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Moriguchi G, Fukunaga T, Ninomiya K, Bamba Y, Tsuchida Y, Matsumoto K, Kishima H, Sasaki M. Atlantoaxial Intradural Synovial Cyst Mimicking an Extradural Lesion Adjacent to a Retro-odontoid Pseudotumor: A Case Report. NMC Case Rep J 2022; 9:389-394. [PMID: 36518905 PMCID: PMC9719744 DOI: 10.2176/jns-nmc.2022-0140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 09/13/2022] [Indexed: 12/01/2023] Open
Abstract
Atlantoaxial synovial cysts can very rarely penetrate the dura mater into the thecal sac and cause direct neural compression. Several case reports have been available on "intradural synovial cysts" (IDSCs). In this study, we report on a case with an atlantoaxial IDSC mimicking an extradural lesion. A 90-year-old man was diagnosed with a cystic lesion located laterally to the atlantoaxial joint adjacent to the retro-odontoid pseudotumor (ROP) causing cervical spinal cord compression. Thus, surgical removal was planned. On preoperative examination, the cyst, which had a two-layer structure showing a T2-isointense small mass inside a T2-hyperintense lesion, was thought to be located in the extradural region. However, operative findings showed that the cyst was located inside the dura mater. Histopathological examination suggested a synovial cyst. No recurrence of the cyst was observed until the latest follow-up after 3 years, and the ROP decreased in size. Almost all IDSCs reported previously were observed in the medial site of the atlantoaxial joint. In our case, however, the cyst was observed adjacent to the posteromedial site of the right atlantoaxial joint and the ROP, mimicking an extradural lesion. We had no knowledge regarding the IDSC before the surgery and assumed an extradural lesion. Albeit rare, the existence of such a condition should be considered.
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Affiliation(s)
- Gento Moriguchi
- Department of Neurosurgery and Spine Surgery, Iseikai Hospital, Osaka, Osaka, Japan
| | - Takanori Fukunaga
- Department of Neurosurgery and Spine Surgery, Iseikai Hospital, Osaka, Osaka, Japan
| | - Koshi Ninomiya
- Department of Neurosurgery and Spine Surgery, Iseikai Hospital, Osaka, Osaka, Japan
| | - Yohei Bamba
- Department of Neurosurgery and Spine Surgery, Iseikai Hospital, Osaka, Osaka, Japan
| | | | - Katsumi Matsumoto
- Department of Neurosurgery and Spine Surgery, Iseikai Hospital, Osaka, Osaka, Japan
| | - Haruhiko Kishima
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Manabu Sasaki
- Department of Neurosurgery and Spine Surgery, Iseikai Hospital, Osaka, Osaka, Japan
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
- Department of Neurosurgery and Spine Surgery, Hanwa Memorial Hospital, Osaka, Osaka, Japan
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Tanaka M, Ayhan S, Yamauchi T, Arataki S, Fujiwara Y, Kanemaru A, Masuda S, Torigoe K, Shiozaki Y. C1 laminoplasty and posterior atlantoaxial fusion for large retro-odontoid pseudotumor with Instability: A technical note. INTERDISCIPLINARY NEUROSURGERY 2022. [DOI: 10.1016/j.inat.2021.101478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Nakano A, Hayama S, Fujishiro T, Nakaya Y, Obo T, Yano T, Baba I, Neo M. In Reply to the Letter to the Editor Regarding "Preoperative Cyst Formation as a Predictive Feature of Spontaneous Regression of Retro-odontoid Pseudotumor After Posterior Fusion". World Neurosurg 2021; 151:336. [PMID: 34243663 DOI: 10.1016/j.wneu.2021.05.095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 05/22/2021] [Indexed: 12/27/2022]
Affiliation(s)
- Atsushi Nakano
- Department of Orthopedic Surgery, Osaka Medical and Pharmaceutical University Mishima-Minami Hospital, Osaka, Japan.
| | - Sachio Hayama
- Department of Orthopedic Surgery, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Takashi Fujishiro
- Department of Orthopedic Surgery, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Yoshiharu Nakaya
- Department of Orthopedic Surgery, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Takuya Obo
- Department of Orthopedic Surgery, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Toma Yano
- Department of Orthopedic Surgery, Katsuragi Hospital, Osaka, Japan
| | - Ichiro Baba
- Department of Orthopedic Surgery, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Masashi Neo
- Department of Orthopedic Surgery, Osaka Medical and Pharmaceutical University, Osaka, Japan
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