Lumbar Intradural Neurenteric Cyst: A Rare Pathology in an Unusual Location

Area of Science:

• Neurology
• Neurosurgery
• Pathology

Background:

• Neurenteric cysts are rare congenital malformations, typically presenting in the spinal canal.
• Intradural neurenteric cysts can cause neurological deficits due to spinal cord compression.

Observation:

• A 48-year-old female presented with low back pain, progressive lower extremity weakness, and right leg numbness.
• Spine MRI revealed an intradural cystic lesion at L1 with lipomatous components, adhering to the conus medullaris.
• Histopathology confirmed a neurenteric cyst with respiratory-type epithelium.

Findings:

• Subtotal cyst resection was performed due to adherence to the conus medullaris.
• Eight-month follow-up MRI showed no recurrence.
• The patient reported improved sensation but residual proximal hip flexor weakness.

Implications:

• Early diagnosis and surgical intervention are crucial for managing neurenteric cysts.
• Complete resection may be challenging due to cyst adherence to neural structures.
• Neurenteric cysts can be effectively treated with subtotal resection and monitoring for recurrence.