Intraspinal enterogenous cyst: delayed appearance following mediastinal cyst resection

Area of Science:

• Pediatric Surgery
• Neurology
• Developmental Biology

Background:

• Enterogenous cysts are rare congenital anomalies that can occur along the entire gastrointestinal tract, including the spinal canal.
• Intradural extra-medullary spinal cysts are uncommon, and cervicothoracic location further adds to their rarity.
• A previous history of mediastinal cyst removal in infancy, without apparent spinal connection, complicates the understanding of spinal cyst etiology.

Purpose of the Study:

• To report a unique case of a cervicothoracic extra-medullary intradural enterogenous cyst with delayed presentation.
• To discuss the diagnostic challenges and potential etiologies of spinal enterogenous cysts, especially in the context of prior mediastinal cyst resection.

Main Methods:

• Case report detailing the clinical presentation, diagnostic imaging (MRI), and surgical management of a pediatric patient.
• Review of relevant literature on spinal enterogenous cysts and their association with mediastinal counterparts.

Main Results:

• A four-year-old boy presented with symptoms attributed to a cervicothoracic extra-medullary intradural enterogenous cyst.
• Imaging confirmed the cyst's location and intradural, extra-medullary nature.
• The cyst appeared years after an initial mediastinal cyst resection in infancy, raising questions about developmental pathways.

Conclusions:

• Delayed presentation of spinal enterogenous cysts is possible, even after prior mediastinal cyst surgery.
• These cases highlight the complex embryological origins of enterogenous cysts and the importance of thorough spinal evaluation.
• Surgical excision remains the primary treatment, with careful consideration of potential recurrence or associated anomalies.