Download PDF
CC BY-NC-ND 4.0 · Asian J Neurosurg 2020; 15(04): 989-996
DOI: 10.4103/ajns.AJNS_322_19
Original Article

Endodermal cysts of the central nervous system: Review of the literature and a case report

Fotios Kalfas
1   Department of Neurosurgery, Padua University Hospital, Padua
,
Claudia Scudieri
2   Department of Neurosurgery and Gamma Knife Radiosurgery, IRCCS San Raffaele Scientific Institute, Vita-Salute University, Milan
3   Department of Neurological Surgery, Galliera Hospitals, Genova
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Context: Endodermal cysts are rare benign developmental cysts lined by mucin-secreting and/or ciliated, cuboidal, or columnar epithelium of probably endodermal origin. Aims: Endodermal cysts are rarely intracranial, frequently located in the posterior fossa. Supratentorial location is the most infrequent and only few cases are reported in the literature, included our case. Settings and Design: The authors report a case of intracranial supratentorial endodermal cyst with a review of the literature. Subjects and Methods: A 40-year-old woman was admitted to our department because of progressive gait disorder for 3 months due to right brachial and crural motor deficit associated to right crural sensory disorder (tactile hypesthesia) and right Babinski response at neurological examination due to an endodermal cyst located in the left frontoparietal convexity. Discussion: Total resection of endodermal cysts is recommended, despite their location and adhesion to the surrounding structures, due to its high risk of recurrence. Fenestration of the cystic content into the subarachnoid cistern may cause obstructive hydrocephalus or chemical meningism. Results: Although rare, surgeons should be aware that these lesions must be differentiated clinically, radiologically, and histologically from other supratentorial cystic lesions.

Key-words:

Central nervous system - endodermal cyst - enterogenous cyst - epithelial cyst - neurenteric cyst - neuroenteric cyst - supratentorial extra-axial cystic lesion

Financial support and sponsorship

Nil.




