Case report: Intradural/extramedullary neuroenteric cyst in a young patient

Abstract

Introduction: Neuroenteric cysts are congenital, benign, solitary and infrequent lesions of the spinal axis, composed of heterotopic endodermic tissue, resulting from an incomplete closure of the neural tube. They mainly occur in men, during the first or second decade of life. The majority of these cysts are located in the intradural/extramedullary compartment, ventrally to the spinal cord, especially at the lower cervical or upper thoracic spine. The neurological symptomatology varies depending on the location of the cyst. The presumptive diagnosis is made with magnetic resonance imaging, and the definitive diagnosis is made with a histopathological assessment, which is done after a complete or partial resection of the mass, generally with a posterior approach.

Case presentation: We describe the case of a 35-year-old female patient, who, 21 years ago, at the age of 14, presented an intradural/extramedullary neuroenteric cyst, located at the lower cervical level, with cervical pain irradiated to upper and lower limbs, radicular pain, loss of muscular strength, and hyperreflexia. A magnetic resonance imaging was indicated, showing a space-occupying lesion at the C4-C5, C5-C6 levels, corresponding to a cystic lesion. A complete resection of this mass was performed. The histopathological assessment reported an intradural/extramedullary neuroenteric cyst, with no cellular atypia. The patient’s postoperative progress and development were satisfactory.

The objective is to describe this case, highlighting its importance, since these lesions are extremely infrequent in the medical literature, with a non-specific symptomatology, which is why they can be confused with other pathologies, and recur, even after their complete resection.