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An unusual case of large posterior fossa neurenteric cyst involving bilateral cerebellopontine angle cisterns: report of a rare case and review of literature.

Arora R, Rani JY, Uppin MS, Ca R - Pol J Radiol (2014)

Bottom Line: Approximately 141 cases have been reported so far.Most of the posterior fossa neurenteric cysts are typically small, located anteriorly to the brainstem in the midline or in the cerebellopontine angle cistern area.We also present a review of the literature on this uncommon finding.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Nizams Institute of Medical Sciences, Hyderabad, India.

ABSTRACT

Background: Intracranial neurenteric cysts are rare cystic masses of endodermal origin lined with mucin producing low columnar or cuboidal epithelium. Approximately 141 cases have been reported so far. Most of the posterior fossa neurenteric cysts are typically small, located anteriorly to the brainstem in the midline or in the cerebellopontine angle cistern area.

Case report: We present a rare, histologically proven case of a large lobulated intracranial neurenteric cyst measuring 4.2 centimeters in the maximal transverse dimension and involving bilateral cerebellopontine angle cisterns. We also present a review of the literature on this uncommon finding.

Conclusions: Imaging features of neurenteric cyst are non-specific and it should be considered in the differential diagnosis for any intracranial extraaxial cystic lesion.

No MeSH data available.


Related in: MedlinePlus

Axial diffusion image shows no evidence of intralesional diffusion restriction.
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Related In: Results  -  Collection


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f5-poljradiol-79-356: Axial diffusion image shows no evidence of intralesional diffusion restriction.

Mentions: A 35-year-old man presented with a four-month history of headache and vertigo. Detailed neurological examination, chest X-ray and routine laboratory investigations were normal. Magnetic Resonance Imaging of brain was advised which showed a large lobulated non-enhancing lesion of 4.2×2.7×4.2 cm in size, located in the right cerebellopontine angle cistern extending across the midline, anteriorly to the brainstem to involve the left CPA cistern as well. The lesion showed a high signal intensity on T1-weighted (Figure 1) and FLAIR image (Figure 2) and low signal intensity on T2-weighted (Figure 3) image with no evidence of contrast enhancement (Figure 4A and 4B) and diffusion restriction (Figure 5). The option of NC versus white epidermoid was presented. The patient was subjected to surgery and the lesion was excised. Histopathologically, multiple sections showed a cyst lined with cuboidal to flattened cells and columnar cells sometimes (Figure 6). No goblet cells, appendages or keratin flakes were seen. Immunohistochemistry with Glial Fibrillary Acidic Protein (GFAP) was negative (Figure 7). These features were consistent with neurenteric cyst. Serial imaging follow-ups were suggested.


An unusual case of large posterior fossa neurenteric cyst involving bilateral cerebellopontine angle cisterns: report of a rare case and review of literature.

Arora R, Rani JY, Uppin MS, Ca R - Pol J Radiol (2014)

Axial diffusion image shows no evidence of intralesional diffusion restriction.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4199459&req=5

f5-poljradiol-79-356: Axial diffusion image shows no evidence of intralesional diffusion restriction.
Mentions: A 35-year-old man presented with a four-month history of headache and vertigo. Detailed neurological examination, chest X-ray and routine laboratory investigations were normal. Magnetic Resonance Imaging of brain was advised which showed a large lobulated non-enhancing lesion of 4.2×2.7×4.2 cm in size, located in the right cerebellopontine angle cistern extending across the midline, anteriorly to the brainstem to involve the left CPA cistern as well. The lesion showed a high signal intensity on T1-weighted (Figure 1) and FLAIR image (Figure 2) and low signal intensity on T2-weighted (Figure 3) image with no evidence of contrast enhancement (Figure 4A and 4B) and diffusion restriction (Figure 5). The option of NC versus white epidermoid was presented. The patient was subjected to surgery and the lesion was excised. Histopathologically, multiple sections showed a cyst lined with cuboidal to flattened cells and columnar cells sometimes (Figure 6). No goblet cells, appendages or keratin flakes were seen. Immunohistochemistry with Glial Fibrillary Acidic Protein (GFAP) was negative (Figure 7). These features were consistent with neurenteric cyst. Serial imaging follow-ups were suggested.

Bottom Line: Approximately 141 cases have been reported so far.Most of the posterior fossa neurenteric cysts are typically small, located anteriorly to the brainstem in the midline or in the cerebellopontine angle cistern area.We also present a review of the literature on this uncommon finding.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Nizams Institute of Medical Sciences, Hyderabad, India.

ABSTRACT

Background: Intracranial neurenteric cysts are rare cystic masses of endodermal origin lined with mucin producing low columnar or cuboidal epithelium. Approximately 141 cases have been reported so far. Most of the posterior fossa neurenteric cysts are typically small, located anteriorly to the brainstem in the midline or in the cerebellopontine angle cistern area.

Case report: We present a rare, histologically proven case of a large lobulated intracranial neurenteric cyst measuring 4.2 centimeters in the maximal transverse dimension and involving bilateral cerebellopontine angle cisterns. We also present a review of the literature on this uncommon finding.

Conclusions: Imaging features of neurenteric cyst are non-specific and it should be considered in the differential diagnosis for any intracranial extraaxial cystic lesion.

No MeSH data available.


Related in: MedlinePlus