CC BY-NC-ND 4.0 · J Neurol Surg Rep 2023; 84(03): e80-e84
DOI: 10.1055/s-0043-1772157
Original Report

A Neuroenteric Cyst of the Cavernous Sinus: A Case Report

Walid Elshamy
1   Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
2   Department of Neurological Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
,
Burak Ozaydin
1   Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
,
Sima Sayyahmelli
1   Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
,
M. Shahriar Salamat
1   Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
3   Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
,
Mustafa K. Baskaya
1   Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
› Author Affiliations

Abstract

Background Neuroenteric cysts (NECs) are benign lesions mostly found as intradural extramedullary lesions in the cervicothoracic spinal cord. NECs in the cavernous sinus are very rare. To the best of our knowledge, this is only the second reported case and the first in an adult.

Presentation We present a left cavernous sinus NEC in a 75-year-old female with gradually worsening headache and facial pain unresponsive to medical treatment. Imaging revealed a cystic mass lesion in the left cavernous sinus encasing the distal petrosal and cavernous segment of the internal carotid artery. Initial differential diagnoses included more common pathologies located near the cavernous sinus, including cystic schwannoma, craniopharyngioma, and dermoid and epidermoid tumors. The patient underwent a left pterional craniotomy with an extradural transcavernous approach for surgical exploration and possible resection of this mass lesion. Histopathology revealed an NEC lined with benign respiratory-type epithelium. Postoperative imaging revealed gross total tumor resection. The patient remained neurologically intact with complete resolution of facial pain.

Conclusion We present a rare pathology that can easily be misinterpreted as other types of lesions. NECs should be kept in mind for differential diagnosis of cavernous sinus cystic lesions. The surgical aim should be maximal safe excision.

Previous Presentations

This manuscript has neither been presented nor published before, either as a whole or in part, nor is it under consideration for publication elsewhere.




Publication History

Received: 24 February 2020

Accepted: 13 June 2023

Article published online:
14 August 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Chaynes P, Thorn-Kany M, Sol JC, Arrué P, Lagarrigue J, Manelfe C. Imaging in neurenteric cysts of the posterior cranial fossa. Neuroradiology 1998; 40 (06) 374-376
  • 2 Puusepp M. Variété rare de tératome sousdural de la region cervicale (intestinome): quadriplégie, extirpation, guérison complete. Rev Neurol (Paris) 1934; 2: 879-886
  • 3 Jhawar SS, Nadkarni T, Goel A. Meckel's cave neurenteric cyst: case report. J Neurol Surg A Cent Eur Neurosurg 2012; 73 (06) 413-415
  • 4 Dokumcu Z, Uygun O, Turhan T, Yalaz M, Ozcan C, Erdener A. Two-stage approach in the management of thoracic neuroenteric cyst with spinal extension: thoracoscopic excision following dorsal laminectomy. Childs Nerv Syst 2015; 31 (02) 185-189
  • 5 El Ahmadieh TY, Sillero R, Kafka B, Aoun SG, Price AV. Isolated dorsal thoracic neuroenteric cyst with spinal cord compression: case reports in pediatrics. World Neurosurg 2018; 118: 296-300
  • 6 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 (02) 592.e9-592.e14
  • 7 Roder C, Ebner FH, Schuhmann MU. Neurenteric cysts of the cerebellopontine angle. J Neurol Surg A Cent Eur Neurosurg 2013; 74 (Suppl. 01) e36-e40
  • 8 Ranguis SC, Chaganti JR, Winder MJ. A bilateral infratentorial neurenteric cyst. J Clin Neurosci 2013; 20 (05) 735-738
  • 9 Tan GS, Hortobágyi T, Al-Sarraj S, Connor SE. Intracranial laterally based supratentorial neurenteric cyst. Br J Radiol 2004; 77 (923) 963-965
  • 10 Scaravilli F, Lidov H, Spalton DJ, Symon L. Neuroenteric cyst of the optic nerve: case report with immunohistochemical study. J Neurol Neurosurg Psychiatry 1992; 55 (12) 1197-1199
  • 11 Kachur E, Ang L-C, Megyesi JF. Intraparenchymal supratentorial neurenteric cyst. Can J Neurol Sci 2004; 31 (03) 412-416
  • 12 Kim JH, Wang KC, Phi JH, Park SH, Cheon JE, Kim SK. Intracranial neurenteric cyst arising at the suprasellar cistern with extension to middle cranial fossa. Childs Nerv Syst 2018; 34 (12) 2491-2495
  • 13 de Oliveira RS, Cinalli G, Roujeau T, Sainte-Rose C, Pierre-Kahn A, Zerah M. Neurenteric cysts in children: 16 consecutive cases and review of the literature. J Neurosurg 2005; 103 (6, Suppl): 512-523
  • 14 Lantos P, VandenBerg S, Kleihues P. Tumors of the nervous system. In Graham D, Lantos P. eds., Greenfield's Neuropathology. London, Arnold: 2002
  • 15 Mittal S, Petrecca K, Sabbagh AJ. et al. Supratentorial neurenteric cysts-A fascinating entity of uncertain embryopathogenesis. Clin Neurol Neurosurg 2010; 112 (02) 89-97
  • 16 Preece MT, Osborn AG, Chin SS, Smirniotopoulos JG. Intracranial neurenteric cysts: imaging and pathology spectrum. AJNR Am J Neuroradiol 2006; 27 (06) 1211-1216
  • 17 Brooks BS, Duvall ER, el Gammal T, Garcia JH, Gupta KL, Kapila A. Neuroimaging features of neurenteric cysts: analysis of nine cases and review of the literature. AJNR Am J Neuroradiol 1993; 14 (03) 735-746
  • 18 Shakudo M, Inoue Y, Ohata K, Tanaka S. Neurenteric cyst with alteration of signal intensity on follow-up MR images. AJNR Am J Neuroradiol 2001; 22 (03) 496-498
  • 19 Patel SK, Liu JK. Staged bilateral far-lateral approach for bilateral cervicomedullary junction neurenteric cysts in a 10-year-old girl. J Neurosurg Pediatr 2013; 12 (03) 274-280
  • 20 Yang Y, Fang J, Li DA, Wang L, Ji N, Zhang J. Recurrent intracranial neurenteric cyst with malignant transformation: a case report and literature review. Oncol Lett 2016; 11 (05) 3395-3402
  • 21 Wang W, Piao YS, Gui QP, Zhang XH, Lu DH. Cerebellopontine angle neurenteric cyst with focal malignant features. Neuropathology 2009; 29 (01) 91-95
  • 22 Sahara Y, Nagasaka T, Takayasu M, Takagi T, Hata N, Yoshida J. Recurrence of a neurenteric cyst with malignant transformation in the foramen magnum after total resection. Case report. J Neurosurg 2001; 95 (02) 341-345
  • 23 Rim HT, Song JH, Kim ES, Kwon MJ. Mucinous adenocarcinoma arising from a residual supratentorial neurenteric cyst and expressing mutated KRAS: a case report. Hum Pathol 2016; 58: 146-151
  • 24 Wang L, Zhang J, Wu Z. et al. Diagnosis and management of adult intracranial neurenteric cysts. Neurosurgery 2011; 68 (01) 44-52 , discussion 52