Malignant transformation of an intraaxial-supratentorial neurenteric cyst – Case report and review of the literature
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Abstract:
Neurenteric cysts are "rare benign mass forming developmental abnormalities" that usually affect young adults. Neurenteric cysts are thought to be derived from primitive endoderm, and form as a result of faulty endodermal-notochordal separation at 3 weeks of embryogenesis. Neurenteric cysts are lined by simple-to-pseudostratified respiratory/gastrointestinal-like epithelium; as such, these lesions closely resemble colloid and Rathke's cleft cysts. Anatomically, neurenteric cysts most frequently arise in an intradural-extraaxial location anterior to the cervical-thoracic spinal cord. Intracranial neurenteric cysts are uncommon but have a tendency to reside in the infratentorial compartment. Malignant transformation of the epithelial component of neurenteric cysts is decidedly rare. Of the 3 reported cases of neurenteric cysts with malignant transformation, all were intracranial (2 infratentorial and 1 supratentorial) and extraaxial. We describe a 58-year-old female with a supratentorial-intraaxial lesion that is consistent with a neurenteric cyst exhibiting malignant transformation into an invasive mucinous papillary cystadenocarcinoma. Areas of direct transition between typical benign neurenteric cyst epithelia and malignant epithelia (i.e., carcinoma in situ), highlighted by an abrupt change in the Ki-67 proliferative index, were identified, and supported the primary nature of this brain neoplasm. Metastatic workup at the time of presentation was unremarkable, and immediately up until being lost to follow-up 38 months after gross total resection, routine follow-up MR imaging had not detected a recurrence. To our knowledge, this would be the first reported case of malignant transformation within a supratentorial-intraaxial neurenteric cyst.Keywords:
Malignant Transformation
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Lumbar Spinal Cord
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Ependymal Cell
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Objective:To study the result and the advantages of microsurgery treatment of intracranial arachnoid cyst(IAC).Methods:Date of 23 caces itracranial arachnoid cyst operated, in which cyst were performde in 3, cyst removal pluscisternel opening in 13, and cyst-peritoreal shunt in 7. Different methods of operation were analyzed comparatively. Results:Of 23 caces, the chief symptoms of 7 got disapeared (cyst removal plus cisternel opening in 5 and cyst were performed in 2), the chief symptoms of 12 got improved in 82.6% of the patients, part of the chief symptoms of 1 got better; 2 caces recured, one of cyst-peritoneal shunt result in the shunt blocked up, and another one case of cyst removal plus cisternel opening got a good outcome by cyst-periconeal shunt. Conclusions:Cyst resection plus cisternel opening by microscope is pefferred in the treatmen of intracranial arachnoid cyst, and the cyst-peritoneal shunt had a better curative effect when the cyst area exceeded half of the cerebral hemisphere.
Arachnoid cyst
Cisterna
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While enkephalin and dynorphin peptides have been well characterized in the spinal cord, the cellular localization of β-endorphin (βE) and the processing of pro-opiomelanocortin (POMC) to βE and other non-opioid peptides in the cord have not been extensively investigated. Other investigators have characterized the various βE forms present in rat spinal cord regions. Previous studies have also suggested that spinal POMC content is entirely derived from supraspinal sources. However, high proportions of βE precursors present in spinal cord sieving profiles led us to suspect the presence of POMC cell bodies intrinsic to the cord. In this study, we performed thoracic spinal cord lesions on a group of animals and demonstrated the persistence of about one-third of control levels of βE immunoreactivity (βE-IR) below the level of the lesions. We also characterized POMC processing in various regions of the spinal cord both before and after lesioning. These data suggested that there may be intrinsic POMC/endorphinergic neuronal systems in the spinal cord.
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Serous Cystadenoma
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