Cervical Intradural Extramedullary Endodermal Cyst Rapidly Manifesting Tetraparesis in a Pediatric Patient. A Case Report

Endodermal cyst (EC) is a rare benign congenital central nervous system tumor. As a common lesion of this entity, the cervical and cervicothoracic regions are reported. This cyst can be generally symptomatic in adult cases. Although symptomatic ECs can be found in pediatric cases, a male predominance was reported. Previously, the number of pediatric female cases with ECs in lower cervical levels seems limited. A four-year-old girl was referred to our hospital, complaining of neck pain, gait disturbance, and motor weakness in the bilateral upper and lower extremities. The symptoms worsened rapidly within two weeks. Magnetic resonance images revealed an intradural extramedullary cystic lesion at C4-C7 levels, which extremely compressed the spinal cord posteriorly. To improve the clinical symptoms of the patient, a right partial laminotomy via the posterior approach and partial removal of the cystic wall was performed. The histopathological diagnosis corresponded to EC. After the operation, the neurological deficits disappeared. Any recurrence of the EC was not observed two years after surgery. We described a female pediatric case of middle and lower cervical intradural extramedullary EC. In this case, rapidly progressive neurological deficits resulted from the EC compressing the spinal cord. In this report, we summarize the previous similar pediatric cases of middle and lower cervical ECs.