Wu Adela, Patel Mahesh, Darbonne Dawn, Singh Harminder
Department of Neurosurgery, Stanford University Medical Center, Stanford, California; and.
Departments of Radiology and.
J Neurosurg Case Lessons. 2021 Mar 29;1(13):CASE2115. doi: 10.3171/CASE2115.
Spinal bronchogenic cysts are rare entities arising from errors in embryogenesis and consisting of respiratory epithelial cells. To date, there are three other published accounts of intramedullary cysts, which were partially resected and thereby warrant close follow-up and monitoring. The authors present an illustrative case of a patient presenting with Klippel-Feil anomaly and a large intramedullary bronchogenic cyst in the upper cervical spine.
The authors noted fusion of the C5-6 laminae as they performed the C2-6 laminectomy. After dural opening, an intramedullary lesion with a smooth, fibrous component emerging from the dorsal spinal cord was immediately observed. The dorsal spinal columns were not involved with this cyst wall or the other smaller cysts, which all contained gray fluid. The cyst walls were partially resected and sent for pathological examination.
Spinal developmental cysts are associated with other anatomical anomalies, such as Klippel-Feil anomaly, arising from errors in embryogenesis. For intramedullary lesions such as this patient's bronchogenic cyst, partial resection and decompression are the goals of surgery because aggressive debulking may lead to neurological compromise. Close imaging follow-up is warranted.
脊柱支气管源性囊肿是一种罕见的因胚胎发育错误而产生的病变，由呼吸道上皮细胞组成。迄今为止，另有三篇关于髓内囊肿的报道，这些囊肿均接受了部分切除，因此需要密切随访和监测。作者报告了一例伴有Klippel-Feil畸形和上颈椎巨大髓内支气管源性囊肿的患者病例。
作者在进行C2-6椎板切除术时注意到C5-6椎板融合。打开硬脑膜后，立即观察到一个髓内病变，其有一个光滑的纤维成分从脊髓背侧发出。脊髓背柱未受累于该囊肿壁或其他较小的囊肿，这些囊肿均含有灰色液体。囊肿壁被部分切除并送去做病理检查。
脊柱发育性囊肿与其他解剖学异常有关，如Klippel-Feil畸形，是由胚胎发育错误引起的。对于此类患者的髓内病变，如支气管源性囊肿，手术的目标是部分切除和减压，因为积极的减容可能导致神经功能损害。需要进行密切的影像学随访。
