This study was performed between 2007-2012 and encompasses 94 patients. The patients were divided in two groups. The first group included the patients who have benefited from surgical treatment (42 cases) and the second one included patients who benefited from conservative treatment. Out of the total number of cases, 63 cases showed an intact simple bone cyst that was most of the time an accidental discovery. 31 patients presented with fracture sustained on a simple bone cyst. There were 63 boys and 31 girls. Their mean age was 9.9 +/- 2.34 years. Single injection was performed for 49 patients; the rest had double or triple injections. The mean follow-up was 34.5 +/- 6.6 months. The procedure succeeded in obtaining healing in 77 cysts (82%). Cyst index of more than five and cortical index of less than 1 mm were significantly prone to pathological fractures and had significant poor results after treatment. Our results suggested that an autogenous bone marrow injection is a safe and effective treatment method for simple bone cysts, when compared with the surgical management, but sometimes-repeated injections are necessary. Cyst index and cortical width are good indicators for treatment outcome.
Ulici, A; Balanescu, R; Topor, L; Barbu, M
Introduction. Simple bone cyst or unicameral bone cysts are benign osteolytic lesions seen in metadiaphysis of long bones in growing children. Various treatment modalities with variable outcomes have been described in the literature. The case report illustrates the surgical technique of minimally invasive method of treatment. Case Study. A 14-year-old boy was diagnosed as active simple bone cyst proximal humerus with pathological fracture. The patient was treated by minimally invasive percutaneous curettage with titanium elastic nail (TENS) and allogenic bone grafting mixed with bone marrow under image intensifier guidance. Results. Pathological fracture was healed and allograft filled in the cavity was well taken up. The patient achieved full range of motion with successful outcome. Conclusion. Minimally invasive percutaneous method using elastic intramedullary nail gives benefit of curettage cyst decompression and stabilization of fracture. Allogenic bone graft fills the cavity and healing of lesion by osteointegration. This method may be considered with advantage of minimally invasive technique in treatment of benign cystic lesions of bone, and the level of evidence was therapeutic level V.
Lakhwani, O. P.
Simple bone cysts are well-defined intraosseous radiolucencies that often extend between the roots and appear clinically like empty cavities. This article aims to provide more information about this lesion with limited prominence in academic literature, to illustrate atypical cases, and to provide a review of the current literature. A series of six atypical cases of simple bone cysts is presented and their clinical, radiographic and microscopic characteristics, differential diagnosis, treatment and follow-up are discussed. Correct diagnosis of this entity is of key importance, since it presents with clinical & radiographic similarities to other bone lesions, some exhibiting more aggressive behaviour. PMID:23218982
Sabino-Bezerra, José Ribamar; Santos-Silva, Alan Roger; Jorge, Jacks; Gouvêa, Adriele Ferreira; Lopes, Márcio Ajudarte
The solid variant of aneurysmal bone cyst (solid ABC) is rarely encountered in long bones and appropriate treatment for this disease remains unclear. We experienced a 13-year-old boy suffering from pain in his left knee caused by solid ABC. Simple curettage of the bone lesion without any adjuvant therapy and a bone graft gave immediate pain relief. Histological examination of the surgical specimen showed typical features of solid ABC, and cycloxygenase-2 (COX-2) expression was confirmed in giant cells with a background of spindle cells by immunohistochemistry. Magnetic resonance imaging showed that soft tissue edema surrounding the lesion was improved two months after surgery and there was no indication of recurrence two years after surgery. If COX-2 secreted from the tumor induces soft tissue edema, simple curettage of the bone lesion seems to be a reasonable treatment for solid ABC and is able to minimize invasive treatment of the patients.
Summary.—A case of aneurysmal bone cyst located at the lateral periosteal surface of the humeral diaphysis is presented. The patient was treated by in-bloc tumor re- section and grafting of liophylized bone. The outcome has been satisfactory without tumor recurrence. Three years after surgery the patients remains free from disease. A relationship between previous trauma and the development of tumor
P. ZAMORA-NAVAS; F. COLLADO TORRES; F. DE LA TORRE SOLÍS
Aneurysmal bone cyst (ABC) is a benign but locally destructive lesion of the bone characterized by the presence of spongy or multi-loculated cystic tissue filled with blood. It accounts for 2.5% of all bone tumors. An ABC may involve almost any bone, but the most frequent sites are long tubular bones and vertebrae. The sternum is a rare location for an ABC. Here we present a case with sternal ABC, discuss the clinical manifestations and treatment, and review the literature. Radical wide resection of primary sternal tumors and reconstruction with appropriately rigid prosthetic material are necessary to avoid chest wall instability and minimize local recurrence. PMID:20494010
Singh, Vikram P; Mir, Ruquaya; Kaul, Sumaid
An enchondroma with complex cystic changes of the proximal femur is described in a 13-year-old male. The case illustrates a unique presentation of an enchondroma and reinforces the importance of considering the presence of secondary aneurysmal bone cysts in both benign and malignant lesions of bone. PMID:22639202
Bird, Justin E; Wang, Wei-Lien; Deavers, Michael T; Madewell, John; Lewis, Valerae O
Aneurysmal bone cyst is a rare, rapidly growing, and destructive benign bone tumor that even more rarely involves the bones of the hand. Various treatment options for aneurysmal bone cyst have been reported in the literature, but controversy exists regarding optimal treatment. Due to its rarity in the hand, no evidence-based treatment regimen has been established. A 21-year-old man presented with a history of pain and local swelling over his fifth metacarpal of 5 months' duration. Physical and radiographic examination of the hand was consistent with aneurysmal bone cyst. After biopsy, pathologic examination confirmed the diagnosis of aneurysmal bone cyst. En-block resection of the tumor and autologous bicortical strut graft fixation with Kirschner wires was performed. The hand was immobilized in a short arm cast for 3 weeks after the patient received 3 weeks of physiotherapy. Kirschner wires were removed 6 weeks postoperatively. Excellent clinical and functional results were obtained with no recurrence after 3 years of follow-up with en-block resection and reconstruction with iliac crest graft. Radiographic examination demonstrated the osseous integration of the graft with no signs of recurrence. Although treatment should be planned individually according to lesion site and size and to patient age, we suggest en-block resection to prevent recurrence and secondary surgical interventions particularly in cases with no articular involvement. PMID:19708623
Ozyurek, Selahattin; Rodop, Osman; Kose, Ozkan; Cilli, Feridun; Mahirogullari, Mahir
Background Simple renal cysts usually have benign clinical features. We report a rare case of papillary renal cell carcinoma (RCC) associated with a large recurrent simple cyst following sclerotherapy. Case Presentation A 47-year-old Japanese woman received minocycline sclerotherapy for a large (9 cm in diameter) simple left renal cyst in May 2005. The cyst regrew, and second-line sclerotherapy with ethanol was performed in November 2005. Three years later, she developed papillary RCC on the wall of the recurrent renal cyst. Radical nephrectomy was performed, but the patient died of metastatic disease 15 months after surgery. Conclusion Malignant transformation from recurrent simple renal cyst to RCC may occur in the years following sclerotherapy, underscoring the need for long-term follow-up.
We designed a semiautomatic segmentation method to easily measure the volume of a bone cyst (simple or aneurysmal) from magnetic resonance imaging (MRI). This method only considers the fluid part of the cyst, even when there are several fluid intensities (fluid-fluid levels) or the cyst is multi-loculated. The nonhomogeneity phenomenon inherent in MRI was handled by a k-means clustering algorithm
Pierre-Louis Docquier; Laurent Paul; Renaud Menten; Olivier Cartiaux; Bernard Francq; Xavier Banse
We report the case of an aneurysmal bone cyst of the left orbital roof in a 12-year-old boy who presented proptosis of the left eye and painless swelling of the left orbital rim. A 3-cm-large tumor developed in less than 3 months, with first visible signs about 2 months after a minor head injury. Radiologically, the lesion was osteolytic and
Marek Mandera; Izabela Malinowska; Ewa Kluczewska
Aneurysmal bone cyst is a benign and locally destructive bone lesion usually seen in the younger population. Its etiology is unknown. Its yearly incidence rate has been reported to be 0.14/100,000, comprising 1% of all bone tumors. It may develop primarily or arise from primary bone tumors. Hemorrhagic fluid content with a septated appearance is the characteristic feature of aneurysmal bone cyst. It is most commonly seen in the metaphysis of the long bones. In rare cases, the cyst is located in the skull. Primary treatment is surgical excision, and the recurrence rate after treatment is 10 to 30%. Based on a review of the current literature, there have been no previous reports of aneurysmal bone cyst located in the middle turbinate. We report a case of aneurysmal bone cyst with an atypical location and discuss the treatment of the patient with endoscopic surgery in light of relevant literature. PMID:23780605
Simsek, Gokce; Saka, Cem; Sonbay, Didem N; Akin, Istemihan; Koybasioglu, Fulya
Three symptomatic non-parasitic liver cysts in three patients were treated by the technique of percutaneous aspiration followed by sclerosis of the cyst lining by irrigation with absolute alcohol. In two patients the treatment was fully successful, with partial success in the third case. Two cysts underwent two separate treatments. The technique, which is reviewed, was shown to be a safe and effective alternative to conventional surgical management. PMID:8512508
McCullough, K M
A correlated histologic and radiographic study of nine giant-cell tumors, six aneurysmal bone cysts, and one combined lesion is presented. Clinical findings and plain radiographic appearances were found to overlap. Angiographically, the giant-cell tumors were richly vascularized, with a marked intratumoral contrast uptake, occasional irregular tumor vessles, a prominent peritumoral arterial net-work, and early draining veins. Microscopic examination revealed fine,
B. Gunterberg; L.-G. Kindblom; S. Laurin
Liver cysts are common, affecting 5%-10% of the population. Most are asymptomatic, however 5% of patients develop symptoms, sometimes due to complications and will require intervention. There is no consensus on their management because complications are so uncommon. The aim of this study was to perform a collected review of how a series of complications were managed at our institutions. Six different patients presenting with rare complications of liver cysts were obtained from Hepatobiliary Units in the United Kingdom and The Netherlands. History and radiological imaging were obtained from case notes and computerised radiology. As a result, 1 patient admitted with inferior vena cava obstruction was managed by cyst aspiration and lanreotide; 1 patient with common bile duct obstruction was first managed by endoscopic retrograde cholangiopancreatography and stenting, followed by open fenestration; 1 patient with ruptured cysts and significant medical co-morbidities was managed by percutaneous drainage; 1 patient with portal vein occlusion and varices was managed by open liver resection; 1 patient with infected cysts was treated with intravenous antibiotics and is awaiting liver transplantation. The final patient with a simple liver cyst mimicking a hydatid was managed by open liver resection. In conclusion, complications of cystic liver disease are rare, and we have demonstrated in this series that both operative and non-operative strategies have defined roles in management. The mainstays of treatment are either aspiration/sclerotherapy or, alternatively laparoscopic fenestration. Medical management with somatostatin analogues is a potentially new and exciting treatment option but requires further study.
Macutkiewicz, Christian; Plastow, Ricci; Chrispijn, Melissa; Filobbos, Rafik; Ammori, Basil A; Sherlock, David J; Drenth, Joost PH; O'Reilly, Derek A
Aneurysmal bone cysts have been described as pseudocysts in view of their lack of an epithelial lining. These cysts are uncommon, but when they do occur they typically involve the long bones of the extremities, the membranous bones of the thorax and pelvis, and the vertebrae. Skull involvement is uncommon. We present the case of a 14-year-old girl who presented with nasal obstruction and a swelling of the right cheek. Contrast-enhanced computed tomography detected a heterogeneous cystic mass involving the sphenoid and ethmoid bones. The mass was excised via a lateral rhinotomy approach, and it was identified as an aneurysmal bone cyst on histologic examination. The patient experienced a recurrence in the right sphenoid sinus within 3 months, and the lesion was removed via transnasal endoscopy. PMID:22614567
Goyal, Arun; Rastogi, Shalabh; Singh, P P; Sharma, Sonal
An aneurysmal bone cyst involving the rib is very rare. Forty-four cases have been reported in the literature. Primary neoplasms of the ribs are uncommon and malignant tumours are significantly more common than benign tumours in this location. The condition is a rare benign, progressive bone tumour. The aetiology and natural history are unknown. The Authors report the case of a 38-year-old man with an aneurysmal bone cyst of the right 6th rib, treated by en-bloc resection. The patient has been followed up now for ten years with no signs of recurrence. PMID:16845881
Sadighi, Arash; Tuccimei, Umberto; Annessi, Paolo
In this study we present a case of Tarlov's cyst that is treated operatively. The operation involved partial excision and oversewing of the cyst wall with connection to the dural sac and methylmethacrylate filling of the sacral bone defect that is formed by the cyst to prevent cyst recurrence. In symptomatic cases Tarlov's cyst can be treated operatively with a favorable outcome. PMID:12468982
Yucesoy, Kemal; Ozer, Ercan; Koyuncuoglu, Meral; Alici, Emin
Albeit rare, the majority of identified bone lesions in pregnancy spare the pelvis. Once encountered with a pelvic bone lesion in pregnancy, the obstetrician may face a challenging situation as it is difficult to determine and predict the effects that labor and parturition impart on the pelvic bones. Bone changes and pelvic bone fractures have been well documented during childbirth. The data regarding clinical outcomes and management of pregnancies complicated by pelvic ABCs is scant. Highly suspected to represent an aneurysmal bone cyst, the clinical evaluation of a pelvic lesion in the ilium of a pregnant individual is presented, and modes of delivery in such a scenario are discussed.
Aneurysmal bone cyst (ABC) is a rare benign cystic lesion of the bone that composes 1-2% of the entire bone tumors. Some are idiopathic, and some occur secondary to other tumors such as giant cell tumor and chondroblastoma. In this article, we report the clinical, radiographic, and histological findings of a secondary ABC following chondroblastoma of the patella with a review of the literature.
Tomoyuki, Kato; Susa, Michiro; Nakayama, Robert; Watanabe, Itsuo; Horiuchi, Keisuke; Toyama, Yoshiaki; Morioka, Hideo
Liver cysts are common, affecting 5%-10% of the population. Most are asymptomatic, however 5% of patients develop symptoms, sometimes due to complications and will require intervention. There is no consensus on their management because complications are so uncommon. The aim of this study was to perform a collected review of how a series of complications were managed at our institutions. Six different patients presenting with rare complications of liver cysts were obtained from Hepatobiliary Units in the United Kingdom and The Netherlands. History and radiological imaging were obtained from case notes and computerised radiology. As a result, 1 patient admitted with inferior vena cava obstruction was managed by cyst aspiration and lanreotide; 1 patient with common bile duct obstruction was first managed by endoscopic retrograde cholangiopancreatography and stenting, followed by open fenestration; 1 patient with ruptured cysts and significant medical co-morbidities was managed by percutaneous drainage; 1 patient with portal vein occlusion and varices was managed by open liver resection; 1 patient with infected cysts was treated with intravenous antibiotics and is awaiting liver transplantation. The final patient with a simple liver cyst mimicking a hydatid was managed by open liver resection. In conclusion, complications of cystic liver disease are rare, and we have demonstrated in this series that both operative and non-operative strategies have defined roles in management. The mainstays of treatment are either aspiration/sclerotherapy or, alternatively laparoscopic fenestration. Medical management with somatostatin analogues is a potentially new and exciting treatment option but requires further study. PMID:23355921
Macutkiewicz, Christian; Plastow, Ricci; Chrispijn, Melissa; Filobbos, Rafik; Ammori, Basil A; Sherlock, David J; Drenth, Joost Ph; O'Reilly, Derek A
Dermoid cysts of the head and neck are rare congenital benign tumors. According to the literature they represent about seven percent of all dermoids and less than one percent of all intracranial neoplasms. Extradural dermoid cysts are very rare. We report a case of intracranial extradural dermoid cyst of mastoid bone. We believe that this is the second documented extradural dermoid cyst, the first case reported in the literature (Ammirati et al., 2007) was in close relation to the petrous apex but ours is in close relation to mastoid antrum. Hearing loss was the only clinical presentation in this case, while neurological symptoms were the main presenting symptoms in the first reported case. We present our management of this rare case with respect to the clinical, radiological, histopathological, and surgical aspects and conclude that dermoid tumors, though rare, need to be included in differential diagnosis of middle ear lesions.
Al-Muhaimeed, Hamad S.; Abdelwahed, Hazem Y.; Elgamal, Essam A.; Alokby, Ghassan M.; Binnasser, Ameen M.; Ashraf, Masoada M.
We report a case of an aneurysmal bone cyst (ABC) of the clavicle in a 9-year-old boy, which initially presented as a pathological fracture of a benign cystic lesion. ABC of the clavicle is rare in children less than 10 years old and radiological diagnosis may prove difficult in the early stages of presentation. PMID:9039723
Vedantam, R; Crawford, A H; Kuwajima, S S
A rare case of aneurysmal bone cyst (ABC) located in the mandibular condyle in a 10-year-old boy is presented. The patient came to our attention for a sudden swelling in the right temporomandibular region, the mouth opening was not reduced. A rapid growing mass, depicting soft tissue invasion, in the right condyle of the mandible was found. Clinically and radiographically
Sandro Pelo; Giulio Gasparini; Roberto Boniello; Alessandro Moro; Pier Francesco Amoroso
An aneurysmal bone cyst is considered as a locally aggressive benign tumour. Intra-lesional extended curettage and bone-grafting is the mainstay of the treatment for aneurysmal bone cysts. Grafting is used usually in cases where the lesion compromises the mechanical strength of the bone. However, the massive size of the highly vascular tumour and the relative inaccessibility of its deeper extensions into the femoral vessels and the intra-abdominal structures, especially the urinary bladder, make it a relatively challenging case to perform excision and curettage.Presenting a case of a 15 years old male patient with the complaint of a right inguinal swelling since the past eight months. The swelling had started growing since the past two months and it was associated with pain. X-ray showed a lytic blowout legion of the entire right pubic ramus. An intra-lesional curettage was done. Complete tumour excision which was done by intra-lesional curettage and biopsy yielded satisfactory results with low complications and low recurrence of aneurysmal bone cyst of the superior ramus of the pubis.
Nayak, Ashok; Kulkarni, Shreepad; Kulkarni, Avinash; Natesh, K.; Bami, Monish
Background: Open curettage with bone graft has been the traditional surgical treatment for symptomatic unicameral calcaneal bone cyst. Endoscopic procedures have recently provided less invasive techniques with shorter postoperative morbidity. Hypothesis: The authors’ endoscopic procedure is effective for young athletes with symptomatic calcaneal bone cyst.Study Design: Case series; Level of evidence, 4.Methods: Of 16 young athletes with symptomatic calcaneal bone
Ken Innami; Masato Takao; Wataru Miyamoto; Satoshi Abe; Hideaki Nishi; Takashi Matsushita
Benign and malignant tumors of the temporomandibular joint are rare. An aneurysmal bone cyst (ABC) of the condyle is even more unusual and usually presents as a slowly enlarging firm swelling which occasionally may be associated with pain and tenderness. Surgical curettage or excision is the treatment of choice, in an attempt to reduce the potential problem of recurrence; we undertook surgical resection of the affected bone. Immediate mandibular reconstruction using autologous bone was deferred though it is generally recommended in such type of cases. PMID:23730077
Rai, Kirthi Kumar; Rana Dharmendrasinh N; Shiva Kumar, H R
Background Unicameral bone cysts are benign lesions that usually spontaneously regress with skeletal maturity; however, the high risk\\u000a of pathologic fractures often justifies treatment that could reinforce a weakened bone cortex. Various treatments have been\\u000a proposed but there is no consensus regarding the best procedure.\\u000a \\u000a \\u000a \\u000a \\u000a Questions\\/purposes We compared the healing rates and failures of two methods of cure based on multiple injections
Claudia Di Bella; Barbara Dozza; Tommaso Frisoni; Luca Cevolani; Davide Donati
This study quantified the radiographic changes of osteoarthritic acetabular bone cysts after uncemented total hip arthroplasty (THA). Ten-year follow-up radiographs from 130 primary THAs were reviewed. Forty-one cysts were identified on immediate postoperative radiographs. Two-dimensional cyst size was measured postoperatively and on long-term radiographs. Mean initial cyst size was 1.0 ± 0.9 cm2. Four (10%) of the 41 cysts expanded
Matthew P. Kelly; Nobuto Kitamura; Serena B. Leung; Charles A. Engh
We describe a case of an aneurysmal bone cyst originating from the zygomatic arch, which, according to the literature, is an extremely rare location. In the preoperative diagnosis the characteristic radiological signs of the high-quality computed tomography and magnetic resonance examinations were the cornerstones. Treatment was successful total excision. Careful diagnostic workup and multidisciplinary approach (head and neck surgeon, radiologist, and pathologist) should be utilized to successfully diagnose and to treat this rare pathology. PMID:23867160
Lerant, Gergely; Ivanyi, Emoke; Toth, Erika; Levai, Andrea; Godeny, Maria
Objective Our goal was to document the presentation, location, diagnostic modalities, preoperative embolization status, treatment, histology, complications, and recurrence rates for aneurysmal bone cysts of the mobile spine. Methods We reviewed our institution's database to identify patients diagnosed with aneurysmal bone cysts of the mobile spine (excluding the sacrum) from 1995 through 2006. Of those 17 patients, three were treated elsewhere and 14 underwent surgical treatment at our institution. Of those 14 patients, the nine (mean age at presentation, 17.2 years; range, 5?32 years) with at least 2 years of follow-up (average, 49.6 months; range, 24?88 months) formed our study group. For those nine patients, we tabulated the presentation, location, diagnostic modalities, preoperative embolization status, treatment, histology, complications, and recurrence rates. Results Pain was the presenting symptom in all nine patients. The lesion most commonly occurred in the cervical spine (five); two occurred in the lumbar spine, and two occurred in the thoracic spine. Patients underwent resection and combined anterior and posterior spinal arthrodesis (six) or resection and posterior spinal arthrodesis (three). There were four complications: one iliac crest donor site infection, one incidental durotomy, and two neurologic defcits. We noted two recurrences (both within 3 months). Conclusions Aneurysmal bone cysts of the spine can be successfully treated with surgical resection and instrumentation.
Mesfin, Addisu; McCarthy, Edward F.; Kebaish, Khaled M.
Aneurysmal bone cysts (ABC) were originally described by Jaffe and Lichtenstein [Arch Surg 1942;44:1004–1025] in 1942 as nonneoplastic benign lesions with obscure pathogenesis. ABC occurring in the temporal bone are uncommon. Those arising from the petrous portion of the temporal bone are exceedingly rare. We report a right petrous ABC in a 16-year-old girl who presented clinically with hearing loss,
Christina M. Sayama; Joel D. MacDonald
To confirm the diagnosis of diffuse cystic angiomatosis, it is necessary to biopsy the bone: the walls of the cysts react to immunological markers of the endothelium (antigens related to factor VIII and CD31). Alternatively, lymphography can avoid the necessity for biopsy. Evolution of the condition is variable and depends on the extent of visceral involvement, and usually the extent of soft tissue and visceral involvement dictates the morbidity and mortality. There is no specific treatment, though osseous lesions can regress spontaneously. Images
Ballina-Garcia, F J; Queiro-Silva, M R; Molina-Suarez, R; Fernandez-Martinez, J; Rivela-Vazquez, M; Rodriguez-Perez, A
Background Cystic lesions of the liver consist of a heterogeneous group of disorders that can present diagnostic and therapeutic challenges. Methods A retrospective review of all medical records of adult patients diagnosed with large (>7 cm) cystic lesions of the liver between January 2000 and December 2011, at Kurume University Hospital. Cases with polycystic disease were excluded. Results Twenty three patients were identified. The mean size was 13.9 cm (range, 7-22cm). The majority of simple cysts were found in women (females: males, 2: 21). In 19 patients, the cyst was removed surgically by wide deroofing (laparoscopically in 16 cases, combined with ethanol sclerotherapy in 13 cases). Infection of the liver cyst occurred in one patient, who later underwent central bi-segmentectomy. Conclusion Simple large cysts of the liver can be successfully treated by laparoscopic deroofing and alcohol sclerotherapy. Large hepatic cyst considered to need drainage should be removed surgically to avoid possible infection.
Maruyama, Yuichiro; Okuda, Koji; Ogata, Toshiro; Yasunaga, Masafumi; Ishikawa, Hiroto; Hirakawa, Yusuke; Fukuyo, Kenjiro; Horiuchi, Hiroyuki; Nakashima, Osamu; Kinoshita, Hisafumi
Aneurysmal bone cyst (ABC) is a non-neoplastic expansile bone lesion that is common in the long bones; only 2% occurs in the head and neck. We present a case of ABC in a 23-year-old male and describe the clinical and radiological features, histopathology and treatment. Magnetic resonance imaging (MRI) demonstrated multiple internal septations, cysts with fluid-fluid levels of varying intensity,
Fumiyuki Suzuki; Satoshi Fukuda; Katsunori Yagi; Eiji Chida; Yukio Inuyama
Aneurysmal bone cyst (ABC) is a benign bone lesion and commonly affects young ado- lescents. It usually grows rapidly with hypervascularity. In the spine, it can cause extensive bone destruction and compress neural structures with eventual vertebral collapse. Operative management of such a lesion may be complicated by profuse hemorrhage. Herein, we report a 15-year-old boy who had an acute
Shih-Hao Chen; Tsung-Jen Huang; Swei Hsueh; Yan-Yaw Lee; Robert Wen-Wei Hsu
Background Solitary bone cysts are benign, fluid-filled, expansive lesions in children. The success rate of bone consolidation in the\\u000a case of a solitary bone cyst is unpredictable following steroid injection.\\u000a \\u000a \\u000a \\u000a \\u000a Methods Among 24 patients with a solitary bone cyst, 11 (femur 8; pelvic bone 3) underwent curettage plus bone grafting for stabilization.\\u000a The remaining 13 patients — 8 long bones (humerus 6;
Akio Sakamoto; Shuichi Matsuda; Tatsuya Yoshida; Yukihide Iwamoto
Purpose. To evaluate the efficacy and long-term results of single-session 50% acetic acid sclerotherapy for the treatment of simple renal cysts, and to compare the therapeutic results of 5 and 20 min sclerosant dwell techniques. Methods. During the past 9 years, 50% acetic acid sclerotherapy was performed on 67 cysts in 66 patients. An acetic acid volume corresponding to a mean of 23% of the aspirated cyst volume was injected into the cysts. A 20 min dwell time with position changes was performed in 32 cysts (31 patients; group I) and 8% of volume for a 5 min dwell time in 35 cysts (35 patients; group II). Three- and 6-month sonographic or CT follow-up was performed for a minimum of 1 year. Complete regression was defined as no remaining cyst measurable on sonography with or without a scar at the renal cortex. Partial regression was defined as a decreased cyst volume compared with that before sclerotherapy. The Mann-Whitney U-test was used to compare the therapeutic results between the two groups. Results. For 67 simple renal cysts, complete regression on follow-up was observed in 21 of 32 cysts (66%; group I) and 22 of 35 cysts (63%; group II); the remaining 24 cysts all showed partial regression. The partial reduction rate of the cyst's volume was 97.4% (91.3-99.4%) in group I and 96.9% (90.8-99.5 %) in group II. There were no procedure-related major complications, and no statistically significant differences in the complete regression and partial volume reduction rates between the two groups (p > 0.05). Conclusion. Fifty percent acetic acid is an effective and safe sclerosing agent for simple renal cysts. Fifty percent acetic acid sclerotherapy with a 5 min sclerosant dwell time, using a volume of about 10% of the aspirated volume, is sufficient for satisfactory results of simple renal cyst sclerotherapy.
Kwon, Se Hwan; Oh, Joo Hyeong [Kyung Hee University Hospital, Department of Diagnostic Radiology (Korea, Republic of)], E-mail: firstname.lastname@example.org; Seo, Tae-Seok [Korea University Guro Hospital, Department of Radiology (Korea, Republic of); Park, Ho Chul [Kyung Hee University Hospital, Department of Surgery (Korea, Republic of)
The aim of this study was to present the results of non-vascularized fibular graft for reconstruction of bone defects after en block resection of giant aneurysmal bone cyst (ABC) of the extremities. Between 1998 and 2006, three patients, aged 6, 8 and 23 years, with giant aneurysmal bone cysts were treated. The cysts were located in the humerus, proximal femur and metatarsal. All patients were given en bloc resection of the cyst followed by non-vascularized fibular bone graft, with the graft length ranging from 6 to 18 cm. All patients needed supplementary fixation with a single Kirschner wire or plate and screws. At the final follow-up, bony union was achieved in each case, and there was no recurrence, limitation of range of motion or disability. In addition, complete regeneration of the fibula at the donor site was seen in the two children. We propose a criterion for giant ABC, when the transverse diameter of the cyst is up to three times or more of the transverse diameter of the nearby bone, it is then called a giant ABC. Non-vascularized fibular graft is an optimal and valuable method for the reconstruction of bone defects after resection of giant ABC in the extremities.
Background Unicameral (or simple) bone cysts (UBC) are benign tumours most often located in long bones of children and adolescents. Pathological fractures are common, and due to high recurrence rates, these lesions remain a challenge to treat. Numerous surgical procedures have been proposed, but there is no general consensus of the ideal treatment. The aim of this investigation therefore was to study the long-term outcome after surgical treatment in UBC. Methods A retrospective analysis of 46 patients surgically treated for UBC was performed for short and mid-term outcome. Clinical and radiological outcome parameters were studied according to a modified Neer classification system. Long-term clinical information was retrieved via a questionnaire at a minimum follow-up of 10 years after surgery. Results Forty-six patients (17 female, 29 male) with a mean age of 10.0 ± 4.8 years and with histopathologically confirmed diagnosis of UBC were included. Pathological fractures were observed in 21 cases (46%). All patients underwent surgery for UBC (35 patients underwent curettage and bone grafting as a primary therapy, 4 curettage alone, 3 received corticoid instillation and 4 decompression by cannulated screws). Overall recurrence rate after the first surgical treatment was 39% (18/46), second (17.4% of all patients) and third recurrence (4.3%) were frequently observed and were addressed by revision surgery. Recurrence was significantly higher in young and in male patients as well as in active cysts. After a mean of 52 months, 40 out of 46 cysts were considered healed. Prognosis was significantly better when recurrence was observed later than 30 months after therapy. After a mean follow-up of 15.5 ± 6.2 years, 40 patients acknowledged clinically excellent results, while five reported mild and casual pain. Only one patient reported a mild limitation of range of motion. Conclusions Our results suggest satisfactory overall long-term outcome for the surgical treatment of UBC, although short-and mid-term observation show a considerable rate of recurrence independent of the surgical technique.
The case of a 15-year-old patient presenting with pain as well as paraesthesia over the lateral aspect of the leg is reported. Clinical and radiological investigations showed an aneurysmal bone cyst arising from the proximal fibula and pressing on the common peroneal nerve. Surgical decompression of the nerve and curettage of the cyst was performed resulting in complete resolution of his symptoms. Our aim is to alert surgeons that this problem may occur and that the entire nerve needs to be exposed when dealing with the cyst. PMID:21822623
Jesudason, Prash; Akhtar, Sabeen; Zenios, Michalis
Aneurysmal bone cysts (ABC) are benign tumors of the bones, formed by multiple cysts filled with blood and eroding the bone. They are rarely located at the skull. We report a case of a right temporal ABC in a 5-year-old girl. On admission, the physical examination showed a tough and fixed tumor, with no inflammatory signs nor vascular characteristics. The neurological examination was normal. Imaging studies showed an heterogeneous extracerebral mass, eroding the temporal bone and the greater wing of the sphenoid bone. The treatment consisted in an extensive tumor resection, associated with reconstructive surgery. The outcome was uneventful (follow-up 27 months). We underline the pathogenetic, diagnostic and therapeutic features of this condition. PMID:10790645
Ait Benali, S; Ibahioin, K; Zamiati, S; Naja, A; Achouri, M; Choukri, M; Lakhdar, A; Sami, A; Ouboukhlik, A; El Kamar, A; El Azhari, A; Sqalli, S; Boucetta, M
A 20 year old girl presented with a history of neck and occipital pain for six weeks, which was found to be due to a unicameral bone cyst of the left occipital condylar region. The differential diagnosis of bone cysts in the skull is discussed. Six months after the operation, the patient again presented with backache due to adhesive arachnoiditis. The latter was believed to have arisen as a result of a combination of spinal infective meningitis and intrathecal ethyl iodophenyl undecylate (iophendylate, Myodil, Pantopaque). The nature of meningeal reactions to iophendylate and the part played by intrathecal corticosteroids in relieving the arachnoiditis in the present case are discussed. Images
Bradley, W. G.; Kalbag, R. M.; Ramani, P. S.; Tomlinson, B. E.
