Spinal neurenteric cysts

Infant with

congenital scoliosisCXR shows congenital scoliosis due to vertebral segmentation anomalies in the upper thoracic spine. Axial CT with contrast of the chest shows a cystic lesion to the right of the spine in the posterior mediastinum.The diagnosis was neurenteric cyst.

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School ager

with a posterior mediastinal mass. CXR AP shows a round soft tissue density in the superior and medial aspect of the right hemithorax which was found on cross sectional imaging to be in the posterior mediastinum, along with multiple hemivertebra segmentation anomalies of the lower cervical and upper thoracic spine causing a curvature of the upper thoracic spine convex to the right.The diagnosis was congenital scoliosis secondary to hemivertebra in a patient with a neurenteric cyst.

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Spinal

neurenteric cyst • Neurenteric cyst - Ganzer Fall bei Radiopaedia

Kwong, Y. Neurenteric cyst. Case study, Radiopaedia.org. (accessed on 07 Nov 2022) https://doi.org/10.53347/rID-21461 • CC by-nc-sa 3.0 (modified)

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Spinal neurenteric cysts are a rare type of foregut duplication cyst, accounting for ~1% of all spinal cord tumors. They are usually classified as spinal or intracranial and are associated with vertebral or CNS abnormalities respectively.

Pathology

Neurenteric cysts result from incomplete resorption of the neurenteric canal.

Location

The intraspinal cysts are usually intradural extramedullary (80-90%) and ventral in location . They most commonly occur in the thoracic region (~40%).

Associations

vertebral anomalies like Klippel-Feil syndrome, hemivertebra and spina bifida

Radiographic features

CT

The cyst is seen as a well-defined hypoattenuating lesion which may show soft-tissue attenuation.

On CT myelography, the cyst does not opacify with intrathecal contrast. However, larger cysts may cause obstruction to the CSF flow; in such cases, intrathecal contrast material forms meniscus shape (meniscus sign) .