Malignant Transformation of a Neurenteric Cyst in the Posterior Fossa Presenting with Intracranial Metastasis: A Case Report and Literature Review

• Fujisawa Naoaki

  Department of Neurosurgery, Saitama Medical Center/University

• Oya Soichi

  Department of Neurosurgery, Saitama Medical Center/University

• Higashi Morihiro

  Department of Pathology, Saitama Medical Center/University

• Matsui Toru

  Department of Neurosurgery, Saitama Medical Center/University

抄録

Intracranial neurenteric cysts are relatively rare and almost exclusively benign. Here we present a case of an intracranial neurenteric cyst that was histologically benign in the first surgery and later demonstrated significant growth and intracranial metastasis with malignant transformation. A 47-year-old woman presented with a headache, which had gradually worsened over 1 year. Initial magnetic resonance (MR) images revealed a solitary cystic lesion in the left cerebellopontine angle with significant mass effect. Subtotal resection leaving a small mass strongly adhered to the brainstem was achieved. Histopathological diagnosis was neurenteric cyst with no malignant features. This lesion recurred 4 years after the first surgery in the form of a cystic mass adjacent to the brainstem. In addition, histopathological examination of a specimen from the second surgery revealed malignant transformation. The patient declined to undergo radiation therapy and was conservatively managed. Three years after the second surgery, MR imaging showed recurrence of the solid mass. Although the patient had been treated with subtotal resection and radiation therapy, she died with metastatic masses in the right frontal lobe and cervical cord. A specimen from the third surgery revealed diffuse malignant features similar to mucinous adenocarcinoma. Our case and literature review indicate that, although rare, malignant transformation can occur particularly among intracranial neurentreric cysts. This finding suggests the importance of long-term follow-up for subtotally or partially resected intracranial neurenteric cysts.

収録刊行物

• NMC Case Report Journal

  NMC Case Report Journal 2 (4), 123-127, 2015

  一般社団法人 日本脳神経外科学会

キーワード

• intracranial tumor
• malignant transformation
• neurenteric cyst
• posterior fossa

詳細情報

• CRID: 1390282680718961792
• NII論文ID: 130005102541
• DOI: 10.2176/nmccrj.cr.2014-0416
• ISSN: 21884226
• Web Site: https://www.jstage.jst.go.jp/article/nmccrj/2/4/2_cr.2014-0416/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2017020599
• 本文言語コード: en
• データソース種別:
  • JaLC
  • Crossref
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可