Bone morphogenetic protein (BMP) has been reported to cause early inflammatory changes, ectopic bony formation, adjacent level fusion, radiculitis, and osteolysis. The authors describe the case of a patient who developed inflammatory fibroblastic cyst formation around the BMP sponge after a lumbar fusion, resulting in compressive lumbar radiculopathy. A 70-year-old woman presented with left L-4 and L-5 radiculopathy caused by a Grade I spondylolisthesis with a left herniated disc at L4-5. She underwent a minimally invasive transforaminal lumbar interbody fusion with BMP packed into the interbody cage at L4-5. Her neurological symptoms resolved immediately postoperatively. Six weeks later, the patient developed recurrence of radiculopathy. Radiological imaging demonstrated an intraspinal cyst with a fluid-fluid level causing compression of the left L-4 and L-5 nerve roots. Reexpoloration of the fusion was performed, and a cyst arising from the posterior aspect of the cage was found to compress the axilla of the left L-4 nerve root and the shoulder of the L-5 nerve root. The cyst was decompressed, and the wall was partially excised. A collagen BMP sponge was found within the cyst and was removed. Postoperatively, the patient's radiculopathy resolved and she went on to achieve interbody fusion. Bone morphogenetic protein can be associated with inflammatory cyst formation resulting in neural compression. Spine surgeons should be aware of this complication in addition to the other reported BMP-related complications. PMID:22176433
Choudhry, Osamah J; Christiano, Lana D; Singh, Rahul; Golden, Barbara M; Liu, James K
OBJECTIVES--To examine the contents of intraosseous cysts in patients with rheumatoid arthritis (RA) through the signal intensity characteristics on gadolinium-DTPA (Gd-DTPA) enhanced magnetic resonance imaging. METHODS--The hand or foot joints of nine patients with the cystic form of RA (where the initial radiological abnormality consisted of intraosseous cysts without erosions) were imaged before and after intravenous administration of Gd-DTPA. A 0.6 unit, T1 weighted spin echo and T2* weighted gradient echo were used to obtain images in at least two perpendicular planes. RESULTS--Most cysts showed a low signal intensity on the non-enhanced T1 weighted (spin echo) images and a high signal intensity on the T2* weighted (gradient echo) images, consistent with a fluid content. No cyst showed an enhancement of signal intensity on the T1 weighted images after intravenous administration of Gd-DTPA, whereas synovium hyperplasia at the site of bony erosions did show an increased signal intensity after Gd-DTPA. Magnetic resonance imaging detected more cysts (as small as 2 mm) than plain films, and the cysts were located truly intraosseously. In six patients no other joint abnormalities were identified by magnetic resonance imaging; the three other patients also showed, after Gd-DTPA administration, an enhanced synovium at the site of bony erosions. CONCLUSIONS--It is suggested that intraosseous bone cysts in patients with RA do not contain hyperaemic synovial proliferation. The bone cysts in patients with the cystic form of RA may be the only joint abnormality. Images
Gubler, F M; Algra, P R; Maas, M; Dijkstra, P F; Falke, T H
The efficacy of osteochondral allografts (OCAs) may be affected by osseous support of the articular cartilage, and thus affected by bone healing and remodeling in the OCA and surrounding host. Bone cysts, and their communication pathways, may be present in various locations after OCA insertion and reflect distinct pathogenic mechanisms. Previously, we analyzed the effect of OCA storage (FRESH, 4°C/14d, 4°C/28d, FROZEN) on cartilage quality in fifteen adult goats after 12months in vivo. The objectives of this study were to further analyze OCAs and contralateral non-operated (Non-Op) CONTROLS from the medial femoral condyle to (1) determine the effect of OCA storage on local subchondral bone (ScB) and trabecular bone (TB) structure, (2) characterize the location and structure of bone cysts and channels, and (3) assess the relationship between cartilage and bone properties. (1) Overall bone structure after OCAs was altered compared to Non-Op, with OCA samples displaying bone cysts, ScB channels, and ScB roughening. ScB BV/TV in FROZEN OCAs was lower than Non-Op and other OCAs. TB BV/TV in FRESH, 4°C/14d, and 4°C/28d OCAs did not vary compared to Non-Op, but BS/TV was lower. (2) OCAs contained "basal" cysts, localized to deeper regions, some "subchondral" cysts, localized near the bone-cartilage interface, and some ScB channels. TB surrounding basal cysts exhibited higher BV/TV than Non-Op. (3) Basal cysts occurred (a) in isolation, (b) with subchondral cysts and ScB channels, (c) with ScB channels, or (d) with subchondral cysts, ScB channels, and ScB erosion. Deterioration of cartilage gross morphology was strongly associated with abnormal ?CT bone structure. Evidence of cartilage-bone communication following OCA repair may favor fluid intrusion as a mechanism for subchondral cyst formation, while bone resorption at the graft-host interface without affecting overall bone and cartilage structure may favor bony contusion mechanism for basal cyst formation. These findings suggest that cysts occurring after OCAs may result from aberrant mechanobiology due to (1) altered compartmentalization that normally separates overlying cartilage and subchondral bone, either from distinct ScB channels or more general ScB plate deterioration, and (2) bone resorption at the basal graft-host interface. PMID:23958821
Pallante-Kichura, Andrea L; Cory, Esther; Bugbee, William D; Sah, Robert L
Bone defects can occur in various forms and present challenges to performing a standard micro-CT evaluation of bone quality because most measures are suited to homogeneous structures rather than ones with spatially focal abnormalities. Such defects are commonly associated with pain and fragility. Research involving bone defects requires quantitative approaches to be developed if micro-CT is to be employed. In this study, we demonstrate that measures of inter-microarchitectural bone spacing are sensitive to the presence of focal defects in the proximal tibia of two distinctly different mouse models: a burr-hole model for fracture healing research, and a model of osteolytic bone metastases. In these models, the cortical and trabecular bone compartments were both affected by the defect and were, therefore, evaluated as a single unit to avoid splitting the defects into multiple analysis regions. The burr-hole defect increased mean spacing (Sp) by 27.6%, spacing standard deviation (SpSD) by 113%, and maximum spacing (Spmax) by 72.8%. Regression modeling revealed SpSD (?=0.974, p<0.0001) to be a significant predictor of the defect volume (R(2)=0.949) and Spmax (?=0.712, p<0.0001) and SpSD (?=0.271, p=0.022) to be significant predictors of the defect diameter (R(2)=0.954). In the mice with osteolytic bone metastases, spacing parameters followed similar patterns of change as reflected by other imaging technologies, specifically bioluminescence data which is indicative of tumor burden. These data highlight the sensitivity of spacing measurements to bone architectural abnormalities from 3D micro-CT data and provide a tool for quantitative evaluation of defects within a bone. PMID:23830560
Buie, Helen R; Bosma, Nick A; Downey, Charlene M; Jirik, Frank R; Boyd, Steven K
Aneurysmal bone cyst (ABC) is an expansile bone lesion that usually involves the long bones. Skull base involvement is rare. Hereby, we describe a 17-year-old man with hoarseness, facial asymmetry, left sided sensorineural hearing loss and left jugular foramen syndrome. CT scan and MRI showed a skull base mass that was confirmed as ABC in histopathology. The case was unusual and interesting due to the clinical presentation of jugular foramen syndrome and radiological findings such as severe enhancement and multiosseous involvement.
Aghaghazvini, Leila; Sedighi, Nahid; Karami, Parisa; Yeganeh, Omid
Haemorrhagic-aneurismal bone cysts (HABCs) are quite rare, benign, non-neoplastic, expansive, and vascular locally destructive lesions. They are generally considered sequelae of an earlier trauma causing an overflow of blood into the bone. HABCs are classified as pseudocysts and they should be differentiated from true cysts because their treatment is different. Since few of these cysts involve subjective symptoms, most are discovered accidentally during radiography, while a sure diagnosis is likely to be obtained only during surgery, on discovery of a non-epithelialised cavity. Here, we report a typical case of a haemorrhagic-mandibular cyst in a 13-year-old girl, which was treated by opening the cavity and scraping its walls following diagnostic arteriography and post-operative transcutaneous intralesional embolization. No further complications were recorded in the post-operative period, although the convalescence lasted for a time longer than expected, because of anemia. No further surgery was performed. She has been disease-free for two years. Evaluation of intralesional blood flow is important for HABCs because of the hemorrhagic risk in surgery. Embolization seems to be a useful procedure in the treatment of HABCs and could be tried as the treatment modality in the standard protocol for the treatment of HABCs.
Grecchi, Francesco; Zollino, Ilaria; Candotto, Valentina; Gallo, Francesco; Rubino, Giuseppe; Bianco, Raffaella; Carinci, Francesco
Background The recurrence rate after aneurysmal bone cyst (ABC) treatment is quite high despite its benign nature. In ABC therapy, curettage is the treatment of choice; en bloc excision results in a lower recurrence rate, but more extensive reconstructive surgery is needed with associated morbidity. The aim of the present study was to compare the outcomes of the two treatment options. Methods A retrospective analysis was performed on 26 patients treated for ABCs: 16 by curettage and 10 by en bloc excision. Each lesion was classified according to Enneking and patients were followed up for a mean time of 9.2 years. On follow-up, radiological examination and functional assessment (range of motion, muscle strength) were performed. Recurrence was defined as the presence of an osteolytic lesion, especially one with a tendency to grow. Results On follow-up, the following symptoms were more prevalent in the en bloc excision group compared to the curettage group: pain (en bloc 20% versus curettage 6.25%), limb length differences (en bloc 20% versus curettage 12.5%), reduced range of motion (en bloc 20% versus curettage 6.25%) and muscle strength impairment (en bloc 50% versus curettage 31.2%); however, the differences were not statistically significant (P >0.05). In the curettage group, two cases of postoperative complications and two cases of recurrence were seen, while in the en bloc excision group one case of complications was noted. Conclusions Curettage is a standard procedure in ABC management. En bloc excision is another option, albeit more technically demanding, that may be considered in recurrent lesions with extensive bone destruction or for cysts in an expendable location.
Introduction The solid variant of aneurysmal bone cyst is rare, and only 13 cases involving the spine have been reported to date, including seven in the thoracic vertebrae. The diagnosis is difficult to secure radiographically before biopsy or surgery. Case report An 18-year-old Hispanic man presented to our facility with a one-year history of left chest pain without any significant neurological deficits. An MRI scan demonstrated a 6 cm diameter enhancing multi-cystic mass centered at the T6 vertebral body with involvement of the left proximal sixth rib and extension into the pleural cavity; the spinal cord was severely compressed with evidence of abnormal T2 signal changes. Our patient was taken to the operating room for a total spondylectomy of T6 with resection of the left sixth rib from a single-stage posterior-only approach. The vertebral column was reconstructed in a 360° manner with an expandable titanium cage and pedicle screw fixation. Histologically, the resected specimen showed predominant solid fibroblastic proliferation, with minor foci of reactive osteoid formation, an area of osteoclastic-like giant cells, and cyst-like areas filled with erythrocytes and focal hemorrhage, consistent with a predominantly solid variant of aneurysmal bone cyst. At 16 months after surgery, our patient remains neurologically intact with resolution of his chest and back pain. Conclusions Because of its rarity, location, and radical treatment approach, we considered this case worthy of reporting. The solid variant of aneurysmal bone cyst is difficult to diagnose radiologically before biopsy or surgery, and we hope to remind other physicians that it should be included in the differential diagnosis of any lytic expansile destructive lesion of the spine.
Toxoplasma gondii is an obligate intracellular parasite that can invade any nucleated cell of warm-blooded animals. During infection, T. gondii disseminates as a fast replicating form called the tachyzoite. Tachyzoites convert into a slow-growing encysted form called the bradyzoite by a signaling process that is not well characterized. Within animals, bradyzoite cysts are found in the central nervous system and muscle tissue and represent the chronic stage of infection. Conversion to bradyzoites can be simulated in tissue culture by CO2 starvation, using medium with high a pH, or the addition of interferon gamma (IFNgamma). Bradyzoites are characterized by the presence of a cyst wall, to which the lectin Dolichos biflorus agglutinin (DBA) binds. Fluorescently labeled DBA is used to visualize the cyst wall in parasites grown in human foreskin fibroblasts (HFFs) that have been exposed to low CO2 and high pH medium. Similarly, parasites residing in murine bone marrow-derived macrophages (BMMs) display a cyst wall detectable by DBA after the BMMs are activated with IFNgamma and lipopolysaccharide (LPS). This protocol will demonstrate how to induce conversion of T. gondii to bradyzoites using a high pH growth medium with low CO2 and activation of BMMs. Host cells will be cultured on coverslips, infected with tachyzoites and either activated with addition of IFNgamma and LPS (BMMs) or exposed to a high pH growth medium (HFFs) for three days. Upon completion of infections, host cells will be fixed, permeabilized, and blocked. Cyst walls will be visualized using rhodamine DBA with fluorescence microscopy. PMID:20736916
Tobin, Crystal; Pollard, Angela; Knoll, Laura
Toxoplasma gondii is an obligate intracellular parasite that can invade any nucleated cell of warm-blooded animals. During infection, T. gondii disseminates as a fast replicating form called the tachyzoite. Tachyzoites convert into a slow-growing encysted form called the bradyzoite by a signaling process that is not well characterized. Within animals, bradyzoite cysts are found in the central nervous system and muscle tissue and represent the chronic stage of infection. Conversion to bradyzoites can be simulated in tissue culture by CO2 starvation, using medium with high a pH, or the addition of interferon gamma (IFN?). Bradyzoites are characterized by the presence of a cyst wall, to which the lectin Dolichos biflorus agglutinin (DBA) binds. Fluorescently labeled DBA is used to visualize the cyst wall in parasites grown in human foreskin fibroblasts (HFFs) that have been exposed to low CO2 and high pH medium. Similarly, parasites residing in murine bone marrow-derived macrophages (BMMs) display a cyst wall detectable by DBA after the BMMs are activated with IFN? and lipopolysaccharide (LPS). This protocol will demonstrate how to induce conversion of T. gondii to bradyzoites using a high pH growth medium with low CO2 and activation of BMMs. Host cells will be cultured on coverslips, infected with tachyzoites and either activated with addition of IFN? and LPS (BMMs) or exposed to a high pH growth medium (HFFs) for three days. Upon completion of infections, host cells will be fixed, permeabilized, and blocked. Cyst walls will be visualized using rhodamine DBA with fluorescence microscopy.
Tobin, Crystal; Pollard, Angela; Knoll, Laura
A 3-year-old girl developed sudden complete paraplegia because of an aneurysmal bone cyst of the fourth thoracic vertebra. We performed a two-step surgical procedure resulting in complete neurological recuperation and no cyst recurrence within 2.5-year follow-up. Although the literature shows the prognosis of such a condition to be poor, this case reveals the positive effect of rapid surgical decompression and
Christian Raftopoulos; Alfredo Hurrel; Linda Ticket; Henri B. Szliwowski; Jacques Brotchi
Aneurysmal bone cyst (ABC) is a locally recurrent bone lesion that has been regarded as a reactive process. Recently, a neoplastic basis in primary ABC was evidenced by demonstration of clonal chromosome band 17p13 translocations that place the USP6 (TRE2 or TRE17) oncogene under the regulatory influence of the highly active CDH11 promoter. Herein, we report CDH11 and/or USP6 rearrangements in 36 of 52 primary ABCs (69%), of which 10 had CDH11-USP6 fusion, 23 had variant USP6 rearrangements without CDH11 rearrangement, and three had variant CDH11 rearrangements without USP6 rearrangement. USP6 and CDH11 rearrangements were restricted to spindle cells in the ABC and were not found in multinucleated giant cells, inflammatory cells, endothelial cells, or osteoblasts. CDH11 and USP6 rearrangements did not correlate with recurrence-free survival, or with other clinicopathological features. CDH11 and USP6 rearrangements were not found in any of 17 secondary ABC associated with giant cell tumor, chondroblastoma, osteoblastoma, and fibrous dysplasia. These findings demonstrate that primary ABC are mesenchymal neoplasms exhibiting USP6 and/or CDH11 oncogenic rearrangements. By contrast, secondary ABC lack CDH11 and USP6 rearrangements, and although morphological mimics of primary ABC, appear to represent a non-specific morphological pattern of a diverse group of non-ABC neoplasms.
Oliveira, Andre M.; Perez-Atayde, Antonio R.; Inwards, Carrie Y.; Medeiros, Fabiola; Derr, Victoria; Hsi, Bae-Li; Gebhardt, Mark C.; Rosenberg, Andrew E.; Fletcher, Jonathan A.
Background The different treatment strategies for bone cysts in children are often associated with persistence and high recurrence rates of the lesions. The safety and clinical outcomes of a combined mechanical and biological treatment with elastic intramedullary nailing, artificial bone substitute and autologous platelet rich plasma are evaluated. Methods From 02/07 to 01/09 we offered all children with bone cysts the treatment combination of elastic intramedullary nailing (ESIN), artificial bone substitute (Orthoss®) and autologous platelet rich plasma, concentrated by the Gravitational Platelet Separation (GPS®) - System. All patients were reviewed radiologically for one year following the removal of the intramedullary nailing, which was possible because of cyst obliteration. Results A cohort of 12 children (4 girls, 8 boys) was recruited. The mean patient age was 11.4 years (range 7-15 years). The bone defects (ten humeral, two femoral) included eight juvenile and four aneurysmal bone cysts. Five patients suffered from persistent cysts following earlier unsuccessful treatment of humeral bone cyst after pathologic fracture; the other seven presented with acute pathologic fractures. No peri- or postoperative complications occurred. The radiographic findings showed a total resolution of the cysts in ten cases (Capanna Grade 1); in two cases a small residual cyst remained (Capanna Grade 2). The intramedullary nails were removed six to twelve months (mean 7.7) after the operation; in one case, a fourteen year old boy (Capanna Grade 2), required a further application of GPS® and Orthoss® to reach a total resolution of the cyst. At follow-up (20-41 months, mean 31.8 months) all patients showed very good functional results and had returned to sporting activity. No refracture occurred, no further procedure was necessary. Conclusions The combination of elastic intramedullary nailing, artificial bone substitute and autologous platelet rich plasma (GPS®) enhances the treatment of bone cysts in children, with no resulting complications.
The traumatic bone cyst (TBC) is an uncommon nonepithelial lined cavity of the jaws. The lesion is mainly diagnosed in young patients most frequently during the second decade of life. The majority of TBCs are located in the mandibular body between the canine and the third molar. Clinically, the lesion is asymptomatic in the majority of cases and is often
Arsinoi A Xanthinaki; Konstantinos I Choupis; Konstantinos Tosios; Vasilios A Pagkalos; Stavros I Papanikolaou
Our case report describes a primary aneurysmal bone cyst (ABC) of the maxillary sinus in a 12-year-old girl. The young patient presented with progressive diplopia, strabismus, and rapidly growing painless swelling of the left cheek. Imaging studies showed a heterogeneous contrast enhancing mass expanding the left maxillary sinus. The lesion was completely resected endoscopically and histological examination reported it as
G. Fyrmpas; J. Constantinidis; D. Televantou; I. Konstantinidis; J. Daniilidis
Aneurysmal bone cyst is a benign osteolytic lesion in childhood and adolescence which primarily arises in metaphyseal long bones. Its presence in bones of the skull base is very rare. In a 3-year old girl presenting with proptosis, MRI demonstrated a well-defined displacing growing mass in the ethmoid sinus, orbita and anterior fossa. The histopathologic examination of biopsy specimens confirmed an aneurysmal bone cyst. Despite radical surgery the child suffered from two recurrences of the lesion in the first year after initial diagnosis. There has been no subsequent recurrence during the last 3 years. Since this lesion is rarely seen at the skull base, is difficult to differentiate clinically and by histopathology and may take an abnormal course, it is described in this case report to emphasize that it should be included in the differential diagnosis of ENT tumors at this location. PMID:20033119
Wendt, S; Flügel, W; Spuler, A; Mairinger, T; Hoch, H; Bloching, M
Unicameral bone cyst (UBC) is a benign cystic lesion in children which is prone to fracture. Various treatments are available, but recurrence after different types of percutaneous injection therapy can cause bone destruction and pathologic fracture. The potential therapeutic effects of anti-resorptive agents, such as bisphosphonates, have not been investigated for UBC. The objective of this study was to characterize the cells from the fibro-cellular membrane of unicameral bone cyst (UBC cells) and to determine whether zoledronate, a nitrogen-containing bisphosphonate, could induce apoptosis in UBC cells. Flow cytometry and immunoblotting were performed in order to determine whether zoledronate induced apoptosis. Cells derived from normal human trabecular bones were used as controls against UBC cells to compare the effect of zoledronate in inducing apoptosis. Immunohisto/cytochemistry (IHC/ICC) and mini-array analyses were performed on tissues and cultured cells. Isolated peripheral blood mononuclear cells were incubated with conditioned media from the UBC cells to determine whether they are capable of inducing osteoclastogenesis. UBC membrane is composed of cells staining positively with CD68, SDF-1, STRO-1 and RANKL, but in vitro cells showed no staining with antibodies to CD68 and STRO-1, suggesting that there was a clonal selection of stromal cells during cell culture. UBC cells also express RUNX2 (runt-related transcription factor-2, core binding factor-1), a key transcription factor for osteoblastic differentiation. In addition, media collected from UBC cells induced a generation of multi-nucleated osteoclast-like cells of peripheral blood mononuclear cells. Zoledronate induced apoptosis of UBC cells in a dose-dependent manner. Apoptosis was evidenced by induction of the active cleaved form of caspase-3. The baseline apoptotic fractions were similar in UBC cells and trabecular bone cells. However, in the overall apoptotic fractions in this study, trabecular bone cells showed 17.2% of apoptosis, significantly lower than 24.2% of UBC cells (p-value=0.007). With the various zoledronate concentrations, mean apoptotic fractions of trabecular bone cells was 19.2%, significantly lower than 27.8% of UBC cells (p-value=0.040). With GGOH co-treatment in various zoledronate concentrations, 15.1% apoptosis was shown in trabecular bone cells, which was not significantly lower than 20.6% of UBC cells (p-value=0.076). This data suggests that zoledronate causes apoptosis in both UBC and trabecular bone cells by inhibition of the mevalonate pathway. In addition to the known anti-osteoclastogenic effect of bisphosphonates, the GGOH inhibitory effects of zoledronate were more prominent in UBC cells than trabecular bone cells, indicating their potential therapeutic role in UBC. PMID:15921873
Yu, John; Chang, Seong-Sil; Suratwala, Sanjeev; Chung, Woo-Sik; Abdelmessieh, Peter; Lee, Hahn-Jun; Yang, Jay; Lee, Francis Young-In
The authors describe a case of giant cell tumor (GCT) with secondary aneurysmal bone cyst (ABC) in a 44-year-old man with chronic, intermittent knee pain. A unique feature is the presentation of GCT with an ossified extraosseous soft tissue mass. Radiograph demonstrates a multiloculated lytic lesion in the distal meta-epiphyseal region of the femur with an adjacent extraosseous soft tissue mass. The soft tissue mass was partially ossified along its margin and internal septa. MRI demonstrates a multiloculated lesion in the distal femur with multiple fluid-fluid levels and cortical penetration of the lesion. Both the intraosseous lesion and extraosseous soft tissue mass have similar MR signal characteristics. At surgery, the intraosseous component was found to be contiguous with the extraosseous soft tissue mass through a cortical perforation. To the best of our knowledge, this is the first case report of GCT with aneurysmal bone cyst initially presenting with an extraosseous soft tissue mass. PMID:23708046
Hong, Won Sun; Sung, Mi Sook; Kim, Jo-Heon; Kim, Hyoung-Min; Kim, Tae Kwan; Chung, Myung Hee; Lim, Yeon Soo; Lim, Hyun Wook
Summary PLO-SL (polycystic lipomembranous osteodysplasia with sclerosing leukoencephalopathy) is a recessively in- herited disorder characterized by systemic bone cysts and progressive presenile frontal-lobe dementia, resulting in death at !50 years of age. Since the 1960s, »160 cases have been reported, mainly in Japan and Finland. The pathogenesis of the disease is unknown. In this article, we report the assignment of
Petra Pekkarinen; Iiris Hovatta; Panu Hakola; Osmo Järvi; Marjo Kestilä; Ulla Lenkkeri; Rolf Adolfsson; Gösta Holmgren; Per-Olof Nylander; Lisbeth Tranebjærg; Joseph D. Terwilliger; Jouko Lönnqvist; Leena Peltonen
The traumatic bone cyst (TBC) is an uncommon nonepithelial lined cavity of the jaws. The lesion is mainly diagnosed in young patients most frequently during the second decade of life. The majority of TBCs are located in the mandibular body between the canine and the third molar. Clinically, the lesion is asymptomatic in the majority of cases and is often accidentally discovered on routine radiological examination usually as an unilocular radiolucent area with a "scalloping effect". The definite diagnosis of traumatic cyst is invariably achieved at surgery. Since material for histologic examination may be scant or non-existent, it is very often difficult for a definite histologic diagnosis to be achieved. We present a well documented radiographically and histopathologically atypical case of TBC involving the ramus of the mandible, which is also of possible iatrogenic origin. The literature is briefly reviewed.
Xanthinaki, Arsinoi A; Choupis, Konstantinos I; Tosios, Konstantinos; Pagkalos, Vasilios A; Papanikolaou, Stavros I
Simple testicular cysts are rare in birds and mammals. However, the condition has recently been reported in the ostrich (Struthio camelus), an economically important farmed bird. The innervation of normal and cryptorchid testes, unlike the simple testicular cysts of birds and mammals, has received considerable attention. This study, therefore, immunohistochemically demonstrates the presence and the general distribution pattern of neuronal and glial markers in the simple intratesticular cyst, and its associated structures, of fourteen adult ostriches using antibodies to neurofilament protein, S-100, neuron-specific enolase and protein gene product 9.5. The LSAB+ Kit(DakoCytomation, Denmark) immunostaining protocol was used in this study. The normal seminiferous peritubular tissue showed few or no immunoreactive nerve fibres. A greater density of neurofilament protein, S-100, neuron-specific enolase and protein gene product 9.5 immunopositive nerve fibres were observed in the tunica albuginea adjacent to the cyst, as well as in the peritubular connective tissue of cystic seminiferous tubules. In addition, the tunica adventitia of blood vessels within the interstitial space of the cystic seminiferous tubules displayed neurofilament protein, S-100 and protein gene product 9.5 immunoreactive nerve fibres of varying intensity and pattern. Protein gene product 9.5 immunostaining was also observed in the multinucleated giant cells of both the normal and the cystic seminiferous tubules. The cystic portion of the testis appears to have a richer innervation than the normal portion of the same testis. The richer innervation of simple testicular cysts in the ostrich is similar to that observed in the cryptorchid testis of mammals. PMID:23898577
Ozegbe, Peter C; Madekurozwa, Mary-Catherine; Aire, Tom A
Unicameral bone cysts can predispose patients to pathologic fracture and deformities of growth. Treatment options vary from continuous decompression with transcortical placement of a cannulated screw to percutaneous aspiration and injection of medical-grade calcium sulfate. From 2005 to 2007, we treated 22 patients with unicameral bone cysts using aspiration and injection of calcium sulfate. Three patients experienced acute laryngospasm and one patient developed tachyarrhythmia, temporarily, associated with injection of calcium sulfate. All reactions occurred in patients under age 18 without predisposing risk factors and resolved spontaneously with supportive care. Although the mechanism is unclear, we hypothesize that these reactions are either due to the nociceptive stimulus of the calcium sulfate injection or a systemic calcium bolus. Clinicians using this product for this indication should be aware that such reactions may occur. We suggest endotracheal intubation and communication to the anesthesiologist about the time of the injection in preparation for these idiopathic responses. Further research is necessary to determine exactly how this reaction occurs and how it can be avoided.
Nystrom, Lukas; Raw, Robert; Buckwalter, Joseph; Morcuende, Jose A.
The intraosseous ganglion cyst (IOGC) is a benign and lytic bone tumor affecting mostly the metaphyseal and epiphyseal regions of long bones. Its location on the short bones, including the carpal bones has been little reported in the literature. Our review of the literature shows consensus about the surgical techniques to use, but there is currently no real consensus about its pathophysiology, and its diagnostic work-up. Complications related to this lesion (mainly the risk of pathologic fracture) are potentially serious, and can cause irreversible damage. They therefore require accurate assessment to guide the choice of medical or surgical treatment, including a CT scan, which - we believe - is essential. PMID:23218682
Dumas, P; Georgiou, C; Chignon-Sicard, B; Balaguer, T; Lebreton, E; Dumontier, C
Two cases of aneurysmal bone cyst in the hand are reported. In one case the entire first metacarpal was resected and grafted using the fourth metatarsal. In the second case diaphysectomy of the middle phalanx of the index digit was performed, and the proximal phalanx of the second toe was used as graft. Satisfactory length and function were maintained, the
G. S. RAO; P. KEOGH; H. WEBSTER; P. G. LUNN; F. D. BURKE
Removal of the acetabular component of a hip resurfacing prosthesis is occasionally necessary for infection, malposition, metal sensitivity, wear, or as a necessary part of a femoral revision. Extraction of a well-fixed acetabular component can be technically demanding as it is often extremely well integrated into host bone and can result in catastrophic bone loss or fracture. We present an undescribed, simple technique that enables use of the Explant system (Zimmer, Warsaw, Ind) to remove the component with minimal bone loss and reduce fracture risk. Bone stock is therefore preserved for subsequent cup reimplantation. PMID:18534434
Taylor, Paul R P; Stoffel, K K; Dunlop, D G; Yates, P J
Dermoid cysts are embryonic lesions usually observed in the lateral eyebrow region and the midline nose and neck areas. Communication of these lesions with the central nervous system is rare and occurs in the nasal region. There are few clinical reports of temporal dermoid cysts presenting with intracranial extension, and we present a 15-year-old girl with a fronto-orbital dermoid cyst with intracranial extension and bone erosion. Her presenting symptom was a lacrimation reduction of the left eye. Excision of the cyst was done using a coronal approach because of its extension and localization. PMID:22976680
Rinna, Claudio; Reale, Gabriele; Calafati, Vincenzo; Calvani, Francesco; Ungari, Claudio
Introduction Hepatic abscesses have been reported as a rare complication of diverticulitis of the bowel. This complication is recognized more commonly at the time of the diagnosis of diverticulitis, or ruptured diverticula, but also can be diagnosed prior to surgery, or postoperatively. Case presentation This report describes a man who developed an hepatic abscess within a simple hepatic cyst, two months after operation for ruptured diverticula of the sigmoid colon. The abscess was drained surgically and the patient made a complete recovery. Conclusion The development of an hepatic abscess in a pre-existing hepatic cyst, secondary to diverticulitis, is a rare complication. A high degree of clinical suspicion is required for immediate diagnosis and treatment.
Chatzipetrou, Maria; Avgerinos, Efthimios; Christianakis, Efstratios; Barmparas, Galinos; Pashalidis, Nikolaos; Stathoulopoulos, Athanasios; Tsatsoulis, Panayiotis; Smailis, Dimitrios; Filippou, Dimitrios
|Visual demonstrations of abstract scientific concepts are effective strategies for enhancing content retention (Shmaefsky 2004). The concepts associated with gene regulation of growth and development are particularly complex and are well suited for teaching with visual models. This demonstration provides a simple and accurate model of Hox gene…
PLO-SL (polycystic lipomembranous osteodysplasia with sclerosing leukoencephalopathy) is a recessively inherited disorder characterized by systemic bone cysts and progressive presenile frontal-lobe dementia, resulting in death at <50 years of age. Since the 1960s, approximately 160 cases have been reported, mainly in Japan and Finland. The pathogenesis of the disease is unknown. In this article, we report the assignment of the locus for PLO-SL, by random genome screening using a modification of the haplotype-sharing method, in patients from a genetically isolated population. By screening five patient samples from 2 Finnish families, followed by linkage analysis of 12 Finnish families, 3 Swedish families, and 1 Norwegian family, we were able to assign the PLO-SL locus to a 9-cM interval between markers D19S191 and D19S420 on chromosome 19q13. The critical region was further restricted, to approximately 1.8 Mb, by linkage-disequilibrium analysis of the Finnish families. According to the haplotype analysis, one Swedish and one Norwegian PLO-SL family are not linked to the chromosome 19 locus, suggesting that PLO-SL is a heterogeneous disease. In this chromosomal region, one potential candidate gene for PLO-SL, the gene encoding amyloid precursor-like protein 1, was analyzed, but no mutations were detected in the coding region.
Pekkarinen, P; Hovatta, I; Hakola, P; Jarvi, O; Kestila, M; Lenkkeri, U; Adolfsson, R; Holmgren, G; Nylander, P O; Tranebjaerg, L; Terwilliger, J D; Lonnqvist, J; Peltonen, L
Summary BACKGROUND: Liver cysts occur with a prevalence of 4–7% in the population. We present our experience in the management of these cysts. METHODS: Between 1994 and 2003, 42 patients (33 women, 9 men) were referred for surgery of dysontogenetic liver cysts. There were 19 patients with polycystic liver disease (PLD), 18 with simple cysts, 4 with Caroli disease, and one
P. Kornprat; H. Bacher; H. Cerwenka; A. El-Shabrawi; H. Hauser; C. Langner; H. J. Mischinger
Radicular cysts are the most common cystic lesions affecting the jaws. They are most commonly found at the apices of the involved teeth. This condition is usually asymptomatic but can result in a slow-growth tumefaction in the affected region. The following case report presents the successful treatment of radicular cysts using autologous periosteum and platelet-rich fibrin with demineralized freeze-dried bone allograft. PMID:23984115
Patil, Veena A; Desai, Manthan H; Patil, Veerendra S; Reddy Kaveti, Hanisha; Ganji, Kiran Kumar; Danappanavar, Prasanna M
Fibrous dysplasia (FD) and aneurysmal bone cyst (ABC) are uncommon benign intraosseous lesions. Simultaneous occurrence of both lesions is extremely rare. We present an example of concomitant FD and ABC in a 7 year-old with left eye blindness and discharge of one month duration. Physical examination revealed a proptotic left eye and bulging of the hard palate. CT and MRI are consistent with FD and ABC that involved the sphenoid and ethmoidal bones bilaterally. Incomplete combined endonasalcranial resection was performed. The patient presented five months postoperatively with a large recurrence and subsequent follow up was lost. Concomitant FD with ABC may occur in paranasal sinuses and may develop rapidly and exhibit locally aggressive behavior.
Bone densitometry using dual energy X-ray absorptiometry (DXA) is the 'gold standard' for osteoporosis diagnosis. However, mass screening for osteoporosis has not been recommended, and no consensus has been reached regarding specific targeted screening programs. Recently, the Simple Calculated Osteoporosis Risk Estimation (SCORE) was developed to identify postmenopausal women likely to have low BMD (< or > -2.0 SD of the young adult normal), who may be selected for DXA testing. This instrument uses a case-selective approach to screen for osteoporosis by summing a score based on: age, race, rheumatoid arthritis, history of nontraumatic fracture over 45 years of age, estrogen use, and weight. In our study, SCORE was validated using 398 postmenopausal women at least 45 years of age residing within 50 km of Toronto, Ontario, Canada (one of 9 centers of the Canadian Multicentre Osteoporosis Study, a national population-based study). At the recommended threshold of 6, SCORE had a sensitivity of 90%, specificity of 32% and a positive predictive value of 64%. From receiver operating characteristic (ROC) analysis, no threshold identified SCORE as a useful instrument in our population; area under the ROC curve was 0. 71. Specificity of the SCORE is poor; at the recommended threshold of 6, 68% of those with normal bone mineral density (BMD) would be selected for bone densitometry. Development and validation of SCORE by Lydick and colleagues may have been confounded by the nature of the study sample; sampling from specialty clinics; and by the choice of outcome, combining data from different DXA machines, and using only data from the femoral neck to identify low BMD. A simple and effective approach to select patients for bone densitometry has yet to be established. PMID:10501785
Cadarette, S M; Jaglal, S B; Murray, T M
A 27 year-old- lady was evaluated due to recurrent ventricular tachycardia. After performing echocardiography and cardiac MRI, she was found to have large pericardial cyst. Pathologic examination confirmed it as mesothelial pericardial cyst. Up to our knowledge it is the first presentation of simple pericardial cyst as ventricular a tachycardia.
