Giant supratentorial neurenteric cyst.

Area of Science:

• Neuroscience
• Neurosurgery
• Developmental Biology

Background:

• Intracranial neurenteric cysts are rare congenital malformations, often presenting diagnostic challenges due to their potential mimicry of neoplastic and non-neoplastic cystic lesions.
• These cysts arise from abnormal separation of the neuroectoderm and notochord, leading to endodermal inclusions within the cranial cavity.

Observation:

• A 35-year-old male presented with a year-long history of progressive left hemiparesis, headache, personality alterations, and seizures.
• Clinical assessment revealed cognitive impairment, left-sided motor deficits (hemiparesis, upper motor neuron signs), and left facial weakness.
• CT imaging demonstrated a non-enhancing, spherical cystic lesion in the frontotemporoparietal region, causing moderate mass effect.

Findings:

• Surgical intervention involving hydrodissection and complete cyst excision was performed.
• Post-operative recovery was uneventful, with no recurrence or residual disease noted at the 3-month follow-up.
• Histopathological confirmation of a neurenteric cyst was obtained.

Implications:

• This case highlights the importance of considering intracranial neurenteric cysts in the differential diagnosis of complex intracranial cystic lesions.
• Complete surgical excision is an effective treatment modality, leading to favorable neurological outcomes and resolution of symptoms.
• Early diagnosis and intervention are crucial for preventing long-term neurological sequelae associated with mass effect from these lesions.