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Janapareddy KK, Peters NJ, Samujh R, Chatterjee D. Intralobar sequestration associated with gastric enterogenous cyst: gastric lung!! Indian J Thorac Cardiovasc Surg 2023; 39:539-542. [PMID: 37609622 PMCID: PMC10441940 DOI: 10.1007/s12055-023-01521-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 04/05/2023] [Accepted: 04/11/2023] [Indexed: 08/24/2023] Open
Abstract
Intralobar sequestration (ILS) is a rare anomaly that may manifest as recurrent pneumonia or rarely as haemoptysis. The co-existence of ILS with enterogenous cyst is extremely rare with only a single case reported. We describe a 6-month-old male infant, with haemoptysis. Evaluation revealed a consolidated segment of the left lung with a pseudoaneurysm of the pulmonary artery and spina bifida. Thoracoscopic excision of the lesion revealed ILS. Recurrent haemoptysis led to re-evaluation and thoracotomy for excision of the cyst which contained gastric mucosal content. We report a rare case of concomitant ILS with an enterogenous cyst and review the relevant literature.
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Affiliation(s)
- Khyati Kiran Janapareddy
- Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Nitin James Peters
- Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ram Samujh
- Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Debajyothi Chatterjee
- Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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2
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Buck ML, Mitchell RA, Murphy MA, Wang YY. Conservative management of recurrent enterogenous cysts of the cervical spine: A case report. J Clin Neurosci 2020; 80:261-263. [PMID: 33099357 DOI: 10.1016/j.jocn.2020.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/01/2020] [Accepted: 08/03/2020] [Indexed: 11/27/2022]
Abstract
Enterogenous cysts are rare benign congenital tumours of the central nervous system. The aim of management is complete resection to minimise the chance of recurrence. To date, management of recurrence has favoured further surgical resection. We describe the case of a recurrent enterogenous cyst of the cervical spine, initially treated with decompression via laminectomy and fenestration. Magnetic Resonance Imaging (MRI) follow up has demonstrated spontaneous recurrence and deflation of the cyst on multiple occasions. We propose that conservative management of recurrent enterogenous cysts may be a valid management option following fenestration or partial resection of the cyst, and that recurrence may not always warrant further surgical intervention.
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Affiliation(s)
| | - Ruth Anne Mitchell
- Department of Surgery, the University of Melbourne, Parkville, Australia; Walter and Eliza Hall Institute, Parkville, Australia.
| | | | - Yi Yuen Wang
- Department of Neurosurgery, St Vincent's Hospital, Fitzroy, Australia; KeyHole Neurosurgery, Fitzroy, Australia
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3
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Anderson T, Kaufman T, Murtagh R. Intracranial neurenteric cyst: A case report and differential diagnosis of intracranial cystic lesions. Radiol Case Rep 2020; 15:2649-54. [PMID: 33093931 DOI: 10.1016/j.radcr.2020.10.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 10/06/2020] [Accepted: 10/06/2020] [Indexed: 11/21/2022] Open
Abstract
Neurenteric cysts are uncommon, benign lesions that are rarely located intracranially. These cysts are likely due to aberrant embryologic development of the notochord. Clinically, neurenteric cysts may present with symptoms of mass effect, or they can be asymptomatic and incidentally discovered. Imaging features of neurenteric cysts have significant overlap with other intracranial cystic lesions, which can make diagnosis difficult. We present a case of a 35-year-old female with a histopathologically confirmed neurenteric cyst in the premedullary and left cerebellomedullary cistern, with associated symptoms of headache, dizziness, tinnitus, and dysphagia. The patient underwent surgical resection, with improvement in symptoms. We present a review of literature, and a discussion of typical features of multiple intracranial cystic lesions. We hope to promote accurate preoperative diagnosis, to allow for appropriate surgical technique to reduce the risk of recurrence.
