Takahashi Toshihide, Yanaka Kiyoyuki, Aiyama Hitoshi, Saura Minami, Kajita Michihide, Takahashi Nobuyuki, Onuma Kuniyuki, Ishikawa Eiichi
Departments of Neurosurgery, Tsukuba Memorial Hospital, Tsukuba, Japan.
Departments of Radiology, Tsukuba Memorial Hospital, Tsukuba, Japan.
J Neurosurg Case Lessons. 2024 Jul 8;8(2). doi: 10.3171/CASE24180.
Neurenteric cysts are relatively rare benign congenital intracranial cystic lesions that enlarge rarely and very slowly. The authors present a case of an enlarging neurenteric cyst at the craniocervical junction with a fluid-fluid level on magnetic resonance imaging (MRI).
A 34-year-old man with no significant medical history underwent head MRI to investigate mild headaches. An incidental cystic lesion, approximately 8 mm in diameter, was revealed at the craniocervical junction. Serial follow-up MRI showed cyst enlargement with a fluid-fluid level. Four years later, the cyst reached a size of 15 mm and was surgically removed. The cyst contained cloudy fluid with a high protein concentration, without any bleeding or tissue fragments. Pathological examination confirmed the diagnosis of a neurenteric cyst. The patient recovered well, was discharged home, and has remained recurrence free for 2 years.
The growth dynamics of the relatively rapidly expanding neurenteric cyst at the craniocervical junction were monitored over time using MRI. This cyst exhibited the distinctive feature of a fluid-fluid level as it enlarged. Investigating the mechanisms underlying fluid-fluid level formation may offer novel insights into the pathogenesis of cyst enlargement. https://thejns.org/doi/10.3171/CASE24180.
神经肠囊肿是相对罕见的良性先天性颅内囊性病变，极少且非常缓慢地增大。作者报告一例颅颈交界处增大的神经肠囊肿，磁共振成像（MRI）显示有液-液平面。
一名无重大病史的34岁男性因轻度头痛接受头部MRI检查。在颅颈交界处发现一个偶然的囊性病变，直径约8毫米。系列随访MRI显示囊肿增大并出现液-液平面。四年后，囊肿大小达到15毫米并接受手术切除。囊肿内含有高蛋白浓度的混浊液体，无任何出血或组织碎片。病理检查确诊为神经肠囊肿。患者恢复良好，出院回家，2年来一直无复发。
使用MRI对颅颈交界处相对快速扩大的神经肠囊肿的生长动态进行了长期监测。该囊肿在增大时表现出液-液平面这一独特特征。研究液-液平面形成的潜在机制可能为囊肿增大的发病机制提供新的见解。https://thejns.org/doi/10.3171/CASE24180
