Supratentorial Neurenteric Cyst Research Articles

A RARE CASE OF NEUROENTERIC CYST INVOLVING THE ANTERIOR FOSSA; REPORT OF A CASE AND REVIEW OF LITERATURE

Neuroenteric cysts, are rare benign endodermal lesions which mostly occur in the central nervous system. We report a case of a neuroenteric cyst in a 30-year-old man who presented with rhinoliquorrhea at the ENT department. After clinical examination, a semisolid mass was revealed in the left nostril. The Computer Tomography Scan revealed a frontal ethmoidal nasal meningoencephalocele with inferior extension into the left nostril. Gadolinium-enhanced T1-weighted MR images showed a well-defined frontal mass with ring-like enhancement and extension into the cribriform plate of the ethmoid bone and into the left nostril. The lesion measured 10/10/20 mm. The tumor was totally resected using a unilateral subfrontal approach. At five months’ follow-up, the patient showed significant amelioration of symptoms and remission of cerebrospinal fluid leakage. Native and Contrast-enhanced Cerebral Computer Tomography, as well as Magnetic Resonance Imaging showed total surgical resection of the cyst. Supratentorial neurenteric cysts involving the anterior fossa are rare. Intracranial neurenteric cysts should be differentiated by any well-demarcated cystic tumors. The gold standard treatment remains complete surgical resection with favorable outcome.

Supratentorial neurenteric cyst: Analysis of 45 cases in the literature

Supratentorial neurenteric cysts (S-NC) are extremely rare. Patients with these lesions may present with headache, seizures or neurological deficit related to their location. Complete surgical excision, including its capsule, must be the aim of the surgery. However, strong adhesion of the cyst wall to the surrounding neurovascular structures may sometimes necessitate subtotal removal of the cyst capsule. In this study, the authors report two cases and review the literature for reported cases of S-NC to analyze clinical and radiographic presentations as well as surgical approaches and neurological outcomes. A MEDLINE/PubMed in English language search was performed, revealing 43 S-NC cases. The authors report two additional cases in the study, resulting a total of 45 cases. Each case was analyzed for clinical presentation, lesion location, radiographic features, treatment method, and outcome. There were 25 male, 18 female and 2 newborns. The average age was 42,2 (range 0–78 years). The majority of cases (63,6%) occurred in patients between the ages of 20 and 50, but 15.9% were over 70. Frontal lobe was affected in 29 cases (64,4%), parietal lobe in 12, temporal lobe in 4, occipital in 1, and sellar or parasellar region in 4. Three cases were intraventricular. Lesions were in left side in 23 cases, in right side in 16, and on midline in 7. The majority of cases (73,3%) were extra-axial. The most common presenting symptom was headache (42,2%). The average size was 5.38 cm (greater measure) Seizures occurred in 35,5% and motor deficit in 17,7%. Other presentations were visual deficit (13,3%) and behavior changes (8,8%). Hemorrhage occurred in 2 cases, one spontaneous and one after cyst aspiration. Craniotomy with resection of the cyst (partial or complete) was performed in 95,5%. One case was treated with cyst aspiration and one case was just observed (surgery was performed in another cyst in posterior fossa). Thirty-two cases showed total improvement of symptoms, and 4 partial improvement after treatment. Two cases presented malignant transformation and two presented recurrent lesion. Complications after treatment occurred in 5 cases: 2 presented seizures in immediate postoperative period, one presented hemorrhage, one had transient SIADH. Infection occurred in just one case. S-NC are rare and challenging lesions. The radiological features are nonspecific, and it is difficult to differentiate enterogenous cysts from other cystic lesions such as arachnoid cyst, epidermoid or glioependymal cyst. In cases with mass effect and refractory symptoms, surgical removal is indicated, including liquid drainage, capsule removal and cisternal communication. Resection of these lesions is associated with favorable outcomes.

Supratentorial Neurenteric Cysts: Case Series and Review of Pathology, Imaging, and Clinical Management

Neurenteric cysts are rare congenital lesions along the neuroaxis, typically found in the spine, and rarely intracranially. Here, we present 3 patients who presented to our institution during a 6-year period with supratentorial intracranial neurenteric cysts and conduct a comprehensive review of the literature to describe the salient pathology, radiologic features, and clinical issues regarding these lesions. Three patients were treated surgically for supratentorial neurenteric cysts. One patient presented in extremis, whereas the others were treated electively. Each patient presented with significantly different signs and symptoms and unique radiologic findings. All patients were neurologically intact after surgery. Neurenteric cysts present with a variety of signs and symptoms. Given the increased use of neuroimaging, supratentorial neurenteric cysts may be encountered more frequently and are important to include on the differential diagnosis and managed accordingly. Postoperative seizures occur in more than 20%, even in patients who had no preoperative seizures. Surgery can be performed safely with good neurologic outcomes.

