- Experimental Biomedicine and Clinical Neurosciences, School of Medicine, Postgraduate Residency Program in Neurological Surgery, Neurosurgical Clinic, AOUP “Paolo Giaccone”, Palermo, Italy,
- Department of Neurosurgery, Texas Tech University Health Sciences Center School of Medicine, Lubbock, TX, USA,
- Department of Neurosurgery, Trauma Center, Gamma Knife Center, Cannizzaro Hospital, Catania, Italy,
- Department of Neurosurgery, Texas A&M University College of Medicine, College Station, TX, USA,
- Department of Neurosurgery, Highly Specialized Hospital and of National Importance “Garibaldi”, Catania, Italy.
Gianluca Scalia, Department of Neurosurgery, Highly Specialized Hospital and of National Importance “Garibaldi,” Catania, Italy.
DOI:10.25259/SNI_89_2022Copyright: © 2022 Surgical Neurology International This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
How to cite this article: Salvatore Marrone1, Abdurrahman F. Kharbat2, Paolo Palmisciano3, Giuseppe Emmanuele Umana3, Ali S. Haider4, Domenico Gerardo Iacopino1, Giovanni Federico Nicoletti5, Gianluca Scalia5. Thoracic spinal extradural arachnoid cyst: A case report and literature review. 18-Feb-2022;13:55
How to cite this URL: Salvatore Marrone1, Abdurrahman F. Kharbat2, Paolo Palmisciano3, Giuseppe Emmanuele Umana3, Ali S. Haider4, Domenico Gerardo Iacopino1, Giovanni Federico Nicoletti5, Gianluca Scalia5. Thoracic spinal extradural arachnoid cyst: A case report and literature review. 18-Feb-2022;13:55. Available from: https://surgicalneurologyint.com/surgicalint-articles/11404/
Background: Spinal extradural arachnoid cysts (SEDACs) are rare and are variously attributed to congenital, traumatic, or inflammatory etiologies. Here, we report a 70-year-old male who presented with a T11-T12 SEDAC and an incidental craniovertebral junction (CVJ) meningioma.
Case Description: A 70-year-old male presented with progressive bilateral lower limb weakness and paresthesias. The thoracic MRI identified an extradural arachnoid cystic lesion at the T11-T12 level. In addition, the brain/ cervical MR documented an incidental meningioma at the CVJ. The patient underwent T11-T12 laminectomy for fenestration/removal of the extradural arachnoid cyst resulting in immediate cord decompression and neurological recovery. The histologic examination was consistent with a SEDAC who underwent successful resection of the SEDAC that resulted in symptom resolution.
Conclusion: We presented a 71-year-old male with a thoracic SEDAC and an incidental CVJ meningioma, where resection of the SEDAC resulted in symptom resolution.
Keywords: Arachnoid cyst, Cyst resection, Extradural cyst, Thoracic spine
Spinal extradural arachnoid cysts (SEDACs) account for <1% of all spinal lesions. They are classified as a subtype of spinal arachnoid cysts that most frequently occur in the mid-to-lower thoracic levels.[
Neurological symptoms of SEDACs that range from radicular pain to compressive myelopathy reflect the level, size, and location of the SEDAC.[
Clinical and radiographic presentation
A 70-year-old male patient presented with 2 years but 3 weeks of marked progression of lower limb weakness/paresthesias associated with a paraparesis/and lower extremity sensory changes. The thoracic MR showed a T11-T12 CSF-like extradural compressive lesion considered to represent an extradural arachnoid cyst [
Surgical management/postoperative course/pathology
A T11-T12 laminectomy was performed, and the extradural arachnoid cyst was fenestrated, marsupialized, and removed en bloc utilizing intraoperative neurophysiological monitoring without any changes being noted [
Intraoperative findings after T11-T12 laminectomy: (a) identification of an extradural cystic lesion and below dural sac, (b) left T11-T12 paramedian dural defect with extension to the neuroforamen detected after cystic fenestration and en bloc removal, (c) microsurgical repair of the dural defect using nonabsorbable Prolene suture, collagen sponge and dural sealant have been performed.
Classification of spinal arachnoid cysts
Spinal arachnoid cysts are usually located either dorsal or ventral to the spinal cord and are mostly observed in adolescents and middle-aged men.[
Here, we presented a 71-year-old male with a T11-T12 extradural arachnoid cyst who underwent successful occlusion of the communication between the subarachnoid space and cyst, followed by cyst excision, and primary dural repair without sequelae.
Patient’s consent not required as patients identity is not disclosed or compromised.
There are no conflicts of interest.
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