Intradural extramedullary bronchogenic cyst: clinical and radiological characteristics, surgical outcomes, and literature review.

Intradural extramedullary bronchogenic cyst: clinical and radiological characteristics, surgical outcomes, and literature review.

World Neurosurg. 2017 Oct 25;:

Authors: Weng JC, Ma JP, Hao SY, Wang L, Wu Z, Zhang LW, Li D, Zhang JT

Abstract
OBJECTIVE: An intradural extramedullary bronchogenic cyst (IEBC) is a congenital malformation and an extremely rare type of endodermal cyst. This study aims to report the clinical and radiological characteristics and surgical outcomes of IEBCs and to review the available literature.
METHODS: The medical records of 6 patients (3 females) with pathologically confirmed bronchogenic cysts involving the spinal cord between 2009 and 2016 were retrospectively reviewed, and follow-up evaluations were performed.
RESULTS: Of the 6 symptomatic lesions, 4 were located in the cervical vertebra, 1 at the lumbar vertebra, and the remaining one at the craniocervical junction. Radiographs showed signals similar to cerebral spinal fluid on all MRI sequences without contrast enhancement. Total resection was achieved in 3 patients. Histopathology revealed simple and pseudostratified respiratory epithelium with benign sub-epithelial mucous glands and fat components neighboring the cyst. After a mean follow-up duration of 49.2 months, 2 asymptomatic residual lesions regrew after non-total resection. In prior literature including 19 cases, most IEBCs (84.2%) tended to be homogeneous and well demarcated on radiological images, and 85.7% were not contrast enhancing. Cervical or upper thoracic segments were predilection sites with intradural extramedullary localization. The majority of IEBCs had similar benign histological features. The recurrence rate was 15.4% after non-total resection but nil after total resection.
CONCLUSIONS: IEBCs displayed an indolent course, and the most effective management with positive outcomes was total resection. Non-total resection, cystic fenestration, and biopsy, which were associated with recurrence, should be avoided.

PMID: 29081395 [PubMed - as supplied by publisher]

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