Surgical treatment of spinal neurenteric cysts
https://doi.org/10.17650/1683-3295-2024-26-3-126-134
Abstract
Background. Spinal neurenteric cysts are very rare benign space-occupying lesions in the vertebral canal emerging due to anomalies of neural tube development during prenatal development of the fetus. Clinically, neurenteric cysts can manifest both in childhood and adulthood.
Aim. To evaluate the results of surgical treatment of adult patients with spinal neurenteric cysts who were operated on at the Neurosurgery Division of the Clinic of Nervous System Diseases of the I.M. Sechenov First Moscow State Medical University.
Materials and methods. The study group included 3 patients (2 women and 1 man) with mean age of 33 years. The main diagnosis method was magnetic resonance imaging. In all cases, radical cyst resection was performed with subsequent histological examination of cyst walls.
Results. In all observations, cyst walls had local areas of increased density and thickness: a distinctive solid component accumulating the contrast agent in magnetic resonance images. This type of structure is considered extremely rare per descriptions presented in literature, but in our case series it was detected in all patients. Cyst resection led to pain syndrome regression and almost full regression of clinical manifestations of spinal cord compression which justifies active surgical tactics in this pathology.
Conclusion. Neurenteric cyst of the vertebral canal can cause spinal cord compression. The main diagnostic method of this pathology is magnetic resonance imaging, however magnetic resonance semiotics of these cyst has not been standardized. The presence of constant pain syndrome without marked clinical signs of compression myelopathy is sufficient reason for cyst resection surgery. Cyst resection allowsto achieve regression of pain syndrome and neurological abnormalities caused by spinal cord compression.
About the Authors
G. Yu. Evzikov
I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Russian Federation
Grigoriy Yulyevich Evzikov
Bld. 4, 2 Bolshaya Pirоgovskaya St., Moscow 119991
R. I. Abdrafiev
I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Russian Federation
Bld. 4, 2 Bolshaya Pirоgovskaya St., Moscow 119991
V. N. Argylova
I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Russian Federation
Bld. 4, 2 Bolshaya Pirоgovskaya St., Moscow 119991
References
1. Savage J.J., Casey J.N., McNeill I.T., Sherman J.H. Neurenteric cysts of the spine. J Craniovertebr Junction Spine 2010;1(1):58–63. DOI: 10.4103/0974-8237.65484
2. Holcomb G.W. Jr, Matson D.D. Thoracic neurenteric cyst. Surgery 1954;35:115–21.
3. Kubie L.S. A clinical and pathological study of two teratomatous cysts of the spinal cord, containing muscus and ciliated cells. Surg Gynecol Obstet 1928;47:297–311.
4. Puusepp M. Variete rare de teratome sous-dural de la region cervicale (intestinome). Rev Neurol Pari 1934;2:879–86.
5. Agnoli A.L., Laun A., Schönmayr R. Enterogenous intraspinal cysts. J Neurosurg 1984;61(5):834–40. DOI: 10.3171/jns.1984.61.5.0834
6. Brooks B.S., Duvall E.R., el Gammal T. Neuroimaging features of neurenteric cysts: analysis of nine cases and review of the literature. AJNR Am J Neuroradiol 1993;14:735–46.
7. Cai C., Shen C., Yang W. et al. Intraspinal neurenteric cysts in children. Can J Neurol Sci 2008;35(5):609–15. DOI: 10.1017/s0317167100009409
8. Holmes G.L., Trader S., Ignatiadis P. Intraspinal enterogenous cysts. A case report and review of pediatric cases in the literature. Am J Dis Child 1978;132(9):906–8.
9. Kumar R., Prakash M. Unusual split cord with neurenteric cyst and cerebellar heterotopia over spinal cord. Childs Nerv Syst 2007;23(2):243–7. DOI: 10.1007/s00381-006-0211-7
10. Martynova M.A., Konovalov N.A., Lubnin A.Yu. et al. Spinal stroke in a pregnant female with an endodermal cyst of the cervical spinal cord (a case report and literature review). Zhurnal Voprosy khirurgii im. N.N. Burdenko = Burdenko’s Journal of Neurosurgery 2016;80(6):74–81. (In Russ., In Engl.). DOI: 10.17116/neiro201680674-81
11. Arai Y., Yamauchi Y., Tsuji T. et al. Spinal neurenteric cyst. Report of two cases and review of forty-one cases reported in Japan. Spine (Phila Pa 1976) 1992;17(11):1421–4.
