Spinal meningeal cysts in autosomal dominant polycystic kidney disease

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In a 44‐year‐old woman with autosomal dominant polycystic kidney disease (ADPKD), arterial hypertension, and dyslipidaemia, abdominal ultrasound revealed a cystic mass in the small pelvis. Subsequent computed tomography showed spinal meningeal cysts in this area. During 14 years of follow‐up, they remain asymptomatic. Figures 1 and S1 show these cysts on magnetic resonance imaging, performed due to the symptoms of lumbosacral spondylosis.
Spinal meningeal cysts, also known as spinal meningeal diverticula, spinal arachnoid cysts, meningocoeles, or radicular cysts, are considered a feature of ADPKD, and are observed in 1.7 % of ADPKD patients.1 To date, they were reported in only five patients with ADPKD,1 including three patients with thoracic, and two patients with sacral localization. All of these patients were women. Usually, spinal meningeal cysts are incidental findings in ADPKD patients who undergo imaging studies. Similarly to our patient, three of the reported cases were asymptomatic. In the remaining two patients, symptoms of intracranial hypotension were observed, including orthostatic headache, and visual disturbances.
Summarizing, spinal arachnoid cysts should be included into the differential diagnosis of paraspinal mass, or headache in ADPKD patients.
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