Amirahmadi, Ali; Emkanjoo, Zahra; Mollazadeh, Reza; Mozaffari, Kambiz
A 27 year-old- lady was evaluated due to recurrent ventricular tachycardia. After performing echocardiography and cardiac MRI, she was found to have large pericardial cyst. Pathologic examination confirmed it as mesothelial pericardial cyst. Up to our knowledge it is the first presentation of simple pericardial cyst as ventricular a tachycardia. PMID:23329874
Amirahmadi, Ali; Emkanjoo, Zahra; Mollazadeh, Reza; Mozaffari, Kambiz
Abstract Objective: To emphasize the importance of early detection, recognition, appropriate investigation, accurate diagnosis, proper referral, and treatment of an aneurysmal bone cyst (ABC) presenting as chronic low back pain (LBP) in a chiropractic office. Clinical features: A 21-year-old female student presented to the chiropractic office with a 2-year history of severe and progressive LBP. The patient described the LBP as an aching type of pain that was more pronounced during activity and exercises. She also reported weight loss and increased fatigue. Intervention and outcome: A detailed clinical, physical, and imaging evaluation was performed. A well-defined, expansile, and lytic bone lesion with the appearance of a possible ABC was detected; it involved the left inferior half and posterolateral aspect of the vertebral body of L3. Results: Treatment consisted of an L3 hemivertebrectomy resection en bloc and a vertebral fusion from L2 to L4 with tricortical iliac crest graft. After surgery and recovery, LBP was relieved and the bone lesion did not recur. Conclusion: Although uncommon, ABC is an important lesion that can affect the spine. Healthcare providers must be aware that the cause of LBP may extend beyond musculoskeletal dysfunction. It is important to identify an ABC and refer the patient for appropriate evaluation and care. PMID:23438037
Tasca, Luana; Reinke, Tari
... Tumor (ATRT) Bone and Connective Tissue Brain Cysts Choroid Plexus Craniopharyngioma Ependymoma Germ Cell Glioblastoma Gliomas Hemangioma ... Tumor (ATRT) Bone and Connective Tissue Brain Cysts Choroid Plexus Craniopharyngioma Ependymoma Germ Cell Glioblastoma Gliomas Hemangioma ...
Nasolabial cyst is a rare nonodontogenics, soft-tissue cyst occurring in the sublabial area and anterior maxillary region. The patient usually presents with a slowly enlarging asymptomatic swelling. They are usually diagnosed in early stages because of cosmetic problems. In our paper we report a nasolabial cyst of a 53-year-old man and discuss the diagnosis, differential diagnosis, and treatment in the light of the literature.
Most work on embryonic stem cell differentiation uses mammalian cells derived from the blastocyst stage and some of the most widely used protocols to induce differentiation involve growing these cells in monolayer culture. Equivalent stem cells can be obtained from embryos of non-mammalian vertebrates, but to date this has only been successful in birds. These cells can contribute to all somatic lineages in chimaeras and can be induced to differentiate into a variety of cell types in vitro via embryoid body formation. However to date there are no reliable methods for differentiating them into descendants from each of the germ layers in monolayer culture, comparable to the protocols used in mammals. Here we describe three simple and reproducible protocols for differentiation of chick embryonic stem cells into mesoderm (bone), endoderm and neuroectoderm (neurons and glia) in monolayer culture. These methods open the way for more direct comparisons of the properties of mammalian and avian embryonic stem cells that may highlight similarities and differences. PMID:23047046
Boast, Sharon; Stern, Claudio D
While syringomyelia is not a rare spinal disorder, syringomyelia associated with a spinal arachnoid cyst is very unusual. Here, we report a 62-year-old man who suffered from gait disturbance and numbness of bilateral lower extremities. Spinal magnetic resonance imaging (MRI) showed the presence of a spinal arachnoid cyst between the 7th cervical and 3rd thoracic vertebral segment and syringomyelia extending between the 6th cervical and 1st thoracic vertebral segment. The cyst had compressed the spinal cord anteriorly. Syringomyelia usually results from lesions that partially obstruct cerebrospinal fluid flow. Therefore, we concluded that the spinal arachnoid cyst was causing the syringomyelia. After simple excision of the arachnoid cyst, the symptoms were relieved. A follow-up MRI demonstrated that the syringomyelia had significantly decreased in size after removal of the arachnoid cyst. This report presents an unusual case of gait disturbance caused by syringomyelia associated with a spinal arachnoid cyst.
For over a century, the arched trabecular patterns of the human proximal femur have been considered to resemble tension and compression stress trajectories produced by stereotypical bending loads. This reflects conventional modeling of the human femoral neck-head region as a short cantilevered beam. Although this conception is the foundation of many biomechanical, clinical, paleontological, and comparative morphological studies of trabecular bone in various species, attempts have not been made to contrast these data to a bone that could be considered a 'control' for simple/stereotypical bending. We quantified trabecular architectural characteristics in sheep and deer calcanei as a first step in potentially establishing them as 'controls' in this context because they have arched trabecular patterns that resemble tension/compression stress trajectories, and have been shown by strain gauge measurements to be relatively simply loaded in bending. Using micro-computed tomography, calcanei from adult domesticated sheep and wild deer were analyzed where in the dorsal 'compression' and plantar 'tension' trabecular tracts they begin to separate and bending is less complex (mid-shaft), and where trabeculae extensively interconnect and loading is more complex (distal shaft). Of the eight trabecular architectural characteristics evaluated, only one (trabecular number, Tb.N) showed a probable mechanically relevant dorsal/plantar difference. However, this was paradoxically opposite in the sheep calcanei. Aside from Tb.N, the architectural characteristics showed little, if any, evidence of habitual bending. The non-uniformity of the stresses between the trabecular tracts in these bones might be reduced by load-sharing functions of their robust cortices and the nearby ligament and tendon, which might account for the similar morphologies between the tracts. These findings may help to explain why in many cases regional trabecular architectural variations seem to lack sufficient sensitivity and specificity for interpreting habitual bending in other bone regions. This cautions against simple interpretations of trabecular bone adaptation in the anthropoid femoral neck. PMID:23481347
Sinclair, Kristofer D; Farnsworth, Ryan W; Pham, Theresa X; Knight, Alex N; Bloebaum, Roy D; Skedros, John G
The calcifying odontogenic cyst (COC) is reported to be associated with odontoma in 24% of cases. Separation of the cases of calcifying odontogenic cyst associated with odontoma (COCaO) may lead to a better understanding of the pathogenesis of this lesion. The literature revealed 52 cases of COCaO. The male to female ratio was 1:1.9, with a mean age of 16 years. Most common location was the maxilla (61.5%). The radiographic appearance of most cases (80.5%) was a well-defined, mixed radiolucent-radiopaque lesion. Histologically, the lesions consisted of a single large cyst with tooth-like structures as an integral part, giving the impression of a single lesion. In addition to the unique histologic features, differences in gender and distribution were found between the cases of COCaO and those of simple COC. COCaO may be regarded as a separate entity and classified as a benign, mixed odontogenic tumor. The term odontocalcifying odontogenic cyst is suggested.
Aswath, Nalini; Mastan, Kader; Manikandan, Tirupathi; Samuel, Gigi
A case is reported that is exceptional in more than one respect. The mandibular region was the site of development of three cysts: a radiculo-dental cyst, a coronodental cyst in appearance but which could have been an epidermoid cyst and a typical epidermoid cyst. Lingual nerve lesions are a rare, major complication of implantations. Dismounting of a stable implant is a very rare occurrence. Histopathology showed a bone integration process in contact with the major part of implant, an interposed fibrous band existing in certain sectors only. PMID:3470884
Commissionat, Y; Forest, M; Clairet, A; Al Himdani, K; Nguyen, P N
The giardiacidal efficacy of simple disinfecting materials, ie lemon juice, vinifer, and vinegar, for uncooked foods with Giardia cysts was investigated to help travelers in Giardia-endemic areas. The cysts were obtained from stools of individuals with Giardia intestinalis infection by modified sucrose gradient procedure. A pooled batch of 3x10 4 \\/ml Giardia cysts was made from all specimens. The cysts
Seyed Mahmoud Sadjjadi; Jamshid Rostami; Mohammad Azadbakht
Introduction. Although adrenal cysts are uncommon, the incidence rate is increasing with the advances in radiological technologies. The incidental detection of adrenal cysts nowadays has become more frequent as a result of the increase usage of high quality imaging modalities. Adrenal cysts originate from the adrenal gland and can be classified into either true or pseudocyst. Presentation of Case. In this report, we described an adrenal cyst of endothelial type, in a 30-year-old lady who was mistakenly diagnosed to have a hydatid cyst both clinically and by imaging. Discussion. Although adrenal cysts are uncommon, the incidence rate is increasing with the frequent use of various high quality radiological technologies. Adrenal cyst should be considered in the differential diagnosis when dealing with upper abdominal cysts. The size of the adrenal cyst can vary from a few millimeters up to 50?cm in diameter. Most of the adrenal cysts are unilateral, while 8%–15% of those cysts do present bilaterally. The majority of cases are diagnosed between the 3rd and 5th decades. Conclusion. Although most of the adrenal cysts are benign in nature, surgical excision is advisable especially when the cysts are greater than 5?cm in diameter and in the case of suspecting malignancy.
Darwish, Abdulla; Nagaraj, Veena; Mustafa, Mohmmed B.
Thyroglossal duct cysts can be found in several different locations, although intra-thyroid presentations are rare. We present the case of an 11-year-old patient with a visible neck mass on the right thyroid lobe. On sonogram, it was consistent with a unilocular cyst measuring 2 centimeters in diameter. The cyst did not take up the radioisotope during a gammagram. Fine needle aspiration cytology suggested a diagnosis of thyroglossal duct cyst. At surgery, we found that there were no lesion-dependent thyroglossal tracts; we therefore performed a simple enucleation of the cyst, sparing the rest of the gland. The pathologic examination confirmed that it was an intra-thyroid thyroglossal duct cyst. After 8 months of follow-up, the patient has remained without complications of any kind or recurrence. Only four prior cases of intra-thyroid thyroglossal cysts have been described in the pediatric population. Half of them presented with a typical thyroglossal tract crossing the hyoid and the other half presented an isolated cyst. It is highly unlikely that a cold, cystic, thyroid mass in a child is a thyroglossal duct cyst. Diagnosis is made on the basis of fine needle aspiration cytology and the lesion is treated surgically. A thyroglossal tract must be methodically sought out during intervention, although they frequently do not exist. PMID:16418962
Pérez-Martínez, A; Bento-Bravo, L; Martínez-Bermejo, M A; Conde-Cortes, J; de Miguel-Medina, C
Here we present the case of a 35-year-old female patient with long standing dyspepsia and imaging studies showing the presence of multiple cysts in the head and tail of the pancreas. The patient underwent endosonography that confirmed the presence of multiple simple cysts throughout the entirety of the pancreas without dilation of the pancreatic duct. The majority of the cysts were less than one centimeter in size, and the largest cyst showed a honeycomb appearance. Cytology of aspirates from the two largest cysts was compatible with benign pancreatic cysts. Endosonography also revealed cysts within the left kidney and spleen. Genetic testing confirmed Von Hippel-Lindau disease. We highlight this case because it is unusual for Von Hippel-Lindau disease, a rare clinical entity, to present solely with cysts in the absence of more common manifestations, such as hemangioblastomas in the central nervous system and malignancy.
Sousa, Ana Lucia; Sousa, Diamantino; Figueiredo, Pedro; Marques, Pedro Pinto; Guerreiro, Horacio
Bone marrow stromal cells (MSCs) can be differentiated into neuronal and glial-like cell types under appropriate experimental conditions. However, previously reported methods are complicated and involve the use of toxic reagents. Here, we present a simplified and nontoxic method for efficient conversion of rat MSCs into neurospheres that express the neuroectodermal marker nestin. These neurospheres can proliferate and differentiate into neuron, astrocyte, and oligodendrocyte phenotypes. We thus propose that MSCs are an emerging model cell for the treatment of a variety of neurological diseases.
Yang Qin; Mu Jun; Li Qi [Department of Neurology, First Affiliated Hospital, Chongqing Medical University, Key Laboratory of Diagnostic Medicine Designated by the Ministry of Education, 1 Yixueyuan Road, Chongqing 400016 (China); Li Ao [Department of Pharmacology, Chongqing Medical University, Chongqing 400016 (China); Zeng Zhilei; Yang Jun; Zhang Xiaodong; Tang Jin [Department of Neurology, First Affiliated Hospital, Chongqing Medical University, Key Laboratory of Diagnostic Medicine Designated by the Ministry of Education, 1 Yixueyuan Road, Chongqing 400016 (China); Xie Peng [Department of Neurology, First Affiliated Hospital, Chongqing Medical University, Key Laboratory of Diagnostic Medicine Designated by the Ministry of Education, 1 Yixueyuan Road, Chongqing 400016 (China) and Institute for Basic Medical Sciences, Chongqing 400016 (China)], E-mail: email@example.com
Over a thirteen year period forty patients underwent surgery to remove an orbital dermoid cyst. Cysts which became manifest after the age of three years were deeper and larger than most that were noted before that age. Three out of four epidermoid cysts appeared after the age of 17 years and had an intracranial component. The majority of cysts showed
W W Ehrlich; J E Wright
We report a rare complication of iatrogenic spinal intradural following minimally invasive extradural endoscopic procedues in the lumbo-sacral spines. To our knowledge, intradural cyst following epiduroscopy has not been reported in the literature. A 65-year-old woman with back pain related with previous lumbar disc surgery underwent endoscopic epidural neuroplasty and nerve block, but her back pain much aggravated after this procedure. Postoperative magnetic resonance imaging revealed a large intradural cyst from S1-2 to L2-3 displacing the nerve roots anteriorly. On T1 and T2-weighted image, the signal within the cyst had the same intensity as cerebrospinal fluid. The patient underwent partial laminectomy of L5 and intradural exploration, and fenestration of the cystic wall was accomplished. During operation, the communication between the cyst and subarachnoid space was not identified, and the content of the cyst was the same as that of cerebrospinal fluid. Postoperatively, the pain attenuated immediately. Incidental durotomy which occurred during advancing the endoscope through epidural space may be the cause of formation of the intradural cyst. Intrdural cyst should be considered, if a patient complains of new symptoms such as aggravation of back pain after epiduroscopy. Surgical treatment, simple fenestration of the cyst may lead to improved outcome. All the procedures using epiduroscopy should be performed with caution.
Ryu, Kyeong-Sik; Rathi, Nitesh Kumar; Kim, Geol
Four perineurial cysts cases (Tarlov's cysts) are reported. The purpose of this study is to describe and to compare them with data from a literature review. The evaluation was performed among 88 adult patients with symptoms of radiculopathy, sacral pain, low back pain. Four patients revealed Tarlov's cysts (4.5%). The diagnosis was made by magnetic resonance imaging. Four cases underwent sacral laminectomy. Following surgery, the claudication pain resolved with no motor or sensory deficits. Tarlov's cysts should be considered as a differential diagnosis of sacral radiculopathy, sacral or lumbar pain syndromes and mainly to the lumbar disc prolapse. The goal of the surgical treatment is to relieve the neural compression and stop bone erosion. PMID:15334232
Sá, Márcia Cristina da Paixão Rodrigues Miranda de; Sá, Renato Carlos Ferreira Leite Miranda de
The aim of this study was to review our experience, examine the clinical and pathological features of nasolabial cysts, and to provide a basis for the diagnosis and treatment in an Asian population. We made a retrospective review of patients with nasolabial cysts who were treated at the Department of Otolaryngology, Tan Tock Seng Hospital between January 1999 and December 2004. Clinical data, presenting symptoms, clinical features, pathological findings, preoperative investigations, treatment, and outcome were analysed for each case. We found 17 patients with nasolabial cysts. The findings of adult onset, higher incidence among women and preponderance on the left side confirmed current opinion. The clinical diagnosis of nasolabial cyst was accurate in all cases. Preoperative computed tomograms (CTs) done for one patient did not alter the management. All patients had the cysts excised completely through a sublabial incision. Breaches of the nasal vestibular mucosa healed spontaneously without repair. Histopathological examination showed that cysts were lined with pseudostratified columnar (n=9), stratified squamous (n=4), mixed respiratory and squamous epithelium (n=3), and simple cuboidal epithelium (n=1). No patient developed complications or recurrences. Nasolabial cysts are relatively common in Singapore, and the diagnosis must be kept in mind if they are to be treated early. Diagnosis is based on clinical features and the treatment of choice is complete excision. PMID:17030357
Yuen, Heng-Wai; Julian, Cheow-Yew Lee; Samuel, Chow-Lin Yeak
The volumes of intracranial arachnoit cysts were measured in 136 CT scans of 86 patients. Absolute and relative cyst size was calculated. Left hemisphere and middle cranial fossa location prevailed. A slight negative correlation of relative cyst size with age (r=-0.21, NS) disappeared when analysis was restricted to the adult age group (=20 years). After the sample was divided into
T. Becker; M. Wagner; E. Hofmann; M. Warmuth-Metz; M. Nadjmi
Objective: In this clinical retrospective study, we aimed to evaluate giant hydatid lung cyst cases as a different clinical entity that recorded in last 10 years in our clinic. Methods: Between February 1990 and May 2000, a total of 305 hydatid lung cyst cases from patients that had been operated were reviewed, and 67 (21.9%) cysts with more than 10
Nurettin Karaoglanoglu; Ibrahim Can Kurkcuoglu; Metin Gorguner; Atilla Eroglu; Atila Turkyilmaz
Objective: In this clinical retrospective study, we aimed to evaluate giant hydatid lung cyst cases as a different clinical entity that recorded in last 10 years in our clinic. Methods: Between February 1990 and May 2000, a total of 305 hydatid lung cyst cases from patients that had been operated were reviewed, and 67 (21.9%) cysts with more than 10
Nurettin Karaoglanoglu; Ibrahim Can Kurkcuoglu; Metin Gorguner; Atilla Eroglu; Atila Turkyilmaz
Tarlov cysts are sacral perineural cysts. This case report describes the clinical course after biopsy of a very large Tarlov cyst via laparoscopy, which was thought preoperatively to be an adnexal mass. It serves as a warning against attempting biopsy or resection of these lesions.
Jane E. Hirst; Hugh Torode; William Sears; Michael J. Cousins
Tarlov cysts are sacral perineural cysts. This case report describes the clinical course after biopsy of a very large Tarlov cyst via laparoscopy, which was thought preoperatively to be an adnexal mass. It serves as a warning against attempting biopsy or resection of these lesions. PMID:19110185
Hirst, Jane E; Torode, Hugh; Sears, William; Cousins, Michael J
Although splenic involvement alone in hydatid disease is very rare, spleen is the third most common organ involved in hydatid disease. The rarity of splenic hydatid disease poses a diagnostic challenge for clinicians, particularly in non-endemic areas. As the hydatid cyst can present as a simple cyst without having the classic serological and imaging features, and later can lead to life-threatening complications like anaphylaxis, hydatid disease of spleen should be considered in differential in every patient in endemic areas with cystic lesion of spleen until proved otherwise. The author used the keyword “splenic hydatid cyst” in PubMed and reviewed the scientific literatures published from January 1965 to June 2012. The present review is to accentuate the incidence, classification, clinical and pathophysiological features, differential diagnosis, diagnostic modalities, and treatment choices of hydatid cyst of spleen along with follow-up strategy and newer treatment approaches.
Rasheed, Khalid; Zargar, Showkat Ali; Telwani, Ajaz Ahmed
A 69-year-old man presented with progressive paralysis of the right arm and leg with a past history of metastatic rectal cancer. Magnetic resonance imaging showed a cystic mass lesion posterior to the odontoid process. Under a preoperative diagnosis of intradural extramedullary tumor, partial transcondylectomy and C1 hemilaminectomy were performed, and the cyst was removed through a transdural approach, decompressing the medulla oblongata and the cervical spinal cord. The histological diagnosis was juxtafacet cyst (ganglion cyst). An atlantoaxial intraspinal juxtafacet cyst at the level of the odontoid process is extremely rare. In our case, the cyst was removed using a posterior approach, resulting in rapid improvement in symptoms. PMID:23438667
Sameshima, Tetsuro; Shibahashi, Keita; Nozaki, Toshiki; Akabane, Atsuya; Kihara, Atsushi; Horiuchi, Hajime; Morita, Akio
Background There has been no consensus on the optimal treatment of symptomatic sacral perineural cysts. Most previous reports concerning the management methods were either sporadic case reports or a series of limited cases. This study is to further optimize the management for patients with symptomatic sacral perineural cysts by analyzing the outcomes of a cohort of patients who were treated with different strategies. Methods and Findings We reviewed the outcomes of 15 patients with symptomatic sacral perineural cysts who were managed by three different modalities from 1998 through 2010. Six patients underwent microsurgical cyst fenestration and cyst wall imbrication. Seven patients underwent a modified surgical procedure, during which the cerebrospinal fluid leak aperture was located and repaired. Two patients were treated with medication and physical therapy. Outcomes of the patients were assessed by following up (13 months to 10 years). All of the six patients treated with microsurgical cyst fenestration and cyst wall imbrication experienced complete or substantial relief of their preoperative symptoms. However, the symptoms of one patient reappeared eight months after the operation. Another patient experienced a postoperative cerebrospinal fluid leakage. Six of the seven patients treated with the modified surgical operation experienced complete or substantial resolution of their preoperative symptoms, with only one patient who experienced temporary worsening of his preoperative urine incontinence, which disappeared gradually one month later. No new postoperative neurological deficits, no cerebrospinal fluid leaks and no recurrence were observed in the seven patients. The symptoms of the two patients treated with conservative measures aggravated with time. Conclusions Microsurgical operation should be a treatment consideration in patients with symptomatic sacral perineural cysts. Furthermore, the surgical procedure with partial cyst removal and aperture repair for prevention of cerebrospinal fluid leakage seemed to be more simple and effective.
Xu, Jianqiang; Sun, Yongdong; Huang, Xin; Luan, Wenzhong
This report is composed of two patients with anteriorly located cervical intradural arachnoid cyst and review of 24 cases in Englishlanguage literature. Both of our patients were in the first two decades of life with neck pain and motor weakness. With suspicious diagnosis of anterior arachnoid cyst surgery was carried out in both cases, though laminectomy in one and laminoplasty in the other. The cyst wall was widely fenestrated with subsequent subtotal excision of the cyst. Both cases had good long-term outcome. The review disclosed male predominance. 73% of the patients were diagnosed within the first two decades of life. Neck pain and motor weakness were the dominant signs and symptoms of this pathology. Magnetic resonance imaging showing a cerebrospinal fluid (CSF) containing cyst was the best mode of diagnosis. Wide cyst fenestration with waying CSF into subarachnoid cyst was the most appropriate and applied surgery with optimal outcome.
This report is composed of two patients with anteriorly located cervical intradural arachnoid cyst and review of 24 cases in Englishlanguage literature. Both of our patients were in the first two decades of life with neck pain and motor weakness. With suspicious diagnosis of anterior arachnoid cyst surgery was carried out in both cases, though laminectomy in one and laminoplasty in the other. The cyst wall was widely fenestrated with subsequent subtotal excision of the cyst. Both cases had good long-term outcome. The review disclosed male predominance. 73% of the patients were diagnosed within the first two decades of life. Neck pain and motor weakness were the dominant signs and symptoms of this pathology. Magnetic resonance imaging showing a cerebrospinal fluid (CSF) containing cyst was the best mode of diagnosis. Wide cyst fenestration with waying CSF into subarachnoid cyst was the most appropriate and applied surgery with optimal outcome. PMID:23741550
Rahimizadeh, Abolfazl; Sharifi, Give
The posterior edentulous maxilla is a critical anatomic region for dental implant therapy. Because of severe alveolar bone resorption and maxillary sinus pneumatization, low bone volume is often presented clinically. Although maxillary sinus augmentation has been developed to promote bone reconstruction and oral rehabilitation, complications have been reported. Possible complications include paranasal sinusitis, loss of the graft, and displacement of an implant into the antrum. In this study, we present an observed rare complication of maxillary sinus augmentation, a postoperative maxillary cyst that occurred 10 years after treatment. PMID:24036833
Kim, Jae Jin; Freire, Marcelo; Yoon, Jung-Hoon; Kim, Hak Kyun
Ninety cases of knee joint cysts were treated surgically. This included 50 patients with rheumatoid arthritis, 22 patients with degenerative-deforming changes, ten children with true cysts, and eight ones with post-traumatic cysts. Double-contrast X-ray examination with Lipiodol Ultra-fluid and air is of the best diagnostic value. All cases of knee joint cysts were treated surgically with a careful plastic closure of cyst gate. For this purpose the authors used the arcus tendon of the semi-membranous muscle. In cases of rheumatoid arthritis and degenerative changes cyst removal was preceded by synovectomy of the knee joint. Early and remote were good, no recurrence was observed. PMID:1299044
Noczy?ski, L; Benarz, W; Wojczys, R
Mesenteric cyst is a rare condition. Presentation with non-typhoid spontaneous infection in an unusual area makes it even more a rare situation with mesenteric cyst. Its diagnosis is mainly based on the imaging modalities. However, there are difficulties in diagnosis when it is present in an uncommon area and rare known complications. Mesenteric cyst can present with few uncommon emergency conditions which pose difficulties in diagnosis as well as treatment options as mentioned in this case. PMID:23605820
Reddy, G Ramesh; Gunadal, Shankar; Banda, Vanaja Reddy; Banda, Naveen Reddy
We describe an unusual case involving an infected hepatic cyst. An 88-year-old woman presented with acute onset of right upper quadrant abdominal pain, mild left lower abdominal pain, diarrhea, and fever. On admission, computed tomography revealed multiple hepatic cysts including an 8-cm cyst located in the left medial segment of the liver, which demonstrated a thickened wall enhanced with contrast media. Ultrasonography showed an 8-cm hypoechoic lesion which differed in appearance from the other, anechoic hepatic cysts. The serum concentration of C-reactive protein was 29.8 mg/dL; white blood cell count, 12,800/microL; CA19-9, 96 U/mL; and CEA, 2.2 ng/mL. Diagnosis of infected hepatic cyst was made by percutaneous transhepatic drainage of the cyst. Milky fluid was obtained and the patient's right upper quadrant abdominal pain resolved after drainage. The cyst fluid CA19-9 concentration was 18,000 U/mL. Cytology of the cyst fluid was negative. Serum CA19-9 (41 U/mL) and CEA (1.8 ng/mL) concentrations were improved 1 week after drainage. Escherichia coli was cultured from the drainage fluid. The patient was discharged 27 days after admission. Percutaneous transhepatic drainage is effective in the treatment of infected hepatic cysts. PMID:12749258
Yoshida, Hiroshi; Onda, Masahiko; Tajiri, Takashi; Mamada, Yasuhiro; Taniai, Nobuhiko; Mineta, Sho; Hirakata, Atsushi; Futami, Ryohei; Arima, Yasuo; Inoue, Matsuoh; Hatta, Shigeo; Kishimoto, Akio
The pathological findings of an intradural and extramedullary cyst in the mid cervical spinal canal are described in a 55 year old woman who presented with a short history of pain and paraesthesia of the right arm. Intradural well defined solitary cystic lesions in the spinal canal are uncommon, their pathogenesis is poorly understood, and their nomenclature is confusing. In this case the cyst was a bronchogenic cyst; these are a rare form of such cysts and they are thought to be a malformation arising from a split notochordal syndrome and not a teratoma. Images
Wilkinson, N.; Reid, H.; Hughes, D.
Summary Eight cases of intraspinal arachnoid cysts are described. The clinical, radiological, intraoperative and histological findings are presented and compared with similar reports in the literature.
A. L. Agnoli; R. Schönmayr; A. Laun
A blood cyst of the orbit is an unusual cause of proptosis and most likely arises in a pre-existing haemangioma. If the cyst occurs at the apex of the orbit the blood should be aspirated. This is followed by excision of the cyst wall, the dissection being done with the aid of an operating microscope. If there is evidence of intracranial connection of the blood cyst, namely, splayed superior orbital fissure or cerebrospinal fluid leak, then the patient should be treated with an antibiotic to prevent intracranial infection. Images
Sevel, D.; Rosales, A.
The purpose of this retrospective study was to analyze our experience with mediastinal cysts, emphasizing the clinical presentations and results of surgery. Thirty-two patients with mediastinal cysts underwent surgery from January 2000 through June 2005. The records of these patients were reviewed for age at presentation, sex, signs and symptoms at presentation, results of the imaging techniques, types of mediastinal cysts, location and size of cysts, types of surgical procedure, length of hospital stay, early postoperative complications, death, and other follow-up information. The 32 mediastinal cysts comprised 12 bronchogenic, 9 pericardial, 7 thymic, and 2 enteric cysts, together with 2 cystic teratomas. Overall, 14 of the 32 patients with mediastinal cysts were asymptomatic. The surgical approach was thoracotomy in 30 patients and median sternotomy in 2 patients. The mean length of hospital stay was 7.7 ± 2.6 days. All patients were free from recurrence during the mean follow-up period of 4.4 ± 3.3 years. Surgery for mediastinal cysts is associated with low morbidity and mortality rates and a very low recurrence rate. It offers a definitive diagnosis and cure, avoiding the higher morbidity and mortality risks associated with conservative observation.
Esme, Hidir; Eren, Sevval; Sezer, Murat; Solak, Okan
The clinical and pathologic features of 50 subcutaneous dermoid cysts were analyzed. The lesions were usually noted at birth and occurred along lines of embryonic fusion. Forty-one cysts were located in the region of the head, mainly about the eyes; nine ...
M. H. Brownstein E. B. Helwig
We present the second case of an enterogenous cyst of the third ventricle. This is a 28-year-old woman who presented with a 2year history of progressive headaches and memory loss. A cystic lesion of the anterior third ventricle was noted on MRI. The cyst was resected via a transcallosal approach and demonstrated simple cystic morphology lined by ciliated cuboidal epithelium with numerous goblet cells. The presentation was unusual with signs of memory loss presumably due to a mass effect on the fornices. Although uncommon, this entity should be considered in the differential diagnosis of a cystic lesion of the third ventricle. PMID:23602490
Salvetti, David J; Williams, Brian J; Posthumus, Jocelyn S; Shaffrey, Mark E
Two patients with left adrenal cysts underwent laparoscopic resection. In one case an adrenal origin of the cyst was suspected. In the other case the cyst was thought to be renal in origin. Both patients were female, ages 16 and 40 years. Operative time was 150 and 160 minutes. Blood loss was 50 and 30 mL. One patient received 14 mg of morphine and 60 mg of ketorolac. The other patient did not require any parenteral analgesics. Hospital stay was 1 day for both patients. Return to normal activity occurred at 15 and 7 days postoperatively, respectively. Histology in both cases revealed benign adrenal cysts. Our experience supports the laparoscopic approach for resection of adrenal cysts. PMID:9892002
Williams, J F; Wolf, J S
Splenic parasitic cysts due to flat worm Echinococci resulting in hydatid disease are a rare presentation as primary site even in the endemic regions. Primary splenic parasitic cysts have an incidence of 0.5-4%. A 21-year-old male with pet dogs at home, presented with 3 months history of gradually increasing discomfort in the left hypochondrium and tender splenomegaly. He had marked eosinophilia with normal liver function tests and positive serum IgM Echinococcus antibodies. Ultrasonography showed a cyst in the hilar region of spleen having septations with internal echos. An upper midline laparotomy was performed and a perisplenic cyst was removed along with spleen from the sub-diaphragmatic location. Histopathological examination confirmed acellular fibrous wall of hydatid cyst with germinal layer and scolices in the centre. Postoperatively, patient was continued on oral Albendazole for one month. PMID:19486579
Sharif, Muhammad Ashraf; Mahmood, Asad; Murtaza, Badar; Malik, Imran Bashir; Khan, Abdullah; Asghar, Zunera; Arif, Adeel
Although most cystic lesions in young adults represent a branchial cleft cyst, the bronchial cervical cyst is not rare (Acta Oto-Laryngologica 2010;130:300). Surgical excision is both diagnostic and curative and also eliminates the risk of infection or recurrence. As we have all known, it is hard to protect some important structures in an inflamed tissue, especially in infants. However, a correct approach can avoid this kind of iatrogenic injury. An accurate diagnosis is always by pathologic examination. The diagnosis can be made before operation when finding cartilage in the nodule. We present the preoperative diagnosis by finding gas in the nodule and removed it by inner cyst approach without surrounding tissue injury. PMID:24036776
Chen, Jiangbing; Shen, Weimin; Cui, Jie
Intramedullary dermoid cysts are rare tumors, especially those not associated with spinal dysraphism. Only six cases have been reported in the literature. Of these, only two cases have had magnetic resonance imaging studies. We report a case of an 18-year-old female patient, who presented with progressive weakness of both the lower limbs and wasting of both the upper limbs. Magnetic resonance imaging (MRI) showed an intramedullary lesion extending from C3 to D2 with peripheral enhancement on contrast. Decompression of the cystic contents with partial removal of cyst wall was done. Hair with oily cholesterol and keratin debris was encountered. Histopathology confirmed the diagnosis of dermoid cyst. This case adds to the previous reported cases of the rare and uncommon intramedullary space occupying lesions of the spinal cord.
Patankar, A. P.; Sheth, J. H.
