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Clinical case of intramedullary spinal neuroenteric cyst
Author(s): ,
G. Januário
Affiliations:
Centro Hospitalar Lisboa Central, Hospital de São José, Neurosurgery, Lisbon, Portugal
,
B. Smet
Affiliations:
Centro Hospitalar Lisboa Central, Hospital de São José, Neurosurgery, Lisbon, Portugal
,
R. Nogueira
Affiliations:
Centro Hospitalar Lisboa Central, Hospital de São José, Neurosurgery, Lisbon, Portugal
,
M. Correia
Affiliations:
Hospital Dona Estefânia, Pediatric Neurosurgery, Lisbon, Portugal
,
A. Sagarribay
Affiliations:
Hospital Dona Estefânia, Pediatric Neurosurgery, Lisbon, Portugal
M. Matos
Affiliations:
Hospital Dona Estefânia, Pediatric Neurosurgery, Lisbon, Portugal
EANS Academy. Janu‡rio G. Oct 21, 2018; 225911; EP6011
Gon�alo Janu‡rio
Gon�alo Janu‡rio
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Abstract
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Background
Neuroenteric cysts are usually benign lesions of the central nervous system. They have endodermal origin, derive from lack of endodermal and neuroectodermal separation during the third week of embryonic development.It is a rare entity, with a prevalence of 0.7-1.3% of spinal tumors.The spinal presentation is 3 times more frequent than the intracranial one, being the most habitual location. Eighty-five percent of spinal neuroenteric cysts are intradural-extramedullary, most of which are in anterior and medial relation to the spinal cord.They occur in infancy or early adulthood. The cervical and thoracic segments are the most affected. Total surgical removal is the treatment of choice. It may be limited by adherence to adjacent neural structures. Partial excision, cystic fenestration and biopsy have recurrence rates of up to 37%.
Methods

The authors describe a clinical case of a 7-year-old girl with normal previous development. Start gait alterations with decreased muscle strength. Cystic intramedullary lesion located in the D6 segment was identified in magnetic resonance.

Results:

The patient has undergone laminotomy D5-D6-D7, with monitoring of EMG motors and somatosensory evoked potentials (SSEPs). Cystic intramedullary lesion, cystic content drainage and excision of the lesion capsule were identified.
There was improvement in muscle strength in the lower limbs, with no sign of the first neuron. It had autonomous march on the day of discharge.

Conclusions
Neuroenteric cysts are rare congenital malformations with specific histopathological features.They should be included in the differential diagnosis of cystic lesions of the spine. Symptoms depend on the local mass effect of the cyst on the spinal cord and adjacent structures. MRI is Gold-Standard in the characterization of these lesions.Complete surgical resection is the goal of treatment associated with an excellent neurological recovery.
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