A 35-year-old woman presented with a 6-day history days of interscapular back pain, 3 days of rapidly progressive leg weakness, and a 24-hour history of urinary retention. She had no significant medical history. Examination revealed spastic plegia of both legs and virtual anesthesia below the T3 dermatome.
Magnetic resonance imaging of the spine (Figure 1) showed a rounded intradural mass at the cervicothoracic junction that had grossly distorted the spinal cord and widened the spinal canal. There was no abnormal enhancement with the addition of gadolinium contrast medium. A band of tissue extended forward from the anterior dura, through a channel in the body of the first thoracic vertebra, to end blindly in the posterior mediastinum, the so-called Kovalesky canal. These findings suggested the diagnosis of neurenteric cyst.
Martin AJ, Penney CC. Spinal Neurenteric Cyst. Arch Neurol. 2001;58(1):126. doi:10.1001/archneur.58.1.126