a rare case of spinal intradural neurenteric cyst in a septuagenarian causing acute paraparesis

Background and aim: neurenteric cysts (ncs) account for 0.7 to 1.3% of all spinal tumors and are most commonly present during the first three decades of life. only two cases have been reported in individuals in their 7th and 8th decades of life. this study described a rare case of an nc in a septuagenarian (70 – 79 years of age) who presented with atypical features of the disease. case presentation: a 77-year-old female patient presented with acute onset paraparesis. magnetic resonance imaging revealed a 13.6 × 14.1 × 15.4 mm intradural extramedullary cystic lesion, which was anteriorly located at the c7-d1 level. it was t1 hypointense, t2 hyperintense, and showed faint contrast enhancement at the junction between the cyst and the spinal cord. at surgery, a cyst with a greyish-white thin wall was noted in the spinal canal, displacing the spinal cord posteriorly. the cyst wall was partially excised, and a small portion adhering to the spinal cord was left behind. the histopathology report was consistent with an nc. at the 2-week follow-up, the patient’s lower limb strength had improved. conclusion: although rare, ncs can present in the seventh decade of life. magnetic resonance imaging may reveal unusual findings, like t1 hypointensity and faint contrast enhancement of the cyst wall. in elderly patients, a portion of the cyst wall may be left behind if it adheres to the spinal cord to avoid the risk of neurological deterioration.