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J Neurol Surg B Skull Base 2015; 76(06): 475-479
DOI: 10.1055/s-0035-1554906
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Surgical Management of Intracranial Neuroenteric Cysts: The UCSF Experience

Jonathan D. Breshears
1   Department of Neurological Surgery, University of California, San Francisco, California, United States
,
Martin J. Rutkowski
1   Department of Neurological Surgery, University of California, San Francisco, California, United States
,
Michael W. McDermott
1   Department of Neurological Surgery, University of California, San Francisco, California, United States
,
Soonmee Cha
2   Department of Radiology and Neurological Surgery, University of California, San Francisco, California, United States
,
Tarik Tihan
3   Department of Pathology, University of California, San Francisco, California, United States
,
Philip V. Theodosopoulos
1   Department of Neurological Surgery, University of California, San Francisco, California, United States
› Author Affiliations
Further Information

Publication History

09 February 2015

23 March 2015

Publication Date:
15 June 2015 (online)

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Abstract

Objective Modern surgical experience with intracranial neuroenteric cysts is limited in the literature. We review our 15-year institutional experience with these rare lesions.

Design Single-institution retrospective study.

Setting Large North American tertiary care center.

Participants Histologically confirmed cases of intracranial neuroenteric cyst from January 2000 to September 2014.

Main Outcome Measures Pre- and postoperative modified Rankin Scale (mRS) scores, extent of resection, and postoperative complications are reported. Clinical presentation, imaging features, pathology, and operative approach are discussed.

Results Five spinal and six intracranial neuroenteric cysts were surgically treated over a 15-year period. Median age at presentation for the intracranial cysts was 38.5 years. Mean cyst diameter was 3.8 cm. Five cysts were located in the pre-pontomedullary cistern, and one was located in the third ventricle. Gross total resection was achieved in four of the five posterior fossa cysts through a far lateral transcondylar approach. Postoperative complications included aseptic meningitis (one), transient abducens palsy (one), and pseudomeningocele requiring reoperation (three). Postoperative mRS scores improved to ≤1 by 6.5 months median follow-up.

Conclusions Intracranial neuroenteric cysts are rare lesions with a variable imaging appearance. Complete surgical resection through a far lateral transcondylar approach is possible and usually results in symptom improvement or resolution.

Keywords

neuroenteric cyst - neurenteric cyst - enterogenous cyst - bronchogenic cyst
 

  • References

  • 1 Gauden AJ, Khurana VG, Tsui AE, Kaye AH. Intracranial neuroenteric cysts: a concise review including an illustrative patient. J Clin Neurosci 2012; 19 (3) 352-359
    CrossrefPubMedSearch in Google Scholar
  • 2 Ostrom QT, Gittleman H, Liao P , et al. CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2007–2011. Neuro-oncol 2014; 16 (Suppl. 04) iv1-iv63
    PubMedSearch in Google Scholar
  • 3 Wang L, Zhang J, Wu Z , et al. Diagnosis and management of adult intracranial neurenteric cysts. Neurosurgery 2011; 68 (1) 44-52 ; discussion 52
    CrossrefPubMedSearch in Google Scholar
  • 4 Preece MT, Osborn AG, Chin SS, Smirniotopoulos JG. Intracranial neurenteric cysts: imaging and pathology spectrum. AJNR Am J Neuroradiol 2006; 27 (6) 1211-1216
    PubMedSearch in Google Scholar
  • 5 Uschold T, Xu DS, Wilson DA , et al. Diagnostic and surgical implications of ventral vertebrobasilar displacement by posterior fossa neurenteric cysts. World Neurosurg 2014; 82 (3–4) 480-484
    CrossrefPubMedSearch in Google Scholar
  • 6 Ranguis SC, Chaganti JR, Winder MJ. A bilateral infratentorial neurenteric cyst. J Clin Neurosci 2013; 20 (5) 735-738
    CrossrefPubMedSearch in Google Scholar
  • 7 Büttner A, Winkler PA, Weis S. Endodermal cyst of the third ventricle: case report. Neurosurgery 1997; 40 (4) 832-835 ; discussion 835
    CrossrefPubMedSearch in Google Scholar
  • 8 Salvetti DJ, Williams BJ, Posthumus JS, Shaffrey ME. Enterogenous cyst of the third ventricle. J Clin Neurosci 2014; 21 (1) 161-163
    CrossrefPubMedSearch in Google Scholar
  • 9 Akimoto J, Nakajima N, Saida A, Miki T, Haraoka J. Symptomatic suprasellar endodermal cyst, possibly originating from the Seessel's pouch, containing fluid with a high carcinoembryonic antigen level. Brain Tumor Pathol 2013; 30 (2) 128-133
    CrossrefPubMedSearch in Google Scholar
  • 10 Graziani N, Dufour H, Figarella-Branger D, Donnet A, Bouillot P, Grisoli F. Do the suprasellar neurenteric cyst, the Rathke cleft cyst and the colloid cyst constitute a same entity?. Acta Neurochir (Wien) 1995; 133 (3–4) 174-180
    CrossrefPubMedSearch in Google Scholar
  • 11 Ho LC, Olivi A, Cho CH, Burger PC, Simeone F, Tihan T. Well-differentiated papillary adenocarcinoma arising in a supratentorial enterogenous cyst: case report. Neurosurgery 1998; 43 (6) 1474-1477
    CrossrefPubMedSearch in Google Scholar
  • 12 Kimura H, Nagatomi A, Ochi M, Kurisu K. Intracranial neurenteric cyst with recurrence and extensive craniospinal dissemination. Acta Neurochir (Wien) 2006; 148 (3) 347-352 ; discussion 352
    CrossrefPubMedSearch in Google Scholar