Giant Supratentorial Enterogenous Cyst: Report of a Case, Literature Review, and Discussion of Pathogenesis

Abstract

Supratentorial ECs, distinctly rare in adult patients, may in some cases present as giant lesions. Total removal seems to be curative once careful examination has eliminated the possibility of a metastasis from an unknown primary. A correct histological diagnosis is important because, in contrast to other benign cysts of similar location and size, ECs may be prone to intraoperative dissemination.

Staged bilateral far-lateral approach for bilateral cervicomedullary junction neurenteric cysts in a 10-year-old girl

“…7,8,12,13,15 Immunohistochemically, neurenteric cysts are known to stain positively for carcinoembryonic an ti gen, cytokeratin, and epithelial membrane antigen, while staining negatively for glial fibrillary acidic protein, neu ron-specific enolase, and vimentin; these features are con sistent with an endodermal, rather than ectodermal, origin of the cyst wall epithelium. 6,12,13,15 In the present case, the cyst displayed features of a mucin-secreting, respiratory-type epithelium in addition to squamous features. The occurrence of respiratory epithelial neurenteric cysts is consistent with the embryogenesis of the respiratory tract, which buds off the neurenteric canal.…”

“…2,3 These cysts are lined by mucinsecreting cuboidal or columnar epithelium that may be of the intestinal type or the respiratory type. 2,3,6 Although these lesions may occur anywhere in the central nervous system and represent 0.01% of all central nervous system tumors, they are most commonly located in the spine, particularly in the lower cervical and upper thoracic regions, and make up 0.3%-0.5% of all spinal tumors. [1][2][3]7,8 Intracranial neurenteric cysts are exceptionally rare and represent only about 10%-17.9% of all neurenteric cysts.…”

Neuroenteric cyst of the left lateral ventricle: case report and review of the literature

“…Because their pathogenesis has not been totally understood, historically this kind of lesions was named endodermal cyst, epithelial cyst, gastrocytoma, enteric cyst, foregut cyst, bronchogenic cyst, neurenteric cyst, enterogenous cyst, neuroenteric cyst and so on [2,9,[11][12][13]. Although the World Health Organization preferred the term "enterogenous" in the revised classification of CNS tumours [14], the term neuroenteric cyst has gained increasing support in the neuropathology literature [9].…”

“…In the reported cases of intracranial NCs, NCs mainly developed along the midline of the posterior cranial fossa, anterior to the brainstem or in the fourth ventricle [8,12,16]. In exceptional cases, multiple NCs in both the supratentorial and the infratentorial compartments have been documented [2,11,13,17,18]. There are 3 cases showed NCs in the supratentorial region [19][20][21], and 2 of these cases reported intramedullary lesions located in the cerebral hemisphere [19,20].…”

“…The most confirmed hypothesis is that NC develops since the failure of the dissolution of the neuroenteric canal between the foregut or the respiratory buds and the notochord [4,12,13,22]. However, it cannot explain the origin of supratentorial NCs [11,23].…”