An exceptional case of lumbar neurenteric cyst revealed by Conus medullaris syndrome: case report with literature review

Abstract Introduction A neurenteric cyst is a rare, benign congenital spinal malformation that is classified as a type of notochordal dysraphism and categorized by the World Health Organization as ‘rare benign developmental, malformative lesions of the Central nervous system’. Its lumbar location is particularly unusual, and its manifestation as a conus medullaris syndrome is even more exceptional. We report an atypical case of a lumbar neurenteric cyst presenting as conus medullaris syndrome. The cyst was completely excised with full recovery from neurological deficits after 1 year. To the best of our knowledge, only a few cases have been reported from Africa and most of them refer to the thoracic or cervical spine being affected. Case report A 29-year-old female patient with no known previous medical history was managed for conus medullaris syndrome. An MRI suggested a neuroenteric cyst, which was confirmed by histopathology following complete excision of the mass. The postoperative period was marked by CSF leak, which resolved after one week. A year post surgery, the patient made a full recovery. Conclusion Lumbar neurenteric cysts are rare and benign congenital malformations. However, this particular location, with compression of the conus medullaris, can cause serious neurological sequelae. Complete resection resolves the symptoms and prevents recurrence.