Journal of Pediatric Neurology 2018; 16(06): 404-407
DOI: 10.1055/s-0038-1639375
Case Report
Georg Thieme Verlag KG Stuttgart · New York

A Neurenteric Cyst Presenting as a Brainstem Tumor: Imaging and Clinical Findings

Juan Domingo Ly
1   Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
,
Subramanian Subramanian
2   Department of Neuroradiology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, United States
,
Stephanie Greene
3   Department of Neurosurgery, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, United States
,
Deepa Rajan
4   Division of Child Neurology, Department of Pediatrics, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, United States
,
Julia Kofler
5   Division of Neuropathology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
,
Giulio Zuccoli
2   Department of Neuroradiology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, United States
› Author Affiliations
Further Information

Publication History

07 December 2017

15 February 2018

Publication Date:
26 March 2018 (online)

Abstract

An 11-year-old girl presented with vomiting, nystagmus, and ataxia. MRI showed a partially enhancing medulla oblongata lesion and an adjacent nonenhancing cystic exophytic lesion. An exophytic brainstem tumor was suspected. Histologically, the lesion was identified as a neurenteric cyst (NC). On retrospective review, the NC was connected to the brainstem by a subtle sinus tract. This led to brainstem inflammation which reversed once the cyst was resected. We describe an unreported case of a patient with a NC at the craniocervical junction connected to the brainstem through a sinus tract and discuss the possible embryological abnormality and imaging features.

Ethical Approval

Formal consent is not required for this type of study.


 
  • References

  • 1 Savage JJ, Casey JN, McNeill IT, Sherman JH. Neurenteric cysts of the spine. J Craniovertebr Junction Spine 2010; 1 (01) 58-63
  • 2 Preece MT, Osborn AG, Chin SS, Smirniotopoulos JG. Intracranial neurenteric cysts: imaging and pathology spectrum. Am J Neuroradiol 2006; 27 (06) 1211-1216
  • 3 Simon JA, Olan WJ, Santi M. Intracranial neurenteric cysts: a differential diagnosis and review. Radiographics 1997; 17 (06) 1587-1593
  • 4 Bentley JFR, Smith JR. Developmental posterior enteric remnants and spinal malformations: the split notochord syndrome. Arch Dis Child 1960; 35 (179) 76-86
  • 5 Osborn AG, Salzman KL, Jhaveri MD, James Barkovich A. Diagnostic Imaging: Brain E-Book. Elsevier Health Sciences; 2015
  • 6 Wang L, Zhang J, Wu Z. , et al. Diagnosis and management of adult intracranial neurenteric cysts. Neurosurgery 2011; 68 (01) 44-52 , discussion 52
  • 7 Wilkins RH, Odom GL. Spinal intradural cysts. In: Vinken PJ, Bruyn GW. , eds. Handbook of Clinical Neurology. Vol 20. Amsterdam: North-Holland Publishing Company; 1976: 55-102
  • 8 Tubbs RS, Salter EG, Oakes WJ. Neurenteric cyst: case report and a review of the potential dysembryology. Clin Anat 2006; 19 (07) 669-672
  • 9 Muzumdar D, Bhatt Y, Sheth J. Intramedullary cervical neurenteric cyst mimicking an abscess. Pediatr Neurosurg 2008; 44 (01) 55-61