Chennai, Apr 03: Demonstrating the critical role of precise diagnosis in neurological care, the medical team at MGM Healthcare identified an exceptionally rare case of a cyst with gastric characteristics located in the brain and successfully removed it, saving the life of a young IT professional who presented with limb weakness.
Medical literature reports only about 45 such cases worldwide, where cysts with gastric characteristics, sac-like structures containing fluid typically associated with the abdomen, are found in the brain region. The surgical intervention, a craniotomy combined with microsurgical removal of the cyst, was particularly challenging. Extreme care was required to prevent any spillage of the cyst’s contents. If released into the brain, the acidic fluid, containing high levels of Amylase, an enzyme that breaks down carbohydrates, could damage surrounding tissue and potentially lead to complications such as severe seizures.
Coincidentally, Dr. V. R. Roopesh Kumar, Director of Neurosurgery, MGM Healthcare, who led the procedure, had encountered a similar rare case nearly two decades ago. This prior experience prompted him to carefully reassess the nature of the cyst when it revealed a yellowish fluid, distinct from the clear, colorless Cerebrospinal fluid typically seen in brain-related conditions.
If the condition had not been accurately identified, the usual course of treatment would have involved draining the fluid while leaving the cyst intact, an approach that could have led to significant long-term damage to the brain. Following the surgery, the patient has made a good recovery, with normal function restored in his limbs.
In his comments, Dr. Roopesh Kumar said,
“What we found in the brain was an enterogenous cyst – that is a cyst lined by tissue similar to the gastrointestinal tract, containing stomach-like lining. The cyst could easily have passed off as a typical brain cyst. However, we were alerted by the light yellow colour of the fluid. Fortunately, I had encountered a similar case nearly twenty years ago, and that experience helped in identifying this condition accurately. We proceeded to analyse the fluid and sent a portion of the cyst for biopsy. Both confirmed that it was not a brain cyst, technically known as an Arachnoid cyst, which is typically filled with Cerebrospinal fluid, a clear, colorless fluid that surrounds the brain and spinal cord.”
He further noted that such rare occurrences can be explained by developmental anomalies. During early development, the spine and intestine lie close to each other. In the process of further development, they separate off, but in few instances, they fail to separate causing the remnants to stay within neural tissues, most commonly spine or lower compartment of cranium. But their presence in the upper compartment is extremely rare, which is what happened in this patient.
In his comments Mr. Nilesh Mundada, COO, MGM Healthcare & Sr. VP – Finance, MGM Group, said,
“This case underscores the critical importance of precise diagnosis backed by deep clinical expertise. The ability of our team to identify a rare enterogenous cyst, something that could easily have been mistaken for a routine brain cyst, highlights the strength of multidisciplinary evaluation at MGM Healthcare. Equally important was the surgical expertise involved in removing the cyst in its entirety without any spillage of its contents, thereby preventing potential damage to the brain. Such outcomes reflect our continued commitment to combining advanced diagnostics with highly skilled surgical care to ensure the best possible outcomes for our patients.”
