Neurenteric Cysts: A Neurosurgical Case Series and Treatment Perspectives

Neurenteric cysts (NC) are rare lesions of endodermal origin lined by mucin-secreting cuboidal or columnar epithelium of an intestinal or respiratory type. They occur more frequently in the spinal cord than in the cranium. From the radiological view, NC may be confused with other lesions of the central nervous system, like arachnoid or epidermoid cysts. However, due to advances in neuroimaging, there is an increasing trend in preoperative diagnosis of NC. We are reporting three cases of NC, each exhibiting markedly distinct symptoms and postoperative courses. The first patient, a 45-year-old woman, had NC in the fourth ventricle. Although she underwent surgery, the lesion recurred 55 months later. The second patient, a 66-year-old woman, had NC in the left cerebellopontine angle. After partial removal, the remaining cyst maintained its size for 94 months. The third patient, a 55-year-old man, presented with NC close to the medullary cone. Despite tumor reduction, a hemorrhagic cyst developed 41 months later, which was accompanied by increased lumbosacral pain. A review of knowledge of current treatment strategies and challenges of NC is discussed. Surgical intervention is the primary therapeutic approach for patients with NC, particularly those experiencing symptoms. The primary challenge in treating NC is preventing cyst recurrence. The complete resection of NC is critical for minimizing the probability of cyst recurrence. Continuous lifelong follow-up is essential, as NC recurrences can occur even after decades.