit as a presenting symptom was less common in our series, a finding that reflects the slow growth of these lesions. In all but one patient some form of vertebral anomaly was associated with the cystic lesions, including two patients with Klippel–Feil abnormalities. There was a high incidence of associated forms of OSD including split cord malformation, lipoma, dermal sinus tract, and tethered spinal cord. In previous reports the authors have suggested that neurenteric cysts are more common in the cervical region and in a position ventral to the cord. In the present series these cysts most commonly occurred as intradural, extramedullary masses in the thoracolumbar region, situated dorsal to the spinal cord. The median follow-up period was 7.5 years, and postoperative outcome reflected a patient's preoperative neurological status; in no patient was outcome worsened due to surgery. Conclusions Complete excision of the neurenteric cyst remains the treatment of choice, as subtotal excision is associated with recurrence.

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“…First described by Puusepp [4] in 1934, these cysts are benign lesions causing spinal cord and brain stem compression with a predilection for the ventral craniocer vical region [8]. There is a male predominance believed to be 2.6-3.2 over females [1,6,12,22,23], Arai et al [23], in a review of the Japanese literature up to 1992, identi fied 43 cases including 2 of their own.…”

Section: Discussionmentioning

confidence: 99%

“…On rare occasions they can be found within the spinal capal in an intradural extramedullary and at times intramedullary location [7][8][9][10]. The cysts are generally located ventral to the spinal cord and cervicomedullary junction [1,6,[11][12][13][14], Thus the patients may present with signs of spinal cord com pression or meningitis [8][9][10][11]. The disturbance of meso dermal elements reflects as vertebral body anomalies which are common [14][15][16][17][18][19], The cysts consist of mucinproducing nonciliated simple or pseudostratified cuboi- Fig.…”

Section: Introductionmentioning

confidence: 99%

Craniocervical Intradural Neurenteric Cysts

Menezes

Ryken²

1995

Pediatr Neurosurg

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Neurenteric cysts are rare lesions of the central nervous system that are lined by epithelium of intestinal nature. They result from abnormal separation of germ cell layers in the 3rd week of embryonic life, leading to persistence of entodermal elements in the spinal canal. The common location is cervical and ventral to the spinal cord. The lesions have been recognized as being entodermal in origin by such markers as vertebral anomalies, gut cysts, bowel reduplication and the presence of keratin markers. Three unusual cases of childhood craniocervical intradural neurenteric cysts in patients aged 4-8 years are described. These cysts were located in the ventral aspect of the spinal canal ranging from the craniocervical junction to the C6 level and were associated with bony anomalies such as a bifid clivus, hemivertebrae and blocked vertebrae. Two patients presented with signs of cervical cord compression and 1 with recurrent meningitis. One child with an anterior cervicomedullary region mass had undergone unsuccessful transoral transpalatal exploration and subsequently required excision with a dorsolateral approach. The second patient, after two successful attempts at drainage via laminectomies, required myelotomy of the spinal cord to allow excision. Thus the patient with the lesion from C4 through C6 underwent vertebrectomy and anterior excision with a C4 through C7 strut graft fusion. There were bony and vascular anomalies which would have complicated a dorsal approach. Pathological diagnosis of neurenteric cysts was based on the findings of nonciliated mucin producing small cuboidal or columnar epithelium lining a cystic cavity. Neurenteric cysts are uncommon congenital anomalies which may become symptomatic in the pediatric population. Their intradural and not infrequent intramedullary ventral location makes surgical approach and management difficult. An anterior approach allows visualization of the bony vertebral and vascular anomalies and permits excision which cannot be accomplished from a dorsal route.

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Neurenteric Cyst Located Dorsal to the Cervical Spine: Case Report

Abstract: A patient with a neurenteric cyst located dorsal to the cervical spine and associated with occult cervical spinal dysraphism is described. The embryological theories that might explain the occurrence of such a lesion are discussed.

Cited by 50 publications

References 0 publications

Multiple Neurenteric Cysts in the Posterior Fossa and Cervical Spinal Canal-Case Report-

Multiple Neurenteric Cysts in the Posterior Fossa and Cervical Spinal Canal-Case Report-

Spinal neurenteric cysts and their relation to more common aspects of occult spinal dysraphism

Craniocervical Intradural Neurenteric Cysts

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