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Title : case 242

Age / Sex : 77 / F



Age / Sex : 6 days / female


Chief complaint : sacral dimple




1) What is your impression?

Two weeks later, you can see the final diagnosis with a brief discussion of this case.

* Send Application Answers to JH Yi, MD (yijh@knu.ac.kr)

Courtesy : Park So Young , Kyung Hee University Hospital at Gangdong


Diagnosis:

Filar cyst



Discussion



Findings: Longitudinal sonography shows well-defined fusiform “cyst” in midline just below conus medullaris. The hypoechoic lesion within filum terminale disappeared on follow-up sonography after two weeks.


                       


Differential Diagnosis: none


 


Diagnosis: Filar cyst


 


Discussion:


The so-called filar cyst is an interesting incidental finding that has only recently been studied, perhaps at least partly because of being detected more often with improved sonographic equipment. Although this lesion has been scantly described in the radiology literature, it is often visible on sonography. There is no autopsy description of a filar cyst, which begs the questions of its origin and its validity as an entity.

Possible explanations for the origin of the filar cyst include that perhaps the normal arachnoid reflections form a pseudocystlike structure or that it is a true ependyma-lined cystic embryonic remnant (possibly indistinguishable from the ventriculus terminalis) that is disrupted by the act of opening the dura during autopsy. Regardless of its origin, it is a normal variant that along has no known clinical significance and that does not require additional imaging. If MRI is performed, in our experience, the filar cyst is less reliably visible than on sonography. Strict imaging criteria for filar cysts should be applied (location midline, within filum, just below conus; fusiform shape, well-defined, hypoechoic appearance of a simple cyst) to avoid the potential for underdiagnosing a true disorder.

Correct Answer
Name Institution
이름:소속병원
Total applicants: 17
Correct answer: 7
배소영: 순천향대부천병원
김성윤: 동대문튼튼병원
박혜영: 일산백병원
정유미: 가천의대길병원
이상희: 서울삼성의료원
이은솔: 서울아산병원
정진영: 서울삼성의료원
Semi-correct answer: 5
이호준: 국군양주병원
윤민아: 서울대병원
김태은: 대구파티마병원
여동명: 여의도성모병원
이경규: 한강성심병원

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