Abstract
Introduction
Neurenteric cysts are a rare cause of central nervous system compression. Pediatric intracranial cysts are even less common.
Case study
We describe the presentation, imaging features, surgical management, and postoperative course of a 5-year-old female with congenital third nerve paresis, worsening headaches, and a cyst of the third nerve. We performed an eyebrow incision and keyhole supraorbital craniotomy for exploration and subsequent resection of a neurenteric cyst that was densely involved with the third nerve at its exit from the midbrain. Postoperatively, she had chemical meningitis and complete third nerve palsy. This entity is extremely rare in this location but should be included in the differential. We summarize the current literature on these lesions and recommend biopsy and fenestration as surgical treatment.
Similar content being viewed by others
References
Bejjani GK, Wright DC, Schessel D, Sekhar LN (1998) Endodermal cysts of the posterior fossa. Report of three cases and review of the literature. J Neurosurg 89:326–335
de Oliveira RS, Cinalli G, Roujeau T, Sainte-Rose C, Pierre-Kahn A, Zerah M (2005) Neurenteric cysts in children: 16 consecutive cases and review of the literature. J Neurosurg 103:512–523
Graziani N, Dufour H, Figarella-Branger D, Donnet A, Bouillot P, Grisoli F (1995) Do the suprasellar neurenteric cyst, the Rathke cleft cyst and the colloid cyst constitute a same entity? Acta Neurochir (Wien) 133:174–180
Mittal S, Petrecca K, Sabbagh AJ, Rayes M, Melancon D, Guiot MC, Olivier A (2010) Supratentorial neurenteric cysts—a fascinating entity of uncertain embryopathogenesis. Clin Neurol Neurosurg 112:89–97
Morgan MA, Enterline DS, Fukushima T, McLendon RE, Cummings TJ (2001) Endodermal cyst of the oculomotor nerve. Neuroradiology 43:1063–1066
Okunaga T, Tsutsumi K, Hayashi T, Nagata I (2006) Endodermal cyst of the oculomotor nerve: case report. Neurosurgery 58:E994, discussion E994
Werner M, Bhatti MT, Vaishnav H, Pincus DW, Eskin T, Yachnis AT (2005) Isolated anisocoria from an endodermal cyst of the third cranial nerve mimicking an Adie’s tonic pupil. J Pediatr Ophthalmol Strabismus 42:176–179
Scaravilli F, Lidov H, Spalton DJ, Symon L (1992) Neuroenteric cyst of the optic nerve: case report with immunohistochemical study. J Neurol Neurosurg Psychiatry 55:1197–1199
Perry A, Scheithauer BW, Zaias BW, Minassian HV (1999) Aggressive enterogenous cyst with extensive craniospinal spread: case report. Neurosurgery 44:401–404, discussion 404–405
Sahara Y, Nagasaka T, Takayasu M, Takagi T, Hata N, Yoshida J (2001) Recurrence of a neurenteric cyst with malignant transformation in the foramen magnum after total resection. Case report. J Neurosurg 95:341–345
Surash S, Ismail A, Loughrey C, van Hille P (2009) Malignant transformation of a neurenteric cyst in the posterior fossa following complete excision. Br J Neurosurg 23:458–461
Preece MT, Osborn AG, Chin SS, Smirniotopoulos JG (2006) Intracranial neurenteric cysts: imaging and pathology spectrum. AJNR Am J Neuroradiol 27:1211–1216
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Wait, S.D., Choi, L.S.J. & Teo, C. Neurenteric cyst: an unusual cause of third nerve palsy. Childs Nerv Syst 27, 639–641 (2011). https://doi.org/10.1007/s00381-010-1332-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00381-010-1332-6