Malignant transformation of an intraaxial-supratentorial neurenteric cyst – Case report and review of the literature
Bibliographic record
Abstract
Neurenteric cysts are "rare benign mass forming developmental abnormalities" that usually affect young adults. Neurenteric cysts are thought to be derived from primitive endoderm, and form as a result of faulty endodermal-notochordal separation at 3 weeks of embryogenesis. Neurenteric cysts are lined by simple-to-pseudostratified respiratory/gastrointestinal-like epithelium; as such, these lesions closely resemble colloid and Rathke's cleft cysts. Anatomically, neurenteric cysts most frequently arise in an intradural-extraaxial location anterior to the cervical-thoracic spinal cord. Intracranial neurenteric cysts are uncommon but have a tendency to reside in the infratentorial compartment. Malignant transformation of the epithelial component of neurenteric cysts is decidedly rare. Of the 3 reported cases of neurenteric cysts with malignant transformation, all were intracranial (2 infratentorial and 1 supratentorial) and extraaxial. We describe a 58-year-old female with a supratentorial-intraaxial lesion that is consistent with a neurenteric cyst exhibiting malignant transformation into an invasive mucinous papillary cystadenocarcinoma. Areas of direct transition between typical benign neurenteric cyst epithelia and malignant epithelia (i.e., carcinoma in situ), highlighted by an abrupt change in the Ki-67 proliferative index, were identified, and supported the primary nature of this brain neoplasm. Metastatic workup at the time of presentation was unremarkable, and immediately up until being lost to follow-up 38 months after gross total resection, routine follow-up MR imaging had not detected a recurrence. To our knowledge, this would be the first reported case of malignant transformation within a supratentorial-intraaxial neurenteric cyst.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.004 | 0.004 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".