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Spinal neurenteric cyst in a dog.

Ferrand FX, Pillard P, Carozzo C, Marchal T, Seurin MJ, Escriou C - Ir Vet J (2015)

Bottom Line: This type of cyst is well-known in humans but has never been described in dogs.We propose that neurenteric cysts should be included in the differential diagnoses for tumor-like or cystic intradural lesions in the young dog.Prognosis for this type of cyst seems to be good, as total surgical removal led to a progressive clinical improvement with no recurrence at 18 months.

View Article: PubMed Central - PubMed

Affiliation: Small Animal Surgery Department, Vet Agro Sup, Campus Vétérinaire de Lyon. 1 Avenue Bourgelat, 69280 Marcy l'Etoile, France.

ABSTRACT
A 2-year-old female crossbreed dog was presented with progressive ataxia and paraparesis. A T3-L3 spinal lesion was determined by neurological examination. Magnetic resonance imaging (MRI) revealed an ovoid-shaped, well-circumscribed mass affecting the spinal cord at the level of the T9 vertebra. A left hemilaminectomy and a durotomy at the level of T9 allowed discovery of an ovoid deformation of the meninges with a cystic appearance. En bloc removal was performed and appeared to be complete. Pathological analysis showed a voluminous cystic lesion lined by a heterogeneous epithelium. Three types of epithelium were present: a pseudostratified columnar epithelium, a stratified squamous epithelium and a transitional epithelium. Mucus production, the morphology of some cells with microvilli at the apical pole and immunohistochemical assays were highly in favor of an endodermal origin of the cyst. The age of the dog, anamnesis, MRI study and histological findings were consistent with an intradural neurenteric cyst as described in humans. Total surgical removal led to a progressive clinical improvement with no recurrence at 18 months. We report an unusual intradural extramedullary cyst, called a neurenteric cyst, in a 2-year-old female crossbreed dog. This type of cyst is well-known in humans but has never been described in dogs. We propose that neurenteric cysts should be included in the differential diagnoses for tumor-like or cystic intradural lesions in the young dog. Prognosis for this type of cyst seems to be good, as total surgical removal led to a progressive clinical improvement with no recurrence at 18 months.

No MeSH data available.


Related in: MedlinePlus

Intra-operative view of the cyst after durotomy
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Fig3: Intra-operative view of the cyst after durotomy

Mentions: An ovoid deformation of the meninges with a cystic appearance could be seen at the level of T8-T9, involving the whole left side of the spine. At the dura mater opening, an intradural extramedullary soft mass could be observed (Fig. 3). A translucent, gelatinous liquid was obtained from the mass by fine needle aspiration, which looked like mucus. Dissection of the mass was then performed using microscopic assistance. The lesion did not adhere to the surrounding nervous tissue, so en bloc removal was possible and appeared to be complete. A concave imprint of the lesion was still present. Summarily, the mass was left sided extramedullary and intradural without nerve root involvement. Pathological analysis showed a voluminous cystic lesion (approximated size of 10 mm × 6.5 mm) lined by a heterogeneous epithelium (Fig. 4). A pseudostratified columnar epithelium with cylindrical cells with basal nuclei and round-shaped apical poles, evoking an enteral or respiratory epithelium, was observed (Fig. 5a). Structures such as cilia or microvilli were sometimes present at the apical pole (Fig. 6). Moreover, a stratified squamous epithelium evoking a Malpighian epithelium, but without keratin production, was observed (Fig. 5b). Finally, a transitional epithelium similar to urinary epithelium was present. Mucus production was established by histochemical assays utilizing periodic acid-Schiff (Fig. 7a and b) and alcian blue (Fig. 7c). This highlighted the secretory nature of the epithelium. All of these different epithelia lacked differentiation. Immunohistochemical labelling was carried out. The wall of the cyst showed antigens of cytokeratin. This finding was consistent with the epithelial nature of the tissue. The cystic epithelial cells also stained positively for carcinoembryonic antigen (Fig. 8). This finding was consistent with an endodermal origin of the cyst. In contrast gliofibrillar acid protein and vimentine antigens were not expressed. Mucus production and the morphology of some cells with microvilli at the apical pole were also highly in favor of an endodermal origin of the cyst. The association of a cystic structure with heterogeneous epithelia of endodermal origin led to the diagnosis of a spinal neurenteric cyst, as described in humans. Post-operatively, neurological deficits dramatically worsened; the patient was paraplegic with loss of nociception in the left hind limb. Deep pain sensibility recovered after 5 days and the capacity to walk after 10 days. Fecal and urinary continence recovered after one month, and proprioceptive deficits were the only remaining neurologic deficit after six months. A follow-up MRI study performed 111 days after the surgery revealed no recurrence of the lesion and no spinal cord compression. No recurrence of clinical signs has been observed 18 months after surgery.Fig. 3


Spinal neurenteric cyst in a dog.