Publication History

Received: 28 October 2019

Accepted: 13 August 2020

Article published online:
16 August 2022

© 2020. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Puusepp M. Rare variety of sudural teratoma of the cervical region (intestinome): Quadriplegia, eradication and complete healing . Rev Neurol (Paris) 1934:2:879-86.
  • 2 Kubie LS, Fulton JF. A clinical and pathological study of two teratomatous cysts of the spinal cord, containing mucinous and ciliated cells. Surg Gynecol Obstet 1928;47:297-311.
  • 3 Holcomb GW Jr., Matson DD. Thoracic neurenteric cyst. Surgery 1954;35:115-21.
  • 4 Knight G, Griffiths T, Williams I. Gastrocystoma of the spinal cord. Br J Surg 1955;42:635-8.
  • 5 Scoville WB, Manlapaz JS, Otis RD, Cabieses F. Intraspinal enterogenous cyst. J Neurosurg 1963;20:704-6.
  • 6 Jeung MY, Gasser B, Gangi A, Bogorin A, Charneau D, Wihlm JM, et al. Imaging of cystic masses of the mediastinum. Radiographics 2002;22S79-93.
  • 7 Kumar R, Jain R, Rao KM, Hussain N. Intraspinal neurenteric cysts – Report of three paediatric cases. Childs Nerv Syst 2001;17:584-8.
  • 8 Chen CT, Lee CY, Lee ST, Chang CN, Wei KC, Wu CT. Neurenteric cysts: risk factors and management of recurrence. Acta Neurochir (Wien) 2016;158(7):1325-31. doi: 10.1007/s00701-016-2828-y. Epub 2016. PMID: 27169426.
  • 9 List CF, Williams JR. Subdural epithelial cyst in the interhemisph- eral fissure. Report of a case, with some remarks concerning the classification of intracranial and thelial cysts. J Neurosurg 1961;18:690-3.
  • 10 Vuia O. Congenital intracerebral epithelial cysts. Neurochirurgia (Stuttg) 1976;19:219-26.
  • 11 Palma L, Celli P. Suprasellar epithelial cyst. Case report. J Neurosurg 1983;58:763-5.
  • 12 Campbell DA, Varma TR. An extraventricular colloid cyst: Case report. Br J Neurosurg 1991;5:519-22.
  • 13 Dauch WA, Hellwig D, Rossberg C, Lütcke A, Mennel HD. Epithelial cyst of the central nervous system. A rare abnormality. Neurochirurgia (Stuttg) 1991;34:111-5.
  • 14 Scaravilli F, Lidov H, Spalton DJ, Symon L. Neuroenteric cyst of the optic nerve: Case report with immunohistochemical study. J Neurol Neurosurg Psychiatry 1992;55:1197-9.
  • 15 Harrison MJ, Morgello S, Post KD. Epithelial cystic lesions of the sellar and parasellar region: A continuum of ectodermal derivatives? J Neurosurg 1994;80:1018-25.
  • 16 Leventer DB, Merriam JC, Defendini R, Behrens MM, Housepian EM, LeQuerica S, et al. Enterogenous cyst of the orbital apex and superior orbital fissure. Ophthalmology 1994;101:1614-21.
  • 17 Graziani N, Dufour H, Figarella-Branger D, Donnet A, Bouillot P, Grisoli F. Do the suprasellar neurenteric cyst, the Rathke cleft cyst and the colloid cyst constitute a same entity? Acta Neurochir (Wien) 1995;133:174-80.
  • 18 Bavetta S, El-Shunnar K, Hamlyn PJ. Neurenteric cyst of the anterior cranial fossa. Br J Neurosurg 1996;10:225-7.
  • 19 Büttner A, Winkler PA, Weis S. Endodermal cyst of the third ventricle: Case report. Neurosurgery 1997;40:832-5.
  • 20 Ho LC, Olivi A, Cho CH, Burger PC, Simeone F, Tihan T. Well- differentiated papillary adenocarcinoma arising in a supratento- rial enterogenous cyst: Case report. Neurosurgery 1998;431474-7.
  • 21 Asamoto S, Sugiyama H, Doi H, Hino K, Ida M, Takahashi M, et al. A case of neuroaxis endodermal cyst. No To Shinkei 1999;51:520-3.
  • 22 Sampath S, Yasha TC, Shetty S, Chandramouli BA. Parasellar neurenteric cyst: Unusual site and histology: Case report Neurosurgery 1999;44:1335-7.
  • 23 Cheng JS, Cusick JF, Ho KC, Ulmer JL. Lateral supratentorial endo- dermal cyst: Case report and review of literature. Neurosurgery 2002;51493-9.
