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[Thoracic solitary neurenteric cyst--case report]
K Matsumoto1, E Kohmura, K Tsuruzono
1Department of Neurosurgery, Osaka Rosai Hospital, Japan.
No to Shinkei = Brain and Nerve
|January 1, 1994
Summary
A rare thoracic spinal neurenteric cyst caused back pain and leg anesthesia in a 61-year-old man. Microscopic analysis revealed columnar epithelium with goblet cells, suggesting an unusual developmental origin.
Area of Science:
- Neurology
- Developmental Biology
- Pathology
Background:
- Spinal neurenteric cysts are rare congenital anomalies.
- They typically arise from remnants of the neurenteric canal, usually in the lumbosacral region.
- Solitary thoracic neurenteric cysts are exceptionally uncommon.
Observation:
- A 61-year-old male presented with recurrent back pain and progressive bilateral lower limb anesthesia.
- Magnetic resonance imaging and myelography identified an intradural, extramedullary tumor at the T8-T9 level.
- Surgical exploration revealed a cystic lesion containing xanthochromic cerebrospinal fluid posterior to the spinal cord.
Findings:
- Microscopic examination of the excised cyst demonstrated columnar epithelium with goblet cells.
- The histological findings are consistent with a neurenteric cyst.
- The thoracic location and solitary nature of this cyst present a diagnostic challenge regarding its precise embryological origin.
Implications:
- This case highlights the importance of considering rare spinal tumors in the differential diagnosis of back pain and neurological deficits.
- The proposed theory suggests thoracic neurenteric cysts may arise from ectodermal-endodermal adhesions during notochordal development.
- Further research into the embryogenesis of spinal neurenteric cysts is warranted to understand these rare developmental anomalies.