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Multiple Neurenteric Cysts along the Spinal Axis of an Infant: A Rare Entity
Viral Vasani1, Subhas Konar2, Bevinahalli Nanjegowda Nandeesh2
1Department of Neurosurgery, Fortis Hospital, Bangalore, India, vmvasani@gmail.com.
Insights
This study reports a rare case of spinal neurenteric cysts in an infant. Early diagnosis and surgical intervention led to significant recovery, highlighting the importance of recognizing these rare spinal cord lesions.
Area of Science:
- Pediatric Neurology
- Neurosurgery
- Developmental Biology
Background:
- Spinal neurenteric cysts are rare congenital malformations.
- They can present across a wide age range, from infancy to adulthood.
- Common locations include the cervical, thoracic, and lumbosacral spine.
Observation:
- A 9-month-old male infant presented with acute lower limb weakness.
- MRI revealed two spinal cord cysts: one cervical and one thoracic.
- The cysts caused significant spinal cord compression.
Findings:
- Surgical excision of the cervical cyst led to initial improvement.
- Histopathology confirmed the diagnosis of neurenteric cysts.
- The patient had two neurenteric cysts in different spinal locations (cervical and thoracic).
Implications:
- Multiple neurenteric cysts can occur within the same patient's neuroaxis.
- Prompt surgical management is crucial for favorable outcomes in pediatric spinal cord compression.
- This case underscores the need for thorough neuroimaging in infants with neurological deficits.
Abstract:
A spinal neurenteric cyst is a rare entity. It commonly presents already at 5 weeks of age up to the 6th decade of life. The most common location is the cervical region followed by thoracic and lumbosacral regions. We report a 9-month-old male infant with sudden onset of weakness in both lower limbs. MRI revealed 2 cystic lesions at cervical and thoracic level with spinal cord compression. He underwent laminectomy and excision of the cervical lesion. The child improved significantly. The postoperative MRI shows complete excision of a dorsal lesion and presence of a cervical lesion. Later, he underwent cervical laminotomy and partial wall excision followed by shunt placement. The histopathological report revealed a neurenteric cyst. Two neurenteric cysts presented in the neuroaxis of the same patient: one was located ventral (thoracic) and the other dorsal (cervical). At the 2-year follow-up, the child was active and walking without support. Multiple cystic lesions in the neuroaxis can be neurenteric cysts.
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