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Neurenteric cyst

Case contributed by Frank Gaillard
Diagnosis certain

Presentation

None available.

Patient Data

Age: 15 years
mri

In the posterior fossa, anterior to the medulla, is a lobulated lesion with striking high T1 signal that does not attenuate on fat suppression nor demonstrate a convincing solid component. Within it is a low signal 'dot' suggesting the lesion is cystic. No diffusion restriction. The clivus appears normal. Appearances are typical of a neurenteric cyst. 

pathology

The cyst lining shows mainly stratified squamous epithelium. Some cells are ciliated. No adnexal structures are seen. The squamous cells show no nuclear atypia. There are sparse goblet cells. Some of the squamous cells show sebaceous differentiation. A large amount of amorphous granular debris, with cholesterol clefts and multinucleated giant cells is present. There is no glial stroma.

The epithelial cells are CAM5.2, p40, EMA and CEA positive.

S-100, transthyretin and GFAP are negative.

FINAL DIAGNOSIS: neuroenteric cyst.

Case Discussion

This case demonstrates typical appearances of a posterior fossa neurenteric cyst

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