DIAGNOSTIC NEURORADIOLOGY Isolated spinal neurenteric cyst presenting as intramedullary calcified cystic mass on imaging studies: case report and review of literature Mateo Ziu & Prasanna Vibhute & Giacomo G. Vecil & James Henry Received: 29 September 2009 / Accepted: 29 October 2009 / Published online: 28 November 2009 # Springer-Verlag 2009 Abstract Intramedullary neurenteric cysts (NEC) without associated malformations are extremely rare and, to our knowledge, have never been reported in association with calcification. We report a unique imaging presentation as a partially calcified mass of an isolated intramedullary neuroenteric cyst of the lower thoracic spinal cord with pathologic correlation. The literature for isolated forms of intramedullary NEC since the advent of magnetic resonance imaging is also reviewed. Keywords Intramedullary lesion . Neurenteric cyst . Neuroenteric cyst . Spine imaging . Spinal cord calcification Abbreviations MRI Magnetic resonance imaging CT Computed tomography NEC Neurenteric cyst FSE Fast spin echo Introduction Imaging plays an important role in identification, localiza- tion, and diagnosis of intramedullary lesions of the spinal cord. Differentiation between various intramedullary lesions based on imaging appearance is important because it may assist in determination of patient prognosis and management strategy [1–3]. The majority of neurenteric cysts (NECs) are localized in the extramedullary compartment and associated with spinal and/or enteric malformations. Isolated forms of intramedullary NEC without bony or soft tissue malforma- tions are rare [4–8]. We report a unique case of isolated intramedullary NEC presented on imaging studies as a partially calcified intra- medullary lesion. We also review, here, the literature for the forms of intramedullary NEC without any associated malformation reported since the advent of magnetic resonance imaging (MRI). Case report A 39-year-old male presented to the emergency department with 2 days of subjective bilateral lower extremity weakness and urinary and fecal incontinence. Neurological examination revealed reduced strength and sensation to light touch with hyperreflexia of both legs. Thoracolumbar MRI revealed an oval, intramedullary lesion at the T11-T12 level without evidence of surrounding edema and presence of susceptibility on gradient imaging. Due to the presence of a low-signal intensity component (Fig. 1a, b), calcification was suspected and a computer tomography (CT) scan examination was performed. The lesion had a partially calcified appearance on CT scan (Fig. 2). No vertebral anomaly was found. M. Ziu : G. G. Vecil Department of Neurosurgery, University of Texas Health Science Center, San Antonio, TX, USA P. Vibhute Department of Radiology, University of Texas Health Science Center, San Antonio, TX, USA J. Henry Department of Pathology, University of Texas Health Science Center, San Antonio, TX, USA P. Vibhute (*) Department of Radiology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA e-mail: Vibhute.Prasanna@mayo.edu Neuroradiology (2010) 52:119–123 DOI 10.1007/s00234-009-0624-6