Spinal neurenteric cyst presenting as recurrent midline sebaceous cysts

A 59-year-old patient had been treated by the general surgery department at her local hospital for a recurrent sebaceous cyst on the back of her neck. Cervical MRI showed a cystic structure, posterior to fused vertebral bodies, connected to the skin by a sinus passing through the middle of a split cord malformation. The lesion was excised via an anterior approach. Histology confirmed a benign neurenteric cyst. This rare developmental anomaly, mimicking a common acquired surgical condition, highlights the need for caution in the diagnosis of midline pathology.