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4
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Viaene AN, Brem S. Recurrent neurenteric cysts compressing the brainstem. Surg Neurol Int 2019; 10:245. [PMID: 31893146 PMCID: PMC6935958 DOI: 10.25259/sni_501_2019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 11/15/2019] [Indexed: 11/18/2022] Open
Abstract
Background: Neurenteric cysts, also referred to as endodermal cysts and enterogenous cysts, are rare lesions of the neuroaxis occurring most frequently within the spinal cord and rarely intracranially. In the literature describing these lesions, examples of intraoperative imaging and cytology preparations are rare to non-existent. Case Description: Here, we describe a case of a recurrent posterior fossa neurenteric cyst compressing the brainstem in a 47-year-old female and causing incontinence and progressive quadriparesis. Intraoperative findings and cytologic and histologic features are presented. Conclusion: Neurenteric cysts are generally considered to be benign and slow-growing though recurrence is common. This case of a recurrent neurenteric cyst is illustrated by intraoperative macroscopic and cytologic images.
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Affiliation(s)
- Angela N Viaene
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Steven Brem
- Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, United States
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Nunes Dias L, Puerta Roldán P, Guillén Quesada A, Suñol Capella M, Hinojosa J. Supratentorial neuroenteric cyst in children: a case report and brief literature review. Childs Nerv Syst 2019; 35:2227-2231. [PMID: 31079180 DOI: 10.1007/s00381-019-04190-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 04/30/2019] [Indexed: 11/30/2022]
Abstract
Neurenteric cysts are rare developmental lesions typically found outside the central nervous system but when they do, we most likely find them in a spinal (cervical or dorsal) intradural extramedular location, often associated with dysraphism. The more unusual intracranial cases have been published because of its rarity, occurring mostly as a posterior fossa extra-axial cyst, in adults. Supratentorial cases are distinctly infrequent, especially in children, resulting in few case reports and even fewer case reviews. We describe a case of a child with a supratentorial neurenteric cyst and present a brief review of the literature about these cysts in children, a noticeable gap in the literature.
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Affiliation(s)
- Lídia Nunes Dias
- Department of Neurosurgery, Hospital Egas Moniz - Centro Hospitalar Lisboa Ocidental EPE, Rua da Junqueira 126, 1349-019, Lisbon, Portugal.
| | | | | | | | - José Hinojosa
- Department of Neurosurgery, Hospital Sant Joan de Déu, Barcelona, Spain
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6
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Liu CX, Meng B, Li YB, Bai H, Wu ZX. A rare case of thoracic spinal intradural extramedullary enterogenous cyst with acute onset: case report and literature review. Ann R Coll Surg Engl 2019; 101:e142-e146. [PMID: 31155903 DOI: 10.1308/rcsann.2019.0066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The intraspinal enterogenous cyst, also called an neurenteric cyst, is a rare congenital disease. It was reported to be local to the C1 to L2 spinal segments, with the majority located in the cervicothoracic region. Most patients present with symptoms of progressive focal pain, myelopathic signs or radicular symptoms. We report a rare case of thoracic spinal intradural extramedullary enterogenous cyst with rapidly progressive weakness of both lower extremities. Additionally, we analysed the literature concerning the clinical features, diagnosis and prognosis of this disease.
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Affiliation(s)
- C X Liu
- Institute of Orthopaedics, Xijing Hospital, Fourth Military Medical University , Xi'an, Shaanxi Province , China
| | - B Meng
- Institute of Orthopaedics, Xijing Hospital, Fourth Military Medical University , Xi'an, Shaanxi Province , China
| | - Y B Li
- Institute of Orthopaedics, Xijing Hospital, Fourth Military Medical University , Xi'an, Shaanxi Province , China
| | - H Bai
- Institute of Orthopaedics, Xijing Hospital, Fourth Military Medical University , Xi'an, Shaanxi Province , China
| | - Z X Wu
- Institute of Orthopaedics, Xijing Hospital, Fourth Military Medical University , Xi'an, Shaanxi Province , China
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Danys D, Martinaitytė R, Zacharic J, Poskus E, Zurauskas E, Poskus T, Strupas K. Enterogenous cyst of the small bowel mesentery: a case report and review of the literature. Acta Chir Belg 2019; 119:52-55. [PMID: 29221426 DOI: 10.1080/00015458.2017.1411551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Enterogenous cysts are a very rare congenital abnormality that can be found anywhere within the gastrointestinal tract, most commonly in the small intestine. The incidence is approximately one in 4500-10,000 live births. Diagnosis can be suggested by ultrasound (US), computed tomography (CT) scans or magnetic resonance imaging (MRI) findings, although histological examination confirms the definitive diagnosis. PATIENTS We present a case of enterogenous cyst in an adult female who underwent a resection of the tumour. RESULTS After two years of observation, there is no evidence of tumour recurrence.
