Axial plain T1-weighted image of the brain at the level of pons shows a well-defined extraaxial homogenous hyperintense lesion measuring 4.2 by 2.7 centimeters anterior to brain stem and involving bilateral cerebellopontine angle cisterns.
Contrast-enhanced axial (A), and sagittal (B) T1-weighted images of the brain show nonenhancement of the mass and cyst size of 4.2 centimeters in craniocaudal dimension (B).
REF.Arora R, Rani JY, Uppin MS, Ca R. An unusual case of large posterior fossa neurenteric cyst involving bilateral cerebellopontine angle cisterns: report of a rare case and review of literature. Pol J Radiol. 2014 Oct 10;79:356-9.
A cyst demonstrated on sagittal T1WI (a) and axial T2WI (b). It was an intradural extramedullary well-demarcated lesion occupying the dorsal space of cerebellar vermis. Six years later, the cyst expanded to a lesion attaining signal intensity alterations on T1WI (c) and T2WI (d). A contrast enhancement with gadolinium of a mural nodule was observed in the rostral parts of the cyst (e). T1WI: T1-weighted images; T2WI: T2-weighted images.
A hypointense on T1WI (a) and hyperintense on T2WI (b) multi-lobular cyst in the left cerebellopontine angle. A follow-up MRI ((c), (d)) revealed that some compartments of the lobules were significantly expanded compared with the lesion imaged seven years before ((a), (b)). The signal intensities of expanded compartments were homogeneous hyperintense on T1WI (c) and hypointense on T2WI (d). T1WI: T1-weighted images; T2WI: T2-weighted images; MRI: magnetic resonance imaging.
Watanabe N, Akasaki Y, Fujigasaki J, Mori R, Aizawa D, Ikeuchi S, Murayama Y. Imaging alterations due to squamous metaplasia in intracranial neurenteric cysts: A report of two cases. Neuroradiol J. 2016 Jun;29(3):187-92.
Neurenteric cysts compressing the brainstem. Magnetic resonance imaging demonstrated multiple, nonenhancing, multiolobulated, expanding, and extra-axial recurrent neurenteric cysts compressing the medulla (a). An intraoperative image showing the cysts which were adherent to but separable from the medulla and upper cervical spinal cord (b).Viaene AN, Brem S. Recurrent neurenteric cysts compressing the brainstem. Surg Neurol Int. 2019 Dec 13;10:245.
Preoperative MR images of the craniocervical junction. A: The T2-weighted axial image shows a homogeneously hyperintense cyst (arrowhead) anterior to the medulla. B and C: Pre-gadolinium T1-weighted axial and sagittal images show a homogeneously hyperintense cyst that compresses the brain stem at the anterior craniocervical junction. D: The post-gadolinium T1-weighted axial image shows no enhancement of the cystic lesion. E: Diffusion MR image shows a homogeneously hyperintense cyst without diffusion restriction. F: Perfusion MR images reveal partial uptake of the contrast medium in the anterior part of the cystic lesion.
Intraoperative photographs of neurenteric cyst resection using the far-lateral transcondylar approach. A: The right semispinalis captitis muscle was seen, and the dissection of the superior and inferior oblique muscles was performed. B: To secure the vertebral artery, the groove of the vertebral artery was located and lateral partial suboccipital craniotomy was performed. Condylectomy was performed to optimize the view of the anterior brain stem. C: A well-defined capsulated cyst that adheres to the lower cranial nerve and vertebral artery was seen. Posterior bulging of the medulla and cervical cord were seen. D: The lesion was punctured and filled with yellowish viscous fluid. E: The decompressed and lax cyst was completely resected after dissection of the adhesion, which was approximately 10 mm long. F: The premedullary cistern was subsequently secured. The medulla, cervical cord, low cranial nerve, C1 nerve root, and vertebral artery were intact.Kim WY, Lim J, Cho KG. Anterior Craniocervical Junctional Neurenteric Cyst. Brain Tumor Res Treat. 2021 Oct;9(2):106-110.
A: An axial T1-weighted magnetic resonance (MR) image with gadolinium enhancement demonstrated a cystic lesion at the left cerebellopontine angle. The wall of a cystic lesion along with the brainstem was slightly enhanced with gadolinium. B: Postoperative T1-weighted MR image showed remarkable shrinkage of the cyst. The hyperintense region indicated a small accumulation of blood inside the cyst cavity (arrowhead). C: The wall of the cyst was lined by a single layer of columnar epithelium (hematoxylin and eosin, 400×). Immunohistochemical analysis showed that the epithelium stained positive for carcinoembryonic antigen (CEA) (D, 200×), epithelium membrane antigen (E, 400×), and cytokeratin (AE1/AE3; F, 400×). Staining for the p53 mutation was negative (H). Periodic acid-Schiff staining demonstrated mucins along the epithelium (G, 200×). The MIB-1 labeling index was almost 0% (I, 400×).
A: Axial magnetic resonance (MR) images demonstrating recurrence of a cystic lesion with a small and slightly enhanced solid portion adjacent to the brainstem (arrow). B: Atypical nuclei and loss of cell polarity were noted (hematoxylin and eosin, 400×). C: Staining for the p53 mutation was weakly positive. D: Immunohistochemical staining with MIB-1 antibody showed approximately 3% nuclear staining in the tumor cells.
Axial magnetic resonance (MR) images revealing significant recurrence of the solid mass with compression of the brain stem (A) and a new gadolinium-enhanced lesion in the right frontal lobe (B). C: Atypical and mitotic nuclei with more prominent than normal nuclei. Pseudostratified nuclei and loss of cell polarity were widely observed (hematoxylin and eosin, 400×). D: Periodic acid-Schiff staining showed strong positivity for mucins. E: Immunohistochemistry for the p53 mutation was positive. F: The MIB-1 labeling index was elevated to 9%.
Fujisawa N, Oya S, Higashi M, Matsui T. Malignant Transformation of a Neurenteric Cyst in the Posterior Fossa Presenting with Intracranial Metastasis: A Case Report and Literature Review. NMC Case Rep J. 2015 Sep 3;2(4):123-127.
Preoperative computed tomographic scan demonstrating only asymmetry of the lateral ventricles, with enlargement of the right lateral ventricle.
Preoperative MR images demonstrate a large cystic lesion occupying almost completely the enlarged right lateral ventricle with CSF-like signal intensity and a unilateral right-sided hydrocephalus with deviation of the septum pellucidum to the left. (A) T2-weighted axial image. (B) T1-weighted coronal image.(A) Intraoperative image reveals whitish wall of cyst obstructing the right foramen of Monro completely. (B) After the midportion of the cyst wall above the foramen of Monro was fenestrated, cystic fluid was expelled.
Gross photographic finding of extracted choroid plexus cyst.
Jeon JH, Lee SW, Ko JK, Choi BG, Cha SH, Song GS, Choi CH. Neuroendoscopic removal of large choroid plexus cyst: a case report. J Korean Med Sci. 2005 Apr;20(2):335-9.
