Antenatally diagnosed intraspinal-posterior mediastinal neurenteric cyst - what is the optimal management?

Clin Neurol Neurosurg. 2022 Jan:212:107040. doi: 10.1016/j.clineuro.2021.107040. Epub 2021 Nov 24.

Abstract

Neurenteric cyst is a rare congenital anomaly that belongs to the spinal dysraphism spectrum. It is classically a disease of late childhood, with some rare reports of intrauterine and adult presentation. The increase in incidental antenatal diagnosis raises new management questions. We present a case of an asymptomatic combined intraspinal-posterior mediastinal neurenteric cyst. The cyst was diagnosed on antenatal ultrasound and was initially treated with image-guided aspiration in early infancy. However, the cyst recurred and the patient developed recurrent episodes of bacterial meningitis. Two-stage surgical resection was performed, although the infection prohibited complete excision. We caution against image guided aspiration of neurenteric cysts, and suggest a management algorithm based on the available literature.

Keywords: Congenital cyst; Intradural extramedullary cyst; Neurenteric cyst; Posterior mediastinal mass.

Publication types

  • Case Reports

MeSH terms

  • Female
  • Humans
  • Infant
  • Laminoplasty
  • Meningitis, Bacterial / drug therapy
  • Neural Tube Defects / diagnostic imaging*
  • Neural Tube Defects / surgery*
  • Ultrasonography, Prenatal