Intramedullary dermoid cysts are rare tumors, especially those not associated with spinal dysraphism. Only six cases have been reported in the literature. Of these, only two cases have had magnetic resonance imaging studies. We report a case of an 18-year-old female patient, who presented with progressive weakness of both the lower limbs and wasting of both the upper limbs. Magnetic resonance imaging (MRI) showed an intramedullary lesion extending from C3 to D2 with peripheral enhancement on contrast. Decompression of the cystic contents with partial removal of cyst wall was done. Hair with oily cholesterol and keratin debris was encountered. Histopathology confirmed the diagnosis of dermoid cyst. This case adds to the previous reported cases of the rare and uncommon intramedullary space occupying lesions of the spinal cord. PMID:22870157
Patankar, A P; Sheth, J H
A review of the English literature reveals a total of 1,337 patients with choledochal cysts. Improved diagnostic techniques to visualize the biliary system are demonstrating an increasing number of unsuspected choledochal cysts in adult patients. Either choledochal cysts remain clinically silent until adulthood or may develop in later life. Experience is reported with adult patients having type I, II, III, and IV choledochal cysts. Type I cysts are preferably managed by excision but cyst anatomy may necessitate choledochoenteric drainage. Type II cysts are treated by excision except for those located within the pancreatic portion of the common bile duct. These are best managed by transduodenal cystoduodenostomy. The type III cyst (choledochocele) should be excised carefully, identifying and preserving the common bile and pancreatic ducts. Type IV cysts include a combination of any one of the first three types of cyst plus the presence of intrahepatic cyst or cysts. Treatment of these cysts is dictated by the type and location of the extrahepatic cyst. Since choledochal cysts are being recognized with increased frequency in adults, surgeons need to be aware of the diagnostic and treatment modalities available for each type of biliary cyst. Images Fig. 3. Fig. 4. Fig. 6. Fig. 7. Fig. 9. Fig. 10.
Powell, C S; Sawyers, J L; Reynolds, V H
Urachal cysts are uncommon. Rarely, these cysts can become infected. Tuberculosis of the urachal cyst is exceedingly rare, with only one case reported previously in the English language literature. Here we report the case of a 23-year-old male who presented with an infra-umbilical mass that turned out to be tuberculosis of the urachal cyst.
Kamal, Mir Reza; Jha, Jayesh Kumar
Urachal cysts are uncommon. Rarely, these cysts can become infected. Tuberculosis of the urachal cyst is exceedingly rare, with only one case reported previously in the English language literature. Here we report the case of a 23-year-old male who presented with an infra-umbilical mass that turned out to be tuberculosis of the urachal cyst. PMID:23346004
Jindal, Tarun; Kamal, Mir Reza; Jha, Jayesh Kumar
INTRODUCTION. Intracranial arachnoids cysts are considered benign developmental anomalies that occur within the arachnoid membrane and generally contain clear and colourless fluid resembling cerebrospinal fluid. The prevalence of these cysts is higher in the first two decades of life, and the incidence is widely quoted as approximately 1% of all space-occupying intracranial lesions. Arachnoids cysts in the elderly person are a rare occurrence. We report the unusual presentation of a woman with an intraventricular arachnoid cyst treated with endoscopic technique. CASE REPORT. A 75-year-old woman presented with progressive hemiparesis of two years duration. Cranial MR imaging showed a right parieto-occipital intraventricular cyst with local mass effect and moderate dilatation of lateral ventricles. A right-sided burr hole was made and the arachnoids cyst was reached and cysto-ventricle shunting was realized. This was followed by a septum pellucidum fenestration. There were no complications during the surgery and the patient presented no symptoms at time of discharge. CONCLUSIONS. The neuroendoscopic approach to intraventricular arachnoid cysts was effective with few complications. PMID:23799598
Rico-Cotelo, María; Diaz-Cabanas, Lucía; Allut, Alfredo G; Gelabert-Gonzalez, Miguel
Background/Objective: Tarlov cysts or spinal perineurial cysts are uncommon lesions. These are mostly incidental findings on magnetic resonance imaging or myelograms. The objectives of this study were to describe Tarlov cysts of the sacral region as a potential cause for retrograde ejaculations and review available management options. Methods: Case report and literature review. Results: A 28-year-old man presented with back pain and retrograde ejaculations resulting in infertility. After microsurgical excision of large perineurial cysts, back pain resolved, but semen quality showed only marginal improvement. Later, the couple successfully conceived by intrauterine insemination. To the best of our knowledge, this is the first reported case of Tarlov cyst associated with retrograde ejaculation and infertility. Conclusions: Despite being mostly asymptomatic and an incidental finding, Tarlov cyst is an important clinical entity because of its tendency to increase in size with time. Tarlov cysts of the sacral and cauda equina region may be a rare underlying cause in otherwise unexplained retrograde ejaculations and infertility. Microsurgical excision may be a good option in a select group of patients.
Singh, Pankaj Kumar; Singh, Vinay Kumar; Azam, Amir; Gupta, Sanjeev
Testicular epidermoid cysts are the most common benign tumors of the testes, but account for only 1-2% of all testicular tumors. In a young man presenting with a testicular mass, a high index of suspicion must be maintained for the malignant testicular germ cell tumor, which is 50-times more common than testicular epidermoid cyst. Bilateral testicular epidermoid cysts are a very rare condition, with only a few reports in the literature. It is extremely important in this condition to make a correct pre-operative diagnosis on imaging to enable a testis-sparing surgery.
Loberant, Norman; Bhatt, Shweta; Messing, Edward; Dogra, Vikram S.
Current literature describes 3 different pathogenetic types of ovarian endometriotic cysts. Cortical invagination cysts arise when surface ovarian endometriotic deposits adhere to another structure (such as the broad ligament), blocking the egress of menstrual fluid produced by cycling endometriosis, which then collects and causes the ovarian cortex to invaginate. Surface inclusion cyst-related endometriotic cysts develop when endometriotic tissue colonizes preexisting inclusion cysts. Physiological cyst-related endometriotic cysts occur when endometriosis gains access to a follicle, such as at the time of ovulation. To determine whether routine histological examination is of use in the classification of endometriotic cysts, and if so, whether such classification is of clinical relevance, we reviewed the histology of endometriotic cysts of 29 women under 35 years of age. Young women were chosen so that ovarian cortex surrounding the endometriotic lining in invagination cysts could be identified by the finding of oocytes. Ten women (34%) had cortical invagination endometriotic cysts, but no inclusion or physiological cyst-related endometriomas were found. The remaining 19 women (66%) had unclassified endometriotic cysts, of which 14 (48% of total) had a fibrous wall between the endometriotic lining and medulla and 5 had extensive destruction of ovarian tissue. We concluded that cortical invagination cysts were the only common diagnosable sort of the 3 types currently being investigated and that unclassified cysts required further study to determine their pathogenesis. Our study highlights the need for a prospective study using standardized pathological and clinical methods. PMID:11293160
Scurry, J; Whitehead, J; Healey, M
During secondary bone healing, different tissue types are formed within the fracture callus depending on the local mechanical and biological environment. Our aim was to understand the temporal succession of these tissue patterns for a normal bone healing progression by means of a basic mechanobiological model. The experimental data stemmed from an extensive, previously published animal experiment on sheep with a 3 mm tibial osteotomy. Using recent experimental data, the development of the hard callus was modelled as a porous material with increasing stiffness and decreasing porosity. A basic phenomenological model was employed with a small number of simulation parameters, which allowed comprehensive parameter studies. The model distinguished between the formation of new bone via endochondral and intramembranous ossification. To evaluate the outcome of the computer simulations, the tissue images of the simulations were compared with experimentally derived tissue images for a normal healing progression in sheep. Parameter studies of the threshold values for the regulation of tissue formation were performed, and the source of the biological stimulation (comprising e.g. stem cells) was varied. It was found that the formation of the hard callus could be reproduced in silico for a wide range of threshold values. However, the bridging of the fracture gap by cartilage on the periosteal side was observed only (i) for a rather specific choice of the threshold values for tissue differentiation and (ii) when assuming a strong source of biological stimulation at the periosteum. PMID:21431883
Vetter, A; Witt, F; Sander, O; Duda, G N; Weinkamer, R
Arachnoid cysts are congenital benign cysts accounting for approximately 1% of all intracranial mass lesions. Uncal herniation due to arachnoid cyst is a rare mode of presentation. It is hypothesized that only tension arachnoid cyst could cause the life-threatening condition that results from a progressive deterioration and worsening of a simple and usually congenital arachnoid cyst, associated with the formation of a "ball valve" at the point of an opening on the cyst wall. To-date only one case of an arachnoid cyst causing Uncal herniation has been reported to the best of our knowledge. We present a rare case of uncal herniation in a 60-year-old lady caused by a giant left temporal arachnoid cyst. She presented to us in emergency room after experiencing headaches since last one week followed by vomiting, seizures, and altered state of consciousness. She was operated immediately and marsupialization of the arachnoid cyst was performed. She showed good recovery. Although arachnoid cyst is a benign slowly growing pathology, it can lead to Uncal herniation as a "tension" arachnoid cyst, possible due to "ball-valve" mechanism. Elective treatment should be considered to prevent progressive significant enlargement of cyst. PMID:22483281
Tahir, Muhammad Zubair; Quadri, S A; Farooqui, Mudassir; Bari, Muhammad Ehsan; Di, Xiao
Ultrasound-guided renal cyst puncture was performed on 31 cysts which were then 95% ethanol instilled to prevent recurrence of cystic fluid. Ethanol was allowed to remain in place for 20 minutes and removed through the catheter. Morphological improvement was observed on IVP and Tc-99m-DMSA renal scintigram, and DMSA renal uptake rate increased slightly. The cystic wall became thicker, and cystic fluid did not remain any more. The renal tissue near the cyst was intact. One third of the patients had hotflush and/or somewhat drunken sense but these symptoms were only temporary. This method of therapy is a safe and effective way of treating renal cysts. PMID:2998166
Higashi, Y; Kawamura, J; Yoshida, O
Seven species of rotifers representing 6 genera, Epiphanes, Plationus, Asplanchna, Philodina species A, Philodina species B. Platyias, and Brachionus, were exposed to Giardia cysts isolated from the feces of experimentally infected holstein calves. Giardia cysts were prestained with a fluorescein isothiocyanate-conjugated monoclonal antibody and mixed with viable rotifers on 3-well Teflon-coated microscope slides. Organisms were observed with phase-contrast, differential interference contrast, and fluorescence microscopy. Five rotifer species, Epiphanes brachionus, Plationus patulus, Philodina (both A and B), and Platyias quadricornis, ingested varying numbers of cysts, which were retained within the rotifers' bodies throughout the observation period. Rotifer ingestion of Giardia cysts may represent a means of reducing water contamination. PMID:12435156
Trout, J M; Walsh, E J; Fayer, R
Two cases of papillary thryoid carcinoma presenting as a cystic lateral neck mass are reported. This tumour characteristically presents in patients under 40-years-old and in the presence of an occult primary tumour may mimic a branchial cyst. In such cases simple aspiration of the cyst will produce a chocolate-brown serous fluid which excludes the diagnosis of a branchial cyst and is characteristic of papillary thyroid carcinoma. Cytological examination of the fluid has a high degree of sensitivity and specificity in the diagnosis of thyroid malignancy and should avoid delay in diagnosis and unnecessary surgical exploration prior to definitive treatment. PMID:8762327
McDermott, I D; Watters, G W
Summary Spinal extradural arachnoid cysts are rare expanding lesions in the spinal canal. They usually present with progressive signs\\u000a and symptoms caused by spinal cord compression if they enlarge. A comprehensive review about spinal extradural arachnoid cyst\\u000a is made including the author’s own case of a 59-year-old woman with a 6-month history of progressive back pain radiating to\\u000a both legs. Key
J. Y. Choi; S. H. Kim; W. S. Lee; K. H. Sung
Background: Curettage is one of the most common treatment options for benign lytic bone tumors and tumor like lesions. The resultant defect is usually filled. We report our outcome curettage of benign bone tumors and tumor like lesions without filling the cavity. Materials and Methods: We retrospectively studied 42 patients (28 males and 14 females) with benign bone tumors who had undergone curettage without grafting or filling of the defect by any other bone graft substitute. The age of the patients ranged from 14 to 66 years. The most common histological diagnosis was that of giant cell tumor followed by simple bone cyst, aneurysamal bone cyst, enchondroma, fibrous dysplasia, chondromyxoid fibroma, and chondroblastoma and giant cell reparative granuloma. Of the 15 giant cell tumors, 4 were radiographic grade 1 lesions, 8 were grade 2 and 3 grade 3. The mean maximum diameter of the cysts was 5.1 (range 1.1-9 cm) cm and the mean volume of the lesions was 34.89 cm3 (range 0.94-194.52 cm3). The plain radiographs of the part before and after curettage were reviewed to establish the size of the initial defect and the rate of reconstitution, filling and remodeling of the bone defect. Patients were reviewed every 3 monthly for a minimum period of 2 years. Results: Most of the bone defects completely reconstituted to a normal appearance while the rest filled partially. Two patients had preoperative and three had postoperative fractures. All the fractures healed uneventfully. Local recurrence occurred in three patients with giant cell tumor who were then reoperated. All other patients had unrestricted activities of daily living after surgery. The rate of bone reconstitution, risk of subsequent fracture or the incidence of complications was related to the size of the cyst/tumor at diagnosis. The benign cystic bone lesions with volume greater than approximately 70 cm3 were found to have higher incidence of complications. Conclusion: This study demonstrates the natural healing ability of bone without filling with bone grafts or bone graft substitutes. In selected sizes and locations of the benign lytic tumors and tumor like lesions extended curettage alone can be sufficient.
Kundu, Zile Singh; Gupta, Vinay; Sangwan, Sukhbir Singh; Rana, Parveen
This case report highlights a massive radicular cyst with respect to the lower left premolars, that developed secondary to endodontic failure and resulted in buccal cortical bone destruction. It also discusses the investigation and the surgical approach which were carried out with regard to the cyst. Following surgical closure, the teeth were endodontically retreated. It also highlights the fact that mandibular true occlusal radiographs could be misleading with regard to the extent of bone destruction, which can otherwise be confirmed on CT scans.
Pavaskar, Rajdeep; Gera, Tarun; Boyapati, Chandra Mohan; Chalakkal, Paul; Bommannavar, Sushma
Purpose The incidence of painful bone metastases increases with longer survival times. While External Beam Radiation Therapy (EBRT) is an effective palliative treatment, it often requires several days from the start of treatment to produce a measurable reduction in pain scores and a qualitative amelioration of patient pain levels. Meanwhile, the use of analgesics remains the best approach early on in the treatment course. We investigated the role of Radiation Therapists as key personnel for collecting daily pain scores to supplement assessments by physician and oncology nursing staff and manage pain more effectively, during radiation treatment. Methods and Materials Daily pain scores were obtained by the radiation therapists for 89 patients undertaking a total of 124 courses of EBRT for bone metastases and compared to pre-treatment pain score. The majority of patients (71%) were treated to 30 (20–37.5) Gy in 10 (8–15) fractions. Results A total of 119 treatment courses (96%) were completed. Pain Scores declined rapidly to 37.5%, 50% and 75% of the pretreatment levels by Days 2, 4, and 10 respectively. Pain was improved in 91 % of patients with only 4% of worse pain at the end of treatment. Improved pain scores were maintained in 83% of patients at 1 month follow up, but in 35% of them the pain was worse than at the end of treatment. Conclusions Collection of daily pain scores by radiation therapists was associated with an effective reduction in pain scores early on during EBRT of painful osseous metastases.
Andrade, Regiane S.; Proctor, Julian W.; Slack, Robert; Marlowe, Ursula; Ashby, Karlotta R.; Schenken, Larry I
Phaeohyphomycosis consists of a heterogeneous group of fungal infections caused by more than 80 genera and species. Subcutaneous infection usually follows traumatic implantation of a fungus by a wooden splinter that the fungus inh abits as a saprophyte. The growth of the fungus forms verrucous plaques or a painless subcutaneous abscess. We report a subcutaneous cyst (phaeomycotic cyst) in the leg of a 60-year-old woman that developed after a thorn prick at that site. With the provisional diagnosis of an epidermoid cyst, she was treated with a simple excision of the cyst. However, histopathological examination of the cyst revealed the typical features of fungus, and a definitive diagnosis of a phaeomycotic cyst was made. As the infective aetiology was not considered clinically, the specimen was not sent for microbiological culture, and hence the exact species was not identified. As the lesion was localised, simple excision was sufficient treatment, and no recurrence was observed during 12 months of follow-up.
Manoharan, Madhavan; Shanmugam, Natarajan; Veeriyan, Saveetha
A Thornwaldt's cyst is an uncommon nasopharyngeal lesion that develops from the remnant of the primitive notochord. A 65-year-old man with a Thornwaldt's cyst is presented in this case report. The patient was diagnosed by rigid nasal endoscopy and magnetic resonance imaging (MRI). These cases are infrequently presented in the English journals. Our study suggested that endoscopic and MRI examinations of the nasopharynx were a simple, rapid, and useful procedure for the diagnosis of the Thornwaldt's cysts. PMID:16255501
Yuca, K; Etlik, O; Kiro?lu, A F; Celebi, S; Yakut, F
Small monozoic cysts found in the spleen of dogs infected with Hepatozoon canis are described from naturally and experimentally infected dogs. These forms of H. canis resemble cysts formed by other Hepatozoon species that infect frogs, lizards, and grey squirrels as intermediate hosts. The H. canis cyst stage differs in size and morphology from the large cysts of H. americanum, the second Hepatozoon species known to infect dogs. PMID:12760658
Baneth, Gad; Shkap, Varda
Perineurial cysts may be responsible for clinical symptoms and a cure effected by their removal. They do not fill on initial myelography but may fill with Pantopaque some time, days or weeks, after Pantopaque has been instilled into the subarachnoid space. Perineurial cysts arise at the site of the posterior root ganglion. The cyst wall is composed of neural tissue.
I. M. Tarlov
Seven cases of intraspinal inclusion cysts, surgically treated between 1970 and 1984, are reported in this paper. Four were epidermoid cysts and three dermoid. Two cysts were located in the thoracic spine (one dermoid and one epidermoid) and five in the lumbosacral region (three epidermoid and two dermoid). Associated spinal dysraphia was noted in five cases. Congenital dermal sinus was
J. Shikata; T. Yamamuro; Y. Mikawa; Y. Kotoura
Historically meniscal cysts have been treated with either an open total menisectomy, isolated cyst excision, or a combination of the two procedures. The advent of arthroscopic techniques has led to innovative treatment options for meniscal cyst management. A review of meniscal cysts and the results of arthroscopic treatment form the basis of this study. From 1986 to 1991, 18 patients with meniscal cysts were treated by arthroscopic cyst decompression. Thirteen men and five women comprised the study group and had an average age of 28 years. The follow-up period ranged from 6 to 60 months (average 26). Eight of the cysts were medial and 10 were lateral. A horizontal cleavage tear was noted in all cases, and 15 partial and three subtotal menisectomies were performed in conjunction with an intraarticular cyst decompression. There have been no recurrences to date, and all patients returned to their previous level of activity. Parameniscal cysts may result from synovial fluid tracking through a horizontal cleavage tear. Successful treatment of the meniscal cyst must include appropriate management of the torn meniscus, which can be entirely arthroscopic, consisting of a partial or subtotal meniscectomy, identification of the cyst opening, and cyst decompression. PMID:8280334
Ryu, R K; Ting, A J
Phaeohyphomycosis designates fungal infections caused by pheoid or melanized fungi and characterized histopathologically by the presence of septate hyphae, pseudohyphae, and yeasts. Etiologic agents include Exophiala, Phoma, Bipolaris, Phialophora, Colletotrichum, Curvularia, Alternaria, Exserohilum, and Phialemonium sp. The most common are Exophiala jeanselmei and Wangiella dermatitidis. The clinical presentation depends on the immune status of the host: superficial (tinea nigra and black piedra); cutaneous (scytalidiosis) and corneal; subcutaneous (mycotic cyst); and systemic phaeohyphomycosis in the immunocompromised host. The mycotic cyst is a localized form, characterized by subcutaneous asymptomatic nodular lesions that develop after traumatic implantation of fungi, especially on the extremities. The average size of the cysts is 2.5 cm. KOH examination reveals pigmented yeasts, pseudohyphae, and hyphae. A cutaneous biopsy specimen usually shows an abscess or a suppurative granuloma with pigmented yeasts and pseudohyphae. The treatment of choice is surgical excision, but additional anti-fungal therapy is recommended for recurrent cases and immunocompromised patients. PMID:22682192
Isa-Isa, Rafael; García, Carlos; Isa, Mariel; Arenas, Roberto
Diffusion rates of numerous trace elements in bone at 20 °C were determined using laser-ablation inductively coupled plasma mass spectrometry analysis of experimentally induced diffusion profiles. Diffusivities are about 1 order of magnitude slower than current semiquantitative geochemical views and about 1.5 orders of magnitude faster than indirect radiotracer estimates. Intrabone volume diffusion is too slow and too similar among many elements to explain trace element profiles in young fossils and archeological materials. Diffusivity differences among elements do, however, explain disparate biokinetic washout of Sr vs. Ba and of light vs. heavy rare earth elements (REEs). These results improve the understanding of the physical principles underlying biokinetic models and rates and mechanisms of trace element alteration of phosphatic tissues in paleontological, archeological, and crystal-chemical contexts. Recrystallization and transport limitations in soils explain trace element profiles in young fossils better than intrabone volume diffusion alone and imply that diffusion of REE and other trivalent cations is likely controlled by a common charge-compensating species rather than ionic radii or partition coefficients. PMID:23267089
Kohn, Matthew J; Moses, Randolph J
We describe a case of multilocular thymic cyst with severe acute inflammation. A 23-year-old man was admitted to our hospital with a sudden onset of chest pain and high fever. A computed tomography scan showed multilocular cystic lesion at anterior mediastinum. We resected the tumor with the thymus by median sternotomy. Macroscopically, the mediastinal mass showed thick-walled multiloculated cavities filled with turbid yellow fluid. Histological examination revealed that the tumor was a multilocular thymic cyst which is reported by Suster. PMID:19280956
Saito, Y; Uragami, T; Satake, A; Yamakawa, Y; Kasugai, T
The case of a 40-year-old woman with increasing ataxia is described. Although the clinical presentation and evoked response studies raised the possibility of multiple sclerosis, further investigation revealed multiple cystic intracranial lesions. Surgical excision of one of the lesions relieved the patient's symptoms. Histological examination revealed that this was an enterogenous cyst. Although single cysts of this type have rarely been reported occurring in the posterior cranial fossa, the occurrence of multiple lesions, some in the supratentorial compartment, appears to be unique. Images
Walls, T J; Purohit, D P; Aji, W S; Schofield, I S; Barwick, D D
Rathke's cleft cysts are rare benign lesions requiring surgical treatment when they become symptomatic. Transsphenoidal surgery is the recommended therapy due to its efficacy and safety. However, whether the optimal surgical strategy is simple drainage and biopsy or cyst wall resection remains controversial. We report a single center's experience of a series of 14 Rathke's cleft cysts treated with transsphenoidal resection of the cyst wall. Postoperatively, there was no cerebrospinal fluid rhinorrhea. The complications included permanent diabetes insipidus, hypocortisolism (including a patient with a coexisting adrenocorticotropic hormone-secreting adenoma), sinusitis and a case of meningitis and intrasellar abscess, one year post-surgery. Visual impairment and headache resolved in all cases. Pituitary dysfunction was restored only in patients with hyperprolactinemia and Cushing's disease. During the follow-up period (median 29 months) there was no recurrence requiring re-operation. According to our experience, the aggressive approach is associated with good surgical results and with low complication and recurrence rates. PMID:19362483
Koutourousiou, M; Grotenhuis, A; Kontogeorgos, G; Seretis, A
Sacral perineurial (Tarlov) cysts are rare lesions. Over a seven year period 4000 patients underwent surgery for lumbar disk herniation. In three patients neurological symptoms were caused by large sacral perineurial cysts. Methods of choice for diagnosis of Tarlov cysts are lumbosacral magnetic resonance imaging and computerized tomography myelography. The majority of Tarlov cysts are asymptomatic. In case of large (> or = 1.5 cm) and symptomatic perineurial cyst, as in three patients reported in this article, microsurgical treatment was successful. Although rare, perineurial (Tarlov) cysts must be taken into consideration when approaching to patient with low back and radicular pain. Authors review the medical literature, pathological and pathophysiological features and treatment options of sacral perineurial cysts. PMID:20102100
Sajko, Tomislav; Kova?, Damir; Kudeli?, Nenad; Kovac, Lana
A 7-year-old intact male pitbull presented with a 2-month history of progressive dysequilibrium. Cerebrospinal fluid analysis was indicative of a central inflammatory or neoplastic disorder. A cerebellar cystic structure was identified on magnetic resonance imaging which was found to be an epidermoid cyst on histopathology. PMID:10528837
Platt, S R; Graham, J; Chrisman, C L; Adjiri-Awere, A; Clemmons, R M
With excision as a standard procedure for treating choledochal cyst, early diagnosis becomes a central issue in reducing morbidity and mortality from that disorder. In a retrospective analysis of 35 patients treated over a 10-year period, we found the diagnosis was delayed for an average of 11.9 months from the beginning of presenting symptoms. Three factors were responsible: (1) a
Jiin-Haur Chuang; Jer-Nan Lin; Kuae-Liang Wang; Chao-Long Chen; Chi Au; Man-Shan Kong; So-Chu Huang
Renal cysts are a common imaging finding. Although most cysts never have symptoms, some cause pain, collecting system compression, hematuria, hypertension, and secondary infection. The mere presence of a cyst is not an indication for intervention, but treatment may be indicated in symptomatic patients or those with secondary obstruction. Urinomas generally are a contained collection of urine outside of the normal pathways where urine travels. As such, urinomas can arise anywhere from the upper abdomen down into the low pelvis and have a variety of etiologies. Ureteral obstruction with forniceal rupture and trauma (blunt, penetrating, or iatrogenic) are the most common causes of urinomas. When urinomas arise spontaneously, the likely cause varies with the patient's age. Blunt or penetrating trauma can cause perinephric urinomas by two mechanisms—direct disruption of the pelvis or collecting system or by degeneration of nonviable tissue. These urinomas are often perinephric, but can also occur in a subcapsular location. This review will discuss diagnosis, classification, and treatment of renal cysts and urinomas.
Lee, Jessica; Darcy, Michael
A case of a dense epidermoid cyst of the suprasellar cistern is presented. The clinical symptoms were headache radiating to the left eye and a quadrant anopsia on the left eye. The density of the epidermoid was 62 HU and no significant contrast enhancement occured after contrast application. The main feature which allows differentiation from other hyperdense suprasellar lesions seems
O. Schubiger; A. Valavanis; E. Gessaga
Background A primary conjunctival epithelial cyst is an uncommon lesion that consists of nonkeratized, stratified squamous epithelium\\u000a without dermal appendages.\\u000a \\u000a \\u000a \\u000a Methods Case report.\\u000a \\u000a \\u000a \\u000a Results A 57-year-old woman presented with a soft mass in the anterior portion of the nasal orbit. Magnetic resonance imaging demonstrated\\u000a a rounded, cystic lesion between the right eye and the nasal bone. Histopathological examination following complete surgical\\u000a excision disclosed
Masamoto Imaizumi; Mayuko Nagata; Celso Soiti Matsumoto; Kazuo Nakatsuka; Kenji Kashima
We report the case of a 40-year-old man remitted to our department with a history of lower back pain and sciatica with no history of trauma. The laboratory analyses showed normal values whereas plain radiographs showed a sacrum rarefaction area. A 99mTc-MDP bone scintigraphy was performed to evaluate the lumbosacral area. Planar images did not show any abnormality. SPECT images revealed photopenic abnormality in the second sacral vertebral right hemibody, with no peripherally increased radiotracer accumulation. Subsequent MRI and CT myelography demonstrated the nature of the photopenic area as secondary to vertebral erosion by sacral perineurial cyst (Tarlov cyst). PMID:10758434
Infante, J R; González, F M; Vallejo, J A; Torres-Avisbal, M; Pacheco, M C; Contreras, P; Arias, M C; Latre, J M
Summary Osteoporosis is a systemic disease in which the skeletal condition is characterized by a decreased mass of normally mineralized bone, due to an augmentation of bone resorption processes. Bone biomarkers serum are used for the diagnosis. On the other hand the main cause of the resorption in the bone jaws are periodontitis, inflammatory cysts, developmental cysts, odontogenic neoplasms. Periodontal diseases can be localized to a single site of the jaws or can affect all the teeth, with a massive bone resorption. The cysts are classified in developmental and inflammatory. They caused a local bone resorption in the jaws. Keratocystic odontogenic tumor produces a large bone resorption for its local aggressive nature. Their diagnosis is clinical and radiological. The aim of our review is to find a correlation between bone biomarkers serum and periodontitis, inflammatory cists, developmental cysts, odontogenetic neoplasms. The RANK/RANKL/OPG system is the most studied not only in osteoporosis but also in the periodontitis, inflammatory cysts, developmental cysts, odontogenic neoplasms. In the last years osteoimmunology was used to study the periodontal disease progression, because the immunity cells start the bone resorption processes. A lot of studies analyze the biomarkers present in the biofluids, as saliva and gingival crevicular fluid, but not the correlation with serum biomarkers. Future studies must be organized to deepen the correlation between bone biomarkers and bone jaws resorption and to allow diagnosis and prognosis of periodontitis, inflammatory cysts, developmental cysts, odontogenic neoplasms.
Duvina, Marco; Barbato, Luigi; Brancato, Leila; Rose, Giovanna Delle; Amunni, Franco; Tonelli, Paolo
This paper has presented the author's experience with the evaluation and follow-up of 62 patients with primary cysts of the iris. On the basis of these observations, a classification of iris cyst is proposed. Accordingly, primary iris cysts are divided into epithelial and stromal categories, each having different clinical characteristics. Epithelial cysts arise between the pigmented epithelial layers of the iris and occur at the pupillary margin (central cysts), in the mid-portion of the iris (midzonal cysts) or, more commonly, in the iridociliary sulcus (peripheral cysts). In some cases, the cysts apparently break free from their epithelial attachment and migrate into the anterior chamber of vitreous chamber (dislodged cysts). Primary stromal cysts occur within the iris stroma and are not directly continuous with the posterior epithelium. They apparently arise from ectopic surface epithelium which is trapped in the iris during embryologic development. A study of the natural course and complications of these lesions has shown that the great majority of primary iris cysts, particularly those which arise from the iris pigment epithelial layer, are stationary lesions which rarely progress or cause visual complications. This finding is contradictory to the contemporary belief of certain authorities who stress that many such lesions lead to severe complications with blindness and loss of the eye. The natural course of primary epithelial cysts differs from that of secondary iris cysts which follow surgical or non-surgical trauma. The latter lesions do frequently enlarge and lead to severe complications such as inflammation and glaucoma. Images FIGURE 1 FIGURE 2 A FIGURE 2 B FIGURE 3 FIGURE 4 A FIGURE 4 B FIGURE 5 FIGURE 6 A FIGURE 6 B FIGURE 7 FIGURE 8 FIGURE 9 A FIGURE 9 B FIGURE 10 A FIGURE 10 B FIGURE 10 C FIGURE 10 D FIGURE 11 FIGURE 12 FIGURE 13 FIGURE 14 A FIGURE 14 B FIGURE 15 FIGURE 16 FIGURE 17 FIGURE 18
Shields, J A
Buccal bifurcation cyst (BBC) is a rare inflammatory odontogenic cyst that typically occurs at the buccal region of the first or second mandibular molars of children. In the current case, a 9-year-old boy complained of an extraoral soft tissue painful swelling. Intraoral examination revealed a partial eruption of the right permanent mandibular first molar with drainage of purulent material and clinical absence of the left mandibular first molar. Panoramic radiographic and computed tomography showed two well-defined areas surrounding the mandibular first molars consistent with cystic lesions. Surgical enucleations were performed and histopathologic analysis revealed inflammatory cysts. Based on the clinical, microscopic, radiographic, and CT images, the diagnosis of bilateral BBC was established. Patient has been under follow-up for about 1 year showing normal bone repair and eruption of the involved teeth. Although BBC is uncommon, it is important to recognize this entity. PMID:22392410
Ramos, Lara Maria Alencar; Vargas, Pablo Agustin; Coletta, Ricardo D; de Almeida, Oslei Paes; Lopes, Márcio Ajudarte
Although synovial cysts are most commonly associated with rheumatoid arthritis and osteoarthritis, they may occur in many other conditions. The clinical manifestations of these cysts are numerous and may result from pressure, dissection or acute rupture. Vascular phenomena occur when popliteal cysts compress vessels, and result in venous stasis with subsequent lower extremity edema or thrombophlebitis. Rarely, popliteal cysts may cause arterial compromise with intermittent claudication. Neurological sequelae include pain, paresthesia, sensory loss, and muscle weakness or atrophy. When synovial cysts occur as mass lesions they may mimic popliteal aneurysms or hematomas, adenopathy, tumors or even inguinal hernias. Cutaneous joint fistulas, septic arthritis or osteomyelitis, and spinal cord and bladder compression are examples of other infrequent complications. Awareness of the heterogeneous manifestations of synovial cysts may enable clinicians to avoid unnecessary diagnostic studies and delay in appropriate management. Arthrography remains the definitive diagnostic procedure of choice, although ultrasound testing may be useful. ImagesFig. 1.Fig. 2.Fig. 3.
Burt, Todd B.; Gelman, Martin I.; MacCarter, Daryl K.; Samuelson, Cecil O.