  • 24 Christov C, Chrétien F, Brugieres P, Djindjian M. Giant supra- tentorial enterogenous cyst: Report of a case, literature review, and discussion of pa
  • 25 Tan GS, Hortobágyi T, Al-Sarraj S, Connor SE. Intracranial laterally based supratentorial neurenteric cyst. Br J Radiol 2004;77:963-5.
  • 26 Kachur E, Ang LC, Megyesi JF. Intraparenchymal supratentorial neurenteric cyst. Can J Neurol Sci 2004;31:412-6.
  • 27 Stubenvoll F, Beschorner R, Danz S, Freudenstein D. Fronto-laterally located supratentorial bronchogenic cyst: Case report and review of the literature. Clin Neuropathol 2006;25:123-7.
  • 28 Preece MT, Osborn AG, Chin SS, Smirniotopoulos JG. Intracranial neurenteric cysts: Imaging and pathology spectrum. AJNR Am J Neuroradiol 2006;27:1211-6.
  • 29 Okunaga T, Tsutsumi K, Hayashi T, Nagata I. Endodermal cyst of the oculomotor nerve: Case report. Neurosurgery 2006;58:E994.
  • 30 Neckrysh S, Valyi-Nagy T, Charbel FT. Neuroenteric cyst of the anterior cranial fossa: Case report and review of the literature. Surg Neurol 2006;65:174-7.
  • 31 Miyagi A, Katayama Y. Neurenteric cyst arising in the high convexity parietal lesion: Case report. Neurosurgery 2007;60:E203-4.
  • 32 Takumi I, Mori O, Mizutani N, Akimoto M, Kobayashi S, Teramoto A. Expansile neurenteric cyst arising in the frontal lobe associated with status epilepticus: Report of a case and discussion of epileptogenesis. Brain Tumor Pathol 2008;25:97-101.
  • 33 Marchionni M, Smith C, Eljamel MS. Intracranial enterogenous cyst extending into both supratentorial and infratentorial compartments: Case report and review of the literature. Skull Base 2008;18:213-6.
  • 34 Basheer N, Kasliwal MK, Suri A, Sharma MC, Arora A, Sharma BS. Lateral extradural, supratentorial neurenteric cyst. J Clin Neurosci 2010;17:639-41.
  • 35 Keiner D, Gaab MR, Ostertag H, Sommer C, Oertel J. Brain abscess formation within an endodermal cyst of the frontal lobe: Case report. Minim Invasive Neurosurg 2009;52:242-5.
  • 36 Garbizu JM, Mateo-Sierra O, Iza B, Ruiz-Juretschke F, Pérez-Calvo JM. Supratentorial endodermal cyst. Case report. Neurocirugia (Astur) 2009;20:367-71.
  • 37 Dunham CP, Curry B, Hamilton M. Malignant transformation of an intraaxial-supratentorial neurenteric cyst – Case report and review of the literature. Clin Neuropathol 2009;28:460-6.
  • 38 Reddy RS, Vijayasaradhi M, Uppin MS, Challa S. A rare case of extradural neurenteric cyst with supratentorial and infratentorial extension. Acta Neurochir (Wien) 2010;152:1957-9.
  • 39 Krishnamurthy G, Roopesh Kumar VR, Rajeswaran R, Rao S. Supratentorial enterogenous cyst: A report of two cases and review of literature. Neurol India 2010;58:774-7.
  • 40 Jhawar SS, Nadkarni T, Goel A. Intraparenchymal temporal neurenteric cyst. J Clin Neurosci 2011;18:415-7.
  • 41 Little MW, Guilfoyle MR, Bulters DO, Scoffings DJ, O'Donovan DG, Kirkpatrick PJ. Neurenteric cyst of the anterior cranial fossa: Case report and literature review. Acta Neurochir (Wien) 2011;153:1519-25.
  • 42 Gauden AJ, Khurana VG, Tsui AE, Kaye AH. Intracranial neuroenteric cysts: A concise review including an illustrative patient. J Clin Neurosci 2012;19:352-9.
  • 43 Natrella F, Mariottini A, Rocchi R, Miracco C. Supratentorial neurenteric cyst associated with a intraparenchymal subependymoma. BMJ Case Rep. 2012;2012:bcr0120125566. Published 2012 Aug 13. doi:10.1136/bcr.01.2012.5566.
