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Giant Tarlov Cyst of Infancy
Mojtaba Dayyani1, Samira Zabihyan2
1Department of Neurosurgery, Ghaem Teaching Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Insights
A rare giant abdominal Tarlov cyst (TC) in an infant presented as irritability and instability. Early recognition and surgery are crucial to prevent neurological and renal complications from this unusual lumbar cyst presentation.
Area of Science:
- Neurology
- Pediatric Surgery
- Radiology
Background:
- Tarlov cysts (TCs) are typically found in the sacral spine.
- Abdominal presentation of TCs, especially in infants, is exceedingly rare.
Observation:
- An 8-month-old infant presented with irritability and inability to sit, with a palpable left upper quadrant abdominal mass.
- Imaging revealed a giant, two-compartment cyst compressing the conus medullaris and left kidney.
Findings:
- Surgical resection and imbrication confirmed the diagnosis of a Tarlov cyst by visualizing the endoneurial nerve root.
- This represents a unique case of a lumbar Tarlov cyst manifesting as a giant abdominal mass in an infant.
Implications:
- Increased physician awareness of this rare presentation is vital for early diagnosis.
- Timely surgical intervention may prevent severe neurological and renal sequelae in affected infants.
Abstract:
We report an 8-month-old female infant with complaints of irritability and recent inability to sit in a stable position. On physical examination, a palpable mass in the left upper quadrant of her abdomen was evident. Sonography and magnetic resonance imaging showed a giant cyst, consisting of 2 communicating compartments: dorsal and ventrolateral. The dorsal part compressed the conus medullaris, and the ventrolateral part compressed the left kidney. Partial cyst wall resection and imbrication for the dorsal pouch were done, and diagnosis of Tarlov cyst was confirmed via the visualization of the endocystic nerve root during surgery. Familiarizing physicians with this unusual presentation of Tarlov cyst may help them in early recognition of this lesion, and subsequent surgery might be considered to prevent clinical sequela. To our knowledge, a lumbar Tarlov cyst presenting as a giant abdominal cyst in an infant has not been reported in the English-language literature.
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