Neurenteric Cyst of the Craniocervical Junction —Case Report—

Abstract

A 60-year-old female presented with occipital headache and limitation of neck movement. Neurological examination showed weakness of the right sternocleidomastoid muscle. Magnetic resonance imaging revealed a cystic lesion at the craniocervical junction and posterior compression of the brain stem. The lesion was totally removed through the transcondylar approach. The histological diagnosis was neu renteric cyst. The transcondylar approach provides a direct operative view of the clivus and anterior craniovertebral junction.

Far-lateral transcondylar approach: surgical technique and its application in neurenteric cysts of the cervicomedullary junction

“…Neurenteric cysts that are located in the anterior cervicomedullary junction are even rarer, and often require a skull base approach for adequate resection. 1,12,14,16,20,21 We describe two cases of neurenteric cysts arising from the cervicomedullary junction that were resected via a far-lateral transcondylar approach. We discuss the surgical approach and operative nuances involved in removing these lesions, and we review the clinical presentation of neurenteric cysts in this region as well as the neuroimaging characteristics, histopathological findings, and surgical management.…”

Cisto neuroentérico espinhal: relato de um caso e revisão da literatura

“…8 Entre os defeitos podemos destacar a espinha bífida anterior ou posterior, defeitos em asa de borboleta, diastematomielias, fusões de corpos vertebrais, hemivérte-bras e Klippel-Feil. 7 Radiologicamente, são lesões não homogêneas, isointensas a levemente hiperintensas em T1, hiperintensas em T2 e sem realce ao meio de contraste. O sinal em T1 pode variar com a concentração de proteínas ou presença de hemorragias dentro do cisto.…”

“…5,6,10 A parede do cisto é positiva para citoqueratina, EMA e CEA e negativa para S100 e GFAP. 7,11 Apesar de consideramos ressecção completa na primeira cirurgia, 11 meses após houve recidiva da lesão, com dorsalgia e piora da fraqueza nos membros inferiores. As principais complicações pós-operatórias são a recidiva, aracnoidite e piora do déficit neurológico.…”

Neurenteric Cyst of the Craniocervical Junction in an Infant -Case Report-

“…Typically the cyst wall is not enhanced by contrast medium. [1][2][3]9) The differential diagnosis of intraspinal cystic masses includes arachnoid cyst, dermoid cyst, epidermoid cyst, teratoma, parasitic cyst, ependymal cyst, cystic cord tumors, and masses with associated syrinx and myelomalacia. Association with bone abnormalities strongly suggests neurenteric cyst.…”

“…5) Neurenteric cyst is predominantly located ventral to the spinal cord in the lower cervical and upper thoracic spinal subarachnoid space, or at the lumbar and sacral levels, and infrequently involve the posterior fossa. 1,3,4) Neurenteric cysts of the craniocervical junction occurring in infancy are extremely rare, and in only two patients aged under 3 years. 4,5) We treated a 1-year-old infant with neurenteric cyst located at the craniocervical junction manifesting as progressive tetraparesis.…”