Endodermal Cysts of the Central Nervous System: Review of the Literature and a Case Report

Asian J Neurosurg. 2020 Dec 21;15(4):989-996. doi: 10.4103/ajns.AJNS_322_19. eCollection 2020 Oct-Dec.

Abstract

Context: Endodermal cysts are rare benign developmental cysts lined by mucin-secreting and/or ciliated, cuboidal, or columnar epithelium of probably endodermal origin.

Aims: Endodermal cysts are rarely intracranial, frequently located in the posterior fossa. Supratentorial location is the most infrequent and only few cases are reported in the literature, included our case.

Settings and design: The authors report a case of intracranial supratentorial endodermal cyst with a review of the literature.

Subjects and methods: A 40-year-old woman was admitted to our department because of progressive gait disorder for 3 months due to right brachial and crural motor deficit associated to right crural sensory disorder (tactile hypesthesia) and right Babinski response at neurological examination due to an endodermal cyst located in the left frontoparietal convexity.

Discussion: Total resection of endodermal cysts is recommended, despite their location and adhesion to the surrounding structures, due to its high risk of recurrence. Fenestration of the cystic content into the subarachnoid cistern may cause obstructive hydrocephalus or chemical meningism.

Results: Although rare, surgeons should be aware that these lesions must be differentiated clinically, radiologically, and histologically from other supratentorial cystic lesions.

Keywords: Central nervous system; endodermal cyst; enterogenous cyst; epithelial cyst; neurenteric cyst; neuroenteric cyst; supratentorial extra-axial cystic lesion.