J Korean Neurosurg Soc.  2015 Feb;57(2):135-139. 10.3340/jkns.2015.57.2.135.

Solitary Cervical Neurenteric Cyst in an Adolescent Patient

• Choi DY
• Lee HJ
• Shin MH
• Kim JT

• KMID: 2191197
• DOI: http://doi.org/10.3340/jkns.2015.57.2.135

Abstract

Spinal neurenteric cysts are uncommon congenital lesions, furthermore solitary neurenteric cysts of the upper cervical spine are very rare. A 15-year-old boy having an intraspinal neurenteric cyst located at cervical spine presented with symptoms of neck pain and both shoulders pain for 2 months. Cervical spine magnetic resonance (MR) imaging demonstrated an intradural extramedullary cystic mass at the C1-3 level without enhancement after gadolinium injection. There was no associated malformation on the MR imaging, computed tomography, and radiography. Hemilaminectomy at the C1-3 levels was performed and the lesion was completely removed through a posterior approach. Histological examination showed the cystic wall lined with ciliated pseudostratified columnar epithelium containing mucinous contents. Neurenteric cyst should be considered in the diagnosis of spinal solitary cystic mass.

Keyword

Cervical spine; Extramedullary; Neurenteric cyst; Posterior approach

MeSH Terms

Adolescent*
Bone Cysts
Diagnosis
Epithelium
Gadolinium
Humans
Magnetic Resonance Imaging
Male
Mucins
Neck Pain
Neural Tube Defects*
Radiography
Shoulder
Spine
Gadolinium
Mucins

Figure

• 

  Fig. 1 Preoperative magnetic resonance images. Sagittal T2-weighted (A) and T1-weighted (B) images show an intradural extramedullary cystic lesion located ventrally to the cord, extending from the C1 to C3 level. The mass is hypointense on T1-weighted images (B) and hyperintense on T2-weighted images (A and C). Compared with cerebrospinal fluid, the cyst is isointense on both T1- and T2-weighted images (A and B). On axial T2-weighted images (C), the adjacent cervical spinal cord is displaced dorsolaterally and significantly compressed by the lesion. Postcontrast T1-weighted images (D) show no enhancement of the lesion. Bony and soft tissue abnormalities are not detected.

• 

  Fig. 2 Intraoperative photograph. Thin-walled cyst (asterisk) is located anterolaterally to the cord after opening the dura.

• 

  Fig. 3 Microscopic findings of the extramedullary neurenteric cyst of the cervical spine. This case show cyst wall lined with ciliated pseudostratified columnar epithelium containing mucinous content. There is no neural, glial or ependymal cells in the cyst wall (H&E, ×200).

• 

  Fig. 4 Postoperative sagittal (A) and axial (B) T2-weighted magnetic resonance images showing no residual cystic lesion and decompression of cord.

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