  • 44 Kitamura Y, Sasaki H, Hashiguchi A, Momoshima S, Shidoh S, Yoshida K. Supratentorial neurenteric cyst with spontaneous repetitive intracystic hemorrhage mimicking brain abscess: A case report. Neurosurg Rev 2014;37:153-9.
  • 45 Caruso R, Artico M, Colonnese C, Marrocco L, Wierzbicki V. Supratentorial endodermal cysts: Review of literature and case report. J Neurol Surg A Cent Eur Neurosurg 2013;74:378-87.
  • 46 Mittal S, Petrecca K, Sabbagh AJ, Rayes M, Melançon D, Guiot MC, et al. Supratentorial neurenteric cysts-A fascinating entity of uncertain embryopathogenesis. Clin Neurol Neurosurg 2010;112:89-97.
  • 47 Arabi M, Ibrahim M, Camelo-Piragua S, Shah G. Supratentorial neurenteric cyst mimicking hydatid cyst: A case report and literature review. Avicenna J Med 2013;3:73-80.
  • 48 Salvetti DJ, Williams BJ, Posthumus JS, Shaffrey ME. Enterogenous cyst of the third ventricle. J Clin Neurosci 2014;21:161-3.
  • 49 Junaid M, Kalsoom A, Khalid M, Bukhari SS. Giant supratentorial neurenteric cyst. J Coll Physicians Surg Pak 2014;24 Suppl 3:S214-5.
  • 50 Janczar K, Tybor K, Papierz W. Supratentorial neurenteric cyst—a case report. Neurol Neurochir Pol 2014;48:219-22.
  • 51 Chakraborty S, Priamo F, Loven T, Li J, Insinga S, Schulder M. Supratentorial Neurenteric Cysts: Case Series and Review of Pathology, Imaging, and Clinical Management. World Neurosurg. 2016;85:143-152. doi:10.1016/j.wneu.2015.08.057.
  • 52 Rangarajan V, Mahore A, Patil MK, Shendarkar AD. Supratentorial endodermal cysts-Report of two cases. Asian J Neurosurg 2016;11:310.
  • 53 Chen CT, Lee CY, Lee ST, Chang CN, Wei KC, Wu CT. Neurenteric cysts: Risk factors and management of recurrence. Acta Neurochir 2016;158:1325-31.
  • 54 Rim HT, Song JH, Kim ES, Kwon MJ. Mucinous adenocarcinoma arising from a residual supratentorial neurenteric cyst and expressing mutated KRAS: a case report. Hum Pathol. 2016 Dec;58:146-151. doi: 10.1016/j.humpath.2016.05.027. Epub 2016 Aug 26. PMID: 27569299.
  • 55 Lopez-Gonzalez MA, Dolan E. Endodermal cyst in pineal region: Rare location. Surg Neurol Int. 2016 May 6;7(Suppl 11):S279-81. doi: 10.4103/2152-7806.181984. PMID: 27217965; PMCID: PMC4866050.
  • 56 Bao XJ, Li XY, Wang QP, Ren XY, Liang ZY, Ma WB, et al. Intraparenchymal endodermal cyst with spontaneous intracystic hemorrhage in the temporal lobe of an adult. Medicine 2016;95:e4968.
  • 57 Góes P, Vaz-Guimaraes F, Suriano IC, Araújo S, Zymberg ST. Supratentorial neurenteric cyst: Analysis of 45 cases in the literature. Interdiscipli Neurosurg Adv Techn Case Manage 11 (2018) 57-64 [doi: 10.1016/j.inat. 2017.08.008].
  • 58 MacMahon P, Iacob S, Bach SE, Elwood ET, Lin JJ, Avellino AM. Neurosurgical management of a rare congenital supratentorial neurenteric cyst with associated nasal dermal sinus: case report, Journal of Neurosurgery: Pediatrics PED, 2017:20;521-5.
  • 59 Kim JH, Wang KC, Phi JH, Park SH, Cheon JE, Kim SK. Intracranial neurenteric cyst arising at the suprasellar cistern with extension to middle cranial fossa. Childs Nerv Syst 2018;34:2491-2495. doi: 10.1007/s00381-018-3892-9. Epub 2018 Jul 6. PMID: 29980836.
  • 60 Nunes Dias L, Puerta Roldán P, Guillén Quesada A, Suñol Capella M, Hinojosa J. Supratentorial neuroenteric cyst in children: a case report and brief literature review. Childs Nerv Syst 2019;35:2227-31. doi: 10.1007/s00381-019-04190-4. Epub 2019 May 11. PMID: 31079180.
  • 61 Burger PC, Scheithauer BW. AFIP Atlas of Tumor Pathology, Series 4. Washington, DC: Armed Forces Institute of Pathology; 2007.
  • 62 Emerson RE, Azzarelli B. Enterogenous cysts of the spinal canal and cerebellopontine angle. Appl Immunohistochem Mol Morphol 2004;12:230-3.