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Affiliation(s)
- Donatas Danys
- Center of Abdominal Surgery, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania
| | | | | | - Eligijus Poskus
- Center of Abdominal Surgery, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania
| | | | - Tomas Poskus
- Center of Abdominal Surgery, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania
| | - Kęstutis Strupas
- Center of Abdominal Surgery, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania
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Abstract
Duplication cyst is a rare congenital malformation. Enterogenous cyst are foregut duplication cyst with or without a vertebral defect. We report a case of a 36hr old neonate with mediastinal enterogenous cyst associated with vertebral defects. The embryology, differentials, and management of enterogenous cyst in the newborn have been discussed.
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Affiliation(s)
- Nidhi Jain
- Department of Neonatology, Maulana Azad Medical College, New Delhi, India
| | - Vijay Gupta
- Department of Neonatology, Maulana Azad Medical College, New Delhi, India
| | - N B Mathur
- Department of Neonatology, Maulana Azad Medical College, New Delhi, India
| | - Ajay Kumar
- Department of Neonatology, Maulana Azad Medical College, New Delhi, India
| | - Nita Khurana
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Yogesh Kumar Sarin
- Department of Pediatric Surgery, Maulana Azad Medical College, New Delhi, India
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Esfahani DR, Burokas L, Brown HG, Hahn YS, Nikas D. Management of an unusual, recurrent neurenteric cyst in an infant: case report and review of the literature. Childs Nerv Syst 2017; 33:1603-7. [PMID: 28643040 DOI: 10.1007/s00381-017-3487-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE Neurenteric cysts are rare congenital remnants formed by a failure of separation between endoderm and ectoderm in utero. METHODS We describe a case of a 7-month-old male with a large cervical neurenteric cyst presenting with intermittent neck stiffness and irritability. RESULTS This cyst was resected, recurred, and required repeat surgery. The patient's postoperative course included aseptic meningitis and hydrocephalus requiring ventriculoperitoneal shunt and later management of tethered cord, necessitating detethering. CONCLUSION Unique features of this case include the presence of intermittent pain symptoms, which may be attributable to cyst filling and emptying. Hydrocephalus is an uncommon finding that may be secondary to aseptic meningitis from cyst rupture. Tethered cord is also an unusual entity that can accompany this diagnosis, warranting additional imaging work-up and monitoring.
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Saitoh Y, Kawahara T, Otani M, Kumano Y, Yao M, Teranishi JI, Uemura H. Enterogenous cyst of pediatric testis: a case report. J Med Case Rep 2017; 11:207. [PMID: 28755658 PMCID: PMC5534243 DOI: 10.1186/s13256-017-1372-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 06/29/2017] [Indexed: 11/10/2022] Open
Abstract
Background An enterogenous cyst is a rare entity categorized as an intestinal cyst. In most cases, enterogenous cysts are seen in the mediastinum, peritoneal cavity, spinal canal, subarachnoid space, and cerebral ventricle. Case presentation A 14-year-old Asian (Japanese) boy reported feeling pain in his left groin, and a mass was found. We did not perform orchiectomy because intraoperative frozen sections showed no malignant findings. On histological examination the resected specimens contained columnar epithelium surrounded by smooth muscle. Based on these findings, an enterogenous cyst was diagnosed. Few cases of enterogenous cysts of the testis have been described. Conclusion We encountered a case of an enterogenous cyst of a pediatric testis.
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Affiliation(s)
- Yoko Saitoh
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Takashi Kawahara
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan. .,Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
| | - Masako Otani
- Division of Diagnostic Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Yohei Kumano
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Masahiro Yao
- Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Jun-Ichi Teranishi
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Hiroji Uemura
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
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11
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Abstract
Neurenteric cysts are rare lesions of the spinal cord, constituting less than 1.3% of all spinal cord tumors. Approximately 90% of neurenteric cysts are located in the intradural extramedullary compartment, while the remaining 10% are divided between an intradural intramedullary or extradural location. They are usually extramedullary and found in the lower cervical and thoracic spine. We report a case of 8 year old child with totally solid calcified intramedullary cyst which has hitherto not been reported in literature. We discuss the challenges faced in the diagnosis and surgical management of such lesions and a brief review of pertinent literature.
