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Lumbosacral neurenteric cyst in an infant. Case report
M S LeDoux1, O M Faye-Petersen, P A Aronin
1Division of Neurosurgery, University of Alabama, Birmingham.
Journal of Neurosurgery
|May 1, 1993
Summary
A rare combined intra- and extraspinal neurenteric cyst in an infant was identified. Squamous epithelial cells found during lumbar puncture led to the diagnosis of this unique spinal lesion.
Area of Science:
- Pediatric Neurosurgery
- Developmental Biology
- Pathology
Background:
- Neurenteric cysts are rare congenital malformations resulting from abnormal separation of the notochord and foregut.
- Combined intra- and extraspinal neurenteric cysts are exceptionally uncommon, posing diagnostic challenges.
Observation:
- A case report details an infant with a combined neurenteric cyst.
- Clinical suspicion for an intraspinal cyst was absent until squamous epithelial cells were identified via lumbar puncture during sepsis workup.
- The cyst presented with an intradural component ventral to the conus medullaris (L-1) and a large presacral component, connected via a defect at the S-4 vertebral body.
Findings:
- Histological examination revealed the entire cystic cavity was lined by stratified squamous epithelium.
- The cyst's extensive intradural and extraspinal (presacral) components were confirmed, linked by a vertebral defect.
Implications:
- This case highlights the importance of considering neurenteric cysts in infants presenting with complex spinal and paraspinal masses.
- The presence of squamous cells in cerebrospinal fluid can be a crucial diagnostic clue for intraspinal neurenteric cysts.
- Understanding the unique presentation and potential pathogenesis of such combined cysts aids in diagnosis and management planning.