Comprehensive Review of Spinal Neurenteric Cysts with a Focus on Histopathological Findings.

Cureus. 2018 Sep 28;10(9):e3379. doi: 10.7759/cureus.3379.

Baek WK, Lachkar S, Iwanaga J, Oskouian RJ, Loukas M, Oakes WJ, Tubbs RS.

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Abstract

Among the occult spinal dysraphisms, neurenteric cysts (NECs) are rare and are thought to arise due to a failure of the separation of the primitive endoderm and ectoderm. Patients experience various neurological symptoms depending on the location of the lesion. As the epithelial morphology of NECs share similarities with other intracranial and intraspinal cystic growths, the definitive diagnosis of NEC can be made after a histochemical analysis with endodermal markers. Complete resection is associated with the lowest disease recurrence rate.

KEYWORDS:

intraspinal cyst; intraspinal endodermal cyst; neurenteric cyst

Figure 1

Schematic drawing of the proposed dysembryology resulting in various neurenteric cysts of the spine.

Figure 2

Enteric remnants and one of their classifications of these (Bentley and Smith Classification).

Figure 3

Histological section of spinal neurenteric cysts noting the typical epithelial lining seen with these pathological entities.

Figure 4

Left: Sagittal T1-weighted magnetic resonance imaging of the patient found to harbor a spinal neurenteric cyst (NEC) (arrow).

Also note the dorsal lipoma posterior to the NEC; Right: Axial T2-weighted MRI of this patient depicting the NEC (arrow).

Figure 5

Left: Intraoperative view of a spinal NEC with dura mater tented laterally with sutures; Right: gross specimens of NEC transected sagittally revealing the smooth inner lining of the cyst.