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Affiliation(s)
| | - Daljit Singh
- Department of Neurosurgery, G B Pant Hospital, New Delhi, India
| | - Sudhir Suggala
- Department of Neurosurgery, G B Pant Hospital, New Delhi, India
| | - Tushit Mewada
- Department of Neurosurgery, G B Pant Hospital, New Delhi, India
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12
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Lavrador JP, Brogna C, Vergani F, Hasegawa H, Aizpurua M, Bhangoo R. Third-ventricle enterogenous cyst presentation mimicking a colloid cyst: uncommon presentation of a rare disease and literature review. Acta Neurochir (Wien) 2017; 159:465-8. [PMID: 27981391 DOI: 10.1007/s00701-016-3052-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 12/08/2016] [Indexed: 10/20/2022]
Abstract
Enterogenous cysts (ECs) are endodermal lesions resulting from splitting anomalies in the neuroenteric canal. We report the case of a 64-year-old patient who presented with a sudden headache followed by collapse. Brain computed tomography revealed a hyperdense lesion in the anterior part of the third ventricle with obstructive hydrocephalus. A presumptive diagnosis of colloid cyst was made and he underwent a right transcortical approach for lesion resection. The histopathological examination revealed an EC. ECs are common lesions in the cervical-thoracic spine but rare in the supratentorial compartment with only two previously described cases occurring in the third ventricle.
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Li T, Wu X, Zhang Y. A Rare Presentation of an Enterogenous Cyst as an Intra-Axial Pontine Lesion. World Neurosurg 2017; 100:707.e1-707.e3. [PMID: 28213198 DOI: 10.1016/j.wneu.2017.02.040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 02/02/2017] [Accepted: 02/06/2017] [Indexed: 02/05/2023]
Abstract
A 56-year-old man was admitted to our hospital with intermittent right facial numbness for 1 year and instability on walking for 6 months. Magnetic resonance imaging revealed an ovoid and well-demarcated intra-axial pontine lesion. Cyst fenestration and biopsy were carried out, and the diagnosis of enterogenous cyst was made by magnetic resonance imaging and pathologic findings. Preoperative symptoms resolved completely 3 months after surgery and no evidence of recurrence was found during 3 years of follow-up. Although total resection of enterogenous cysts is recommended, cyst fenestration may be useful if the cyst is adherent to vital neurovascular structures.
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Affiliation(s)
- Tengfei Li
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan Province, P. R. China
| | - Xia Wu
- Department of Pathology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, P. R. China
| | - Yuekang Zhang
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan Province, P. R. China.
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Wang L, Chang X, Fu C, Yu W, Fang X. An enterogenous cyst with atypical pathological findings and chemical meningitis. Springerplus 2016; 5:1993. [PMID: 27933249 PMCID: PMC5118380 DOI: 10.1186/s40064-016-3677-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 11/11/2016] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Intracranial enterogenous cysts are rare and mainly occur in the posterior fossa. These cysts are usually extra-axial, midline, anterior to the brainstem, or at the cerebellopontine angle. We report a case of an enterogenous cyst in which diagnosis was difficult because the lesion showed atypical pathologic findings. CASE PRESENTATION A healthy 41-year-old man complained of paroxysmal occipital headaches lasting over a week, with increased severity for 3 days accompanied by slight dizziness and mild nausea. Magnetic resonance imaging showed a cystic lesion between clivus and brainstem. The patient underwent surgery for removal of the lesion via the right-sided far-later approach, and the lesion was resected totally. Although pathologic examinations showed a cyst had a mono-to-multilayered squamous epithelium, which are not accord with typical enterogenous cyst, the diagnosis was finally made based on the presence of basement membrane and immunohistochemical results. DISCUSSION AND EVALUATION To confirm the diagnosis of enterogenous cyst, further pathologic examinations were performed and immunohistochemical characters were summarized. Chemical meningitis, a rare complication of enterogenous cyst, happened in current case. Use a syringe and aspirate the contents before incision might be a procedure to prevent chemical meningitis. CONCLUSIONS To our knowledge, this is the first report of an enterogenous cyst associated with mono-to-multilayered squamous epithelium. Although during the follow-up time, no recurrence happened, long-term follow-up is needed.