Ferrand FX, Pillard P, Carozzo C, Marchal T, Seurin MJ, Escriou C - Ir Vet J (2015)

Intra-operative view of the cyst after durotomy
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4940728&req=5

Fig3: Intra-operative view of the cyst after durotomy
Mentions: An ovoid deformation of the meninges with a cystic appearance could be seen at the level of T8-T9, involving the whole left side of the spine. At the dura mater opening, an intradural extramedullary soft mass could be observed (Fig. 3). A translucent, gelatinous liquid was obtained from the mass by fine needle aspiration, which looked like mucus. Dissection of the mass was then performed using microscopic assistance. The lesion did not adhere to the surrounding nervous tissue, so en bloc removal was possible and appeared to be complete. A concave imprint of the lesion was still present. Summarily, the mass was left sided extramedullary and intradural without nerve root involvement. Pathological analysis showed a voluminous cystic lesion (approximated size of 10 mm × 6.5 mm) lined by a heterogeneous epithelium (Fig. 4). A pseudostratified columnar epithelium with cylindrical cells with basal nuclei and round-shaped apical poles, evoking an enteral or respiratory epithelium, was observed (Fig. 5a). Structures such as cilia or microvilli were sometimes present at the apical pole (Fig. 6). Moreover, a stratified squamous epithelium evoking a Malpighian epithelium, but without keratin production, was observed (Fig. 5b). Finally, a transitional epithelium similar to urinary epithelium was present. Mucus production was established by histochemical assays utilizing periodic acid-Schiff (Fig. 7a and b) and alcian blue (Fig. 7c). This highlighted the secretory nature of the epithelium. All of these different epithelia lacked differentiation. Immunohistochemical labelling was carried out. The wall of the cyst showed antigens of cytokeratin. This finding was consistent with the epithelial nature of the tissue. The cystic epithelial cells also stained positively for carcinoembryonic antigen (Fig. 8). This finding was consistent with an endodermal origin of the cyst. In contrast gliofibrillar acid protein and vimentine antigens were not expressed. Mucus production and the morphology of some cells with microvilli at the apical pole were also highly in favor of an endodermal origin of the cyst. The association of a cystic structure with heterogeneous epithelia of endodermal origin led to the diagnosis of a spinal neurenteric cyst, as described in humans. Post-operatively, neurological deficits dramatically worsened; the patient was paraplegic with loss of nociception in the left hind limb. Deep pain sensibility recovered after 5 days and the capacity to walk after 10 days. Fecal and urinary continence recovered after one month, and proprioceptive deficits were the only remaining neurologic deficit after six months. A follow-up MRI study performed 111 days after the surgery revealed no recurrence of the lesion and no spinal cord compression. No recurrence of clinical signs has been observed 18 months after surgery.Fig. 3

Bottom Line: This type of cyst is well-known in humans but has never been described in dogs.We propose that neurenteric cysts should be included in the differential diagnoses for tumor-like or cystic intradural lesions in the young dog.Prognosis for this type of cyst seems to be good, as total surgical removal led to a progressive clinical improvement with no recurrence at 18 months.

View Article: PubMed Central - PubMed

Affiliation: Small Animal Surgery Department, Vet Agro Sup, Campus Vétérinaire de Lyon. 1 Avenue Bourgelat, 69280 Marcy l'Etoile, France.

ABSTRACT
A 2-year-old female crossbreed dog was presented with progressive ataxia and paraparesis. A T3-L3 spinal lesion was determined by neurological examination. Magnetic resonance imaging (MRI) revealed an ovoid-shaped, well-circumscribed mass affecting the spinal cord at the level of the T9 vertebra. A left hemilaminectomy and a durotomy at the level of T9 allowed discovery of an ovoid deformation of the meninges with a cystic appearance. En bloc removal was performed and appeared to be complete. Pathological analysis showed a voluminous cystic lesion lined by a heterogeneous epithelium. Three types of epithelium were present: a pseudostratified columnar epithelium, a stratified squamous epithelium and a transitional epithelium. Mucus production, the morphology of some cells with microvilli at the apical pole and immunohistochemical assays were highly in favor of an endodermal origin of the cyst. The age of the dog, anamnesis, MRI study and histological findings were consistent with an intradural neurenteric cyst as described in humans. Total surgical removal led to a progressive clinical improvement with no recurrence at 18 months. We report an unusual intradural extramedullary cyst, called a neurenteric cyst, in a 2-year-old female crossbreed dog. This type of cyst is well-known in humans but has never been described in dogs. We propose that neurenteric cysts should be included in the differential diagnoses for tumor-like or cystic intradural lesions in the young dog. Prognosis for this type of cyst seems to be good, as total surgical removal led to a progressive clinical improvement with no recurrence at 18 months.

No MeSH data available.


Related in: MedlinePlus