Comprehensive Review of Spinal Neurenteric Cysts with a Focus on Histopathological Findings

Abstract

Among the occult spinal dysraphisms, neurenteric cysts (NECs) are rare and are thought to arise due to a failure of the separation of the primitive endoderm and ectoderm. Patients experience various neurological symptoms depending on the location of the lesion. As the epithelial morphology of NECs share similarities with other intracranial and intraspinal cystic growths, the definitive diagnosis of NEC can be made after a histochemical analysis with endodermal markers. Complete resection is associated with the lowest disease recurrence rate.

Lumbar Intradural Neurenteric Cyst: A Rare Pathology in an Unusual Location

“…1 Histopathologically, a neurenteric cyst is lined by cuboidal or columnar epithelial cells which may demonstrate features of the respiratory or gastrointestinal tract, such as cilia, mucous glands, and/or goblet cells. 2 This accounts for alternative terminologies in the literature including "endodermal" cyst or "bronchogenic" cyst when lined by respiratory epithelium, such as in our case.…”

“…Spinal intradural extramedullary neurenteric cysts are rare, making up to 0.7%-1.3% of all spinal tumors, with a propensity for cervical and upper thoracic regions. 1,2 Here, we present a case of a neurenteric cyst in an uncommon location at the L1 vertebral level. Neurenteric cysts are hypothesized to result from abnormal partitioning of the foregut endoderm from the notochordal plate during early embryogenesis.…”

“…3 Non-neoplastic intradural extramedullary spinal mass lesions include lipoma, dermoid, epidermoid, and arachnoid cysts, and rarely neurenteric cysts. 2 The differential can sometimes be narrowed based on characteristic features on MRI, which is the modality of choice for distinguishing such lesions. The most common MRI finding for spinal neurenteric cyst is a homogeneous lesion that appears hypointense on T1 and hyperintense on T2 and does not enhance following administration of gadolinium contrast agent.…”

“…The most common MRI finding for spinal neurenteric cyst is a homogeneous lesion that appears hypointense on T1 and hyperintense on T2 and does not enhance following administration of gadolinium contrast agent. 1,2,4 However, variable T1 and T2 intensity have been described depending on the protein content of the cyst. Cases reported in the literature also occasionally demonstrate a lipomatous component on MRI, as seen in our case.…”

Intracranial neurenteric cyst: A case report and differential diagnosis of intracranial cystic lesions

“…Histologically, neurenteric cysts are defined as benign cystic lesions lined by respiratory-type or gastrointestinal-type epithelium. The cyst lining can range from simple to pseudostratified, cuboidal to columnar epithelium, with or without cilia [6 , 7] . While extremely rare, there are few reports of malignant transformation [7] .…”