Supratentorial neurenteric cyst mimicking hydatid cyst: A case report and literature review

Neurenteric (NE) cysts are uncommon congenital cysts of endodermal origin. These cysts are commonly encountered in the posterior fossa surrounding the brain stem structures. We present a case of pathologically proven supratentorial NE cyst that mimicked a hydatid cyst in its clinical presentation and imaging appearance. Including this pathology in the differential diagnosis of supratentorial cystic lesions is important due to the differences in medical and surgical management.

Supratentorial neurenteric cyst with spontaneous repetitive intracystic hemorrhage mimicking brain abscess: a case report

Neurenteric cyst (NC) is a benign epithelial cyst (BEC) of endodermal origin that mostly occurs in the spinal subdural space or posterior cranial fossa. A 28-year-old male presented with a left frontal lobe NC associated with spontaneous repetitive intracystic hemorrhage, which was initially diagnosed and treated as a brain abscess. He presented with headache and disorientation, without underlying diseases. A cystic tumor was suspected because of a hypointense signal on diffusion-weighted magnetic resonance imaging (MRI). One day after admission, his condition deteriorated rapidly and emergency cyst aspiration was performed. A brown viscous liquid like bloody pus comprising many neutrophils and macrophages was obtained. Although culture was negative, we initially started antibiotic treatment because of cyst content characteristics and rapid clinical course compatible with brain abscess. He was discharged without neurological deficits, but occasionally complained of intense headache. Computed tomography/MRI showed repetitive intracystic hemorrhage and gradual re-enlargement of the lesion. He underwent radical cyst excision by frontal craniotomy 34months after aspiration. The pathological diagnosis was NC. We believe this is the first report of a supratentorial NC with spontaneous repetitive intracystic hemorrhage. BECs, especially with intracystic hemorrhage, are difficult to be distinguished from brain abscesses. In cases of cystic lesions or presumed brain abscesses refractory to treatment with aspiration and/or antibiotics, BECs should be considered, and radical cyst wall removal should be considered a treatment option.

Neurenteric cyst of the anterior cranial fossa: case report and literature review

Intracranial neurenteric cysts are rare congenital lesions that typically occur in the posterior fossa. We report a case of a 70-year-old gentleman presenting with gait disturbance, found to have a neurenteric cyst primarily arising from and expanding the sella turcica. A review of the literature revealed 27 reports of supratentorial neurenteric cysts. Clinical presentation, radiological characteristics, treatment, prognosis and embryological origin are discussed. Intracranial neurenteric cysts should be included in the differential with any well-demarcated cystic lesion without enhancement on magnetic resonance imaging (MRI). Complete surgical excision is the treatment of choice, with good prognosis.

Lateral extradural, supratentorial neurenteric cyst

Neurenteric cysts are rare congenital, benign, endodermal lesions of the central nervous system that occur mainly in the spinal canal. Intracranial neurenteric cysts are rare; the posterior fossa being the most common site. A laterally based supratentorial neurenteric cyst is exceptionally uncommon. The rarity of supratentorial neurenteric cysts and their variable imaging features preclude preoperative diagnosis. A search of the literature revealed no other extradural supratentorial neurenteric cyst. We present a patient with an extradural giant neurenteric cyst that occupied both the supratentorial and infratentorial compartments, further highlighting the heterogeneity of this rare intracranial lesion and emphasizing the need to consider this in the differential diagnosis of cystic intracranial brain lesions.

Expansile neurenteric cyst arising in the frontal lobe associated with status epilepticus: report of a case and discussion of epileptogenesis

The case of a 32-year-old Japanese man with an expansile supratentorial neurenteric cyst is described. The initial MRI revealed a left frontal extraaxial mass lesion 20 mm in diameter that showed marked expansion to 32 mm and change in its signal intensity 13 months later. Fifteen months after his visit, the patient fell into status epilepticus and underwent surgery. The cyst wall was excised, and the cyst content was totally removed. The cytology of the cystic content and pathological findings of the cyst wall were compatible with the diagnosis of neurenteric cyst. Our literature search revealed that in 86% of the patients with this lesion, the lesion was involved in the occurrence of epilepsy during the perioperative period. When a neurenteric cyst is diagnosed, shunt surgery should be avoided to prevent migrating spread of neurenteric cells.

Intracranial laterally based supratentorial neurenteric cyst

Neurenteric cysts are rare developmental cysts lined by endodermal derived epithelium. We present the case of a 68-year-old patient presenting with seizures who was found to have an extra-axial low density lesion with associated wall calcification on CT. Aspiration and biopsy of the cyst revealed a neurenteric cyst. Such lesions of the lateral supratentorial convexity are extremely rare and calcification has not been previously reported in these intracranial cysts.