The aim of our study was to share our experience by comparing preoperative MRI with intraoperative ultrasound and postoperative histopathology in a very rare disease. A 24-year-old patient presented to our hospital with lower back pain radiating to the right leg, accompanied by numbness in the same region, bladder and bowel dysfunction, erectile problems, and sexual disability. MRI with contrast of the spinal cord was performed, revealing a mass. The lesion was intradural at the Th12–L1 level, but it was difficult to determine whether it was intramedullary. A surgical decision was made. Th12–L1 laminectomy was performed. Using intraoperative neuromonitoring and intraoperative ultrasound, the level of the lesion was precisely assessed. After opening the meningeal layer, the tumor was visualized at the end of the conus medullaris. With microvascular surgical technique, the tumor was removed, achieving gross total resection. Histologically, the patient was diagnosed with a bronchogenic cyst.The patient was discharged from the hospital without neurological complications. Postoperatively, we monitored the patient systematically, and no recurrence was observed at 18-month follow-up.With this study, we want to emphasize that although these benign tumors are mostly located at upper levels of the spinal cord, bronchogenic cysts can also appear at the end of the conus, before the cauda equina. Correlation of preoperative MRI with intraoperative ultrasound provides very reliable results. With accurate histological diagnosis, patients can have a long tumor-free life.
Tchatchia et al. (Sat,) studied this question.