PMC4900197_01
2-year-old male with thoraco-abdominal enteric duplication cyst. AP radiograph of chest demonstrates mass effect in left hemithorax, displacing the mediastinum to the right, and cervico-thoracic vertebral and rib anomalies on the left side.
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A plain radiograph of the chest demonstrated displacement of the mediastinum into the right chest by mass effect in left chest (Fig. 1).
2-year-old male with thoraco-abdominal enteric duplication cyst. A. Axial T2W MRI at the level of the upper thoracic cord. A left lateral myelomeningocele sac is positioned anterior to a fluid enteric cyst. This sac shows loss of T2 signal secondary to turbulent CSF flow (arrows). B. Sagittal T2W MRI of the spine shows the same myelomeningocele positioned ventral to the spinal canal and superior to the fluid-filled enteric cyst (arrow).
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These cystic structures appeared separate from but contiguous to the myelocele, as proven by intraspinal contrast placed proximally (Fig. 2).
2-year-old male with thoraco-abdominal enteric duplication cyst. Coronal (A) and sagittal (B) reformats demonstrate myelographic contrast in neurenteric cyst (arrow) adjacent to thoracic portions of duplication (d) in posterior mediastinum extending across diaphragm into upper and lower abdomen.
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Low-dose CT (CTDIvol) of the abdomen showed continuation of the cystic structure through the diaphragm from the left hemithorax crossing into the right upper abdomen just anterior to the aorta between the celiac axis and superior mesenteric artery (Fig. 3).
2-year-old male with thoraco-abdominal enteric duplication cyst. A. Axial CT in lower chest demonstrates hypoplasia of left lung and dextroposition of heart related to enteric duplication (ed) with multiple folds in the chest. B. Coronal CT reformat demonstrates transdiaphragmatic duplication (td) showing entrance through diaphragm extending to right lower quadrant (d).
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MRI confirmed the presence of a cystic left paravertebral structure consistent with myeloocele and definite separation of the large thoracoabdominal enteric cyst from the myelocele (Fig. 4).
2-year-old male with thoraco-abdominal enteric duplication cyst. Duplication cyst, proximal on left side of figure. Pale proximal mucosa corresponds to esophageal lining. Gastric and small intestinal features are found sequentially in more distal portions.
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Pathologic examination revealed that the specimen from the inferior and superior portion of the thoracoabdominal cyst consisted of two tubular structures resembling bowel (Fig. 5A). Sections of this spinal cyst demonstrated a glial component and foregut elements consisting of bronchial cartilage and mucus glands, consistent with neurenteric cyst (Figure 5B, Figure 5C).