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Affiliation(s)
- Lu Wang
- Department of Neurosurgery, The China-Japan Union Hospital, Jilin University, Changchun, 130033 Jilin People's Republic of China
| | - Xiaona Chang
- The Key Laboratory of Pathobiology, Ministry of Education, Bethune Medical School, Jilin University, Changchun, 130021 Jilin People's Republic of China
| | - Chao Fu
- Department of Neurosurgery, The China-Japan Union Hospital, Jilin University, Changchun, 130033 Jilin People's Republic of China
| | - Weidong Yu
- Department of Neurosurgery, The China-Japan Union Hospital, Jilin University, Changchun, 130033 Jilin People's Republic of China
| | - Xiaoxuan Fang
- Department of Neurosurgery, The China-Japan Union Hospital, Jilin University, Changchun, 130033 Jilin People's Republic of China
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Abstract
We describe two rare cases of frontal cystic lesions presenting with symptoms and signs of raised intracranial pressure. Both had a preoperative diagnosis of an arachnoid cyst and were subjected to a craniotomy with marsupialization of the cyst. However, the histology confirmed them to be an endodermal cyst (EC) on both occasions. Both the patients have been closely followed with no recurrence of symptoms. ECs of the central nervous system are usually reported in the spinal canal, mid-line posterior fossa, and the suprasellar regions. Supratentorial and non-midline ECs are rare, with only about 22 cases previously reported in literature. We discuss both the cases and review the relevant literature.
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Affiliation(s)
- Vithal Rangarajan
- Department of Neurosurgery, Seth Gordhandas Sunderdas Medical College and King Edward Memorial Hospital, Parel, Mumbai, Maharashtra, India
| | - Amit Mahore
- Department of Neurosurgery, Seth Gordhandas Sunderdas Medical College and King Edward Memorial Hospital, Parel, Mumbai, Maharashtra, India
| | - Manoj Kashinath Patil
- Department of Neurosurgery, Seth Gordhandas Sunderdas Medical College and King Edward Memorial Hospital, Parel, Mumbai, Maharashtra, India
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Matsumoto H, Minami H, Tominaga S, Yamaura I, Yoshida Y, Yoshida K. Cerebellar Enterogenous Cyst with Atypical Appearance and Pathological Findings. World Neurosurg 2015; 86:510.e19-28. [PMID: 26485416 DOI: 10.1016/j.wneu.2015.10.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 10/03/2015] [Accepted: 10/05/2015] [Indexed: 02/08/2023]
Abstract
BACKGROUND Intracranial enterogenous cysts are rare and occur mainly in the posterior fossa. These cysts are usually extra-axial, midline, anterior to the brainstem, or at the cerebellopontine angle. Intracranial intra-axial enterogenous cysts are extremely rare. We report a case of an intra-axial cerebellar enterogenous cyst in which diagnosis was difficult because the lesion resembled an arachnoid cyst in appearance and showed atypical pathologic findings. CASE DESCRIPTION A 69-year-old woman had a 2-year history of progressive headache, giddiness, and unsteadiness of gait. Magnetic resonance imaging showed a cystic lesion with isointensity to cerebrospinal fluid in the left cerebellar hemisphere, reaching into the fourth ventricle. The patient underwent fenestration of the cyst and creation of a communication between the fourth ventricle and cyst because the tight attachment of the cyst wall to the cerebellum prevented total removal of the cyst. Although pathologic examinations did not show findings typical of enterogenous cyst, the diagnosis was finally made based on the presence of basement membrane and immunohistochemical results. CONCLUSION The diagnosis of enterogenous cyst is based mainly on histologic findings, because characteristic findings on neuroimaging have not been defined. Although total resection of enterogenous cysts is recommended in general, partial resection while ensuring the cyst communicates adequately with the surrounding cerebrospinal fluid space with or without a shunt procedure may be useful if the cyst is adherent to surrounding neurovascular structures.
