Mobile spinal enterogenous cyst resulting in intermittent paraplegia in a child: case report
Satoko Kojima1, Junichi Yoshimura2, Tetsuro Takao2,3
1Division of Pediatrics, Department of Medicine, Niigata Prefectural Central Hospital, Joetsu City.
Abstract:
The authors report the case of a mobile spinal enterogenous cyst in a 2-year-old boy, who was admitted to the hospital several times for intermittent paraplegia. Magnetic resonance imaging and CT revealed an isolated cyst in the lumbar spinal canal. The symptoms were caused by transient myelopathy of the conus medullaris and radiculopathy of the cauda equina due to the changing size and location of the cyst. The cyst was surgically extirpated, after which the symptoms resolved. The histopathological diagnosis was enterogenous cyst. The clinical history of intraspinal enterogenous cyst is usually progressive. Mobility and changes in size are rare pathophysiological findings. The authors speculate that the cyst wall did not adhere to the surrounding structures and had ruptured and quickly reformed. Enterogenous cyst should be considered in the differential diagnosis of spinal intradural cysts in children with radiculomyelopathy.
Insights
A rare mobile spinal enterogenous cyst caused intermittent paraplegia in a child. Surgical removal resolved symptoms, highlighting the need to consider mobile cysts in pediatric spinal conditions.
Area of Science:
- Pediatric Neurology
- Neurosurgery
- Developmental Biology
Background:
- Intraspinal enterogenous cysts are rare congenital anomalies.
- Typically, their clinical presentation is progressive, leading to myelopathy or radiculopathy.
- This case presents a unique mobile spinal enterogenous cyst.
Observation:
- A 2-year-old boy experienced intermittent paraplegia due to a mobile lumbar spinal canal cyst.
- Imaging revealed a cyst with changing size and location, causing transient conus medullaris myelopathy and cauda equina radiculopathy.
- The cyst's mobility is a rare pathophysiological finding.
Findings:
- Histopathological diagnosis confirmed an enterogenous cyst.
- Surgical extirpation of the mobile cyst led to complete symptom resolution.
- The authors hypothesize the cyst's mobility resulted from a non-adherent wall that ruptured and reformed.
Implications:
- Enterogenous cysts should be included in the differential diagnosis for pediatric spinal intradural cysts.
- The rare finding of a mobile cyst expands understanding of spinal cyst pathophysiology.
- This case underscores the importance of considering dynamic lesions in pediatric radiculomyelopathy.
