Management of an unusual, recurrent neurenteric cyst in an infant: case report and review of the literature

• Published in: Child's nervous system 2017-09, Vol.33 (9), p.1603-1607
• Main Authors: Esfahani, Darian R., Burokas, Laura, Brown, Henry G., Hahn, Yoon S., Nikas, Dimitrios
• Format: Article
• Language: English
• Subjects: Case Report; Cervical Vertebrae - surgery; Humans; Hydrocephalus - etiology; Infant; Male; Medicine; Medicine & Public Health; Meningitis, Aseptic - etiology; Neural Tube Defects - pathology; Neural Tube Defects - surgery; Neurosciences; Neurosurgery; Neurosurgical Procedures - adverse effects; Neurosurgical Procedures - methods; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Recurrence
• ISSN: 0256-7040; 1433-0350
• DOI: 10.1007/s00381-017-3487-x

Purpose Neurenteric cysts are rare congenital remnants formed by a failure of separation between endoderm and ectoderm in utero. Methods We describe a case of a 7-month-old male with a large cervical neurenteric cyst presenting with intermittent neck stiffness and irritability. Results This cyst was resected, recurred, and required repeat surgery. The patient’s postoperative course included aseptic meningitis and hydrocephalus requiring ventriculoperitoneal shunt and later management of tethered cord, necessitating detethering. Conclusion Unique features of this case include the presence of intermittent pain symptoms, which may be attributable to cyst filling and emptying. Hydrocephalus is an uncommon finding that may be secondary to aseptic meningitis from cyst rupture. Tethered cord is also an unusual entity that can accompany this diagnosis, warranting additional imaging work-up and monitoring.