We report 2 cases of hydatid cysts occurring in the submandibular gland and buccal submucosa, respectively. Our first case occurred in the submandibular salivary gland of a 20-year-old woman and the second involved the buccal submucosa of a 6-year-old boy. Both diagnoses were made after the excision of the lesions. Both patients were evaluated after surgery, and both were followed
M. M. R. Bouckaert; E. J. Raubenheimer; F. J. Jacobs
Rathke's cleft cysts (RCCs) are benign, sellar and/or suprasellar lesions originating from the remnants of Rathke's pouch. Although a common finding in routine autopsies (12-33% of normal pituitary glands), symptomatic cases are rare and comprise 5-15% of all surgically resected sellar lesions. Small, asymptomatic RCC do not require surgical intervention, and their natural history is not clear. In series of nonoperated presumed RCCs, 26-94% did not progress during follow-up periods up to 9 years. In symptomatic ones, surgery is indicated, aiming to drain the cyst content and safely remove as much of the capsule as possible. Following surgical intervention, headaches and visual field defects improve or resolve in a significant number of patients (40-100% and 33-100%, respectively) and partial hypopituitarism recovers in 14-50%. Data on relapse rates published in the last 15 years are based on variable follow-up periods and show wide variation (between 0% and 33%). The lowest relapse rates have been described in reports with relatively short mean observation periods (<3 years), whereas in those with longer follow-up the relapse rates increase. Most of the relapses occur within 5-6 years, suggesting that follow-up is required for at least 5 years after surgery. Risk factors for relapse include the presence of squamous metaplasia in the cyst wall, cyst size and the presence of inflammation. Long-term sufficiently powered studies aiming to clarify the natural history of asymptomatic RCCs and of those relapsing postoperatively are required. PMID:21951110
Trifanescu, Raluca; Ansorge, Olaf; Wass, John A H; Grossman, Ashley B; Karavitaki, Niki
Background Extradural arachnoid cysts in the spine are uncommon causes of spinal cord compression in the pediatric population that are\\u000a thought to arise from congenital defects in the dura mater. Most reports describe such cysts as communicating with the intrathecal\\u000a subarachnoid space through a small defect in the dura. Excision of the cyst with obliteration of the communicating dural defect\\u000a is
Ricardo Santos de Oliveira; Marcelo Campos Moraes Amato; Marcelo Volpon Santos; Gustavo Novelino Simão; Helio Rubens Machado
We present a case of a 20-year-old woman presenting initially with an asymptomatic palatal swelling. Radiographic examination showed a cyst at the right maxilla with bucco-lingual expansion and perforation of palatal bone. Incisional biopsy was carried out via a buccal approach and the result revealed a benign odontogenic cyst, in keeping with radicular cyst. The patient was then scheduled for cyst enucleation. During the procedure, it was found that the palatal lesion was unrelated to the maxillary cyst. Incisional biopsy of the palatal mass was carried out and revealed a low-grade mucoepidermoid carcinoma. The patient then had a partial maxillectomy with fibula flap reconstruction. There was no recurrence at postoperative 1 year follow-up and she was rehabilitated with dental implants. PMID:23761616
Nabil, Syed; Lo, Regina Cheuk Lam; Choi, Wing Shan
Intrapericardial cysts were identified as the cause of impaired cardiac filling in six young dogs. Pneumopericardiography and two-dimensional echocardiography showed the cysts in 2 of 2 dogs and in 4 of 4 dogs, respectively. One dog, which was also infected with heartworms, died before surgical excision of the cyst could be performed. In the remaining dogs, surgical excision of the cysts and subtotal pericardiectomy was successfully accomplished. Histologic examination of the excised tissue from one dog suggested that it was a pericardial coelomic cyst. The gross and histologic characteristics of the cysts removed from the other five dogs resembled those of acquired cystic hematomas. The etiopathogenesis of these cysts was uncertain, but all cysts were connected to a fatty pedicle of tissue. In one dog, a stalk of tissue was observed to enter the pericardium through a small peritoneopericardial diaphragmatic hernia. In four dogs, the stalk of tissue was adhered to the apex of the parietal pericardium. These observations suggested that intrapericardial cysts, in some dogs, develop in association with, and possibly as a result of, congenital herniation and entrapment of omentum or a portion of the falciform ligament into the pericardial sac. PMID:8114033
Sisson, D; Thomas, W P; Reed, J; Atkins, C E; Gelberg, H B
Introduction Osteoarthritic subchondral cysts within or around the hip joint can sometimes be difficult to distinguish from primary osseous and soft tissue tumors due to their radiological appearance and uncommon location. Case presentation We report the case of a 74-year-old Turkish man with a subchondral cyst arising from the hip joint, eroding the acetabulum and located on the medial side of the iliac bone, which imitated a soft tissue tumor. This cystic lesion was resected and the results of histopathological analysis of tissue samples were found to be consistent with an osteoarthritic cyst. Conclusions The present case illustrates how an osteoarthritic subchondral cyst can grow into the soft tissue planes in the presence of destruction of the articular cartilage and subchondral bone continuity, and present as an apparent soft tissue tumor.
Hydatid cyst disease is a parasitic infection which is caused by the metacestode form of Echinococcus granulosus and affects primarily the liver and lung. Bone involvement is found in 1% of patients afflicted with this disease. The spine is involved in about 50% of these cases. Herein, we report a 70 year old male case with pelvic and spinal hydatid cyst who was operated on eleven times. PMID:22203512
Dikta?, Hüsrev; Cakmak, Selami; Turhan, Vedat; Kantemir, Ali; Güleç, Bülent; Öncül, Oral; Rodop, Osman; Öztürk, Ersin; Görenek, Levent
Arachnoid cysts are common, accounting for approximately 1% of intracranial mass lesions. Most are congenital, clinically silent, and remain static in size. Occasionally, they increase in size and produce symptoms due to mass effect or obstruction. The mechanism of enlargement of arachnoid cysts is controversial. One-way slit valves are often hypothesized as the mechanism for enlargement. The authors present 4 cases of suprasellar prepontine arachnoid cysts in which a slit valve was identified. The patients presented with hydrocephalus due to enlargement of the cyst. The valve was located in the arachnoid wall of the cyst directly over the basilar artery. The authors believe this slit valve was responsible for the net influx of CSF into the cyst and for its enlargement. They also present 1 case of an arachnoid cyst in the middle cranial fossa that had a small circular opening but lacked a slit valve. This cyst did not enlarge but surgery was required because of rupture and the development of a subdural hygroma. One-way slit valves exist and are a possible mechanism of enlargement of suprasellar prepontine arachnoid cysts. The valve was located directly over the basilar artery in each of these cases. Caudad-to-cephalad CSF flow during the cardiac cycle increased the opening of the valve, whereas cephalad-to-caudad CSF flow during the remainder of the cardiac cycle pushed the slit opening against the basilar artery and decreased the size of the opening. Arachnoid cysts that communicate CSF via circular, nonslit valves are probably more likely to remain stable. PMID:23662935
Halani, Sameer H; Safain, Mina G; Heilman, Carl B
Twelve children with intracranial cysts ofEchinococcus granulosus underwent surgery during a period of 5 years and constituted 19% of all children operated on for intracranial space-occupying lesions. The more common symptoms were raised intracranial pressure (8 cases) and hemiparesis (7 cases). The total number of procedures was 14, with a standard craniotomy approach in 13. In 6 the cysts were
Romuald Krajewski; Zbigniew Stelmasiak
Bronchogenic cysts are a rare type of mediastinal mass thought to arise from abnormal budding of the embryologic foregut. This paper presents a rare case of a 32-year-old male who developed multiple serious complications from a bronchial cyst. This rare presentation is discussed and the role of CT and MR imaging in making the diagnosis is highlighted.
Marshall, G; Cheah, C; Lenzo, NP
The case histories of 14 children are described in which hydrocephalus was found on investigation to be associated with a cyst of the posterior fossa or subarachnoid cisterns. The neuroradiological and histological findings are described. The cysts are considered to be developmental in origin. Their recognition and management are discussed.
M. J. G. Harrison
Meniscal cysts occur most commonly in the lateral compartment of the knee, rarely involving the medial meniscus.In patients who are symptomatic and require treatment, an associated tear of the meniscus can commonly be found. Although the etiology of meniscal cysts remains controversial, it seems likely that influx of synovial fluid through microscopic and macroscopic tears in the meniscus plays a
Jess H. Lonner; J. Serge Parisien
A French bulldog was presented with a facial swelling. Histology revealed a branchial cleft cyst. The first attempt to treat by incision, aspiration and drainage was unsuccessful. A complete surgical excision of the mass using a CO2 Laser lead to a full recovery. The location, size and type of tissues were compatible with a first branchial cleft cyst Type II. PMID:23985094
Roux, P; Kuehn, N
Objective: Iniencephaly is a rare neural tube defectwith consisting of a defect in the occipital bone,spina bifida of many vertebrae, and retroflexion of the head on the spine. In majorty of cases it is a le-\\thal condition. Methods: We present the first case of iniencephalywith large bronchogenic cyst diagnosed prenatally. Results: At 19 week?s gestation showed that fetalcardiac activity was present with normal placentaand amniotic fluid, fetus had occipital bone defect, anencephaly, retroflexion of the head, abnormally short cervicothoracic spine and posterior mediastinal unilocular anechoic cyst. Therapeutic abortion was induced. Conclusion: Iniencephaly is a rare condition during prenatal life. When diagnosed early in pregnancy amultidisciplinary approach is firmly suggested.
Akdemir, Yesim; Ayvac?, Habibe; Demirci, Oya; Sahin, Davut; Demirag, Ersan; Sozen, Hamdullah; Uludogan, Mehmet
The edict to contain costs and meet goals imposed by DRG remuneration policies mandates the work-up of asymptomatic renal mass lesions on an outpatient basis. This proved feasible in 98 per cent of patients. The vast majority of such mass lesions (82 to 90 per cent) is diagnosed with acceptable confidence by computed tomography and sonography alone. For a shrinking group of such patients, yet still 16 to 18 per cent, guided percutaneous aspiration biopsy is necessary to affirm the diagnosis. However, this technique has been refined during recent years to incorporate the use of thin needle equipment and can now be performed on an outpatient basis without significant risk of morbidity. For diagnosing hyperdense inflammatory and infected renal cysts, guided percutaneous aspiration is recommended as the most effective method. This procedure should take precedence over surgical exploration because it can diagnose and provide pertinent bacteriologic information that may determine the course of therapy. In many instances inflammatory cysts or even silent renal abscesses are diagnosed by a percutaneous aspiration technique that is then expanded to serve therapeutic purposes such as percutaneous drainage. Even these procedures can be performed safely on an outpatient basis provided the patient is followed closely. Because complications of percutaneous aspiration procedures are extremely rare, the procedure can be used safely on an outpatient basis. The impact of magnetic resonance imaging on the diagnosis of asymptomatic space-occupying lesions of the kidney is as yet not fully determined; however, this method appears promising for diagnosing some of the refractory lesions such as hemorrhagic cysts, aneurysms, or arteriovenous malformations. PMID:3101262
Lang, E K
A 51-year-old male bricklayer without cerebral symptoms underwent whole-body FDG PET for suspicion of mediastinal sarcoidosis. PET/CT incidentally demonstrated a voluminous right frontal arachnoid cyst with normal glucose metabolism in the adjacent cortex. MRI demonstrated compression of the ipsilateral cerebral parenchyma and precentral, angulate, callosal, and superior frontal sulci. Functional bilateral finger-thumb paradigm MRI revealed right hemispheric reorganization of cortical motor activation with prominent activation between the inferior frontal gyrus and the postcentral gyrus. PMID:22955072
Hubele, Fabrice; Imperiale, Alessio; Kremer, Stéphane; Namer, Izzie Jacques
The scintigraphic appearances of 12 surgically proven cases of choledochal cyst were retrospectively reviewed. In seven of 12 cases, radionuclide accumulated in the choledochal cyst (i.e., the dilated common bile duct) in less than 1 hr. In three additional cases, delayed accumulation (1-24 hr) within the cyst was seen. In two of the 12 cases, no ductal activity appeared and the diagnosis of choledochal cyst could not be made, although in one of these two cases delayed images were not obtained. Other frequent findings included delayed or nonvisualization of the gallbladder (11 of 12) and the appearance of prominent intrahepatic ducts (five of 12). We conclude that hepatobiliary scintigraphy is a noninvasive test useful in the diagnosis of choledochal cyst.
Camponovo, E.; Buck, J.L.; Drane, W.E.
Ten patients with intracranial arachnoid cysts were treated with direct shunting of the cyst to a lateral ventricle. The strategic goal of cystoventricular shunting is to establish physiologically normal intracranial pressure relationships, rather than cyst obliteration. Cystoventricular shunts were successful in treating single and multiple intracranial cysts in supratentorial and infratentorial locations and in patients with normal and enlarged lateral
Lori A. McBride; Ken R. Winston; Jane E. Freeman
Ganglion cysts are the most common tumor in the wrist. Dorsal carpal ganglion cysts represent 60 to 70% of all ganglion cysts in the hand and wrist. Standard treatment has been limited to observation, rest, immobilization, aspiration with or without injection, and surgical excision. Arthroscopic resection of dorsal carpal ganglion cyst have been done since the late 1980s. It has
Thomas Wiedrich; A. Lee Osterman
Epicardial cysts originating directly from the epicardium are seen very rarely. Complete surgical excision is recommended when these cysts are detected. If cysts compress surrounding vital structures, cardiopulmonary bypass (CPB) should also be considered. We report herein 2 cases of multiloculated epicardial cysts, both of which were successfully excised, 1 with CPB. PMID:22360907
Hatemi, Ali Can; Kumbasar, Ulas; Servet, Ercan; Coskun, Ugur; Bostan, Cem; Oz, Büge
For clarifying the pathophysiology of arachnoid cysts and restablishing therapeutic criteria for such cases, we reviewed a series of 90 cases with arachnoid cysts focusing on the traumatic origin. Arachnoid cysts of congenital origin have been well known. But we suspected that 14 out of 90 patients (15.6%) with arachnoid cyst were closely related to head trauma. Seven of them
Joong-Uhn Choi; Dong-Seok Kim
There is little in the literature about the clinical spectrum of orbital cysts of childhood and no comprehensive classification has been proposed. The authors propose a classification of orbital cysts of childhood and review their clinical features, pathology, and management. The major categories in the classification include cysts of surface epithelium, teratomatous cysts, neural cysts, secondary cysts, inflammatory cysts, and
Jerry A Shields; Carol L Shields
Primary benign cystic lesions in the brain are uncommon. However, extracerebral cysts like arachnoid cyst, epidermoid cyst and craniopharyngiomas are fairly common lesions. Also, colloid cyst in the third ventricle, dermoid cyst and endodermal cyst in the extracerebral location are not uncommon. On the contrary, intraventricular ependymal and choroidal cysts in the intraventricular location are infrequent. Surgical intervention is warranted
Sanjay J. Pawar; Rewati Raman Sharma; Ashok K. Mahapatra; Ebenezer J. Dev
There may be several kinds of pathological conditions in the cystic lesion which are clinically diagnosed as benign intracranial cysts on CT scan. Light and electron microscopic studies on cyst walls were important in the differential diagnosis of benign intracranial cysts. We have studied 5 cases of intracranial arachnoid cysts and two epithelial cysts using the light and electron microscopy. Five cases of intracranial arachnoid cysts included two children and three adults (three females and two males). Three cases of them were localized in the middle cranial fossa, one case in the anterior and middle cranial fossa and one case in the lateral ventricle, giving headache and convulsion as the initial complaints. As for the epithelial cysts, one was localized at the para-collicular area complaining enlarged head and swollen anterior fontanelle and the other of four years was located in the fourth ventricle with headache and ataxic gait. On CT all of them demonstrated diffuse low density areas in both the arachnoid and the epithelial cysts without communicating findings between the cystic cavities and subarachnoid space on metrizamide CT cisternography. The arachnoid cyst walls were basically similar in structure to the normal arachnoid membrane and composed of elongated epithelial cells like the arachnoid cell and the connective tissues with lamellar collagen fiber bundles. However, 3 of the 5 cases had only fibrous tissues without epithelial cells. The inner sheath of the arachnoid cyst walls was composed of one or several layers of the arachnoid cells with flattened and relatively electron-dense cytoplasm on electron micrograph. They had a lot of elongated process and were tangled with each other, making large extracellular spaces between them. Below the electron dense arachnoid cells, compact packed cells with interdigitation partly demonstrated intercellular contacts such as numerous desmosomes and tight junctions. In those intercellular spaces collagen fibers and microfibrils were observed. The cells contained abundant cytoplasmic microfibrils and numerous organelles. They were separated from numerous collagen fibers and fibroblasts by non continuous basal lamina under the epithelial cells. Epithelial cyst wall had a layer of cuboidal or columnal epithelium in the inner layer of cyst wall. Those epithelial cells demonstrated granules having positive in PAS and mucicarmine stain in their cytoplasm. On electron microscopical study epithelial cells revealed a lot of microvilli and coating materials on the surface of them without cilia. The basement membranes were well developed under the epithelial cells separated from the connective tissues. In the intercellular clefts of the epithelial cells tight junctions and interdigitations were recognized.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:1910938
Miyagami, M; Kasahara, E; Miyazaki, S; Tsubokawa, T; Kagawa, Y
We present the case report of an 18-year-old female patient who presented with unilateral nasal obstruction. Computed tomography scanning revealed an unerupted molar in the posterior wall of the right maxillary sinus with a cystic swelling in the sinus. The preoperative diagnosis was a dentigerous cyst. The patient underwent endoscopic removal of the cyst and tooth. The operative findings and histopathology showed that it was an odontogenic keratocyst. This paper stresses the importance of diagnosing this condition and that a tooth in a cyst is not always dentigerous. PMID:23120487
Vaid, Neelam; Kothadiya, Ajay; Adwani, Sushama
Two new cases of leptomeningeal cysts subsequent to vacuum extraction are reported. Both children presented with a huge, nonpulsating, transilluminating subgaleal collection over the anterior fontanel that appeared soon after instrument delivery. Plain X-rays, computed tomography, and magnetic resonance imaging confirmed that the subgaleal collection was cerebrospinal fluid and showed the presence of a diastatic coronal suture in both cases. Treatment consisted of duraplasty with periosteal flaps and application of fibrin glue. In one case, an associated porencephalic cyst was treated with a cystoperitoneal shunt. Surgical treatment of leptomeningeal cyst due to vacuum extraction is simple and should not be postponed, despite the tendency for the extracranial cyst to regress, because of the potential risk of continuous growth of an underlying porencephalic cyst and risk of neurological damage. PMID:8869777
Djientcheu, V D; Rilliet, B; Delavelle, J; Argyropoulo, M; Gudinchet, F; de Tribolet, N
SUMMARY Introduction. Nasopalatine duct cysts (NPDCs) are the most common developmental epithelial non-odontogenic cysts of the maxillae. Their origin, however, is still a source of considerable debate. Aims. The aim of this investigation is to describe and discuss the etiology, differential diagnosis, clinic-pathological characteristics as well as to report the relative frequency and distribution of nasopalatine duct cysts in population (NPDCs) with a literature’s review on the topic. Methods The retrospective study was carried out using 36 clinical cases, with histopatological confirmation for NPDC, radiographs and oral photographs. Data included age and gender of the patient, radiographic findings, etiological factors, treatment, and prognosis of NPDC. Few surgical consideration are discussed. Results The study results report a clear male predilection with a 3:1 ratio. No statistically significant correlation was observed between the size of the lesion and patient’s gender. Lesions were usually asymptomatic. All cysts were located in the anterior maxillary midline region. Panoramic X-rays and computed tomography was used to identify the lesion. Surgical treatment was performed under local anesthesia including the dissection and removal of the cyst, adopting a usually palatine approach, with an enveloping flap from 1.4 to 2.4. Conclusions The etiology of NPDC is unclear and a male predilection was observed. Simple surgical resection is recommended, followed by clinical and radiological control to ensure correct resolution of the case.
CECCHETTI, F.; OTTRIA, L.; BARTULI, F.; BRAMANTI, N. E.; ARCURI, C.
Background Femoral head cysts have been identified as a risk factor for early femoral failures after metal-on-metal hip resurfacing arthroplasty (HRA) based on limited scientific data. However, we routinely performed HRA if less than 1/3 of the femoral head appeared destroyed by cysts on the preoperative radiograph. This study was undertaken to analyze whether there was an added risk of early femoral failures in HRA when femoral head cysts were present. Methods This retrospective case-control study included 939 MOM HRAs operated by a single surgeon with use of the posterior minimally invasive surgical (MIS) approach between November 2005 and January 2009. Patients with all diagnoses except osteonecrosis were included. Among them, 117 HRAs had femoral head cysts ? 1 cm identified in surgery. All cysts were treated with bone grafting using acetabular reamings packed into the cavitary defect (instead of filling the cysts with cement). The control group, which had no cyst observed at the time of surgery, was randomly selected from our database using computer algorithms to match those cases in the study group for the parameters of surgical date, age, gender, body mass index, diagnosis, femoral fixation method, and the size of the femoral component. Results The minimum follow-up was 24 months for both groups. The early femoral failure rate in the study group was 3/117 (2.6%) and 0/117 in the control group; there was no statistical difference between these two groups (P = 0.08). In the study group, there were two femoral neck fractures (revised): both occurred in patients having a cyst size of 1 cm3; and there was one femoral component loosening at 3-year follow up in a patient having a cyst size of 2 cm3. Conclusion Although the risk of early femoral failures among the group with cysts appeared higher than the group without cysts, we could not demonstrate a significant statistical difference between the two groups. It is possible that bone grafting cysts rather than cementing them may account for the low failure rate, and that this technique may minimize the risk of resurfacing a femoral head with cysts.
Calcifying epithelial odontogenic cyst (CEOC) is an odontogenic cyst with epithelial lining. CEOC is a rare entity that occurs in a wide age range, does not show any gender predilection, and accounts for only 1% of all jaw cysts. The lesion generally occurs in the region anterior to maxillary and mandibular molars and either intraosseously or extraosseusly. This entity might present as a cystic or solid lesion. Enucleation is the recommended treatment for a simple, unicystic CEOC. A case of recurring CEOC in the right maxilla antrum is presented here. The patient presented to the authors after postsurgical recurrence. The case was evaluated thoroughly, and the cyst was resolved. PMID:24064174
Karun, Vinayak; Mishra, Amit Kumar; Saikhedkar, Rashmi
Perineurial cysts may be responsible for clinical symptoms and a cure effected by their removal. They do not fill on initial myelography but may fill with Pantopaque some time, days or weeks, after Pantopaque has been instilled into the subarachnoid space. Perineurial cysts arise at the site of the posterior root ganglion. The cyst wall is composed of neural tissue. When initial myelography fails to reveal an adequate cause for the patient's symptoms and signs referable to the caudal nerve roots, then about a millilitre of Pantopaque should be left in the canal for delayed myelography which may later reveal a sacral perineurial cyst or, occasionally, a meningeal cyst. Meningeal diverticula occur proximal to the posterior root ganglia and usually fill on initial myelography. They are in free communication with the subarachnoid space and are rarely in my experience responsible for clinical symptoms. Meningeal diverticula and meningeal cysts appear to represent a continuum. Pantopaque left in the subarachnoid space may convert a meningeal diverticulum into an expanding symptomatic meningeal cyst, as in the case described. Many cases described as perineurial cysts represent abnormally long arachnoidal prolongations over nerve roots or meningeal diverticula. In general, neither of the latter is of pathological significance. Perineurial, like meningeal cysts and diverticula, may be asymptomatic. They should be operated upon only if they produce progressive or disabling symptoms or signs clearly attributable to them. When myelography must be done, and this should be done only as a preliminary to a probable necessary operation, then patient effort should be made to remove the Pantopaque. PMID:5531903
Tarlov, I M
Perineurial cysts may be responsible for clinical symptoms and a cure effected by their removal. They do not fill on initial myelography but may fill with Pantopaque some time, days or weeks, after Pantopaque has been instilled into the subarachnoid space. Perineurial cysts arise at the site of the posterior root ganglion. The cyst wall is composed of neural tissue. When initial myelography fails to reveal an adequate cause for the patient's symptoms and signs referable to the caudal nerve roots, then about a millilitre of Pantopaque should be left in the canal for delayed myelography which may later reveal a sacral perineurial cyst or, occasionally, a meningeal cyst. Meningeal diverticula occur proximal to the posterior root ganglia and usually fill on initial myelography. They are in free communication with the subarachnoid space and are rarely in my experience responsible for clinical symptoms. Meningeal diverticula and meningeal cysts appear to represent a continuum. Pantopaque left in the subarachnoid space may convert a meningeal diverticulum into an expanding symptomatic meningeal cyst, as in the case described. Many cases described as perineurial cysts represent abnormally long arachnoidal prolongations over nerve roots or meningeal diverticula. In general, neither of the latter is of pathological significance. Perineurial, like meningeal cysts and diverticula, may be asymptomatic. They should be operated upon only if they produce progressive or disabling symptoms or signs clearly attributable to them. When myelography must be done, and this should be done only as a preliminary to a probable necessary operation, then patient effort should be made to remove the Pantopaque. Images
Tarlov, I. M.
Primary lesions of hydatid cysts caused by Echinococcus granulosus, are frequently localized in liver, followed by lungs, muscles, kidneys, spleen and bones. Pelvic inoculations are rare and usually occur as a secondary infection. In this report, a case of primary hydatid cyst in the abdomen, spleen and pelvic organs, clinically mimicking tuboovarian abscess, was presented. A nineteen-years-old female patient was admitted to the gynecology outpatient clinic with the complaint of abdominal pain for two days. The case was considered as tuboovarian abscess according to the initial examination findings and hospitalized for treatment and follow-up. In transabdominal ultrasound examination, 44 x 43 mm thin-walled septated cysts in the left ovary and 65 x 65 mm thin-walled multiloculated cysts in the spleen were detected. Abdominal computerized tomography also yielded multivesicular cystic masses in spleen, front abdominal wall and the left ovary. Since the clinical and vital findings worsened, she initially underwent ovarian cystectomy by laparoscopy, then abdominal cystectomy and splenectomy. The operation material examined macroscopically was compatible with hydatid cyst with the characteristics of a germinative membrane and hydatid sand. The diagnosis was confirmed by histopathological examination. The patient was discharged without complication on post-operative sixth day, with a recommendation of albendezol (15 mg/kg/day, 3 months) treatment. Since the patient had undergone emergency surgery, indirect hemaglutination (IHA) test had not been performed pre-operatively. However, post-operative third month serum sample revealed a positive (1/32) IHA titer. In conclusion, hydatid cyst should be kept in mind in the differential diagnosis of patients with abdominal pain, in response to the high prevalence of the parasite in our country. PMID:23621737
Do?an, Keziban; Kaya, Cihan; Karaman, Ulkü; Kalayc?, Mustafa Uygar; Baytekin, Halil F?rat
Tarlov cysts or perineural cyst are lesions of the nerve roots located at the sacral level and uncertain aetiology. Most of these cysts remain asymptomatic with no clinical relevance. The symptomatic cysts are uncommon and the usual symptoms are pain or radiculopathy. We report the case of a 53-year-old woman witha symptomatic cyst (with a history of frequency and urgency syndrom), that disappears after surgery. PMID:19143297
Ruibal Moldes, M; Sánchez Rodríguez-Losada, J; López García, D; Casas Agudo, V; Janeiro País, J M; González Martín, M
Eruption cysts are benign cysts that appear on the mucosa of a tooth shortly before its eruption. They may disappear by themselves but if they hurt, bleed or are infected they may require surgical treatment to expose the tooth and drain the contents. Here we present 2 case reports of eruption cysts presenting with different chief complaint. The treatment included incising the eruption cyst and draining the contents of the cyst.
Dhawan, Preeti; Kochhar, Gulsheen Kaur; Chachra, Sanjay; Advani, Shweta
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. PMID:19919821
Dunham, C P; Curry, B; Hamilton, M
Ten cases of intra-orbital hydatid cysts were operated from January 85 to December 91. The aim of this retrospective study is to show the importance of this pathology with regard to other intra-orbital expansive processes and to discuss the efficiency of neurosurgical approaches. The mean age was 25 years, with 5 women and 5 men. The symptoms consisted in progressive unilateral exophthalmia in 8 cases and acute one in 2 cases. Visual deterioration was observed in 7 cases: a reduced vision acuity in 6 cases and blindness in one case. Fundus oculi showed papillary oedema in 4 cases and optical atrophy in one case. Slight disturbance of ocular mobility was observed in 5 cases. CT Scan gave positive diagnosis and predicted the hydatid nature in 9 cases. Fronto-orbital approach, taking away the squamous portion of the frontal bone, orbital arc and roof, was made in 9 cases. It permitted to remove the cyst without rupture of the capsule in all cases. Fronto-temporal approach was used in one case. The evolution was excellent after 8 months to 6 years in 4 patients. Five patients were improved with reduction of exophthalmia, stabilisation of visual acuity and eye movements. Blindness remained unchanged in one patient. PMID:8815414
Sami, A; Achouri, M; Harouch, M; Choukry, M; Ouboukhlik, A; Elkamar, A; Elazhari, A; Amraoui, A; Boucetta, M
We previously devised and reported a laparoscopic resection of benign ovarian cysts. In the present paper, we report precautions and improvements in the procedure and the application of the mini-laparotomy. 1. The subjects consisted of a total of 41 cases with preoperatively diagnosed cysts. These were 17 cases with simple cysts, 15 cases with dermoid cysts, and nine cases with chocolate cysts. The present surgical procedure was performed on 34 (83%) cases. 2. One case, preoperatively diagnosed as a chocolate cyst, was diagnosed as an endometrioid adenocarcinoma. 3. Laparotomy was required in 7 cases; in four as a result of hard adhesions, in one because it was impossible to withdraw fluid, in one due to a damaged urinary bladder and in one due to endometrioid adenocarcinoma. 4. It became essential to classify the ovarian cysts into three groups according to size. 5. Mini-laparotomy was performed for two giant ovarian cysts and five ovarian cysts in pregnant women. In this procedure the goal is minimal, simple, safe and reliable surgery with results equal to those of standard laparotomy. PMID:8258730
Ikuma, K; Shiotani, T; Shibahara, H
A 5-year-old girl presented with abdominal pain, intermittent jaundice and a gall bladder lump. Clinical examination and preoperative imaging suggested the diagnosis of a type I choledochal cyst (CDC). During surgery, this was found to be a hydatid cyst (HC) occupying the head of pancreas causing obstruction to the common bile duct (CBD). A pancreatic HC mimicking a CDC and presenting with CBD obstruction is unusual.
Agrawal, Sanwar; Parag, Pulak
With more frequent antenatal and postnatal diagnosis, the management of ovarian cysts has become somewhat controversial. Management protocols for simple ovarian cysts have been proposed. The purpose of this study was to establish a management protocol for complex ovarian cysts presenting antenatally and in the first year of life. We reviewed the records of nine infants who underwent surgical treatment for ovarian cysts over a 10-year period (1980 through 1989). Antenatal ultrasound performed between 24 and 34 weeks of gestation showed ovarian cysts in six infants. All six infants had complex cysts ranging in size from 3 to 10 cm on postnatal ultrasound. Exploration with oophorectomy or salpingooophorectomy was carried out at 2 days to 3 months of age for ovarian torsion. Ovarian cysts measuring up to 7 cm were diagnosed postnatally in three infants from 1 day to 7 months of age with ultrasound confirmation of complex, cystic intraabdominal masses. All patients underwent salpingooophorectomy, two for tuboovarian torsion and the third patient for a juvenile granulosa cell tumor. We recommend that all complex ovarian cysts, regardless of size, be surgically removed because they represent torsion, neoplasm, or alternate diagnoses, and removal can prevent possible complications. PMID:1765908
Croitoru, D P; Aaron, L E; Laberge, J M; Neilson, I R; Guttman, F M
Most surgeons agree that complex neonatal ovarian cysts, regardless of size, warrant operative intervention. Management of simple cysts >4 cm is still controversial, although many favor intervention because of the increased risk of torsion. Whereas laparoscopic cyst resection is favored by some, others prefer less invasive percutaneous needle aspiration. We present a newborn infant who was admitted with sepsis and respiratory failure after home delivery. Ultrasound done on day 8 to check for umbilical venous line placement incidentally showed a simple cyst measuring 3.6 x 5.9 x 6.9 cm that was presumed to be of ovarian origin. Percutaneous needle aspiration was atraumatic and revealed serous fluid, with a high estradiol level. Four days later, surgery was indicated for clinical deterioration with suspected hemorrhage into the cyst. We found a midgut volvulus with extensive necrosis secondary to a jejunal duplication cyst. Ovaries were normal and there was no evidence of malrotation. Postoperatively, after discussion with the parents, support was withdrawn and the child died. We should not rely solely on ultrasonographic features and fluid characteristics to diagnose a large neonatal abdominal cyst, but rather confirm the diagnosis with laparoscopy. PMID:19349004
Puligandla, Pramod S; Laberge, Jean-Martin
A case is presented of an intraspinal extradural ganglion cyst at the L4–5 level. The clinical picture suggested a herniated nucleus pulposus at this level. A myelogram revealed a round lesion almost completely obstructing the flow of Pantopaque at the L4–5 level. A ganglion cyst with a haemorrhage into it and the surrounding tissue was removed, and surgery was followed by complete recovery. Images
Brish, Adam; Payan, Hushong M.
