Giant supratentorial enterogenous cyst: report of a case, literature review, and discussion of pathogenesis.

Abstract

OBJECTIVE AND IMPORTANCE:

To describe a histologically well-documented adult case of a giant supratentorial enterogenous cyst (EC). Fewer than 15 cases of supratentorial ECs are on record: 8 associated with the brain hemispheres or the overlying meninges, 4 with the sellar region, and 2 with the optic nerve.

CLINICAL PRESENTATION:

A 31-year-old woman complained of long-standing mild left brachial and crural motor deficit precipitated by headache and signs of intracranial hypertension. Magnetic resonance imaging revealed a huge cyst overlying the frontoparietal brain.

INTERVENTION:

Symptoms were relieved by evacuation of the cyst content by means of a Rickam's reservoir, and the lesion was subsequently removed in toto. Histological and immunohistochemical examination of the cyst wall clearly established the enterogenous nature of its epithelium. Follow-up for up to 2 years after intervention showed no sign of recurrence, and symptoms, including treatment-resistant seizures in the postoperative period, have entirely subsided.

CONCLUSION:

Supratentorial ECs, distinctly rare in adult patients, may in some cases present as giant lesions. Total removal seems to be curative once careful examination has eliminated the possibility of a metastasis from an unknown primary. A correct histological diagnosis is important because, in contrast to other benign cysts of similar location and size, ECs may be prone to intraoperative dissemination.

• Authors: Christo Christov, Fabrice Chrétien, Pierre Brugieres, Michel Djindjian
• Journal: Neurosurgery (Neurosurgery) Vol. 54 Issue 3 Pg. 759-63; discussion 763 (Mar 2004) ISSN: 0148-396X [Print] United States
• PMID: 15028155 (Publication Type: Case Reports, Journal Article)

Chemical References

• Biomarkers, Tumor
• Carcinoembryonic Antigen
• Mucin-1
• Keratins

Topics

• Adult
• Arachnoid Cysts (pathology, surgery)
• Biomarkers, Tumor (analysis)
• Carcinoembryonic Antigen (analysis)
• Central Nervous System Cysts (pathology, surgery)
• Craniotomy
• Diagnosis, Differential
• Epithelium (pathology)
• Female
• Follow-Up Studies
• Frontal Lobe (pathology, surgery)
• Humans
• Intracranial Hypertension (pathology, surgery)
• Keratins (analysis)
• Magnetic Resonance Imaging
• Meningeal Neoplasms (pathology, surgery)
• Mucin-1 (analysis)
• Neural Tube Defects (pathology, surgery)
• Parietal Lobe (pathology, surgery)
• Supratentorial Neoplasms (pathology, surgery)