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Affiliation(s)
| | - Hiroaki Minami
- Department of Neurosurgery, Eisyokai Yoshida Hospital, Kobe, Japan
| | - Shogo Tominaga
- Department of Neurosurgery, Eisyokai Yoshida Hospital, Kobe, Japan
| | - Ikuya Yamaura
- Department of Neurosurgery, Eisyokai Yoshida Hospital, Kobe, Japan
| | - Yasuhisa Yoshida
- Department of Neurosurgery, Eisyokai Yoshida Hospital, Kobe, Japan
| | - Kozo Yoshida
- Department of Neurosurgery, Eisyokai Yoshida Hospital, Kobe, Japan
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Shah N, Lizardo-Escaño T, Shaaban H, Dhadham G, Karki A, Spira R. Enterogenous cyst of the small bowel causing intussusception in an adult: Case report and review of literature. J Nat Sci Biol Med 2015; 6:208-10. [PMID: 25810663 PMCID: PMC4367038 DOI: 10.4103/0976-9668.149124] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Small bowel intussusception is a rare congenital disease entity, mostly manifesting before the age of two with abdominal pain and acute intestinal obstruction. In adults, colon intussusception is a rare event causing approximately 1% of all acute intestinal obstructions and they can occur idiopathically in adults or due to an intraluminal tumor mass. We report a case of an enterogenous cyst causing intussusception and iron deficiency anemia in an adult treated by surgical excision and resection of the small bowel.
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Affiliation(s)
- Nihar Shah
- Department of Internal Medicine, Saint Michael's Medical Center, Newark, USA ; Department of Gastroenterology, Saintt Joseph's Regional Medical Center, Paterson, NJ, USA
| | | | - Hamid Shaaban
- Department of Internal Medicine, Saint Michael's Medical Center, Newark, USA
| | - Gautamy Dhadham
- Department of Gastroenterology, Saintt Joseph's Regional Medical Center, Paterson, NJ, USA
| | - Arya Karki
- Department of Gastroenterology, Saintt Joseph's Regional Medical Center, Paterson, NJ, USA
| | - Robert Spira
- Department of Internal Medicine, Saint Michael's Medical Center, Newark, USA
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Can A, Dos Santos Rubio EJ, Jasperse B, Verdijk RM, Harhangi BS. Spinal Neurenteric Cyst in Association with Klippel-Feil Syndrome: Case Report and Literature Review. World Neurosurg 2015; 84:592.e9-14. [PMID: 25790871 DOI: 10.1016/j.wneu.2015.03.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Revised: 03/08/2015] [Accepted: 03/09/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND Spinal neurenteric cysts, also known as endodermal or enterogenous cysts, are rare epithelium-lined structures of presumed endodermal origin. Congenital vertebral anomalies are frequently seen in patients with neurenteric cysts, most typically anterior spina bifida, butterfly vertebrae, and hemivertebrae. However, few series of intraspinal neurenteric cysts accompanied by Klippel-Feil syndrome have been reported previously. CASE DESCRIPTION Our purpose is to present the clinical, radiological, and histological results of a 29-year-old patient with a spinal neurenteric cyst associated with Klippel-Feil syndrome and to review previous reported cases of neurenteric cysts associated with Klippel-Feil syndrome. In our patient, cervical radiography demonstrated C5-T1 vertebral fusion and magnetic resonance imaging revealed a large intradural cystic mass. The cystic lesion was removed successfully, and it was histopathologically diagnosed as a neurenteric cyst. CONCLUSION Neurenteric cysts should always be considered in the differential diagnosis of an intraspinal cystic mass seen in the setting of vertebral anomalies.