A prospective study of 36 consecutive patients with congenital arachnoid cysts treated endoscopically is reported. There were\\u000a 15 female and 21 male patients. The mean age at the time of diagnosis was 12.3 years (10 days to 38 years). Arachnoid cysts\\u000a were located in the suprasellar region in 16 patients, the sylvian fissure in 11, the quadrigeminal cistern in 4
Joong-Uhn Choi; Dong-Seok Kim; Ryoong Huh
Background Microsurgical resection, stereotactic aspiration, endoscopically assisted microsurgical resection, and ventriculoperitoneal shunt have been the treatment options for colloid cysts of the third ventricle. Recently, an endoscopic approach has been recognized as an effective alternative to open surgery. There is suspicion about the long-term recurrence rate and about obtaining complete removal of cyst.Patients and Methods This is a prospective study of 24 patients with colloid cyst who underwent endoscopic resection. Preoperative computed tomography (CT) scans revealed hydrocephalus in all the patients. Postoperative magnetic resonance imaging (MRI) was done in all cases.Results Age ranged from 16 to 57 years. There were 16 male and 8 female patients. The diameter of the cyst varied from 14 to 24 mm. Operating time ranged from 90 to 156 minutes. Total resection was achieved in 21 patients. All patients with subtotal excision underwent coagulation of residual cyst wall. The follow-up period ranged from 6 to 78 months (mean, 37 months). None of the patients developed any symptoms at 26, 31, and 39 months of follow-up. Preoperative symptoms disappeared in all the patients except for memory disorders and seizures in one patient each. No residual cyst was observed on the postoperative MRIs in 21 patients. Hospital stay was 4 to 10 days (median, 6 days). No endoscopic operation was converted into an open resection.Conclusion Endoscopic excision of a colloid cyst is an effective and safe alternate method. Although the follow-up time was short, residual cyst wall remained asymptomatic without any evidence of growth after subtotal excision and coagulation of wall. PMID:23700169
Yadav, Yad Ram; Parihar, Vijay; Pande, Sonjjay; Namdev, Hemant
Objective: To study the development of chocolate cysts by serial transvaginal ultrasonographic tracking of ovarian follicles.Design: Retrospective study.Setting: Department of Obstetrics and Gynaecology, Sunderland Royal Hospital, Sunderland, United Kingdom.Patient(s): We reviewed case notes of all patients who underwent laparoscopy for diathermy to endometriosis\\/ovarian diathermy\\/aspiration of ovarian cysts from 1989 to 1998. Twelve women with histories of infertility and proven chocolate
Smita Jain; Maureen E Dalton
We report the case of a patient with a palpable mass and abdominal pain in the left upper quadrant. A physical examination revealed tenderness in this region. An ultrasound performed initially showed a large cystic structure. A CT examination revealed a large cyst originating in the spleen with loculations in its upper part and focal calcification in the wall. On MRI, the cystic mass showed high signal on T1-weighted and T2-weighted images. The carbohydrate antigen 19-9 (CA 19-9) was measured at 88 U/ml (standard <37.1 mUI/l). According to the imaging examinations and laboratory tests performed, it was impossible to determine if the splenic cyst was parasitic or non-parasitic. Given the most important risks of complications encountered in parasitic cysts, it was decided to treat this splenic cyst as a parasitic cyst. For this reason, an elective laparoscopic splenectomy with preoperative embolisation of the splenic artery was performed. The histological diagnosis was a primary epidermoid splenic cyst with inner lining epithelial cells. PMID:23667225
Vo, Quoc Duy; Monnard, Etienne; Hoogewoud, Henri Marcel
Cysts of the oesophagus are unusual findings and they are classified according to the embryological site of origin. It may represent inclusion cysts, retention cysts and developmental cysts. We present a case of keratinous inclusion cyst of the lower oesophagus in a 71-year-old Malay woman who presented with dyspepsia and severe epigastric pain. An oesophago-gastro-duodenoscopy demonstrated a sliding hiatus hernia with whitish ulcer-like lesion at the lower oesophagus. Biopsy from the lesion revealed a keratinous inclusion cyst. The patient was given pantoprazole and put on regular follow-up for monitoring any other development. PMID:23878290
Wan Abdul Rahman, Wan Faiziah; Mutum, Samarendra Singh; Fauzi, Mohd Hashairi
Eosinophilic granuloma is a common expression of Langerhans cell histiocytosis and corresponds with typical bone lesions. The radiographic appearance of eosinophilic granuloma in the jaw is variable and not specific. It may resemble periodontitis, radicular cyst, or malignancies. The purpose of this report is to describe the characteristic radiographic features of eosinophilic granuloma of a 39-year-old male. The lesion in the anterior mandible was first diagnosed as radicular cyst because the radiographic findings were ovoid radiolucent lesion with well-defined border. However, careful interpretation revealed a non-corticated border and floating tooth appearance that were the characteristic radiographic features for the differential diagnosis. Early clinical signs of eosinophilic granuloma can occur in the jaw and a bony destructive lesion might be mistaken for periodontitis or an odontogenic cystic lesion; therefore, careful interpretation of radiographs should be emphasized.
Lee, Wan; Lee, Jun; Son, Hyun-Jin
With technological advancements and wider availability of multimodality imaging, incidental lesions are frequently identified in patients undergoing various imaging studies. We report here a case of multiloculated disseminated perineural or Tarlov cysts (TCs). The primary aim of this case study was to (1) provide a comprehensive review of the clinical, imaging, and histopathological features of TCs (2) to draw attention to the fact that multiple lumbosacral and dorsal TCs can produce nerve injuries and serious movement disturbances, and (3) to document the usefulness of the magnetic resonance imaging and bone scan in non-invasive diagnosis and guiding management in such cases. These cysts are clearly identified by magnetic resonance imaging (MRI) and computerized tomography imaging of the lumbosacral spine. However, there are no reports on the scintigraphic findings of multilocular disseminated TC in literature. TCs are typically benign, asymptomatic lesions that can simply be monitored. To date, no consensus exists about the best surgical strategy to use when indicated.
Padma, Subramanyam; Palaniswamy, Shanmuga Sundaram
With technological advancements and wider availability of multimodality imaging, incidental lesions are frequently identified in patients undergoing various imaging studies. We report here a case of multiloculated disseminated perineural or Tarlov cysts (TCs). The primary aim of this case study was to (1) provide a comprehensive review of the clinical, imaging, and histopathological features of TCs (2) to draw attention to the fact that multiple lumbosacral and dorsal TCs can produce nerve injuries and serious movement disturbances, and (3) to document the usefulness of the magnetic resonance imaging and bone scan in non-invasive diagnosis and guiding management in such cases. These cysts are clearly identified by magnetic resonance imaging (MRI) and computerized tomography imaging of the lumbosacral spine. However, there are no reports on the scintigraphic findings of multilocular disseminated TC in literature. TCs are typically benign, asymptomatic lesions that can simply be monitored. To date, no consensus exists about the best surgical strategy to use when indicated. PMID:23723584
Padma, Subramanyam; Palaniswamy, Shanmuga Sundaram
Recent radiologic procedures in bone and joints, some of which eliminate the need for surgery are exposed, including: trephine biopsies of the thoracic and lumbar spine, sacro-iliac joints, peripheral bones synovial membrane and soft tissues, using either fluoroscopic echographic or CT guidance - chemonucleolysis - vascular embolization of skeletal tumors and management of vertebral hemangiomas - selective steroid injection in a broad spectrum of diseases including vertebral facet syndrome, cervicobrachial nerve root pain, rotator cuff calcium deposit, bone cysts.
Bard, M.; Laredo, J.D.
Perineural cysts have become a common incidental finding during lumbosacral magnetic resonance (MR) imaging. Only some of the symptomatic cysts warrant treatment. The authors describe the successful operative treatment of a patient with, to the best of their knowledge, the largest perineural cyst reported to date. A 29-year-old woman had been suffering from long-standing constipation and low-back pain. During an obstetric investigation for infertility, the clinician discovered a huge presacral cystic mass. Computed tomography myelography showed the lesion to be a huge Tarlov cyst arising from the left S-3 nerve root and compressing the ipsilateral S-2 nerve. The cyst was successfully treated by ligation of the cyst neck together with sectioning of the S-3 nerve root. Postoperative improvement in her symptoms and MR imaging findings were noted. Identification of the nerve root involved by the cyst wall, operative indication, operative procedure, and treatment of multiple cysts are important preoperative considerations. PMID:17688070
Ishii, Kazuhiko; Yuzurihara, Masahito; Asamoto, Shunji; Doi, Hiroshi; Kubota, Motoo
This is a case report of a unique osteolytic lesion of the skull. Following a workup for convulsive seizures, a circumscribed osteolytic lesion of the left occipital bone was found by X-ray. Surgical exploration revealed an arachnoid cyst eroding the skull. A history of head injury to the left occiput two years previously was obtained. There was no fracture.
Mohammed Sartawi; Frederic T. Schwartz; John L. Fox
Most of Tarlov or perineurial cysts remain asymptomatic throughout the patient's life. The pathogenesis is still unclear. Hemorrhage has been suggested as one of the possible causes and trauma with resultant hemorrhage into subarachnoid space has been suggested as an origin of these cysts. However, Tarlov cysts related to spontaneous subarachnoid hemorrhage has not been reported. The authors report a case of Tarlov cyst which was symptomatic following spontaneous subarachnoid hemorrhage.
Kong, Woo Keun; Hong, Seung-Koan
Most of Tarlov or perineurial cysts remain asymptomatic throughout the patient's life. The pathogenesis is still unclear. Hemorrhage has been suggested as one of the possible causes and trauma with resultant hemorrhage into subarachnoid space has been suggested as an origin of these cysts. However, Tarlov cysts related to spontaneous subarachnoid hemorrhage has not been reported. The authors report a case of Tarlov cyst which was symptomatic following spontaneous subarachnoid hemorrhage. PMID:22053232
Kong, Woo Keun; Cho, Keun-Tae; Hong, Seung-Koan
Hydatid cyst is caused by the parasite Echinococcus granulosus commonly seen in temperate regions. Primary omental hydatid cyst is rare entity. Diagnosis can be achieved with contrast-enhanced computed tomography of abdomen and pelvis along with serology. Eosinophilia is a strong pointer to hydatid cyst as a differential diagnosis. Open or laparoscopic excision of the cyst along with medical therapy remains the treatment of choice.
Sable, Shailesh; Mehta, Jyoti; Yadav, Sudeep; Jategaokar, Priyadarshan; Haldar, Premashish J.
We performed a retrospective review of 5375 aspirations performed during the last 16 years of noncomplex cysts. Cytology results and outcomes following aspirations of simple and complicated cysts performed by the senior author at our institution were reviewed. Complex cysts with associated solid components which were core biopsied are excluded from this review. We present our data as the largest series to date performed by one breast radiologist at a single institution. Our data separate cysts with atypia or malignant cytology into those sampled concurrently with solid neoplasms and those which were isolated lesions. Various technical issues which have not been previously addressed in the literature are discussed. Noncomplex cysts are benign 99% of the time. Cysts with papillary cytology require no further workup. Margin-negative seromas do not require cytologic analysis of fluid. Sixteen malignancies were revealed (0.3%), eight of which were solitary cysts (0.1%). Atypical cytology predicted malignancy in 21%; therefore, atypical cytology requires further workup. Malignant cytology was associated with breast cancer in 90.9% of patients; therefore, all patients with malignant cytology require biopsy. PMID:22845618
Sanders, Linda M; Lacz, Nicole L; Lara, Jonathan
Lumbar synovial cysts frequently present with back pain, chronic radiculopathy and/or progressive symptoms of spinal canal compromise. These cysts generally appear in the context of degenerative lumbar spinal disease. Few cases of spontaneous hemorrhage into synovial cysts have been reported in the literature.
Alen, Jose F.; Ramos, Ana; Lobato, Ramiro D.; Lagares, Alfonso
Recently, laparoscopic surgery has been reported for symptomatic renal cysts. A 60-year-old female was referred to Toyama Medical and Pharmaceutical University Hospital with a chief complaint of general fatigue and left back pain. CT demonstrated bilateral peripelvic renal cysts, and DIP demonstrated left hydronephrosis and a medial shift of the left renal pelvis. Laparoscopic ablation of bilateral peripelvic renal cysts
Akiou Okumura; Hideki Fuse; Yasuhiro Muraishi; Remon Nishio; Tetsuo Nozaki
Summary Suprasellar arachnoid cysts are uncommon lesions the optimal management of which is still subject for debate. Various authors have presented differing treatment preferences which include: 1) Subfrontal fenestration of the cyst to the basal cisterns; 2) Transcallosal fenestration of the cyst into the lateral ventricles with optional shunting; 3) Cystoperitoneal shunt; 4) Percutaneous ventriculocystostomy. There is a significant incidence
Z. H. Rappaport
A mediastinal hydatid cyst is rare (< 0.1% of hydatidosis). It most frequently progresses to calcification rather than a pulmonary hydatid cyst because there is no relationship to ventilation. We report a case of calcified mediastinal hydatid cyst which was confirmed on histological examinations from the operative specimen, in an agricultural worker of 58 who presented with a homolateral paralysed diaphragm. PMID:9082506
Benzarti, M; Jerray, M; Khirouni, S; Souissi, J; Ommezzine, N; Mezghenni, S; Hayouni, A; Garrouche, A; Klabi, N
OBJECTIVE. The purpose of our study was to characterize the radiographic fea- tures of thin-walled air-filled structures (cysts) related to Pneumocystls carinil pneu- monia in a large series of patients, determine the natural history of the cysts, and test the hypothesis that the cysts are associated with an increased risk of pneumothorax. MATERIALS AND METHODS. Of 100 patients with proved
Radiographic Characteristics; Caroline Chow; Philip A. Templeton; Charles S. White
This activity is designed to learn about simple machines and to have fun doing so! First, use this website to learn backround information on the basics of simple machines. Try the quiz! Simple Machines Learning Site Next, play a game that tests your ability to identify simple machines.... Edheads: Simple Machines Finally, view this video to see how students your age used applied simple machines to do a cool task... Building Simple Machines: A Glass of Milk, Please ...
A 3-year-old bull was examined because of a fluctuant mass on the ventral midline of the cranial portion of the cervical area. The mass originally developed after the bull was handled in a squeeze chute for routine health care. The mass was aspirated and incised repeatedly during the 18 months before referral. The mass was excised at the referral center, and the histologic diagnosis was dermoid cyst. The mass had not redeveloped by 18 months after surgery. Dermoid cysts are most often seen in Rhodesian Ridgeback dogs, although a similar condition has been reported in a 5-week-old calf. PMID:8428839
Baird, A N; Wolfe, D F; Groth, A H
Phaeohyphomycosis consists of a heterogeneous group of fungal infections caused by more than 80 genera and species. Subcutaneous infection usually follows traumatic implantation of a fungus by a wooden splinter that the fungus inh abits as a saprophyte. The growth of the fungus forms verrucous plaques or a painless subcutaneous abscess. We report a subcutaneous cyst (phaeomycotic cyst) in the leg of a 60-year-old woman that developed after a thorn prick at that site. With the provisional diagnosis of an epidermoid cyst, she was treated with a simple excision of the cyst. However, histopathological examination of the cyst revealed the typical features of fungus, and a definitive diagnosis of a phaeomycotic cyst was made. As the infective aetiology was not considered clinically, the specimen was not sent for microbiological culture, and hence the exact species was not identified. As the lesion was localised, simple excision was sufficient treatment, and no recurrence was observed during 12 months of follow-up. PMID:22135592
Manoharan, Madhavan; Shanmugam, Natarajan; Veeriyan, Saveetha
Epidermoid cysts are rare, slow-growing, benign, developmental cysts that are derived from abnormally situated ectodermal tissue. Epidermoid cysts may grow anywhere on the body and about 7% of them are located in the head and neck. In literature, very few epidermoid cysts have been reported in the temporal region. Histopathologically, they are lined with plain stratified keratin-producing squamous epithelium, although in some cases part of the lining is made up of mucous secreting and ciliated epithelium. This may suggest an endodermal rather than an ectodermal origin. We present and discuss the management of a patient presenting a posttraumatic epidermoid cyst of the temporal region. PMID:21889899
Boffano, Paolo; Roccia, Fabio; Campisi, Paola; Zavattero, Emanuele; Gallesio, Cesare; Bosco, Giovanni Francesco
Cardiac hydatid cyst is known to be a rarely occurring disease. The appearance of large cysts in the interventricular septum in childhood is even more rare. Although such cysts are usually asymptomatic, they can behave like valvular disorders, depending on their location. In addition, cardiac hydatid cysts originating from the interventricular septum carry the risk of rupturing into both ventricular cavities, which may lead to fatal complications. Thus, early surgical treatment is of extreme importance. We describe the case of a 7-year-old girl with a cardiac hydatid cyst that originated in the interventricular septum. PMID:18270135
Omay, Oguz; Celebi, Serdar; Kumbasar, Ulas; Babaoglu, Kadir; Gunay, Ilhan
Pericardial cysts are uncommon mediastinal lesions that are usually congenital in origin. Patients are usually asymptomatic and the cysts are generally discovered on routine radiography for unrelated purposes. This case illustrates a symptomatic presentation of a haemorrhagic pericardial cyst in which radiographic, echocardiographic and multislice (MRI and CT) imaging were performed. The imaging findings were not typical of pericardial cysts leading to a diagnostic quandary despite the varied imaging techniques. In conclusion, it is important to appreciate that the imaging findings of pericardial cysts can be varied. Radiologists and clinicians alike should be aware of this variability. PMID:22921797
Abu Bakar, Norzailin; Abdul Aziz, Yang Faridah; Singh Sandhu, Ravinderjit; Fadzli, Farhana; Yaakub, Nur Adura; Krishnasamy, Sivakumar; Raja Mokhtar, Raja Amin
Tarlov or perineural cysts are nerve root cysts found most commonly at the sacral spine level arising between covering layers of the perineurium and the endoneurium near the dorsal root ganglion and are usually asymptomatic. Symptomatic sacral perineural cysts are uncommon but sometimes require surgical treatment. A 69-year-old male presented with pain in the buttock. He was diagnosed as having a sacral cyst with magnetic resonance imaging. For the nonoperative diagnosis and treatment, caudal peridurography and block were performed. After the treatment, the patient's symptom was relieved. We suggest a caudal peridural block is effective in relieving pain from a sacral cyst. PMID:22787551
Jung, Ki Tae; Lee, Hyun Young; Lim, Kyung Joon
Tarlov or perineural cysts are nerve root cysts found most commonly at the sacral spine level arising between covering layers of the perineurium and the endoneurium near the dorsal root ganglion and are usually asymptomatic. Symptomatic sacral perineural cysts are uncommon but sometimes require surgical treatment. A 69-year-old male presented with pain in the buttock. He was diagnosed as having a sacral cyst with magnetic resonance imaging. For the nonoperative diagnosis and treatment, caudal peridurography and block were performed. After the treatment, the patient's symptom was relieved. We suggest a caudal peridural block is effective in relieving pain from a sacral cyst.
Jung, Ki Tae; Lee, Hyun Young
Paraurethral cysts arising from Skene's gland are a rare cause of urogenital masses in the neonate. We report the case of a pelvic mass noted at the vaginal introitus on prenatal ultrasound that following delivery was found to be a paraurethral cyst. On prenatal ultrasound, there was no evidence of involvement of the urinary, gastrointestinal, or upper genital tract. Serial ultrasounds demonstrated slight enlargement of the cyst without other changes. The patient delivered at 33 weeks and postnatal evaluation demonstrated a paraurethral cyst. The cyst was managed expectantly and drained spontaneously on the second day of life with complete resolution. PMID:23146295
Johnson, Clark T; Millard, Sarah E; Wang, Ming-Hsien; Ehsanipoor, Robert M
Retroperitoneal contamination may occur during the natural history of hydatid disease. Primary hydatid cyst of the retroperitoneum is extremely rare. The authors report a case of a giant retroperitoneal hydatid cyst. Clinicians and surgeons must be aware of this possibility and follow a policy of nonsystematic puncture of an abdominal cyst and avoid spillage during surgery. Symptoms are related to the size, location, or ensuing complications of a cyst. Its occurrence should be strongly suspected ahead of any abdominal cyst, especially in an endemic area, where it may act as a parasite. Total and careful surgical excision is the gold-standard therapy. PMID:19954768
Sall, Ibrahima; Ali, Abdelmounaim Ait; El Kaoui, Hakim; Bouchentouf, Sidi Mohammed; El Hjouji, Abderrahmane; El Fahssi, Mohammed; Bounaim, Ahmed; Zentar, Aziz; Sair, Khalid
Tarlov or perineural cysts are nerve root cysts found most commonly at the sacral spine level arising between covering layers of the perineurium and the endoneurium near the dorsal root ganglion. The cysts are relatively rare and most of them are asymptomatic. Some Tarlov cysts can exert pressure on nerve elements resulting in pain, radiculopathy and even multiple radiculopathy of cauda equina. There is no consensus on the appropriate therapeutic options of Tarlov cysts. The authors present a case of two sacral cysts diagnosed with magnetic resonance imaging. The initial symptoms were low back pain and sciatica and progressed to cauda equina syndrome. Surgical treatment was performed by sacral laminectomy and wide cyst fenestration. The neurological deficits were recovered and had not recurred after a follow-up period of nine months. The literature was reviewed and discussed. This is the first reported case in Thailand. PMID:16881441
Chaiyabud, Pradit; Suwanpratheep, Kitti
Rathke's cleft cyst is a benign growth found on the pituitary gland in the brain, specifically a fluid-filled cyst in the posterior portion of the anterior pituitary gland. It occurs when the Rathke's pouch does not develop properly, and ranges in size from 2 to 40 mm in diameter. Asymptomatic cysts are common, detected during autopsies of 2-26% of individuals who have died of unrelated causes. Symptomatic cysts are rare and only approximately 150 cases have been reported. Females are twice as likely as males to have a cyst. Symptomatic cysts can trigger visual disturbances, pituitary dysfunction and headaches. Here we present a case of a 40-year-old female patient who presented with complains of visual disturbances, headache and amenorrhoea. On investigations, MRI of brain revealed findings suggestive of Rathke's cleft cyst. PMID:23355555
Naik, Vismay Dinesh; Thakore, Nilay Rajendra
This article gives an overview of the topic, with emphasis on current concepts and management of the clinical situations in question, in particular the concepts related to treatment. An extensive review of the etiology and monitoring of patients with non-parasitic splenic cysts is also made. These reports are derived from major clinical studies published in the current medical literature. PMID:21340260
Schlittler, Luis Alberto; Dallagasperina, Viviane Weiller
8 Children surgically treated for posterior fossa arachnoid cyst are described. In all the cases an enlarging head was the presenting sign; intracranial hypertension was evident in 6 patients; 2 children were clinically regarded as being affected by ‘arrested’ hydrocephalus. Preoperative subarachnoid lumbar infusion tests (8 cases) and prolonged intraventricular CSF pressure recordings (2 cases) demonstrated abnormal CSF dynamics in
Concezio di Rocco; Massimo Caldarelli; Girolamo di Trapani
Twenty supratentorial and 10 infratentorial arachnoid cysts are reported. The patients were from 0 to 15 years of age. The commonest presenting symptoms in children were cranial enlargement, epileptic seizures, and psychomotor retardation. Neuroradiological evaluation included CT, metrizamide CT, cisternography, and angiography. Echography was performed in 5 newborns. Therapeutic criteria according to the clinical and neuroradiological findings are reviewed. Cystoperitoneal
D. Locatelli; N. Bonfanti; R. Sfogliarini; T. M. Gajno; S. Pezzotta
Two cases of epidermal cyst of the breast are presented. Mammography and ultrasonography merely confirmed that the masses were solid. As is usual with these extremely rare lesions, the initial diagnoses (fibroadenoma and carcinoma) were incorrect. Images Fig. 1 Fig. 2 Fig. 3A Fig. 3B Fig. 4 Fig. 5
Kowand, L M; Verhulst, L A; Copeland, C M; Bose, B
Objective: Neonatal ovarian cysts (NOC) are usually self-limiting structures. However, large or complex cysts may lead to severe complications. A standard guide to management, treatment and follow-up of NOC is not yet available. The aim of this study was to evaluate retrospectively the records of NOC patients from two medical centers. Methods: A total of 20 newborns with NOC were included in the study. The size and localization of the cyst, the age, the signs and symptoms at presentation, and the possible maternal and fetal-neonatal etiologic factors were recorded. Follow-up procedures and treatment modalities were evaluated. Results: The mean age at diagnosis was 34 gestational weeks. The cysts (mean size 53±15 mm) were predominantly in the right ovary (75%) and were evaluated as large cysts in 16 (80%) of the patients. In 5 of the patients with large cysts and in 1 of the 4 patients with small cysts, the cysts were evaluated as complex cysts. Torsion of the ovary was detected in five (25%) cases and these cases were treated surgically. Patients with simple cysts were closely followed by ultrasonography until the cysts disappeared. Conclusion: To date, there is no precise guide for the monitoring and treatment of NOCs. Surgical treatment should always be performed in a way to protect the ovaries and to ensure future fertility. In our NOC series, it has been possible to apply a non-invasive follow-up program and minimally invasive surgical procedures. Conflict of interest:None declared.
Ak?n, Leyla; Ozbek, Sibel; Tireli, Gulay; Kavuncuoglu, Sultan; Sander, Serdar; Akcakus, Mustafa; Gunes, Tamer; Ozturk, M. Adnan; Kurtoglu, Selim
Tears of the rotator cuff (RC) complicated by bone cysts at the footprint might represent a challenge for the shoulder surgeon. This might be additionally aggravated in elderly patients with inferior bone quality due to osteopenia or osteoporosis. In this report we present a technique for open repair of RC tears by augmenting the cystic lesion at the greater tuberosity using bone void filler in combination with a double row anchor reconstruction technique. Despite disadvantageous position and size of the cyst, using this technique the footprint can be restored by obtaining an anatomical position of the supraspinatus tendon. The application range of this technique is not limited to defined bony defects and presents a promising novel surgical approach. Level of evidence V. PMID:23070221
Postl, L K; Braunstein, V; von Eisenhart-Rothe, R; Kirchhoff, C
OBJECTIVE. The purpose of this article is to determine the natural history of adrenal cysts on the basis of long-term imaging follow-up. MATERIALS AND METHODS. This retrospective study included patients with adrenal cysts who had at least 12 months of imaging follow-up (1993-2010). Medical records were reviewed. Two radiologists reviewed imaging examinations in consensus and recorded wall thickness (thin, ? 3 mm; thick, > 3 mm), septations, and calcification. CT attenuation value, MRI signal intensity, the presence or absence of enhancement, and typical sonographic features were used to confirm fluid content of the lesions. Cyst wall enhancement was recorded (thin, ? 3 mm and smooth; thick, > 3 mm). Cyst diameter on the initial and most remote follow-up examinations was compared. The Wilcoxon matched-pairs signed rank test was applied to assess statistically significant differences in size and CT attenuation on follow-up examinations. RESULTS. Twenty patients with unilateral adrenal cysts (seven male and 13 female patients; mean age, 44 years; range, 10-75 years) had a mean imaging follow-up period of 64 months (range, 12-198 months). CT, MRI, and ultrasound examinations were obtained in 19, 11, and 13 patients, respectively. Cysts were diagnosed by lack of enhancement on CT or MRI in 12 patients, typical sonographic features in three patients, and combination of CT and sonographic or MRI features in five patients. Signal intensities typical for fluid were found on all MRI examinations, attenuations of less than 20 HU on 17 of 19 (89%) CT examinations, and features of either simple or mildly complicated cysts on all sonograms. Thin walls, wall calcifications, and thin septations were found in 20 (100%), 12 (60%), and four (20%) lesions, respectively. During the follow-up of 20 lesions, the median cyst diameter increased by 26.0% (interquartile range, 6.8-68.4%) in 12 (60%) patients, decreased by 32.9% (interquartile range, 7.1-42.8%) in six (30%) patients, and was unchanged in two (10%) patients. The median baseline CT attenuation values did not significantly change on follow-up CT examinations (p = 0.72). No patient developed a complication of adrenal cyst. Four patients had histologically confirmed benign adrenal cysts. CONCLUSION. Interval enlargement of an adrenal cyst is frequent and as an isolated finding does not indicate malignancy or presence of a complication. However, some adrenal cysts may decrease or remain stable in size over time. PMID:24147471
Ricci, Zina; Chernyak, Victoria; Hsu, Kevin; Mazzariol, Fernanda S; Flusberg, Milana; Oh, Sarah; Stein, Marjorie; Rozenblit, Alla
39 patients with 42 arachnoid cysts have been reviewed in a retrospective study. All kinds of arachnoid cysts reported in the literature were also found in this study. These consist mainly of congenital primary and posttraumatic secondary cysts. Cysts which cause no major neurological deficits require conservative treatment of symptoms only. Cysts which cause major symptoms because of their space
Kwesi Dei-Anang; Dieter Voth
The flux of cells from germinated cysts is critical in the population dynamics of many dinoflagellates. Here, data from a large-scale cyst survey are combined with surveys in other years to yield an Alexandrium fundyense cyst distribution map for the Gulf of Maine that is massive in geographic extent and cyst abundance. The benthic cyst population extends nearly 500km alongshore.
Donald M. Anderson; Charles A. Stock; Bruce A. Keafer; Amy Bronzino Nelson; Brian Thompson; Dennis J. McGillicuddy; Maureen Keller; Patricia A. Matrai; Jennifer Martin
Background: Surgical treatment of endodermal cysts requires total removal of the cyst wall during the first operation to prevent recurrence. Therefore, intraoperative pathological diagnosis plays an important role in determining the optimal surgical strategy. We present a rare case of a spinal endodermal cyst and discuss its diagnostic difficulty during the intraoperative pathological examination. Case Description: An 18-year-old male presented with progressive paraparesis and precordial oppression. Magnetic resonance (MR) imaging revealed an intradural extramedullary cystic mass having the same signal intensity as cerebrospinal fluid (CSF) without gadolinium enhancement at the T1-T2 level. The preoperative diagnosis was an endodermal or arachnoid cyst. The patient underwent surgery. An intraoperative frozen section showed a cyst wall consisting of loose, thin, fibrous tissue intermittently covered by flattened epithelium. The diagnosis was an arachnoid cyst. Accordingly, partial resection of the cyst wall was performed to create CSF communication between the cyst and subarachnoid space. However, the postoperative pathological diagnosis from permanent sections was an endodermal cyst, which was lined with ciliated columnar epithelium that was immunopositive for cytokeratin and epithelial membrane antigen. Subsequent paraffin embedding and immunostaining of the intraoperative frozen sample also confirmed patchy cytokeratin expression by all flattened epithelial cells. The patient's cyst had refilled 10 months after surgery, and he subsequently underwent fenestration of the cyst wall and placement of a cyst-subarachnoid shunt. Conclusion: Examination of multiple samples from multiple sites or intraoperative immunostaining of frozen sections is recommended for accurate intraoperative diagnosis of endodermal cysts.
Kikkawa, Yuichiro; Nakamizo, Akira; Suzuki, Satoshi O; Tanaka, Shunya; Tsuchimochi, Ryosuke; Amano, Toshiyuki; Yoshimoto, Koji; Mizoguchi, Masahiro; Iwaki, Toru; Sasaki, Tomio
By using an antiserum against isolated cyst walls from resting cysts of the ciliate Colpoda inflata, cyst wall polypeptides have been identified by immunoblotting test. Likewise, an immunoelectron microscopical study on both complete resting cysts and isolated cyst walls to localize the cyst wall proteins recognized by the antiserum, has been carried out. The immunoblotting test showed that three main polypeptide bands were recognized by the antiserum, with tentative molecular weights of 61, 66 and 70 kDa respectively. This methodology provides a better identification of cyst wall proteins after electrophoretic separation of cyst wall samples from ciliate resting cysts. PMID:1905585
Martin-Gonzalez, A; Benitez, L; Cortadellas, N; Gutierrez, J C
A simple spectrophotometric method for the determination of phosphate in soil, detergents, water, bone and food samples through the formation of phosphomolybdate complex followed by its reduction with thiourea
A simple spectrophotometric method is developed here for the determination of phosphate present in the samples of soil, detergents, water, bone and food based on the formation of phosphomolybdate complex with the added molybdate followed by the reduction of the complex with thiourea in aqueous sulfuric acid medium. The system obeys Beer's law at 840 nm in the phosphate concentration range, 0.5-10.0 ?g/ml. Molar absorptivity, correlation coefficient and Sandell's sensitivity values are found to be 1.712 mol -1 cm -1, 0.9769 and 0.0555 ?g cm -2 respectively. For a comparison of the results determined from the developed method, phosphate present in the same set of samples is determined separately following an official method. The results of the developed method are agreeing well with those of the official phosphomolybdate method.
Shyla, B.; Mahadevaiah; Nagendrappa, G.
A simple spectrophotometric method for the determination of phosphate in soil, detergents, water, bone and food samples through the formation of phosphomolybdate complex followed by its reduction with thiourea.
A simple spectrophotometric method is developed here for the determination of phosphate present in the samples of soil, detergents, water, bone and food based on the formation of phosphomolybdate complex with the added molybdate followed by the reduction of the complex with thiourea in aqueous sulfuric acid medium. The system obeys Beer's law at 840 nm in the phosphate concentration range, 0.5-10.0 ?g/ml. Molar absorptivity, correlation coefficient and Sandell's sensitivity values are found to be 1.712 mol(-1) cm(-1), 0.9769 and 0.0555 ?g cm(-2) respectively. For a comparison of the results determined from the developed method, phosphate present in the same set of samples is determined separately following an official method. The results of the developed method are agreeing well with those of the official phosphomolybdate method. PMID:21145780
Shyla, B; Mahadevaiah; Nagendrappa, G
Echinococcal cysts usually involve the liver; extrahepatic localization is reported in 11% of all cases of abdominal hydatid disease. We report a case of a prevesical hydatid cyst. A 53-year-old man was admitted with a large suprapubic mass. Ultrasonography and computed tomography revealed a cystic mass situated in front of the urinary bladder. There were no cysts in any other location. Serological tests were positive for Echinococcus. The patient was operated on and the cyst was completely excised. The pathologic examination confirmed the diagnosis of Echinococcosis. Isolated hydatid cyst situated in front of the urinary bladder has never been described in the literature. Hydatid cyst should always be considered in the differential diagnosis of abdominopelvic masses in endemic regions, before any procedure like puncture, biopsy or cystectomy, in order to avoid dissemination of the cystic contents or an anaphylactic shock. PMID:18953152
Chokki, A; Zribi, R; Nouira, S; Dziri, Ch
We report a baby with an unusual umbilical cord swelling. On the antenatal scans, a cystic area within the umbilical cord near its insertion onto the abdominal wall was detected. Postnatally an unusually thick umbilical cord with a yellow fluid filled cyst at the base was noted. The fluid from the cyst was confirmed as urine and ultrasound confirmed patent urachus. The baby underwent a cystoscopy and excision of patent urachus with associated allantoic cyst. Allantoic cyst is a rare swelling formed at the base of umbilicus associated with a patent urachus which results from an allantoic remnant. Paediatricians need to be aware about this condition as investigation is required to differentiate allantois cysts from umbilical pseudocysts. A patent urachus with allantoic cyst requires surgical excision.
