Intraspinal Neurenteric Cysts in Children

Abstract

Background:Neurenteric cysts are rare congenital epithelium-lined cysts of the central nervous system. They are found predominantly in the spinal cord, with lower incidence in the intracranial compartment, and may be associated with various other congenital spinal anomalies. Seven patients with symptomatic intraspinal neurenteric cysts are presented.Materials and Methods:Seven patients with intraspinal neurenteric cysts aged from nine months to ten years treated at this hospital from May 2000 to July 2006 were reviewed. The clinical manifestations, imaging and surgical findings of patients were analyzed retrospectively. All patients underwent operation. One patient's cervical neurenteric cyst was resected using the lateral cervical approach, and the other six resections were performed with posterior approach.Results:All seven patients presented with neurological involvement. One patient had an intramedullary cyst, while the other six cysts were situated ventrally. Three patients' cysts occurred in the cervical region, two in the cervicothoracic region, one in the thoracic region and one in the lumbar region. One patient had bony anomalies, and one had a lumbar posterior occult spinal dysraphism. Five patients' symptoms improved rapidly after surgery.Conclusions:Intraspinal neurenteric cysts in children are rare and most occur ventral to the spinal cord. Magnetic resonance imaging (MRI) is the most effective imaging modality. Earlier diagnosis and surgical resection of spinal neurenteric cysts improves prognosis.

Primary spinal epidural non-Hodgkin’s lymphoma presented with spinal cord compression syndrome

“…MRI is now the main diagnostic modality of choice for patients with spinal symptoms [17]. It provides greater anatomic detail, offers more information about bone and soft tissue involvement, and potentially characterizes the tissue of the tumor mass itself.…”

Clinical presentation and surgical outcomes of intramedullary neurenteric cysts

“…10,[20][21][22]25,[32][33][34][37][38][39] In 4 infants, they presented as a meningitis-like syndrome, probably resulting from rupture of the cyst into the subarachnoid space. 8,14,19,26,40 Although commonly associated with other abnormalities, intraspinal NECs may be found without any abnormalities, and bone abnormalities were found in only 8 patients (21.1%) with an intramedullary NEC. 3,18,19,21,24,37,[40][41][42] Surgical methods ranged from cyst puncture and aspiration 25,39 to resection with cyst marsupialization or cyst-subarachnoid shunting.…”

“…The GTR rates for IDEM NECs in the literature range from 71% to 75%. 8,10,12 However, GTR is not feasible for intramedullary NECs. In 8 cases in the present study, the cyst wall showed no adhesion to the spinal cord, and GTR was achieved by using microsurgical techniques.…”

“…12,25 The recurrence rates of IDEM NECs range from 0% to 37%. 8,9 We reviewed the literature and found the recurrence rate of intramedullary NECs to be 23.3%. We believe that the real value was higher than that, because nearly half of the reported patients had no or relatively short-term follow-up (< 1 year).…”

“…22 To our knowledge, only 38 cases of NEC (with or without concurrent malformations) have been described since the publication of the earliest report in 1954. [2][3][4]8,10,[12][13][14]16,[18][19][20][21][22][24][25][26][27][29][30][31][32][33][34][35][37][38][39][40][41][42]44,45 Most previous publications regarding intramedullary NECs have been case reports. Therefore, the optimal management for this lesion has not been fully determined.…”