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Atypical spinal endodermal cyst presenting with contralateral C2 neuralgia and aseptic meningitis
Koh Horikoshi1, Satoshi Tsutsumi1, Masanori Ito1
1Department of Neurological Surgery, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan.
Radiology Case Reports
|March 9, 2019
Summary
A rare endodermal cyst in the upper cervical spine caused severe pain and aseptic meningitis. Surgical removal resolved symptoms, highlighting the importance of considering this diagnosis for similar spinal masses.
Area of Science:
- Neurology
- Neurosurgery
- Pathology
Background:
- A 43-year-old male presented with persistent occipitalgia and neck stiffness.
- Magnetic resonance imaging revealed a C2 intradural mass with spinal cord surface enhancement.
Observation:
- Neurological exam showed severe right C2 pain and neck stiffness.
- Cranial CT revealed ventriculomegaly, necessitating a shunt post-surgery.
- Cerebrospinal fluid analysis showed albuminocytologic dissociation without infection.
Findings:
- Histological diagnosis confirmed an endodermal cyst.
- Surgical resection via C2 hemilaminectomy successfully removed the mass and relieved symptoms.
- Postoperative recovery included resolution of pain and neck stiffness.
Implications:
- Polycystic intradural masses in the upper cervical spine may represent endodermal cysts.
- These cysts can present with contralateral occipitalgia and aseptic meningitis.
- Early diagnosis and surgical intervention are crucial for favorable outcomes.
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