12. Rao M.B., Rout D., Misra B.K., Radhakrishnan V.V. Craniospinal and spinal enterogenous cysts – report of three cases. Clin Neurol Neurosurg 1996;98(1):32–6. DOI: 10.1016/0303-8467(95)00076-3
13. Garg N., Sampath S., Yasha T.C. et al. Is total excision of spinal neurenteric cysts possible? Br J Neurosurg 2008;22(2):241–51. DOI: 10.1080/02688690701818919
14. Kimura H., Nagatomi A., Ochi M., Kurisu K. Intracranial neurenteric cyst with recurrence and extensive craniospinal dissemination. Acta Neurochir (Wien) 2006;148:347–52; discussion 352. DOI: 10.1007/s00701-005-0714-0
15. Malcolm G.P., Symon L., Kendall B., Pires M. Intracranial neurenteric cysts. Report of two cases. J Neurosurg 1991;75(1):115–20. DOI: 10.3171/jns.1991.75.1.0115
16. Oyama H., Ikeda A., Inoue S. et al. Multiple neurenteric cysts in the posterior fossa and cervical spinal canal – case report. Neurol Med Chir (Tokyo) 2004;44(3):146–9. DOI: 10.2176/nmc.44.146
17. Perry A., Scheithauer B.W., Zaias B.W., Minassian H.V. Aggressive enterogenous cyst with extensive craniospinal spread: case report. Neurosurgery 1999;44(2):401–4; discussion 404–5. DOI: 10.1097/00006123-199902000-00098
18. Miyagi K., Mukawa J., Mekaru S. et al. Enterogenous cyst in the cervical spinal canal. Case report. J Neurosurg 1988;68(2):292–6. DOI: 10.3171/jns.1988.68.2.0292
19. Menezes A.H., Traynelis V.C. Spinal neurenteric cysts in the magnetic resonance imaging era. Neurosurgery 2006;58(1):97–105; discussion 97–105. DOI: 10.1227/01.neu.0000192160.79897.25
20. Fernandes E.T., Custer M.D., Burton E.M. et al. Neurenteric cyst: surgery and diagnostic imaging. J Pediatr Surg 1991;26(1):108–10. DOI: 10.1016/0022-3468(91)90444-x
21. Shimanskiy V.N., Shevchenko K.V., Poshataev V.K. et al. Intracranial neurenteric cysts: experience of the Burdenko Neurosurgical Institute in the XXI century. Zhurnal Voprosy khirurgii im. N.N. Burdenko = Burdenko’s Journal of Neurosurgery 2017;81(6):16–25. (In Russ., in Engl.). DOI: 10.17116/neiro201781616-24
22. Tripathi M., Savardekar A., Chhabra R. et al. Unusual imaging finding of a “fluid–fluid” level in a neurenteric cyst at anterior margin of the cervico-medullary junction. Br J Neurosurg 2015;29(3);432–34. DOI: 10.3109/02688697.2014.993594
23. Jung H.S., Park S.M., Kim G.U. et al. Unique imaging features of spinal neurenteric cyst. Clin Orthop Surg 2015;7(4):515–8. DOI: 10.4055/cios.2015.7.4.515
24. Jhawar S.S., Nadkarni T., Goel A. Meckel’s cave neurenteric cyst: case report. J Neurol Surg A Cent Eur Neurosurg 2012;73(6): 413–5. DOI: 10.1055/s-0032-1313595
Review
For citations:
Evzikov G.Yu., Abdrafiev R.I., Argylova V.N. Surgical treatment of spinal neurenteric cysts. Russian journal of neurosurgery. 2024;26(3):126-134. (In Russ.) https://doi.org/10.17650/1683-3295-2024-26-3-126-134
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