Ricardo H Menéndez1, Daniel H D'Osvaldo2, Augusto Vilariño2, Marcelo F Amante3, Horacio S Dillon2. 1. Department of Neurosciences, Hospital Aleman, Buenos Aires, Argentina. Electronic address: rhmenendez@hotmail.com. 2. Department of Neurosciences, Hospital Aleman, Buenos Aires, Argentina. 3. Department of Pathology, Hospital Aleman, Buenos Aires, Argentina.
Abstract
BACKGROUND: Neurenteric cysts (NCs) are rare, non-neoplastic lesions arising from a failure of dissolution of the transient neurenteric canal between the foregut and the notochord. They are most frequently seen in the intradural extramedullary space in the lower cervical and upper thoracic spine. The authors describe a rare case of NC arising from the ventral cervicomedullary junction that was totally resected via a posterior approach. CASE DESCRIPTION: A 24-year-old woman presented with a 4-week history of neck pain and progressive left hemiparesis. Admission magnetic resonance imaging scans demonstrated an intradural extramedullary cystic mass lesion ventral to the upper spinal cord from medulla to C2. We performed a posterior approach and the lesion was totally removed. Surgical treatment resulted in resolution of the neurologic impairments. The histological results were consistent with NC. Postoperative course was uneventful. At the 6-month follow-up, the patient is asymptomatic and magnetic resonance imaging scan shows no residual lesion. CONCLUSIONS: NC is a rare lesion of the craniospinal junction and should be considered among differential diagnoses. Complete excision is the treatment of choice. In most instances a dorsal surgical approach will be satisfactory.
BACKGROUND: Neurenteric cysts (NCs) are rare, non-neoplastic lesions arising from a failure of dissolution of the transient neurenteric canal between the foregut and the notochord. They are most frequently seen in the intradural extramedullary space in the lower cervical and upper thoracic spine. The authors describe a rare case of NC arising from the ventral cervicomedullary junction that was totally resected via a posterior approach. CASE DESCRIPTION: A 24-year-old woman presented with a 4-week history of neck pain and progressive left hemiparesis. Admission magnetic resonance imaging scans demonstrated an intradural extramedullary cystic mass lesion ventral to the upper spinal cord from medulla to C2. We performed a posterior approach and the lesion was totally removed. Surgical treatment resulted in resolution of the neurologic impairments. The histological results were consistent with NC. Postoperative course was uneventful. At the 6-month follow-up, the patient is asymptomatic and magnetic resonance imaging scan shows no residual lesion. CONCLUSIONS: NC is a rare lesion of the craniospinal junction and should be considered among differential diagnoses. Complete excision is the treatment of choice. In most instances a dorsal surgical approach will be satisfactory.