Neurenteric cyst-MRI

A young adult referred for MRI with neck pain, shows a relatively well defined cyst in the anterior and anterolateral aspect of the cervical cord,measuring 5 mm appx with rest of the study normal including CV junction and vertebral bodies as well as posterior elements. Radiological diagnosis of Neurenteric cyst was suggested. Contrast study is declined by the patient. Case submitted by Dr MGK Murthy.

Teaching points

• Neurenteric cysts are rare with about 0.3 to 0.5% of spinal cord tumours

• Also refd to as enteric/enterogenous/gastrocytoma/teratomatous cysts

• Etiology is controversial

• One theory suggests normally interposed notochordal plate (between neurendoderm and ectoderm) may split , if there is accessory neurenteric canal

• Others believe primary splitting of chord is responsible due to incomplete/faulty escalation of notochord

• MRI is usually the best modality and usually shows cervical location anteriorly or anterolaterally

• Dorsal and lumbosacral regions account for minority

• Asymptomatic or may present with motor symptoms if anterior and sensory if posterior location

• Moderate enhancement after contrast occurs

• D/d includes, parasitic, dermoid etc and uncommon presentation of all etiologies including neoplasms