Ventriculus terminalis cyst in an infant: a case report

Arnold H Menezes; Yutaka Sato; Brian J Dlouhy; Karra A Jones; Steven A Moore

doi:10.1186/s13256-023-03759-7

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Ventriculus terminalis cyst in an infant: a case report

Journal article

Open access

Peer reviewed

Ventriculus terminalis cyst in an infant: a case report

Arnold H Menezes, Yutaka Sato, Brian J Dlouhy, Karra A Jones and Steven A Moore

Journal of medical case reports, Vol.17(1), 22

01/23/2023

DOI: 10.1186/s13256-023-03759-7

PMCID: PMC9869499

PMID: 36683067

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https://doi.org/10.1186/s13256-023-03759-7View

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Abstract

Filar cysts are frequently found on neonatal ultrasound and are physiologically involuting structures with natural resolution. Hence, there has been no previous histologic correlation. Ventriculus terminalis is a focal central canal dilation in the conus medullaris and usually not clinically significant. Extra-axial cyst at the conus-filum junction connected to ventriculus terminalis is extremely rare, especially when associated with tethered lipomatous filum terminale and with progressive cyst enlargement. A Caucasian female neonate with abnormal gluteal cleft had ventriculus terminalis cyst with an extra-axial cyst at the conus-filar junction and taut lipomatous filum on ultrasound examination and magnetic resonance imaging. This persisted at 6-month follow up imaging. In light of the nonresolving extra-axial mass and thick taut lipomatous filum, the child underwent L1-L3 osteoplastic laminectomies. The extra-axial cyst expanded after bony decompression and furthermore on dural opening; visualized on ultrasound. It communicated with the central canal and was documented with intraoperative photomicrographs. It was excised and filum sectioned. Histological immunostaining of the cyst wall showed neuroglial and axonal elements. The child did well without deficits at 4-year follow up with normal urodynamics. Progression dilation of ventriculus terminalis and extra-axial conofilar cyst with tethered lipomatous filum will likely progress to clinical significance and require surgical intervention. The embryologic basis for this pathology is discussed, with literature review.

Magnetic Resonance Imaging

Animals

Cauda Equina

Child

Cysts - diagnostic imaging

Cysts - surgery

Dilatation, Pathologic - pathology

Female

Gizzard, Avian

Humans

Infant

Infant, Newborn

Spinal Cord - pathology

Details

Title: Subtitle: Ventriculus terminalis cyst in an infant: a case report
Creators: Arnold H Menezes - University of Iowa Hospitals and Clinics
Yutaka Sato - University of Iowa
Brian J Dlouhy - University of Iowa
Karra A Jones - University of Iowa
Steven A Moore - University of Iowa
Resource Type: Journal article
Publication Details: Journal of medical case reports, Vol.17(1), 22
DOI: 10.1186/s13256-023-03759-7
PMID: 36683067
PMCID: PMC9869499
NLM abbreviation: J Med Case Rep
ISSN: 1752-1947
eISSN: 1752-1947
Language: English
Date published: 01/23/2023
Academic Unit: Radiology; Stead Family Department of Pediatrics; Pathology; Iowa Neuroscience Institute; Neurosurgery; Otolaryngology
Record Identifier: 9984361748902771

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