Gupta, N; Corbett, H; Ismail, R; Sathanantharajah, R; Sivakumar, S; McCarthy, Liam
Tarlov's cyst or perineurial cyst is disease on portion of the posterior nerve root in lumbo-sacral region. The lack of knowledge of physicians around the world about Tarlov's cyst as to their nature, significance and treatment also with differential diagnostics to radiculopathy in legs. With review of literature discuss about definition, etiopathogenesis, diagnostic investigation and treatment clinic and/or surgery. The pathogenesis Tarlov's cyst remains unclear; several cases have history of the trauma, old hemorrhage, congenital and iatrogenic. Cysts provoke low back pain, sacral radiculopathy, dyspareunia, urinary incontence. The magnetic resonance imaging is now the gold standard to diagnose cysts. The treatment is clinic or surgery depending neurologics finding and neuroimage. PMID:18625096
De Sá, Márcia Cristina; D'Angelo, Carla Tereza; Da Ros Malacarne, Guilherme; Neto, Pedro; Pagura, Jorge
Serious complications following installation of a cyst-peritoneal shunt in an 8-year-old boy with asymptomatic arachnoid cyst in the middle cranial fossa are reported. Highly elevated intracranial pressure without association of ventriculomegaly seen in this patient indicates slit ventricle syndrome caused by malfunction of the cyst-peritoneal shunt. This phenomenon is worth recognizing as a possible consequence of cyst-peritoneal shunting for the
Nobuhiko Aoki; Tatsuo Sakai; Yoshihiro Umezawa
The magnitude of the protein divergence strongly suggests that Globodera<\\/u>rostochiensis<\\/u> and G.<\\/u>pallida<\\/u> have experienced hardly any morphological evolution during a time period of millions of years (chapter II). These morphologically nearly indistinguishable potato cyst nematode species are discriminated from one another by 70 % of their proteins revealed by two dimensional gel electrophoresis (2-DGE), which definitively excludes a recent divergence
The majority of pancreatic cysts are detected incidentally when abdominal imaging is performed during unrelated procedures. The aim of the present study was to assess the diagnostic utility and clinical value of carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA 19-9) and amylase analysis in pancreatic cyst fluid. The study included 52 patients with pancreatic cystic lesions, who underwent fine-needle aspiration biopsy to collect cystic fluid for cytological and biochemical analysis. Cysts were classified as benign (simple cysts, pseudocysts and serous cystadenomas) in 36 patients or premalignant/malignant (mucinous cyst-adenomas, intraductal papillary mucinous neoplasm and cystadenocarcinomas) in 16 patients. CEA and CA 19-9 were elevated in patients with malignant cysts (238±12.5 ng/ml and 222±31.5 U/ml, respectively) compared with benign lesions (34.5±3.7 ng/ml and 18.5±1.9 U/ml, respectively; P<0.001). Based on these results, the sensitivity and specificity of CEA were 91.8 and 63.9% and of CA 19-9 were 81.3 and 69.4%, respectively. Mean amylase levels in benign lesions (27825.7±91.9 U/l) were higher compared with malignant pancreatic cysts (8359.2±32.7 U/l; P<0.05). Cyst fluid analysis may prove a safe and useful adjunct for the differential diagnosis of pancreatic cystic lesions. In the present study, promising results for CEA and CA 19-9 have been demonstrated, however, the clinical value of these molecules must be confirmed.
TALAR-WOJNAROWSKA, RENATA; PAZUREK, MAREK; DURKO, LUKASZ; DEGOWSKA, MALGORZATA; RYDZEWSKA, GRAZYNA; SMIGIELSKI, JACEK; JANIAK, ADAM; OLAKOWSKI, MAREK; LAMPE, PAWEL; GRZELAK, PIOTR; STEFANCZYK, LUDOMIR; MALECKA-PANAS, EWA
... below an area of the brain called the cerebral cortex. These cysts can grow in size and number. ... subcortical cysts? ataxia ; atrophy ; autosomal ; autosomal recessive ; cell ; cerebral cortex ; coma ; cysts ; difficulty swallowing ; dysarthria ; dysphagia ; dystonia ; gene ; ...
A 67-year-old man presented with persistent penis and scrotum pain due to S-2 and S-3 radiculopathy caused by a sacral perineural cyst. The cyst was treated with microsurgical partial cyst removal and cyst wall imbrication, together with closure of the point through which cerebrospinal fluid (CSF) flowed from the subarachnoid space into the cyst cavity. His pain resolved without recurrence of the cyst or complications. Symptomatic perineural cysts are quite rare. Surgical closure of the point through which CSF flows from the subarachnoid space into the cyst cavity is the most important intervention for symptomatic perineural cysts. If the source of CSF leakage cannot be detected, placement of a cyst-subarachnoid shunt should be considered in addition to partial cyst removal and cyst wall imbrication. PMID:22198114
Matsumoto, Hiroaki; Matsumoto, Shigeo; Miki, Takanori; Miyaji, Yuki; Minami, Hiroaki; Masuda, Atsushi; Tominaga, Shogo; Yoshida, Yasuhisa; Yamaura, Ikuya; Natsume, Shigeatsu; Yoshida, Kozo
...2010-01-01 false Hogs affected with tapeworm cysts. 311.24 Section 311.24 ...PARTS Â§ 311.24 Hogs affected with tapeworm cysts. Carcasses of hogs affected with tapeworm cysts (Cysticercus cellulosae) may be...
...2009-01-01 false Hogs affected with tapeworm cysts. 311.24 Section 311.24 ...PARTS Â§ 311.24 Hogs affected with tapeworm cysts. Carcasses of hogs affected with tapeworm cysts (Cysticercus cellulosae) may be...
Objective. This report describes 3 cases of ciliated epithelium-lined radicular cysts among 256 apical periodontitis lesions and also illustrates the occurrence of an Actinomyces-infected periapical cyst. Study Design. Serial and step serial sections of 256 plastic-embedded root apices with attached apical periodontitis lesions that were prepared for a previous investigation were reviewed for the presence of ciliated epithelium-lined radicular cysts.
P. N. Ramachandran Nair; Gion Pajarola; Hans-Ulrich Luder
Perineural cysts are common and usually detected incidentally during magnetic resonance imaging of the lumbosacral spine. Treatment is indicated only when the cyst is symptomatic. We report one such patients presented with cauda equina syndrome and another with low back pain with claudication. They underwent excision and duraplasty; both motor and sensory fibres were carefully separated from the cyst wall using a nerve root retractor and penfield. There was no nerve root damage or neural deficit. Symptoms were relieved postoperatively. PMID:22535818
Sen, Ramesh Kumar; Goyal, Tarun; Tripathy, Sujit Kumar; Chakraborty, Soumya
An eight-year-old female border collie was referred with a two-month history of faecal tenesmus. Ultrasonography and radiology identified fluid-filled masses in the cranial vagina. The fluid was drained from the vaginal cysts via an episiotomy and the clinical signs resolved. Histological examination confirmed that the cysts were of urogenital origin. This is believed to be the first report of vaginal cysts causing faecal tenesmus in the dog. PMID:7474963
Cauvin, A; Sullivan, M; Harvey, M J; Thompson, H
This is an online activity about simple machines. Learners will try their hand at putting these amazing devices to work. They will use several simple machines to help "build" a tree house. This is an excellent activity to demonstrate how science - in particular, simple machines - are at work in our every day lives.
Scrotal calcinosis, consisting of solitary or multiple circumscribed deposits of calcium within the dermis of the scrotum, has generally been assumed to be idiopathic. We have recently examined three patients in whom scrotal epidermoid cysts in varying stages of inflammation coexisted with scrotal calcinosis. Some cysts showed calcification of their keratin contents with little evidence of active inflammation. Other cysts showed rupture of their epithelial walls associated with the presence of keratin fibers, granulomatous inflammation, and calcium granules in the surrounding dermis. It seems that so-called idiopathic scrotal calcinosis may represent the end stage of dystrophic calcification associated with the inflammation of scrotal epidermoid cysts. PMID:7149755
Swinehart, J M; Golitz, L E
Hydatidosis is an endemic affection in Tunisia. Cerebral echinococcosis is a relatively rare entity accounting for only 1-2% of all hydatid cysts in humans. Extradural hydatid cyst of the posterior fossa is a very uncommon site for the disease. We report the case of a four-year-old child admitted for high intracranial pressure. Brain CT scan showed an extradural posterior fossa cyst without enhancement after contrast medium injection. Operative finding revealed a hydatid cyst. The histological examination of the tissue sample confirmed the diagnosis. The patient was given albendazole post operatively. She feels well six months later. PMID:17434701
Braham, E; Bellil, S; Bellil, K; Chelly, I; Mekni, A; Haouet, S; Kchir, N; Khaldi, M; Zitouna, M
Hydatidosis is an endemic disease in Morocco. Cerebral echinococcosis is a relatively rare entity accounting for only 1-2% of all hydatid cysts in humans. Extradural hydatid cyst of the posterior fossa is a very uncommon site for the disease: only four cases have been reported in the literature. We report the case of a 37-year-old admitted for high intracranial pressure. Brain MRI showed an extradural and extracranial posterior fossa cyst without enhancement after contrast medium injection. Multiple hydatid cysts were removed and the histological examination of the tissue sample confirmed the diagnosis. The patient was given albendazole postoperatively with good follow-up 6 months later. PMID:20138319
Lakhdar, F; Arkha, Y; Bougrine, M; Derraz, S; El Ouahabi, A; El Khamlichi, A
Abstract Purpose Since its first detailed description in 1995, the laparoscopic management of neonatal ovarian cysts has typically required multiple incisions, specialized equipment, and advanced laparoscopic skills. After some initial frustration with neonatal laparoscopy, we developed a simplified single-incision laparoscopic-assisted transumbilical extracorporeal cystectomy (LATEC). This paper reviews our experience with this technique and compares outcomes to those of our other surgically managed neonatal ovarian cyst patients. Materials and Methods A retrospective record review of 20 patients treated surgically between 1992 and 2006. Student's t-tests were used for comparisons (P < 0.05 was significant). Results Means were: age, 11 days; weight, 3.7 kg; and cyst diameter, 5.0 cm. Nineteen patients were diagnosed prenatally, at the mean gestational age of 33 weeks. Twelve of 20 (60%) had torsed cysts (1 bilateral). Three of 13 torsed cysts (23%) were less than 4 cm diameter (range, 2.9–3.5). Laparotomies were transverse lower abdominal incisions. Laparoscopic operations used 2 (3 patients) or 3 incisions (2 patients). LATEC involved transumbilical laparoscopy, complete cyst aspiration, and then cyst evisceration through the umbilicus for either ovarian cystectomy (simple cysts) or salpingo-oophorectomy (torsed cysts). Laparoscopic patients had similar time to feeds, length of stay, and postoperative narcotic requirements, when compared to laparotomy patients (P = nonsignificant). LATEC patients had shorter surgical times, more rapid advancement to full enteral feedings, shorter length of hospital stay, and equal ovarian preservation, when compared to laparoscopy. Cosmetic results with LATEC were outstanding. Conclusions Both laparoscopic and “open” approaches have acceptable perioperative morbidity and rapid recovery. LATEC is a relatively simple procedure, which combines laparoscopy and traditional extracorporeal surgery, and may be successfully performed by experienced pediatric surgeons and with a single incision.
Schenkman, Lucy; Weiner, Timothy M.
Symptomatic sacral perineural cysts are uncommon. Several hypotheses have been proposed to explain the etiologies of perineural cysts, but the accurate etiologies remain unclear. We experienced two cases of symptomatic sacral perineural cysts (Tarlov cysts) in one family, who presented with perianal paresthesia. Both of them were operated and postoperatively their symptoms were disappeared immediately. We experienced the excellent treatment outcome with the surgical management of symptomatic perineural cysts in the sacral region. We assume that the theory of congenital origin including a familial tendency is the most plausible of the hypotheses that have been proposed.
Park, Hyun Jun; Lee, Sang Won; Son, Byung Chul
Symptomatic sacral perineural cysts are uncommon. Several hypotheses have been proposed to explain the etiologies of perineural cysts, but the accurate etiologies remain unclear. We experienced two cases of symptomatic sacral perineural cysts (Tarlov cysts) in one family, who presented with perianal paresthesia. Both of them were operated and postoperatively their symptoms were disappeared immediately. We experienced the excellent treatment outcome with the surgical management of symptomatic perineural cysts in the sacral region. We assume that the theory of congenital origin including a familial tendency is the most plausible of the hypotheses that have been proposed. PMID:19096672
Park, Hyun Jun; Kim, Il Sup; Lee, Sang Won; Son, Byung Chul
Solitary cyst is a place of osteolytic bone loss. In this paper presents the biomechanical aspect of the remodeling and adaptation of the topology of the calcaneus suffering from this disease, which leads to the avoidance of pathological fracture. PMID:23050417
Lorkowski, Jacek; Mrzyg?ód, Miros?aw; H?adki, Waldemar
You will be learning about several types of simple machines. Have fun!! Review the first website (which is right here!! Simple machines) . It has information about simple machines. DON\\"T click until you read all directions!!! Prepare to discuss each type in class. You will need to take some basic notes about each machine, using a bubble-map format. Don\\'t forget ...
Hydatid disease of the spleen is a rare condition. The standard treatment is open total or partial splenectomy. Recently hand assisted laparoscopic total splenectomy for splenic hydatid cyst has been reported. A case is described of splenic hydatid cyst in a 45 year old man that was excised laparoscopically; the related literature is reviewed.???Keywords: hydatid disease; spleen; laparoscopy; Jordan
Tactics and results of surgical treatment of 5 patients for splenic cyst were analyzed. The original method of splenic cyst resection, using blood-preserving technologies (ultrasonic aspirator-destructor, the argon laser and hemostatics) was applied. The data obtained permit to consider the splenic resection performance an adequate procedure for the focal organ pathology treatment. PMID:18982720
Lifshits, Iu Z; Valetski?, V L; Za?chenko, P A; Savitski?, R V; Sychev, V A; Iarovo?, A V
We report the case of a child with frequent episodes of arms and neck hypertonia and regurgitation. These characteristics, associated with an esophagitis, suggested the diagnosis of gastroesophageal reflux disease (Sandifer syndrome?). Because after an appropriate therapy the symptoms didn't disappear, a neurological disorder was suspected: MRI showed two bulky intramedullary cysts. After the removal of the cysts symptoms resolved. PMID:16922053
De Palma, Alessandra; Pattarino, Giulia; Paccagnini, Susanna; Stringhi, Carlo; Zibordi, Federica
Primary epidermoid cyst of the salivary gland is extremely rare and has only been reported once in the parotid gland A case\\u000a of epidermoid cyst of the submandibular gland is presented, which required excisional biopsy for the diagnosis. Such excision\\u000a is also curative.
Sunil N. Dutt; Y L Hock; Yousuf Saleem; Nazir Bhat; David M East
The so-called idiopathic scrotal calcinosis does not appear to be idiopathic, but rather a process of dystrophic calcification of epidermal cysts. We report a case that would be otherwise called "idiopathic" where we found squamous epithelial lining around the calcified masses. Literature is reviewed in support of the view that the calcified scrotal nodules are related to epidermal cysts. PMID:6482461
Sarma, D P; Weilbaecher, T G
We describe a ciliated hepatic foregut cyst that was clinically considered neoplastic because it was large, bilocular, and associated with a high serological level of carbohydrate antigen 19-9 (CA 19-9). Histologically, the wall of the cyst showed characteristic pseudopapillae lined by ciliated stratified columnar epithelium with interspersed goblet cells and underlying smooth muscle. The epithelium was strongly immunoreactive for CA
Mark Li-cheng Wu; Michael M. Abecassis; M. Sambasiva Rao
Tunica albuginea (TA) cyst is the most common extratesticular benign mass, which is usually palpable. Ultrasound examination is the imaging modality of choice to characterize palpable testicular lesions. This pictorial essay presents the spectrum of sonographic features of TA cysts in order to assist radiologists in making the correct diagnosis and avoid unnecessary surgeries.
Alvarez, Daniel M.; Bhatt, Shweta; Dogra, Vikram S.
BACKGROUNDThe surgical indications and management of posterior fossa arachnoid cysts (AC) are still controversial. Different surgical techniques and management have already been suggested for arachnoid cysts of the posterior fossa. AC involving the posterior fossa and especially the cerebellopontine angle may carry a high surgical morbidity because of the involvement of important neurovascular structures (e.g., brain stem and cranial nerves).
Madjid Samii; Gustavo A Carvalho; Martin U Schuhmann; Cordula Matthies
Arachnoid cysts (ACs) are relatively common intracranial mass lesions, which occur most often in the middle cranial fossa. While these lesions can present as a mass lesion, many are asymptomatic. Rarely, posttraumatic or spontaneous rupture of ACs can result in intracystic hemorrhage, subdural hematoma or subdural hygroma. We have encountered two cases of ruptured arachnoid cysts that resulted in subdural
Jill W. Donaldson; Mary Edwards-Brown; Thomas G. Luerssen
Surgery is considered to be the standard therapy for arachnoid cysts (ACs). We report the case of a 13-year-old boy in whom a right temporal AC disappeared spontaneously over a period of 10 years. Bulging of the right temporal skull led to the detection of the cyst by computed tomography (CT) scan at the age of 3 years. There were
R. Weber; T. Voit; C. Lumenta; H.-G. Lenard
Spinal intradural arachnoid cysts are seen most frequently in the thoracic region, particularly near the midline posteriorly. A thoracic intradural arachnoid cyst in this typical location is reported, with the additional unusual finding of herniation of the spinal cord through an anterior defect in the dura mater. The MRI findings are described.
J. P. Slavotinek; M. R. Sage; B. P. Brophy
The immunohistological features and surgical treatment of an intramedullary ependymal cyst in the conus medullaris is presented. An intramedullary ependymal cyst is a rare lesion of dysembryoplastic origin. There have been only seven patients reported with pathologically proven ependymal cysts in the conus medullaris. A 64-year-old woman reported pain and numbness in both thighs and feet. Neither sensory nor motor impairment was present in the lower extremities. MRI revealed a cyst on the right side of the conus medullaris, compressing the spinal cord upward. Clinical signs and symptoms disappeared following surgical resection of the cyst. Histological examination showed that this cyst was lined with a single layer of tall columnar or low cuboidal cells on fibrous connective tissue. The basement membrane was absent in the cyst wall. Reactivity to CAM5.2 and AE1/AE3 anti-keratin antibodies suggested that the cyst was of neuroepithelial origin. No recurrence has been noted 3 years after surgery. PMID:20036544
Nagano, Satoshi; Ijiri, Kosei; Kawabata, Ryodai; Zenmyo, Michihisa; Yone, Kazunori; Kitajima, Shinichi; Komiya, Setsuro
A 25-year-old man presented with left lumboischialgia refractory to medical treatment. Neurological examination revealed L5 and S1 radiculopathy which rapidly worsened over a short period. Magnetic resonance imaging demonstrated disk bulging with a discal cyst at the L4-5 intervertebral space and disk herniation at the L5-S1 intervertebral space. Computed tomography showed osteolytic change of the L5 vertebral body adjacent to the cyst. Resection of the cyst and removal of the herniated disk were performed following fenestration of the L4-5 and L5-S1 interlaminar spaces. Bloody serous fluid followed by clear serous fluid was recognized during the aspiration and partial resection of the cyst at the L4-5 level. Histological examination demonstrated a cyst wall consisting of fibrous connective tissue without a single-layer lining of cells, and fibrin deposits. The patient's symptoms disappeared immediately after the operation. This osteolytic lumbar discal cyst possibly occurred subsequent to hemorrhage from the epidural venous plexus following intervertebral disk injury, hematoma encapsulation by connective fibrous tissue, and cyst wall formation in reaction to the disk injury and hemorrhage. The cyst may have enlarged due to the inflow of the serous fluid from the water-containing degenerated disk. PMID:18719328
Marushima, Aiki; Uemura, Kazuya; Sato, Naoaki; Maruno, Toru; Matsumura, Akira
An 18-year-old female patient developed a mass in the superomedial angle of her left orbit. After evaluation, this tumor was surgically removed. A dysembryoplastic cyst lined with conjunctival epithelium was diagnosed by light microscopic examination. Clinical and pathological data are detailed. The characteristics of dysembryoplastic orbital cysts are reviewed. PMID:11139706
Meyer, A; Desjardins, L; D'hermies, F; Renard, G
Background: Hydatid disease is a parasitic infection caused by Echinococcus granulosus, characterized by cystic lesions in the liver, lungs, and, rarely, in other parts of the body. The large cysts in the lung are a special clinical entity called giant hydatid cysts. Characteristics on presentation, operative techniques, and postoperative morbidity and mortality rates in 47 patients with 50 giant pulmonary
Semih Halezeroglu; Muharrem Celik; Aziz Uysal; Canan Senol; Murat Keles; Bulent Arman
Background Simple cysts found within the filum terminale of infants on lumbar spine sonography are relatively common, but no study has\\u000a established their clinical significance.\\u000a \\u000a \\u000a \\u000a Objective To obtain information on the sonographic features of isolated filar cysts and determine their clinical significance in comparison\\u000a with age- and sex-matched controls.\\u000a \\u000a \\u000a \\u000a Materials and methods We performed a retrospective review of 644 consecutive spine sonograms in
Neville Irani; Asha R. Goud; Lisa H. Lowe
At this website, EdHeads, a nonprofit, offers five interactive, animated modules to educate second- through sixth-graders about simple machines. By identifying the many machines located throughout a house, students can learn about fulcrums, wheel and axles, levers, pulleys, inclined planes, and much more. The website is equipped with simple animations to help children understand how the machines work. After students have a handle on simple machines, they can begin to see how they work together to create compound machines. The website also provides a brief glossary summarizing nine types of simple machines. This site is also reviewed in the February 18, 2005_NSDL Physical Sciences Report_.
Although most of sacral perineural cysts are asymptomatic, some may produce symptoms. Specific radicular pain may be due to distortion, compression, or stretching of nerve root by a space occupying cyst. We report a rare case of S1 radiculopathy caused by sacral perineural cyst accompanying disc herniation. The patient underwent a microscopic discectomy at L5-S1 level. However, the patient's symptoms did not improved. The hypesthesia persisted, as did the right leg pain. Cyst-subarachnoid shunt was set to decompress nerve root and to equalize the cerebrospinal fluid pressure between the cephalad thecal sac and cyst. Immediately after surgery, the patient had no leg pain. After 6 months, the patient still remained free of leg pain.
Ju, Chang Il; Shin, Ho; Kim, Hyeun Sung
Hydatid disease, a parasitic infection is caused by Echinococcus granulosus. It has serious impact on health and economy especially in countries where it is endemic. It occurs frequently in liver and lung. The disease is chronic and cyst can localize in different organs. A hydatid cyst occurrence in the head and neck is extremely rare. To know the distribution of disease can help in its control and prevention. We report a case of primary cervical hydatid cyst in 20 year old female. A high index of suspicion is required to diagnose hydatid cyst in rare locations like this. Hydatid cyst should be considered in differential diagnosis of benign swellings of head and neck region, so that it can be managed during surgery to prevent acute anaphylaxis. Virtual slides The virtual slides’ for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/4915595218376646
During Acanthamoeba castellanii trophozoite-cysts differentiation, four morphological stages were identified by scanning electron microscopy: trophozoite, precyst, immature cysts, and mature cysts. Fluorescence microscopy reveals the presence of small cumulus of actin in the cytoplasm of precysts after treatment with rhodamine phalloidin. By the contrary, in mature cysts, fluorescence was not observed. However, when excystation was induced, large fluorescent patches were present. By transmission electron microscopy, encysting amebas showed small cytoplasmic vesicles containing fibrillar material, surrounded by a narrow area of thin fibrils. Similar appearance was observed in pseudopods and phagocytic invaginations. In addition, large aggregates of rod-shape elements, similar to the chromatoid bodies, described in other amebas, were present in the cytoplasm. These cysts presented large areas with orange fluorescence after treatment with acridine orange. PMID:23319266
Chávez-Munguía, Bibiana; Salazar-Villatoro, Lizbeth; Lagunes-Guillén, Anel; Omaña-Molina, Maritza; Espinosa-Cantellano, Martha; Martínez-Palomo, Adolfo
Arachnoid cysts are frequent incidental findings on neuroimaging studies and in clinical practice. Theories of their origin, still matter for debate, compose four categories: 1) a ball-valve mechanism; 2) an osmotic gradient between the intra- and extracystic medium; 3) primary malformation of the arachnoid membrane or cerebral lobe agenesis; and 4) fluid hypersecretion by the lining cells of the cyst wall. The cause of cyst enlargement is also debatable, although there is strong controversial evidence supporting the last two theories rather than the former. Brain water homeostasis and its regulatory pathways are weakly understood at the molecular level. In this brief report the authors attempt to add new insights into the pathogenesis of arachnoid cysts by considering aquaporin expression in the cyst wall and discuss possible future research directions and molecular targets. PMID:17608347
Basaldella, Luca; Orvieto, Enrico; Dei Tos, Angelo Paolo; Della Barbera, Mila; Valente, Marialuisa; Longatti, Pierluigi
The aim of the study is to evaluate the clinical application in veterinary orthopedics of bone marrow mononuclear cells (BMMNCs)\\u000a and cultured bone marrow stromal cells (cBMSCs) for the treatment of some orthopaedic lesions in the dog. The authors carried\\u000a out a clinical study on 14 dogs of different breed, age and size with the following lesions: 1 bone cyst
A. Crovace; A. Favia; L. Lacitignola; M. S. Di Comite; F. Staffieri; E. Francioso
Cyst formation and growth in autosomal dominant polycystic kidney disease. Previous morphologic studies on kidneys from adult patients with autosomal dominant polycystic kidney disease (ADPKD) indicates that the cysts developed from nephrons and collecting ducts in association with hyperplasia of epithelial cells lining the cyst walls. In the present study, we systematically evaluated by scanning electron microscopy 387 cysts in
Jared J Grantham; James L Geiser; Andrew P Evan
Arachnoid cysts which develop in relation to the cerebral hemispheres are usually found in the middle cranial fossa. These cysts are usually asymptomatic but can produce symptoms if there is haemorrhage into the cyst or the development of an associated subdural hematoma. Recent publications have emphasised the association of arachnoid cysts of the middle fossa with subdural haematomas. This report
P A Cullis; J Gilroy
Objective: To assess the role of infection in the management of children with urachal cysts.Methods: A retrospective study on 10 children with urachal cysts operated on over an 11–year period (from 1987 to 1998) was performed. Uncomplicated urachal cysts were found in 2 children who underwent primary cyst removal. The remaining 8 were admitted with severe sepsis due to the
Ciro Pesce; Lorenzo Costa; Luciano Musi; Paolo Campobasso; Leoluca Zimbardo
The authors present their experience with the evaluation and follow-up of 62 patients with primary cysts of the iris, discuss their clinical and pathological features, and propose a simple classification for these lesions. The results suggest that the great majority of primary iris cysts, particularly those which arise from the iris pigment epithelial layers, are stationary lesions which rarely progress or cause visual complications. This finding is contradictory to the belief of certain authorities who stress that many such lesions lead to severe complications, with blindness and loss of the eye. The natural course of primary epithelial cysts differs from that of secondary iris cysts which follow surgical or nonsurgical trauma. The latter lesions do frequently enlarge and lead to severe complications such as inflammation and glaucoma. The major clinical importance of primary iris cysts lies in their similarity to neoplasms of the iris and ciliary body. It is concluded that the great majority of them are ophthalmic curiosities which require no treatment. Images
Shields, J. A.; Kline, M. W.; Augsburger, J. J.
Thymic cysts are rarerly encountered lesions which are only 1 to 2% of all mediastinal masses. We present six patients with thymic cysts diagnosed between 2000 and 2004 in this report. There were three male and three female patients whose ages ranged from 34 to 64 years (mean age, 46 years). Four patients are nonsmoker. None of the patients had a previous history of an etiologic factor such as trauma, surgical procedure or evidence of significant inflammation. While one patient was asymptomatic, there were chest pain in three patients, cough in two patients, hemoptysis in two patients and dyspnea in one patient. Thymic cyst was located in anterior mediastinum in five patients and in upper mediastinum in one patient. Cysts were resected with thoracotomy in four cases and with sternotomy in two cases. Their size ranged from 5 to 9 cm in diameter. In pathologic examination, two cysts were multilocular. In conclusion, thymic cysts are rare masses. Differential diagnosis of mediastinal masses, especially anterior mediastinal masses should be included thymic cysts. PMID:16924575
Ertu?rul, Müyesser; Bayram Selvi, Ummühan; Damado?lu, Ebru; Arinç, Sibel; Sulu, Ebru; Ya?ci Tuncer, Leyla; Atasalihi, Ali; Yilmaz, Adnan
Abstract Objective: Fetal ovarian cysts (FOCs) are the most common intra-abdominal cystic structures formed during antenatal period. The aim of this study was to evaluate prenatal characteristics and postnatal outcome of sonographically suspected FOCs. Methods: We reviewed prenatal sonographic data and postnatal medical records of 29 fetuses that were suspected to have ovarian cysts in our hospital, between January 2001 and September 2012. Perinatal outcomes were obtained for all cases. Results: In a total of 29 cases, we confirmed initial antenatal diagnosis of ovarian cyst in 20 cases (68.9%) at postnatal period. Diagnosis of remaining nine cases revealed urogenital sinus anomaly in four cases, multicystic dysplastic kidney in two cases, mesenteric cyst in one case, intestinal duplication cyst in one case and lymphangioma in one case postnatally. In seven of the 20 ovarian cysts (35%), resolution of the cyst occurred prenatally. Intrauterine death of a fetus occurred at second trimester. In the postnatal period, most often cases (11/20) were spontaneously resolved and surgery was performed on two babies due to ovarian torsion (2/20). Conclusion: Differential diagnosis of FOCs should always include genitourinary tract disorders, gastrointestinal tract disorders and other intra-abdominal cystic structures. PMID:23617816
Turgal, Mert; Ozyuncu, Ozgur; Yazicioglu, Aslihan
A recent study describing two epileptic patients with brain cysts has suggested that elevated concentrations of excitatory amino acids in cysts may play a role in induction and maintenance of epileptogenesis [Epilepsy Res. 28 (1997) 245]. Here, we report that only in 3 out of 22 patients with brain cysts undergoing brain surgery cyst fluids displayed highly increased amounts of
Heinz-Gregor Wieser; Uwe Rudolpha; Nenad Blau; Detlev Boison; Hans-Georg Imhof; René Bernays; Yasuhiro Yonekawae
This series of three interactive, multimedia activities introduce and demonstrate the properties of six simple machines. Specifically, the lessons show how levers, pulleys, inclined planes, screws, wheels and axles, and wedges can reduce the amount of work done by humans. After learning about the characteristics of each classification, users can try to find the simple machines that make up a lawn mower. By inspecting the mower from different angles, several simple machines are revealed and must be identified. The final activity lets users test their knowledge of the mechanics of simple machines. Following a builder through each stage of constructing a tree house, users can apply equations to determine the mechanical advantage supplied by using the tools.
Objective: Primary cysts constitute 25% of all masses in the mediastinum. Because radiological investigations are often inconclusive, many adults require mediastinoscopy, thoracotomy, video-assisted thoracic surgery, or computed tomography-guided transbronchial, transesophageal, or transcutaneous aspiration to confirm the cystic nature of these lesions. Minimally invasive procedures fail when the cyst contents are gelatinous and mucoid (failure to aspirate) or when the cyst wall continues to secrete fluid. Though Pursel reported mediastinoscopic extirpation of benign cysts 35 years ago, it remains a “therapeutic curiosity” with sporadic reports of its usage. We report 2 successful mediastinal cyst extirpations performed as out-patient procedures and review the literature with regards to its management. Methods: A rigid, 8-mm mediastinoscope was inserted into the anterior mediastinum following the creation of a 2-cm suprasternal incision and dissection along the anterior surface of the trachea. After aspiration, cytology of the contents revealed their benign nature. Right paratracheal cysts in 2 adult males were successfully removed mediastinoscopically by blunt and sharp dissection. Results: Histopathology revealed benign mesothelial cysts in both instances. Both patients had an uncomplicated procedure and were discharged within 23 hours. No other pathology was detected on mediastinoscopy, and follow-up at 3 months and 6 months has revealed no recurrence. Conclusion: Mediastinoscopic cyst removal is a minimally invasive procedure with a very low morbidity and mortality rate. Morbidity, recovery, and discharge times are much less than those of more invasive procedures (video-assisted thoracic surgery / thoracotomy). We suggest that it should be the first-choice procedure for the excision of appropriately located benign mediastinal cysts.
Taddeucci, Raymond; Arcidi, Joseph
Arachnoid cysts are cerebrospinal fluid collections in the spine that can present with neurological symptoms or be discovered accidentally. Intradural location of such cysts especially in the lumbosacral region is relatively rare. The association of such cysts with other congenital anomalies such as tethered cord lends evidence to the developmental origin of arachnoid cysts. We report a case of lumbosacral arachnoid cyst with tethered cord in a 6-year-old male child and discuss the etiopathogenesis and management options.
Jain, S. K.; Sundar, I. Vijay; Sharma, Vinod; Goel, Ravishankar S.
