Case Report Series and Review of Rare Intradural Extramedullary Neoplasms-Bronchiogenic Cysts

Abstract

The congenital malformation known as an intraspinal bronchiogenic cyst is a rare form of endodermal (neurenteric, enterogenous) cyst lined with respiratory tract epithelium. We describe 3 new cases of intradural extramedullary bronchiogenic cyst in the Department of Neurosurgery between the years 2006 and 2014. Three patients were performed resection of intradural extramedullary bronchiogenic cysts and finally symptoms were relieved. Taken together with 10 previous reports identified from a PubMed search, an analysis of 13 cases of intradural bronchiogenic cysts was conducted. The aim of this literature review was to provide information on histopathology, mechanisms of pathogenesis, clinical manifestations, radiographic features, and surgical strategies.Symptoms in spinal bronchiogenic cyst patients primarily depend on the local mass effect of the cyst on the spinal cord. magnetic resonance imaging, together with myelograms and computed tomography scans, is necessary to preoperative evaluation of spinal bronchiogenic cysts. The aim of surgery is total resection, although tight adhesion, ventral and intramedullary locations, and vertebral anomalies make it more challenging.

FIGURE 1

Radiographic images of the presenting cases. Case 1: (A) sagittal MRI demonstrates isointense signal on T1WI and (B) hyperintense signal on T2WI. Case 2: (C) scoliosis is seen in the X-ray examination. (D) An intradural extramedullary lesion at T9 to T10 is noted in the contrasted T1WI. Case 3: sagittal MRI illustrates (E) isointense lesion on T1WI and (F) slightly hyperintense signal on T2WI at craniocervical junction. (G) A corresponding axis MRI shows no enhancement after intravenous contrast material on T1WI. (H) No relapsing cystic mass is noted in the follow-up MRI examination. MRI = magnetic resonance imaging, T1WI = T1-weighted images, T2WI = T2-weighted images.

FIGURE 2

Histopathological appearances of the presenting cases. Case 1 (A), case 2 (B), and case 3 (D) demonstrating ciliated pseudostratified columnar epithelium (hematoxylin and eosin, ×200). Case 3 (C) presented the light-yellow gourd-shaped gross tumor after surgery.