>Cirugía y Cirujanos
>Year 2011, Issue 4
Ramos-Zúñiga R, Casillas-Espinosa PM, Sánchez-Prieto JA, Encarnación-Ibarra O, López-Hernández MS
Long-term follow-up and pregnancy in a patient with neurenteric cyst. Case report
Cir Cir 2011; 79 (4)
PDF: 288.02 Kb.
Background: Neurenteric cysts (NC) are rare congenital anomalies. Cysts are secretory with an epithelial lining and features that resemble those of gastrointestinal and/or respiratory mucosa. They originate embryologically and result from an incomplete separation of the neurenteric canal from the foregut.
Clinical case: We describe the 21-year follow-up of a female patient with a history of partial control of urinary and anal sphincters. The patient had a 6-month course of pain associated with saddle hypoesthesia, limited gait, chronic constipation, plus inferior paresthesia of the limbs. These features, along with the MRI findings, were compatible with the diagnosis of neurenteric cyst. The patient underwent two surgical procedures. We used a nonradical approach because of the connection of the cyst with the rectum and nerves in the deep plane. At age 22, she became pregnant and, after an uneventful gestation, gave birth to a healthy newborn.
Discussion: The selection of surgical strategy is oriented to mass effect resolution. In accordance with the literature, evaluation of the best choice for each patient is mandatory to obtain a balance of the risk and the potential functional preservation. This report demonstrates the importance of sensory and motor function preservation instead of using aggressive treatment.
Conclusion: Our goal in each procedure was symptom alleviation, reduction of cyst size, clearance of the mass effect, and an attempt to resect the cyst capsule as much as possible without compromising quality of life and neurological functions.
||Neurenteric cyst, pregnancy.
Čolović R, Micev M, Jovanović M, Matić S, Grubor N, Atkinson HD. Abdominal neurenteric cyst. World J Gastroenterol 2008;14:3759-3762.
Klekamp J, Samii M. Extramedullary tumors. En: Klekamp J, Samii M, eds. Surgery of Spinal Tumors. 1st ed. Berlin: Springer; 2007. pp. 144-312.
Ribas AT, González MA, Salas JS, Izquierdo-García FM, Fernández- Fernández J. Adenocarcinoma en quiste neuroentérico: VII Congreso Virtual Hispanoamericano, España, Universidad de Castilla-La Mancha, Comunidad Virtual de Anatomía Patológica; 2005. Disponible en http://www.conganat.org/7congreso/PDF/316.pdf
Stapleton S. Spinal dysraphism. En: Moore AJ, Newell DW, eds. Neurosurgery. Principles and Practice. London: Springer; 2005. pp. 475-487.
Becker GW, Battersby RD. Spinal neurenteric cyst presenting as recurrent midline sebaceous cysts. Ann R Coll Surg Engl 2005;87:W1-4.
Demirbilek S, Kanmaz T, Bitiren M, Yücesan S. Mediastinal neurenteric cyst in a child. İnönü Üniversitesi Tıp Fakültesi Dergisi 2005;12:41-43.
Santos-de Oliveira R, Cinalli G, Sainte-Rose C. Neuroenteric cysts. En: Özek MM, Cinalli G, Maixner WJ, eds. Spina Bifida. Management and Outcome. Milan: Springer; 2008. pp. 475-485.
Kapoor V, Johnson DR, Fukui MB, Rothfus WE, Jho HD. Neuroradiologic- pathologic correlation in a neurenteric cyst of the clivus. AJNR Am J Neuroradiol 2002;23:476–479.
Khosla A, Wippold FJ. CT myelography and MR imaging of extramedullary cysts of the spinal canal in adult and pediatric patients. AJR Am J Roentgenol 2002;178:201-207.
Wilkins RH, Odom GL. Spinal intradural cysts. Vol. 20. Tumors of the spine and spinal cord. II. En: Vinkin PJ, Bruyn GW, eds. Handbook of Clinical Neurology. Amsterdam: North Holland; 1976. pp. 55-102.
Gimeno A, López F, Figuera D, Rodrigo L. Neuroenteric cyst. Neuroradiology 1972;3:167-172.
Kim CY, Wang KC, Choe G, Kim HJ, Jung HW, Kim IO, et al. Neurenteric cyst: its various presentations. Childs Nerv Syst 1999;15:333-341.
Brooks BS, Duvall ER, El Gammal T, Garcia JH, Gupta KL, Kapila A. Neuroimaging features of neurenteric cysts: analysis of nine cases and review of the literature. AJNR Am J Neuroradiol 1993;14:735–746.
Chavda SV, Davies AM, Cassar-Pullicino VN. Enterogenous cysts of the nervous system: a report of eight cases. Clin Radiol 1985;36:245-251.
Gulrajani M, David K, Sy W, Braithwaite A. Prenatal diagnosis of a neurenteric cyst by magnetic resonance imaging. Am J Perinatol 1993;10:304-306.
Perera GB, Milne M. Neurenteric cyst: antenatal diagnosis by ultrasound. Australas Radiol 1997;41:300-302.
Scaravilli F, Lidov H, Spalton DJ, Symon L. Neuroenteric cyst of the optic nerve: case report with immunohistochemical study. J Neurol Neurosurg Psychiatry 1992;55:1197-1199.
Yasuda M, Nakagawa H, Ozawa H, Inukai C, Watabe T, Mizuno J, et al. Disseminated neurenteric cyst. Case report. J Neurosurg Spine 2008;9:382-386.
De Verney YM, Resener TD, Knebel R. Neurenteric cyst. Rev de Cir Infantil 1997;3:171-174.
Uludag S, Madazli R, Erdogan E, Eap C, Duntze J, Scherpereel B, et al. A case of prenatally diagnosed fetal neurenteric cyst. Ultrasound Obstet Gynecol 2001;18:277-279.
Kumar R, Nayak SR. Unusual neurenteric cysts. Diagnosis and management. Pediatr Neurosurg 2002;37:321-330.
Theret E, Litre CF, Lefebvre F, Eap C, Duntze J, Scherpereel B, et al. Huge intramedullar neurenteric cyst with intrathoracic development in a 1-month-old boy: excision though the anterior approach. A case report and review of the literature. Acta Neurochir 2010;152:481-483.
Kabs C, Boschert J, Back W, Dietmar D, Hosie S. Successful treatment of recurrent abdominopelvic neurenteric cysts by OK-432 injection. J Pediatr Surg 2009;44:1019-1021.
Bilik R, Ginzberg H, Superina RA. Unconventional treatment of neuroenteric cyst in a newborn. J Pediatr Surg 1995;30:115-117.
>Cirugía y Cirujanos
>Year 2011, Issue 4