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Endodermal cyst ventral to the lower brain stem.

Shigeo Matsunaga1, Kazuhiko Fujitsu, Saburo Yagishita

  • 1Department of Neurosurgery, National Hospital Organization Yokohama Medical Center, Yokohama, Kanagawa, Japan. shigeo-m@mui.biglobe.ne.jp

Neurologia Medico-Chirurgica
|December 23, 2006
PubMed
Summary

A rare endodermal cyst caused recurrent aseptic meningitis in a young woman. Surgical removal of this brain stem cyst led to a full recovery, highlighting the importance of early diagnosis.

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Area of Science:

  • Neurology
  • Neurosurgery
  • Pathology

Background:

  • Endodermal cysts are rare congenital lesions that can occur in various locations, including the central nervous system.
  • Aseptic meningitis can be caused by various factors, including infections, autoimmune disorders, and neoplastic or cystic lesions.
  • Cysts located ventral to the brain stem pose a diagnostic and surgical challenge due to their proximity to critical neurovascular structures.

Observation:

  • A 28-year-old woman presented with recurrent aseptic meningitis.
  • Imaging revealed a cystic mass ventral to the lower brain stem, extending from the prepontine to the upper cervical (C-2) cistern.
  • The patient underwent surgical resection via retrosigmoid craniotomy and C1-2 hemilaminectomy.

Findings:

  • Histological and immunohistochemical examination confirmed the cyst was of endodermal origin.

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  • The final diagnosis was endodermal cyst.
  • Complete surgical removal of the cyst was achieved.

    • Implications:

    • This case highlights the importance of considering rare cystic lesions, such as endodermal cysts, in the differential diagnosis of recurrent aseptic meningitis.
    • Early diagnosis and complete surgical excision are crucial for favorable patient outcomes.
    • Multidisciplinary collaboration between neurology, neurosurgery, and pathology is essential for managing such complex cases.