Objective and Importance:The authors report the first known case of a giant multiloculated grape-like enterogenous cyst extending from the upper cervical canal to the ambient cistern. Clinical Presentation/Methods: We report the case of a 40-year-old male who had a prior transmastoid craniotomy at an outside facility 14 months prior with an indeterminate diagnosis, who presented to the University of New Mexico with recurrent headaches and nausea. Scans demonstrated a giant multiloculated cystic lesion in the right cerebellopontine angle that extended superiorly and inferiorly with brainstem compression and hydrocephalus. Intervention/Results: We took the patient to the operating room for a retrosigmoid suboccipital craniectomy for tumor resection. Post-operatively, the patient improved but required ventriculoperitoneal shunting for continued communicating hydrocephalus. Conclusion:This is the first known case of a giant multiloculated grape-like enterogenous cyst extending simultaneously from the upper cervical canal to the ambient cistern. Enterogenous cysts should be considered on the differential diagnosis of giant grape-like lesions extending from the cervical canal to the prepontine cistern.
Cite this paper
H. Chen, P. Kaloostian, F. Westhout and S. Khan, "The Giant Grape-Like Enterogenous Cyst Extending from the Upper Cervical Canal to the Ambient Cistern: Case Report and Literature Review," Open Journal of Modern Neurosurgery, Vol. 3 No. 3, 2013, pp. 48-51. doi: 10.4236/ojmn.2013.33011.
 M. Puusepp, “Variete Rare de Teratome, Sousdural de la Region Cervical (Intestionome): Quadriplegie, Extirpation Guerison Complete,” Revue Neurologique, Vol. 2, 1934, pp. 879-886.
 S. Matsunaga, K. Fujitsu, S. Yagashita, T. Ichikawa, Y. Takemoto, Y. Takeda, et al., “Endodermal Cyst Ventral to the Lower Brainstem,” Neurologia Medico-Chirurgica, Vol. 46, No. 12, 2006, pp. 614-618.
 R. R. Sharma, R. R. Ravi, N. T. Gurusinghe, C. Coutinho, A. K. Mahapatra, J. Sousa, et al., “Cranio-Spinal Enterogenous Cysts: Clinic-Radiolgoical Analysis in a Series of Ten Cases,” Journal of Clinical Neuroscience, Vol. 8, No. 2, 2001, pp. 133-139. doi:10.1054/jocn.2000.0792
 A. Perry, B. W. Scheitauer, B. W. Zaias and H. V. Minassian, “Aggressive Enterogenous Cyst with Extensive Craniospinal Spread: Case Report,” Neurosurgery, Vol. 44, No. 2, 1999, pp. 401-404.
 W. I. Silvernail Jr. and R. Brown, “Intramedullary Enterogenous Cyst,” Journal of Neurosurgery, Vol. 20, No. 2, 1972, pp. 235-238. doi:10.3171/jns.1972.36.2.0235
 F. Afshar and C. L. Scholtz, “Enterogenous Cyst of the Fourth Ventricle,” Journal of Neurosurgery, Vol. 54, No. 6, 1981, pp. 836-838. doi:10.3171/jns.1981.54.6.0836
 S. Ito, S. Fujiwara, K. Mizoi, T. Namiki and T. Yosimoto, “Enterogenous Cyst at the Cerebellopontine Angle,” Surgical Neurology, Vol. 37, No. 5, 1992, pp. 366-370.
 J. Lin, H. Feng, F. Li, Z. Chen and G. Wu, “Ventral Brainstem Enterogenous Cyst: An Unusual Location,” Acta Neurochirurgica, Vol. 146, No. 4, 2004, pp. 419-420. doi:10.1007/s00701-004-0227-2
 V. S. Mehta, C. Choudhary and R. Bhatia, “Neuroenteric Cyst of the Cerebellum,” Potgraduate Medical Journal, Vol. 60, No. 702, 1984, pp. 287-289.
 A. Zalatnia, “Neurenteric Cyst of the Medulla Oblongata —A Curiosity,” Neuropediatrics, Vol. 18, No. 1, 1987, pp. 40-41. doi:10.1055/s-2008-1052433
 H. Elmadbouh, S. F. Halpin, J. Neal, R. H. Hatgfield and M. D. Hourihan, “Posterior Fossa Epithelial Cyst: Case Report and Review of the Literature,” AJNR, Vol. 20, No. 4, 1999, pp. 681-685.
 C. Christov, F. Chretien, P. Brugieres and M. Djindjian, “Giant Supratentorial Enterogenous Cysts: Report of a Case, Literature Review and Discussion of Pathogenesis,” Neurosurgery, Vol. 54, No. 3, 2003, pp. 759-763.
 C. O. Harris, M. S. Dias, D. L. Brockmeyer, J. J. Townsend, B. K. Willis and R. I. Apfelbaum, “Neurenteric Cyst of the Posterior Fossa: Cognition, Management, and Embryogenesis,” Neurosurgery, Vol. 29, No. 6, 1991, pp. 893-897. doi:10.1227/00006123-199112000-00015
 R. H. Wilkins and G. L. Odon, “Spinal Intradural Cyst. Tumors of the Spine and Spinal Cord, Part II,” In: Handbook of Clinical Neurology, Vol. 20, North Holland, New York, 1976, pp. 55-102.
 G. P. Malcolm, L. Symon, B. Kendall and M. Pires, “Intracranial Neurenteric Cyst. Report of Two Cases,” Journal of Neurosurgery, Vol. 75, No. 1, 199, pp. 115-120.
 G. Beijani, D. C. Wright, D. Schessel and L. N. Sekhar, “Endodermal Cysts of the Posterior Fossa. Report of Three Cases and Review of the Literature,” Journal of Neurosurgery, Vol. 89, No. 2, 1998, pp. 326-335.
 R. Perrini, S. A. Rutherford, A. T. King, D. Plessis and N. Lorenzo, “Enterogenous Cysts of the Cerebellopontine Angle: Short Review Illustrated by Two New Patients,” Acta Neurochirurgica, Vol. 150, No. 2, 2008, pp. 177-184. doi:10.1007/s00701-007-1483-8