Neurenteric Cysts of the Cerebellopontine Angle

Abstract

Neurenteric cysts in the central nervous system are rare developmental malformations. Usually the cysts are located ventral to the high thoracic or low cervical spinal cord. Only a few cases of intracranial neurenteric cysts have been reported in the literature to date. We report two cases of intracranial neurenteric cysts in the cerebellopontine angle with totally different radiographic, macroscopic, and microscopic appearance. As seen in these cases, the imaging spectrum of neurenteric cysts can be diverse, including malignancy-suspecting partial rim-enhancement or low-grade glioma features. Microsurgical therapy should include endoscopic assistance to ensure complete removal of cyst content.

Keywords

neurenteric cyst - endodermal cyst - posterior fossa - cerebellopontine angle

• References

• 1 Filho FL, Tatagiba M, Carvalho GA, Weichhold W, Klekamp J, Samii M. Neurenteric cyst of the craniocervical junction. Report of three cases. J Neurosurg 2001; 94 (1, Suppl) 129-132
• 2 Wang W, Piao YS, Gui QP, Zhang XH, Lu DH. Cerebellopontine angle neurenteric cyst with focal malignant features. Neuropathology 2009; 29 (1) 91-95
• 3 Preece MT, Osborn AG, Chin SS, Smirniotopoulos JG. Intracranial neurenteric cysts: imaging and pathology spectrum. AJNR Am J Neuroradiol 2006; 27 (6) 1211-1216
• 4 Kimura H, Nagatomi A, Ochi M, Kurisu K. Intracranial neurenteric cyst with recurrence and extensive craniospinal dissemination. Acta Neurochir (Wien) 2006; 148 (3) 347-352 , discussion 352
• 5 Harris CP, Dias MS, Brockmeyer DL, Townsend JJ, Willis BK, Apfelbaum RI. Neurenteric cysts of the posterior fossa: recognition, management, and embryogenesis. Neurosurgery 1991; 29 (6) 893-897 , discussion 897–898
• 6 Cho JM, Ahn JY, Kim SH, Lee KS, Chang JH. An endodermal cyst mimicking an intra-axial tumor in the medulla oblongata. Childs Nerv Syst 2010; 26 (6) 853-856
• 7 Little MW, Guilfoyle MR, Bulters DO, Scoffings DJ, O'Donovan DG, Kirkpatrick PJ. Neurenteric cyst of the anterior cranial fossa: case report and literature review. Acta Neurochir (Wien) 2011; 153 (7) 1519-1525
• 8 Menezes AH, Ryken TC. Craniocervical intradural neurenteric cysts. Pediatr Neurosurg 1995; 22 (2) 88-95
• 9 Oyama H, Ikeda A, Inoue S, Nakamura S, Nishimura Y, Shibuya M. Multiple neurenteric cysts in the posterior fossa and cervical spinal canal—case report. Neurol Med Chir (Tokyo) 2004; 44 (3) 146-149
• 10 Brooks BS, Duvall ER, el Gammal T, Garcia JH, Gupta KL, Kapila A. Neuroimaging features of neurenteric cysts: analysis of nine cases and review of the literature. AJNR Am J Neuroradiol 1993; 14 (3) 735-746
• 11 Eynon-Lewis NJ, Kitchen N, Scaravilli F, Brookes GB. Neurenteric cyst of the cerebellopontine angle: case report. Neurosurgery 1998; 42 (3) 655-658
• 12 Kim CY, Wang KC, Choe G , et al. Neurenteric cyst: its various presentations. Childs Nerv Syst 1999; 15 (6-7) 333-341
• 13 Osborn AG, Blaser S, Salzman K. Neurenteric cyst. In: Diagnostic Imaging: Brain. Salt Lake City, UT: Amirsys; 2004. I–7. 40-41
• 14 Bonneville F, Savatovsky J, Chiras J. Imaging of cerebellopontine angle lesions: an update. Part 2: intra-axial lesions, skull base lesions that may invade the CPA region, and non-enhancing extra-axial lesions. Eur Radiol 2007; 17 (11) 2908-2920
• 15 Inoue T, Kawahara N, Shibahara J, Masumoto T, Usami K, Kirino T. Extradural neurenteric cyst of the cerebellopontine angle. Case report. J Neurosurg 2004; 100 (6) 1091-1093
• 16 Shin JH, Byun BJ, Kim DW, Choi DL. Neurenteric cyst in the cerebellopontine angle with xanthogranulomatous changes: serial MR findings with pathologic correlation. AJNR Am J Neuroradiol 2002; 23 (4) 663-665
• 17 Ko BS, Jung S, Jung TY, Moon KS, Kim IY, Kang SS. Neurenteric cyst with xanthomatous changes in the prepontine area: unusual radiological findings. J Neurosurg Pediatr 2008; 2 (5) 351-354