Meningocele, Cervical Filiform

Fabrice Cuillier, MD*, Verg, MD**, Balu, MD***

*    Department of Gynecology, CHR Félix Guyon, 97400 Saint-Denis, Ile de la Réunion, France. 
** Gynecologist, CHR Félix Guyon, 97400 Saint-Denis, Ile de la Réunion, France. 
*** Department of Radiology, CHR Félix Guyon, 97400 Saint-Denis, Ile de la Réunion, France. 

Case report :

A 28-year-old-woman, G2P1, with unknown obstetric risk factors and no relevant medical history underwent a first ultrasound scans at 13 weeks which revealed no anomalies. The nuchal translucency was 1 mm (CRL: 60 mm). The triple test was  done (1/10000).

At 24 weeks, a second ultrasound examination revealed a cervical cutaneous posterior anomaly  which suggested a possible cervical filiform meningocele (Image 1,2) . Our differential diagnosis was epidermal cyst.

2D sagittal view of the spine confirmed the diagnosis (Image 3-7). A cervical meningocele with a filifirm connection was our final hypothesis.  

An amniocentesis was performed. Fetal karyotype and ACE dosage was normal. Although a prenatal cerebral and spine MRI was performed (Image 8), the diagnosis could not be confirmed. At 36 weeks, this cervical meningocele was poorly visible.

At 38 week, a normal delivery happened. Postnatal neurological examination did not revealed any deficit. The skin’s spine was normal, but there was a midline cervical fluid-like mass. (Image 9). 

At one month of life, we performed a postnatal MRI (Image 10-11) to confirm our first diagnosis . The baby was operated one week later for his meningocele.  

Image 1-7: 2D ultrasound from 24 to 30 weeks of gestation suggested a cervical filiform meningocele .  

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Image 8:  prenatal MRI.

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Image 9 : a midline cervical fluid-like mass 
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mage 10-11:post natal MRI 
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