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Affiliation(s)
- Anil Can
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA; Department of Neurosurgery, Erasmus Medical Center, Rotterdam, The Netherlands.
| | | | - Bas Jasperse
- Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Robert M Verdijk
- Department of Pathology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - B Sanjay Harhangi
- Department of Neurosurgery, Erasmus Medical Center, Rotterdam, The Netherlands
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Shin SY, Cho MY, Ryu H, Kim JW, Kim HS, Kim JM, Ko AN, Yu TS, Park HJ. Adenocarcinoma originating from a completely isolated duplication cyst of the mesentery in an adult. Intest Res 2014; 12:328-32. [PMID: 25374500 PMCID: PMC4214961 DOI: 10.5217/ir.2014.12.4.328] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2013] [Revised: 10/27/2013] [Accepted: 10/28/2013] [Indexed: 02/07/2023] Open
Abstract
Alimentary tract duplications are uncommon congenital abnormalities that usually have an anatomical connection with some part of the gastrointestinal tract and have a common blood supply with the adjacent segment of intestine. A completely isolated duplication cyst (CIDC) is a very rare type of gastrointestinal duplication that does not communicate with the normal bowel segment and possesses its own exclusive blood supply. Only 5 CIDC cases in adults have been reported in the English medical literature. Additionally, only 1 case of mucinous cystadenoma from an infected CIDC of the ileum has been reported. This report describes a 52-year-old male patient with a peritoneal CIDC, which upon curative excision was found to have given rise to an adenocarcinoma. The latter was lined internally with malignant glandular cells and contained a smooth muscular outer layer as determined by microscopic examination of the tissue. We believe that this is the first reported case of an adenocarcinoma originating from a CIDC in an adult.
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Affiliation(s)
- Seung Yong Shin
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Mee Yon Cho
- Department of Pathology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Hoon Ryu
- Department of General Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jae Woo Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Hyun-Soo Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jung Min Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - An Na Ko
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Tae-Sun Yu
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Hong Jun Park
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
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Paniraj GL, Panigrahi M, Reddy AK, Immaneni S. Suprasellar colloid cyst: an unusual location. World Neurosurg 2013; 81:202.e15-8. [PMID: 23895926 DOI: 10.1016/j.wneu.2013.07.073] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Revised: 03/16/2013] [Accepted: 07/19/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Colloid cysts are rare intracerebral lesions that are preferentially encountered within the third ventricle. There are only a few reports in which colloid cysts are described in other locations such as the fourth ventricle, brainstem, cerebellum, and suprasellar region. CASE DESCRIPTION A young woman presented with headaches for 1 year and an episode of generalized tonic, clonic seizures 1 week ago. She had bitemporal visual field cuts on examination. Imaging showed an hyperdense suprasellar lesion that was isointense on T1-weighted magnetic resonance imagings, profoundly hypointense on T2-weighted images, and did not show any enhancement on contrast magnetic resonance study at follow-up. It showed no restriction on diffusion-weighted imaging. A pteronal craniotomy and total excision of the lesion was done and the patient recovered well with no further neurological deficits. Pathology was consistent with a colloid cyst. CONCLUSIONS Colloid cysts are rarely found in a suprasellar location. Such a rare diagnosis has to be considered in the differential diagnosis in patients who present with a suprasellar cystic lesion.
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Affiliation(s)
- Gurram Lokamanya Paniraj
- Department of Neurosurgery, Krishna Institute of Medical Sciences, Secunderabad, Andhra Pradesh, India.
| | - Manas Panigrahi
- Department of Neurosurgery, Krishna Institute of Medical Sciences, Secunderabad, Andhra Pradesh, India
| | - Agasti Krishna Reddy
- Department of Neurosurgery, Krishna Institute of Medical Sciences, Secunderabad, Andhra Pradesh, India
| | - Satish Immaneni
- Department of Neuropathology, Krishna Institute of Medical Sciences, Secunderabad, Andhra Pradesh, India
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Marchionni M, Smith C, Eljamel MS. Intracranial enterogenous cyst extending into both supratentorial and infratentorial compartments: case report and review of the literature. Skull Base 2011; 18:213-6. [PMID: 18978968 DOI: 10.1055/s-2007-1023230] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Intracranial enterogenous cysts are rare. There have been only two cases reported of such cysts that extended into both the infratentorial and supratentorial compartments. We add a third case and review the literature to assess their pathogenesis, clinical features, and management.
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Affiliation(s)
- M Marchionni
- Department of Neurosurgery, Ninewells Hospital and Medical School, Dundee, United Kingdom
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