• Soichiro Takamiya, Toshitaka Seki, Takuma Ikeda, Shin-Ichiro Shinada, Shuji Hamauchi, Shunsuke Terasaka, and Kiyohiro Houkin.
• Department of Neurosurgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan. Electronic address: soichiro.tkmy@gmail.com.
• World Neurosurg. 2018 Nov 1; 119: 172-175.

BackgroundMyelocystoceles, which are classified as closed neural tube defects, are usually covered by skin and rarely complicated by hydrocephalus. We encountered an unusual case of a terminal myelocystocele with hydrocephalus with clinical characteristics of a myelomeningocele.Case DescriptionSevere hydrocephalus and a lumbosacral lesion were detected in the fetus of a gravid 34-year-old woman. Cesarean section was performed at 37 weeks. The neonate presented with a lumbosacral mass with a partial skin defect. As myelomeningocele was suspected, the neonate underwent surgery on the day of birth. The intraoperative findings pointed to a myelocystocele rather than a myelomeningocele. After insertion of a ventriculoperitoneal shunt, the neonate was discharged without any neurologic deficits.ConclusionsPresence of skin abnormalities, hydrocephalus, and lumbosacral mass strongly suggests a diagnosis of myelomeningocele. However, such cases should be differentiated from myelocystocele, especially when associated with severe hydrocephalus.Copyright © 2018 Elsevier Inc. All rights reserved.

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