Extramedullary Cystic Lesion Research Articles

Neuroenteric cyst: A rare cause of childhood hemiparesis

Neuroenteric cysts are rare congenital anomalies derived from the displaced endodermal tissue at around third embryonic week. These are commonly encountered in the mediastinum and rarely seen in the spinal canal in the intradural extramedullary and at times in intramedullary location. We report a case of neuroenteric cyst of spinal canal presenting with hemiparesis in a 12 years old female child. The patient had no associated underlying occult spinal deformity. On investigation her magnetic resonance imaging, revealed evidence of well-defined, intradural extramedullary cystic lesions at C6 to D2 vertebral level, situated anterior and right to the cord causing posterior and leftward displacement with marked cord compression at this level. The child underwent posterior laminectomy and excision of cyst with complete recovery and no residual deficit.

Congenital spinal intradural arachnoid cyst associated with intrathoracic meningocele in a child

Congenital spinal intradural arachnoid cyst associated with intrathoracic meningocele is very rare. We report a case in a 9-year-old Chinese boy who presented with a two-week history of progressive paraparesis and gait ataxia. Magnetic resonance imaging revealed that a dorsal intradural extramedullary cystic lesion extended from T1 to T5 and compressed the spinal cord. A left lateral intrathoracic meningocele pouch was found incidentally at the level of T1. The arachnoid cyst as well as meningocele was removed and the spinal cord compression was relieved. Arachnoid cyst was confirmed by histological examination. The patient recovered well postoperatively. This is the second report of such a case in the world according to the available literature. The take-home message for our case is that the surgical approach should be individualized, depending on the size and location.

Herniated Lumbar Disc Combined with Spinal Intradural Extramedullary Cysticercosis

Spinal cysticercosis is a very uncommon manifestation of neurocysticercosis which is caused by the larvae of Taenia solium. However, it can develop as a primary infection through blood stream or direct larval migration. It can result in high recurrence and severe neurologic morbidity if not treated appropriately. We report the case of a 43-year-old woman who presented with severe lower back pain and left leg radiating pain in recent 2 weeks. Magnetic resonance image (MRI) of lumbar spine demonstrated extruded disc at the L5-S1 level combined with intradural extramedullary cystic lesion. We performed the open lumbar microdiscectomy (OLM) at L5-S1 on the left with total excision of cystic mass. After surgery, the patient showed an improvement of previous symptoms. Diagnosis was confirmed by histopathological examination as intradural extramedullary cysticercosis. We discuss clinical features, diagnostic screening, and treatment options of spinal cysticercosis.

Multiple Intradural Spinal Hydatid Disease

A case report. We present an unusual case of pathologically confirmed multiple distinct spinal intradural extramedullar spinal hydatid cyst after 1 year of lung cyst hydatid operation. Hydatid disease is usually diagnosed in endemic regions. Spinal involvement of disease is very unusual and the literature about this entity is generally restricted to regional publications. Furthermore, intradural multiple involvement was not reported in literature. A 14-year-old boy admitted to our clinic with pain in the back, both of leg and disability in walking. The patient presented with back pain, asymmetrical paraparesis, right more than left and weakness. Multiple distinct spinal intradural extramedullary cystic lesion was identified with magnetic resonance imaging and was shown to be hydatid cyst by histopathologic confirmation after the surgical removal. T5 and L4, L5, S1 laminectomies were performed at the same session, after these a lot of pearly white hydatid cysts located intradural extramedullary were removed totally with their capsule, and the cavity was irrigated with 20% hypertonic saline. Surgical treatment was uneventful. Second-month follow-up neurologic examination was normal and the hydatid cysts had totally disappeared in both regions in the second month of postoperative magnetic resonance imaging. Spinal hydatid disease are uncommon. Among these, multiple distinct spinal intradural extramedullar location is extremely rare. Although total removal of the cysts without rupture should be the surgical goal in all cases, the best treatment remains an active nationwide prevention of the disease.

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

A 1-year-old boy presented with an extremely rare neurenteric cyst of the craniocervical junction manifesting as weakness in all extremities, slowly progressing over 2 months with rapid deterioration during the last few days. Neurological examination on admission showed tetraparesis with hyper-reflexia in the extremities. Magnetic resonance imaging demonstrated an intradural extramedullary cystic lesion located ventrally to the cord, extending from the craniocervical junction to the C3 level. The cyst wall was not enhanced with contrast medium, and the cyst content was isointense to the cerebrospinal fluid. He underwent total removal of the cyst through a left suboccipital craniectomy with C1 hemilaminectomy. The lesion had not adhered to the surrounding structures except for attachment to the left C2 nerve root outlet. Histological examination of the surgical specimen revealed typical neurenteric cyst with single layer epithelium. His symptoms improved significantly after the surgery, and he suffered no recurrence during the 2-year follow-up period. Neurenteric cyst should be considered in the differential diagnosis of intradural extramedullary cystic lesion located ventrally to the cord at the craniocervical junction in infants. Early surgical removal is recommended.

Imagerie des lésions kystiques du canal rachidien chez l’adulte

Intrarachidian cystic lesions are frequent, with highly varied causes. They can be classified according to their location into intramedullary cystic lesions and extramedullary cystic lesions. In these two categories, they can then be regrouped according to the tissue from which they develop. MRI is the first-choice examination for the study of the intracanal contents and the differential diagnosis between the various lesions.

A high cervical intradural extramedullary bronchogenic cyst. Case report

This article describes a 16-year-old male patient, otherwise healthy, with intractable suboccipital pain due to an intradural, extramedullary bronchogenic cyst at C1 level. Computed tomographic and magnetic resonance imaging scans showed an extramedullary cystic lesion on the right anterolateral side of the spinal cord at C1 level. No other vertebral, spinal cord, or cutaneous abnormality was associated. The patient underwent posterolateral resection of the C1 bony ring on the right side, followed by complete removal of a cyst microsurgically. Histology suggested that the mass, with its contents of slightly viscous and opaque liquid, was an atypical form of bronchogenic cyst with abundant pseudostratified ciliated epithelial cells.