the differential diagnosis of a subcutaneous paraspinal cyst includes: cystic hygroma, when seen in the cervical region; however, this abnormality is often septate, extends laterally, and may be associated with hydrops and chromosomal anomalies (turnerís syndrome, trisomies 21 and 18), unlike the isolated myelocystocele. a closed simple meningocele with a small spinal defect may present in a similar fashion, without associated cranial features. larger neural tube defects, however, are more likely to demonstrate hydrocephalus and the arnold-chiari malformation, and raised maternal serum and amniotic fluid alpha-fetoprotein concentrations may enable the correct diagnosis.