  • 63 Sahara Y, Nagasaka T, Takayasu M, Takagi T, Hata N, Yoshida J. Recurrence of a neurenteric cyst with malignant transformation in the foramen magnum after total resection. Case report. J Neurosurg 2001;95:341-5.
  • 64 Monaco R, Boscaino A, Di Blasi A, D'Antonio A, Profeta G, De Falco R, et al. Intraepithelial carcinoma arising in an endodermal cyst of the posterior fossa. Neuropathology 2003;23:219-24.
  • 65 Gessi M, Legnani FG, Maderna E, Casali C, Solero CL, Pollo B, et al. Mucinous low-grade adenocarcinoma arising in an intracranial enterogenous cyst: Case report. Neurosurgery 2008;62:E972-3.
  • 66 Wang W, Piao YS, Gui QP, Zhang XH, Lu DH. Cerebellopontine angle neurenteric cyst with focal malignant features. Neuropathology 2009;29:91-5.
  • 67 Okabe H, Katsura K, Yamano T, Tenjin H, Nakahara Y, Ishida M, et al. Mucinous adenocarcinoma arising from supratentorial intramedullary neuroenteric cyst with broncho-pulmonary differentiation. Neuropathology 2014;34:420-4.
  • 68 Wilkins RH, Odom GL. Tumors of the spine and spinal cord, part 2. In: Vinken PJ, Bruyn GW, editors. Handbook of Clinical Neurology. Amsterdam; 1976. p. 55-102.
  • 69 Christov C, Chrétien F, Brugieres P, Djindjian M. Giant supratentorial enterogenous cyst: Report of a case, literature review, and discussion of pathogenesis. Neurosurgery 2004;54:759-63.
  • 70 Andre E, Xu M, Yang D, Siow JK, Yeo TT, Xu Y, et al. MR spectroscopy in sinus mucocele: N-acetyl mimics of brain N-acetylaspartate. AJNR Am J Neuroradiol 2006;27:2210-3.
  • 71 Periakaruppan A, Kesavadas C, Radhakrishnan VV, Thomas B, Rao RM. Unique MR spectroscopic finding in colloid-like cyst. Neuroradiology 2008;50:137-44.
  • 72 Mehnert F, Beschorner R, Küker W, Hahn U, Nägele T. Retroclival ecchordosis physaliphora: MR imaging and review of the literature. AJNR Am J Neuroradiol 2004;25:1851-5.
  • 73 Inoue T, Kawahara N, Shibahara J, Masumoto T, Usami K, Kirino T. Extradural neurenteric cyst of the cerebellopontine angle. Case report. J Neurosurg 2004;100:1091-3.
  • 74 Ochi M, Hayashi K, Hayashi T, Morikawa M, Ogino A, Hashmi R, et al. Unusual CT and MR appearance of an epidermoid tumor of the cerebellopontine angle. AJNR Am J Neuroradiol 1998;19:1113-5.
  • 75 Vlaho S, Gebhardt B, Gerlach R, Weidauer S, Kieslich M. Cyst of the third ventricle as an unusual cause of acquired hydrocephalus. Pediatr Neurol 2003;28:225-7.
  • 76 Pianetti Filho G, Fonseca LF. High medular compression cause by neurenteric cyst. Report of a case. Arq Neuropsiquiatr 1993;51:253-7.
  • 77 Inoue T, Matsushima T, Fukui M, Iwaki T, Takeshita I, Kuromatsu C. Immunohistochemical study of intracranial cysts. Neurosurgery 1988;23:576-81.
  • 78 Ito S, Fujiwara S, Mizoi K, Namiki T, Yosimoto T. Enterogenous cyst at the cerebellopontine angle: Case report. Surg Neurol 1992;37:366-70.
  • 79 Khalatbari MR, Moharamzad Y. Spontaneous hemorrhage into a neurenteric cyst of the cerebellar vermis. Neuropediatrics 2011;42:116-8.
  • 80 Malcolm GP, Symon L, Kendall B, Pires M. Intracranial neurenteric cysts. Report of two cases. J Neurosurg 1991;75:115-20.
  • 81 Scarone P, Boissonnet H, Heran F, Gray F, Robert G. Neurenteric cyst of the posterior fossa. Case report and review of the literature. Neurochirurgie 2009;55:45-52.
  • 82 Weiss MA, Gebarski SS, McKeever PE. Foramen magnum neurenteric cyst causing Mollaret meningitis: MR findings. AJNR 1996;17:386-8.
  • 83 Yang T, Wu L, Fang J, Yang C, Deng X, Xu Y. Clinical presentation and surgical outcomes of intramedullary neurenteric cysts. J Neurosurg Spine 2015;23:99-110.