Post-traumatic cortical bone cyst is a rare occurrence in children. It is typically located in the distal radius, as a result of greenstick fracture. We report three cases referred to our fracture clinic as a tumour in bones. In one of our cases, the cystic lesion was noted following a displaced fracture in the femur, which is not previously published in the literature. The cyst-like lesion appeared as an oval radiolucency proximal to the previous fracture site on radiograph films. These lesions can cause concern for the on-call teams as they can mimic an infection or a tumour of the bone. We highlight the pathogenesis of the lesion with a review of the literature. PMID:17968207
Houshian, Shirzad; Pedersen, Niels Wisbech; Torfing, Trine; Venkatram, Navaneethakrishnan
BACKGROUND—Iris cysts in children are uncommon and there is relatively little information on their classification, incidence, and management.?METHODS—The records of all children under age 20 years who were diagnosed with iris cyst were reviewed and the types and incidence of iris cysts of childhood determined. Based on these observations recommendations were made regarding management of iris cysts in children.?RESULTS—Of 57 iris cysts in children, 53 were primary and four were secondary. There were 44 primary cysts of the iris pigment epithelium, 34 of which were of the peripheral or iridociliary type, accounting for 59% of all childhood iris cysts. It was most commonly diagnosed in the teenage years, more common in girls (68%), was not recognised in infancy, remained stationary or regressed, and required no treatment. The five mid-zonal pigment epithelial cysts were diagnosed at a mean age of 14 years, were more common in boys (83%), remained stationary, and required no treatment. The pupillary type of pigment epithelial cyst was generally recognised in infancy and, despite involvement of the pupillary aperture, also required no treatment. There were nine cases of primary iris stromal cysts, accounting for 16% of all childhood iris cysts. This cyst was usually diagnosed in infancy, was generally progressive, and required treatment in eight of the nine cases, usually by aspiration and cryotherapy or surgical resection. Among the secondary iris cysts, two were post-traumatic epithelial ingrowth cysts and two were tumour induced cysts, one arising from an intraocular lacrimal gland choristoma and one adjacent to a peripheral iris naevus.?CONCLUSIONS—Most iris cysts of childhood are primary pigment epithelial cysts and require no treatment. However, the iris stromal cyst, usually recognised in infancy, is generally an aggressive lesion that requires treatment by aspiration or surgical excision.?? Keywords: iris cysts; children
Shields, J.; Shields, C.; Lois, N.; Mercado, G.
This article discusses bone as a source of lead to the rest of the body and as a record of past lead exposure. Bone lead levels generally increase with age at rates dependent on the skeletal site and lead exposure. After occupational exposure, the slow decline in blood lead, a 5- to 19-year half-life, reflects the long skeletal half-life. Repeated measurements of bone lead demonstrate the slow elimination of lead from bone. Stable isotope ratios have revealed many details of skeletal uptake and subsequent release. The bulk turnover rates for compact bone are about 2% per year and 8% for spine. Turnover activity varies with age and health. Even though lead approximates calcium, radium, strontium, barium, fluorine, and other bone seekers, the rates for each are different. A simple, two-pool (bone and blood) kinetic model is presented with proposed numerical values for the changes in blood lead levels that occur with changes in turnover rates. Two approaches are offered to further quantify lead turnover. One involves a study of subjects with known past exposure. Changes in the ratio of blood lead to bone lead with time would reflect the course of bone lead availability. Also, stable isotopes and subjects who move from one geographical area to another offer opportunities. Sequential isotope measurements would indicate how much of the lead in blood is from current exposure or bone stores, distinct from changes in absorption or excretion.
Rabinowitz, M B
The purpose of this study was to investigate the surgical outcomes and to determine indicators of the necessity of surgical intervention. Twelve consecutive patients harboring symptomatic sacral perineural cysts were treated between 1995 and 2003. All patients were assessed for neurological deficits and pain by neurological examination. Magnetic resonance of imaging, computerized tomography, and myelography were performed to detect signs of delayed filling of the cysts. We performed a release of the valve and imbrication of the sacral cysts with laminectomies in 8 cases or recapping laminectomies in 4 cases. After surgery, symptoms improved in 10 (83%) of 12 patients, with an average follow-up of 27 months. Ten patients had sacral perineural cysts with signs of positive filling defect. Two (17%) of 12 patients experienced no significant improvement. In one of these patients, the filling defect was negative. In conclusion, a positive filling defect may become an indicator of good treatment outcomes. PMID:16508691
Tanaka, Masato; Nakahara, Shinnosuke; Ito, Yasuo; Nakanishi, Kazuo; Sugimoto, Yoshihisa; Ikuma, Hisanori; Ozaki, Toshifumi
As technology advances, the techniques of laparoscopic surgery are being refined and their aplication is expanding to include many disease processes and organs. The new-generation laparoscopic instruments are becoming smaller (less than 5 mm). Expected advantages include improvements in cosmesis and patient satisfaction, and decreased postoperative analgesic requirements. Non-neoplastic cysts of the spleen are rare, and their management has evolved from total open splenectomy to laparoscopic cyst decapsulation. A 22-year-old woman with a symptomatic 10-cm epithelial cyst was treated by splenic decapsulation with needlescopic instruments (3 mm or smaller). Three trocars were used: one 12-mm umbilical and two 3-mm subcostal ports. The cyst was punctured by a Veress needle, and after drainage of straw-coloured fluid, circumferential decapsulation with 5-mm laparoscopic shears through the umbilical port site was done. The patient was discharged within 24 hours, having had a single intramuscular injection of meperidine and an excellent cosmetic result.
Seshadri, Pieter A.; Poulin, Eric C.; Mamazza, Joseph; Schlachta, Christopher M.
Arachnoid cysts are very common lesions in paediatric patients, with treatment depending on their location and symptomatology. They are usually solitary cysts but may be associated with other central nervous system diseases such as tumours and congenital deformities. We describe the case of a neonate diagnosed with an arachnoid cyst of the quadrigeminal cistern treated by endoscopy. After the operation, the child's condition worsened; a CT scan revealed a midline posterior fossa tumour not visible in the preoperative neuroradiological tests. The tumour, a medulloblastoma, was partially removed. Given the child's age and the poor prognosis, oncological treatment was not undertaken. The association between medulloblastoma and arachnoid cyst is very rare, and we could find only one such case in the literature. PMID:23453310
Gelabert González, Miguel; Serramito-García, Ramón; Liñares Paz, Mercedes; Aran-Echabe, Eduardo; García-Allut, Alfredo
BackgroundIdiopathic arachnoid cysts are rare lesions not associated with trauma or other inflammatory insults. To date, there have been few large series describing the presentation and management of these lesions.
Michael Y Wang; Allan D. O Levi; Barth A Green
In all animals, germline cells differentiate in intimate contact with somatic cells and interactions between germline and soma are particularly important for germline development and function. In the male gonad of Drosophila melanogaster, the developing germline cells are enclosed by somatic cyst cells. The cyst cells are derived from cyst stem cells (CySCs) of somatic origin and codifferentiate with the germline cells. The fast generation cycle and the genetic tractability of Drosophila has made the Drosophila testis an excellent model for studying both the roles of somatic cells in guiding germline development and the interdependence of two separate stem cell lineages. This review focuses on our current understanding of CySC specification, CySC self-renewing divisions, cyst cell differentiation, and soma-germline interactions. Many of the mechanisms guiding these processes in Drosophila testes are similarly essential for the development and function of tissues in other organisms, most importantly for gametogenesis in mammals.
Zoller, Richard; Schulz, Cordula
Embryoanatomical peculiarities are responsible for low occurrence of inguinal hernias in females. Amongst them, ovarian hernias are rarer. They are commonly noticed in children. An attending surgeon commonly faces diagnostic and operative dilemmas in managing these overtly “simple-looking” clinical scenarios. Although ovarian cysts are one of the common contents of the sac, we report a case of adult incarcerated ovarian hernia who presented with a ruptured hemorrhagic ovarian cyst. This differential should be kept in mind while treating an adult female with painful inguinal swelling. As far our knowledge goes, such case with ruptured ovarian cyst presenting as an incarcerated hernia in an emergency scenario has not been reported as yet.
Jategaonkar, Priyadarshan Anand; Yadav, Sudeep Pradeep
A case of a true dermoid cyst in a Rhodesian ridgeback is described. The mass was located in the dorsal cervical midline at the level of the first cervical vertebra, and was resected surgically. In contrast to other types of dermoid sinus described in the literature, the mass did not have a tract connecting it to, nor an opening on to, the surface of the skin. A diagnosis of true dermoid cyst was made. PMID:11002937
Tshamala, M; Moens, Y
BackgroundSimultaneous or concomitant bilateral adnexal pathology is rare. But simultaneous tubal pregnancy and twisted ovarian cyst is even rarer.CaseA 25-year-old woman, gravida 2, parity 0, presented with acute abdomen after 12 weeks of amenorrhea. Simultaneous right tubal pregnancy and twisted left ovarian cyst were intraoperatively diagnosed. Right salpingostomy and left salpingo-oophorectomy were performed. The follow-up serum beta-hCG was negative at the
Vorapong Phupong; Somjate Manipalviratn
Intracerebral cysts and cystic appearing intracerebral masses are common findings at routine cerebral imaging examination. We discuss here the most interesting aspects of some intracerebral cysts encountered in medical practice in terms of imaging, clinical and pathological description, and problems of differential diagnosis. On an almost routine basis, the neurologists have to deal with such differentials. Therefore, we aim to mention here some of the frequently encountered diagnosis problems when a patient presents with a cystic cerebral mass.
Intracerebral cysts and cystic appearing intracerebral masses are common findings at routine cerebral imaging examination. We discuss here the most interesting aspects of some intracerebral cysts encountered in medical practice in terms of imaging, clinical and pathological description, and problems of differential diagnosis. On an almost routine basis, the neurologists have to deal with such differentials. Therefore, we aim to mention here some of the frequently encountered diagnosis problems when a patient presents with a cystic cerebral mass. PMID:23737706
Opri?an, Alexandra; Popescu, Bogdan O
We report a case of epidural hydatid cyst in the posterior fossa in a 5-year-old child. The disease was revealed by raised intracranial pressure with torticollis. The diagnosis was based on the brain CT scan and MRI, and confirmed surgically. The course was uneventful. Cranial epidural hydatid cysts are very rare: only 18 cases have been reported previously in the literature. PMID:11015677
Gazzaz, M; Bouyaakoub, F A; Akhaddar, A; Derraz, S; Elkhamlichi, A
Dermoid cysts are common tumors resulting from entrapped ectodermal elements at fetal suture lines. Management is conceptually straightforward, with surgical excision of the mass in its entirety without rupture. The conspicuous location and potential scarring from direct excision can be objectionable, particularly in children. The authors describe 2 cases using a hidden hairline incision and an endoscopic approach to remove dermoid cysts in the nasoglabellar region. PMID:20305523
Lee, Seongmu; Taban, Mehryar; Mancini, Ronald; Chong, Kelvin; Goldberg, Robert A; Douglas, Raymond S
Blood cysts of the mitral valve are mostly benign diverticuli lined by endothelium and filled with blood and can be safely monitored with echocardiographic follow-up. We report a case of asymptomatic blood cyst of the mitral valve in a 63-year-old woman referred for a systolic murmur. At 3-year echo follow-up, the patient is free from notable clinical events. PMID:22089814
Grimaldi, Antonio; Capritti, Elvia; Pappalardo, Federico; Radinovic, Andrea; Ferrarello, Santo; Cammalleri, Valeria; Collu, Egidio; Ammirati, Enrico; Fumero, Andrea; Benussi, Stefano; De Bonis, Michele; Zangrillo, Alberto; Alfieri, Ottavio
Eleven patients with sharply circumscribed round to ovoid renal cysts measuring 70-90 H on CT are reported. The cysts were hyperdense on unenhanced scans, measuring 30-60 H greater than the adjacent parenchyma, and either hypodense, isodense, or hyperdense on enhanced scans. Four patients had polycystic kidney disease; of the other 7 patients, the cysts were cortical in 6 and parapelvic in 1. Eight patients had a solitary cyst and 3 had multiple cysts. Sonography demonstrated internal echoes and/or lack of increased through-transmission in 6 patients. Pathological analysis was available in 6 cases and indicated a benign, hemorrhagic renal cyst. This hyperdense CT appearance is characteristic of some hemorrhagic renal cysts, though differentiation between benign and malignant cysts requires cyst puncture and/or surgery.
Sussman, S.; Cochran, S.T.; Pagani, J.J.; McArdle, C.; Wong, W.; Austin, R.; Curry, N.; Kelly, K.M.
Perineural cysts are believed to be asymptomatic; however, they rarely cause symptoms related to nerve root compression. Cervical symptomatic perineural cysts are in fact exceedingly rare. There are no reported cervical perineural cysts in the literature that present like cubital tunnel syndrome. A patient with motor weakness of the abductor and adductor muscles of the fingers of the left hand and hypoesthesia in the hypothenar region of the left hand presented at our clinic. A neurological examination, and neuroradiological and electrophysiological evaluations supported the finding that the patient's clinical condition was caused by a perineural cyst located around the C8 neural root. The neurological symptoms of the patient markedly improved after medical treatment. We reported the first cervical perineural cyst as presenting like cubital tunnel syndrome patient in the literature. The visualization of perineural cyst may need extra magnetic resonance imaging (MRI) sections in order to view the nerve root through the neural foramen or extraforaminal area. These lesions are benign, and the appropriate treatment is curative. PMID:21574015
Bayrakli, Fatih; Kurtuncu, Murat; Karaarslan, Ercan; Ozgen, Serdar
Cystic abdominal structures in first trimester fetuses are rare. In order to elucidate the clinical significance of first trimester abdominal cysts, we present three cases of the ultrasonographic detection of upper abdominal cysts in first trimester fetuses with spontaneous regression until birth. Cysts with maximum diameters of 20, 15 and 21?mm were diagnosed in the first scan at 12?+?3 weeks of gestation and two times at 13?+?0 weeks of gestation, respectively. They had echogenic walls, a longish shape and were all located in the upper part of the abdomen. Further anomalies, relevant maternal infections, the most frequent cystic fibrosis mutations and fetal chromosomal abnormalities were excluded. In all three cases follow-up scans showed similar characteristics: The relatively large intraabdominal cyst resolved during the early second trimester. A hyperdense structure of up to 24?mm close to the liver capsule was the sole prenatally detectable remnant. During the first months after birth, development of all three children was normal. Pediatric ultrasound examination reported subcapsular liver calcifications. In conclusion, these cases demonstrate that first trimester upper abdominal cysts with spontaneous resolution until birth are associated with a favorable outcome, if infections and additional anatomical or chromosomal anomalies are ruled out. Nevertheless, one should be aware that postnatal gastrointestinal complications have been described in a few cases, even if the cyst had resolved spontaneously in utero. PMID:22447294
Holschbach, V; Lattrich, C R; Ortmann, O; Müller, A M; Germer, U
Intracranial dermoid cysts are rare congenital lesions that typically occur in the cisternal spaces. However, exceptionally rare cases of intraaxial involvement have been reported, with only 8 cases having been described in the literature. The authors report the first case of an intraaxial dermoid cyst located in the medulla and the first occurrence in an elderly patient. They also review the literature of the existing intraparenchymal cases and provide treatment guidelines. A 66-year-old man presented with slowly progressive dysphagia, left lower-extremity numbness, nausea, and hyperhidrosis. Neurological examination revealed decreased pinprick sensation of the left side of his face and body, and decreased vibratory sensation in his left lower extremity. Additionally, he had an unusual extraocular movement in which abduction of the eye resulted in closure of the contralateral eye. Magnetic resonance imaging revealed a nonenhancing cystic lesion centered in the medulla. The patient underwent a suboccipital craniotomy with laminectomy of C1-2 for excision of the cyst, with subtotal resection due to adherence of the cyst wall to the brainstem. At follow-up 7.5 years after surgery, the patient's neurological examination was stable. Magnetic resonance imaging did not reveal any progression or recurrence of the cyst. As the cyst wall is typically adherent to surrounding structures, resection is usually subtotal due to the risk of neurological deficits. As there have been no cases of progression after subtotal resection, gross-total resection is not warranted for the treatment of these lesions. PMID:23621596
Park, Jong G; Babu, Ranjith; Kranz, Peter G; McLendon, Roger E; Adamson, Cory
With standardized English Language Arts exams on the horizon, the author thought a game of Antonyms would provide not only a quick language arts activity for her sixth graders, but also a nice segue to an art lesson in contrast. In this article, she describes a project, a simple saucer on a pedestal base, which required students to demonstrate…
We reported a unique case of posttraumatic giant infratentorial extradural intradiploic epidermoid cyst. A 54-year-old male, with a previous history of an open scalp injury and underlying linear skull fracture in the left occipital region in childhood, presented with a painful subcutaneous swelling, which had been developed gradually in the same region and moderate headache, nausea, vomiting and cerebellar ataxia. The duration of symptoms on admission was 3 months. Imaging studies revealed occipital bone destruction and giant extradural intradiploic lesion. The preoperative diagnosis was giant infratentorial extradural intradiploic epidermoid cyst. Surgery achieved total removal of the lesion, which was histologically confirmed and the postoperative course was uneventful. To our knowledge, this is the first case of giant infratentorial extradural intradiploic epidermoid cyst with a traumatic etiology described in the literature.
Kamenov, Bogidar; William, Alla; Karakostov, Vasil
A 4-year-old boy presented with history of left anterolateral neck swelling since birth. He was clinically diagnosed to have a branchial cleft cyst. A CT scan revealed findings suggestive of a thymic remnant cyst. The lesion was excised and the diagnosis was confirmed by histopathology. PMID:19881106
Daga, Bipin V; Chaudhary, V A; Dhamangaokar, V B
A 4-year-old boy presented with history of left anterolateral neck swelling since birth. He was clinically diagnosed to have a branchial cleft cyst. A CT scan revealed findings suggestive of a thymic remnant cyst. The lesion was excised and the diagnosis was confirmed by histopathology.
Daga, Bipin V; Chaudhary, VA; Dhamangaokar, VB
1. The vegetative forms of amebæ may be developed in vitro from the cysts. 2. The cysts of Entamœba tetragena and Entamœba coli each produce only a single vegetative individual. It has not been observed in vitro that a number of daughter amebæ, corresponding to the number of nuclei present in the cyst, emerge from the mother cyst, as claimed by Casagrandi and Barbagallo, Schaudinn, and a number of other investigators. 3. The daughter nuclei in the cystic stage correspond to the gamete nuclei of other protozoa. The syngamic nuclear union in the case of these two amebæ does not take place in the tetranuclear stage of the cyst, as claimed by Schaudinn and Wenyon, but during reproduction. 4. The process of autogamy of both amebæ is not restricted to two nuclei; it may involve more than two, which unite to form a syncaryon. In the case of all other protozoa, autogamy is restricted to two nuclei. 5. In order to distinguish the two types of autogamy, one has been termed simple autogamy and the other polynuclear autogamy. The latter may again be classified according to the number of nuclei involved, as trinuclear and tetranuclear autogamy. 6. The majority of cysts treated for 5 minutes in a 2 per cent solution of hydrochloric acid survives. 7. It was possible to demonstrate in vitro the developmental cycle of Entamœba tetragena. 8. No evidence of heterogamy has been observed in vitro in Entamœba tetragena or Entamœba coli. 9. The vegetative form of Entamœba tetragena, at a certain stage of its life cycle in vitro, shortly after its formation, has not only one or two, but may have as many as three or four nuclei.
1. The vegetative forms of amebae may be developed in vitro from the cysts. 2. The cysts of Entamoeba tetragena and Entamoeba coli each produce only a single vegetative individual. It has not been observed in vitro that a number of daughter amebae, corresponding to the number of nuclei present in the cyst, emerge from the mother cyst, as claimed by Casagrandi and Barbagallo, Schaudinn, and a number of other investigators. 3. The daughter nuclei in the cystic stage correspond to the gamete nuclei of other protozoa. The syngamic nuclear union in the case of these two amebae does not take place in the tetranuclear stage of the cyst, as claimed by Schaudinn and Wenyon, but during reproduction. 4. The process of autogamy of both amebae is not restricted to two nuclei; it may involve more than two, which unite to form a syncaryon. In the case of all other protozoa, autogamy is restricted to two nuclei. 5. In order to distinguish the two types of autogamy, one has been termed simple autogamy and the other polynuclear autogamy. The latter may again be classified according to the number of nuclei involved, as trinuclear and tetranuclear autogamy. 6. The majority of cysts treated for 5 minutes in a 2 per cent solution of hydrochloric acid survives. 7. It was possible to demonstrate in vitro the developmental cycle of Entamoeba tetragena. 8. No evidence of heterogamy has been observed in vitro in Entamoeba tetragena or Entamoeba coli. 9. The vegetative form of Entamoeba tetragena, at a certain stage of its life cycle in vitro, shortly after its formation, has not only one or two, but may have as many as three or four nuclei. PMID:19868451
Synovial cysts at the atlantoaxial level are found uncommonly. Lumbar symptomatic cases are treated by percutaneous cyst aspiration with or without corticoid injection or by surgical resection, but synovial cysts at the C1-C2 level are usually treated by surgery. We report here a 92-year-old woman with a retro-odontoid synovial cyst producing spinal cord compression that was treated by percutaneous aspiration of the cyst under CT guidance. To our knowledge, this is the first reported case of an atlantoaxial synovial cyst successfully treated with a minimally invasive procedure.
Velan, Osvaldo, E-mail: firstname.lastname@example.org [Hospital Italiano de Buenos Aires, Department of Radiology (Argentina); Rabadan, Alejandra, E-mail: email@example.com [Hospital Italiano de Buenos Aires, Department of Neurosurgery (Argentina); Paganini, Lisandro, E-mail: firstname.lastname@example.org [Hospital Italiano de Buenos Aires, Department of Radiology (Argentina); Langhi, Luciano, E-mail: email@example.com [Hospital Italiano de Buenos Aires, Department of Neurosurgery (Argentina)
Dentigerous cysts are the second most common odontogenic cysts after radicular cysts and are most commonly seen in association with third molars and maxillary canines. Only 5% of dentigerous cysts involve supernumerary teeth, of which mesiodens is the most frequent type. This paper presents a case of dentigerous cyst associated with a mesiodens that caused a painless swelling in the upper lip of an 18-year-old female. The patient was treated surgically by enucleation of total cyst and surgical extraction of mesiodens under local anesthesia. PMID:23019514
Vosough Hosseini, Sepideh; Moradzadeh, Monir; Lotfi, Mehrdad; Ala Aghbali, Amir; Fattahi, Shirin
Dentigerous cysts are the second most common odontogenic cysts after radicular cysts and are most commonly seen in association with third molars and maxillary canines. Only 5% of dentigerous cysts involve supernumerary teeth, of which mesiodens is the most frequent type. This paper presents a case of dentigerous cyst associated with a mesiodens that caused a painless swelling in the upper lip of an 18-year-old female. The patient was treated surgically by enucleation of total cyst and surgical extraction of mesiodens under local anesthesia.
Vosough Hosseini, Sepideh; Moradzadeh, Monir; Lotfi, Mehrdad; Ala Aghbali, Amir; Fattahi, Shirin
Cysts of the liver may be parasitic or non-parasitic, the non-parasitic cysts being further subdivided into neoplastic, inflammatory, post-traumatic and congenital. Symptomatic congenital solitary cysts represent a good indication for laparoscopic treatment. During the therapeutic procedure, the roof of the cyst is fenestrated or removed such that at least one-third of the circumference of the cyst is removed, which is best done using a harmonic scalpel. In order to prevent a recurrence, it is recommended that a portion of the greater omentum be placed in the floor of the cyst, thus filling the cystic cavity. PMID:9499541
Köckerling, F; Schneider, C; Reck, T; Scheuerlein, H; Hohenberger, W
The goals for this introduction activity to Simple Machines are.: - Generate scientific questions about the world based on observation - Design and conduct scientific investigations - Use tools and equipment appropriate to scientific investigations - Use sources of information in support of scientific investigation - Write and follow procedures in the form of step-by-step instructions, formulas, flow diagram, and sketches - Show how common themes of science, mathematics, and technology apply in real-world contexts - Recognize the contributions made in science by cultures and individuals of diverse backgrounds - Design strategies for moving objects by application of forces, including the use of simple machines MERC Online Reviewer Comments: Good computer activities for under-represented students who want to pursue manufacturing education. Distance Learning is a plus.
Parietal bone defects are rare and exhibit variable etiologies. We report on a 16-year-old girl with an isolated, giant parietal bone defect with encephalomalacia, and an asymptomatic Rathke's cleft cyst. The patient presented with epilepsy. We discuss the differential diagnosis and pertinent neurologic associations. Irrespective of cause, parietal bone defects remain a benign clinical entity. However, it is important to define the extent of the bone defect and associated intracranial abnormalities, and if needed, to take early preventive steps, medical as well as surgical, against potential brain damage. PMID:18555171
Gupta, Surya N; Brook, Belay; Rishikesh, Ranjitha
We describe a case of sacral perineural cyst presenting with complaints of low back pain with neurological claudication. The patient was treated by laminectomy and excision of the cyst. Tarlov cysts (sacral perineural cysts) are nerve root cysts found most commonly in the sacral roots, arising between the covering layer of the perineurium and the endoneurium near the dorsal root ganglion. The incidence of Tarlov cysts is 5% and most of them are asymptomatic, usually detected as incidental findings on MRI. Symptomatic Tarlov cysts are extremely rare, commonly presenting as sacral or lumbar pain syndromes, sciatica or rarely as cauda equina syndrome. Tarlov cysts should be considered in the differential diagnosis of patients presenting with these complaints. PMID:21139800
Prashad, Bhagwat; Jain, Anil K; Dhammi, Ish K
We describe a case of sacral perineural cyst presenting with complaints of low back pain with neurological claudication. The patient was treated by laminectomy and excision of the cyst. Tarlov cysts (sacral perineural cysts) are nerve root cysts found most commonly in the sacral roots, arising between the covering layer of the perineurium and the endoneurium near the dorsal root ganglion. The incidence of Tarlov cysts is 5% and most of them are asymptomatic, usually detected as incidental findings on MRI. Symptomatic Tarlov cysts are extremely rare, commonly presenting as sacral or lumbar pain syndromes, sciatica or rarely as cauda equina syndrome. Tarlov cysts should be considered in the differential diagnosis of patients presenting with these complaints.
Prashad, Bhagwat; Jain, Anil K; Dhammi, Ish K
Supratentorial endodermal cysts are very rare pathological entities. Their pathoembryology is largely unknown and they can represent a diagnostic challenge. A research performed on the PubMed database in December 2010, to screen for supratentorial endodermal cyst studies, demonstrated that since 1960 only 31 supratentorial endodermal cysts have been described in the literature, including our case: a 42-year-old woman with a parasellar endodermal cyst. These lesions are usually benign. As with other types of brain cysts, the signs and symptoms caused by supratentorial endodermal cysts are mainly linked to the compression or irritation of surrounding neural structures. Upon neuroimaging examination, they typically appear as a round or lobulated mass. The signal intensity may vary depending on the protein content of the cyst. The majority of reported supratentorial endodermal cysts were completely excised with good or excellent results. Incomplete excision can result in an increased risk of recurrence, infection, and dissemination. PMID:22700451
Caruso, Riccardo; Artico, Marco; Colonnese, Claudio; Marrocco, Luigi; Wierzbicki, Venceslao
We describe a rare case of clitoromegaly due to a large clitoral cyst that occurred spontaneously without any declared previous female genital mutilation. The cyst was excised successfully with good cosmetic results. PMID:23222050
Al-Ojaimi, Eftekhar Hassan; Abdulla, Maryam Mohd
Two cases of sacral insufficiency fractures occurring in patients with large Tarlov cysts are described. We suggest that Tarlov cysts and other bony defects in the sacrum may predispose to these fractures. PMID:1464204
Peh, W C; Evans, N S
The following heteroxenous and cyst-forming coccidian genera, Besnoitia, Cystoisospora, Frenkelia, Hammondia, Neospora, Sarcocystis and Toxoplasma have been compared biologically, and a key to determine their tissue cysts is provided.
J. K. Frenkel; D. D. Smith
A method was developed for the detection of Giardia cysts by using the polymerase chain reaction (PCR) and the giardin gene as the target. DNA amplification by PCR, using giardin DNA as the target, resulted in detection of both live and dead cysts. When giardin mRNA was used as the target, the ability to amplify cDNA by PCR depended on the mode of killing. Cysts killed by freezing were not detected by PCR when giardin mRNA was the target. Cysts killed by heating or exposure to monochloramine, however, gave positive detection signals for both DNA and giardin mRNA targets. The amount of giardin mRNA and total RNA was significantly increased in live cysts following the induction of excystation. Cysts killed by freezing, heating, or exposure to monochloramine did not show a change in RNA content. The detection of the giardin gene by PCR permits a sensitive and specific diagnosis for Giardia spp. Discrimination between live and dead cysts can be made by measuring the amounts of RNA or PCR-amplified product from the giardin mRNA target before and after the induction of excystation. Images
Mahbubani, M H; Bej, A K; Perlin, M; Schaefer, F W; Jakubowski, W; Atlas, R M
The aim of this case study is to present effectiveness of percutaneous drainage as a treatment option of ruptured lung and liver hydatid cysts. A 65-year-old male patient was admitted with complicated liver and lung hydatid cysts. A liver hydatid cyst had ruptured transdiaphragmatically, and a lung hydatid cyst had ruptured both into bronchi and pleural space. The patient could not undergo surgery because of decreased respiratory function. Both cysts were drained percutaneously using oral albendazole. Povidone-iodine was used to treat the liver cyst after closure of the diaphragmatic rupture. The drainage was considered successful, and the patient had no recurrence of signs and symptoms. Clinical, laboratory, and radiologic recovery was observed during 2.5 months of catheterization. The patient was asymptomatic after catheter drainage. No recurrence was detected during 86 months of follow-up. For inoperable patients with ruptured liver and lung hydatid cysts, percutaneous drainage with oral albendazole is an alternative treatment option to surgery. The percutaneous approach can be life-saving in such cases.
Ar Latin-Small-Letter-Dotless-I bas, Bilgin Kadri, E-mail: firstname.lastname@example.org; Dingil, Guerbuez [A.Y. Ankara Oncology Training and Research Hospital, Department of Radiology (Turkey); Koeroglu, Mert [Sueleyman Demirel University School of Medicine, Department of Radiology (Turkey); Uenguel, Uemit; Zaral Latin-Small-Letter-Dotless-I , Aliye Ceylan [A.Y. Ankara Oncology Training and Research Hospital, Department of Radiology (Turkey)
Intratarsal keratinous cyst of the meibomian gland is a recently described entity that recurs if not completely excised. Herein, we report 2 cases and discuss their diagnosis and management: (1) A 57-year-old man with a recurrent mass of the upper eyelid treated with incision and drainage as a chalazion for more than 5 years and (2) An 85-year-old man presented with a slow growing nodule of the upper eyelid. Exploration via the eyelid crease approach revealed cysts fixed to the tarsus that were completely excised with a portion of the anterior tarsus. Histologically, these cysts exhibited a keratinizing squamous epithelium without a granular layer (trichilemmal keratinization), were lined by an eosinophilic undulating cuticle, contain string-like keratin debris, and had a fibrous wall without sebaceous lobules. All epithelial components strongly expressed high-molecular weight keratins, whereas the lining, cuticle, and keratin contents strongly expressed carcinoembryonic antigen. No recurrence has occurred 7 and 12 months postoperatively. The location and clinicopathologic findings of intratarsal keratinous cysts distinguish it from sebaceous tumors, steatocystoma simplex, epidermoid cyst, and dermoid cyst. However, like steatocystomas, intratarsal keratinous cysts exhibit a sebaceous duct phenotype. The anterior lid crease approach with partial tarsectomy seems to be an effective treatment. PMID:21712690
Patel, Vaidehi S; Meyer, Dale R; Carlson, J Andrew
Cranial dermal sinus, usually associated with dermoid cyst, is the persistance of an abnormal embryonal communication between the skin and the central nervous system. It may be the source of intracranial infection, most often a meningitis and rarely an abscess formation. Two cases of little girls (18 months and 2 years) having dermal sinus with dermoid cyst revealed by cerebellar abscess formations are reported. In the first case there were multiple cerebellar abscesses with hydrocephalus leading to a raised intracranial pressure. In the second case there was an abscess formation adjacent to the dermoid cyst. CT scan showed cysts and abscesses but MRI, achieved in the second case, was useful in demonstrating the sinus tract as well as the associated cyst and abscess. The two patients underwent a posterior fossa surgery with antibiotic therapy. In the first case abscess drainage and ventricular external drainage were necessary before sinus and cyst excision. Two months after surgery the two patients were neurologically intact and developping well. Surgery with total excision of dermal sinus and dermoid cyst, even sometimes difficult, must be preferred to the simple abscess drainage and antibiotic therapy. PMID:11404682
Hayek, G; Mercier, P; Fournier, H D; Menei, P; Pouplard, F; Guy, G
Objective. To present our experience of endoscopic surgery for symptomatic mucus retention cyst of the maxillary sinus. Design. Retrospective study. Setting. Teaching hospital, Israel. Patients. 60 patients with 65 symptomatic cysts of the maxillary sinus who were operated on endoscopically. Only patients with large cysts that filled at least 50% of the sinus space were included. Intervention. A rigid nasal
T. Hadar; J. Shvero; B. I. Nageris; E. Yaniv
Swelling of the upper lip can result from various diseases such as salivary tumors, infectious and inflammatory diseases and cysts. Among the latter, dentigerous cysts, typically involving unerupted teeth, are sometimes associated with supernumerary teeth in the maxillary anterior incisors region called the mesiodens. We report an unusual case of a large dentigerous cyst associated with an impacted mesiodens in
Paolo Scolozzi; Tommaso Lombardi; Michel Richter
Summary The clinical and pathological features of an apparently unique case of an adenomyotic cyst of the uterus are reported. The cyst was located within the subserosal myometrium of a 39-year-old woman. Prior to hysterectomy, it had ruptured with bleeding into the peritoneal cavity. The differential diagnosis of myometrial cysts is briefly discussed.
Sarah Keating; Noel F. Quenville; G. W. Korn; P. B. Clement
The clinical and radiological findings in six extradural and nine intradural arachnoid cysts are discussed in relation to previous reports. Only two cysts failed to opacify during positive contrast myelography; in both cases Myodil was used and in one of them contrast medium had entered the cyst on delayed films taken at 24 h. Pain was always improved and generally
B. E. Kendall; A. R. Valentine; B. Keis
Summary A case of a recurrent arachnoid cyst in the thoracic region in a 13-year-old boy is reported. At the first operation, complete removal of the cyst proved impossible. At a second operation four years later, it was still impossible to remove the cyst so we performed a shunt procedure with drainage through a Hakim valve to the right atrium.
F. Jensen; V. Knudsen; S. Troelsen
16 pediatric and 4 adult cases of small-or medium-sized middle fossa arachnoid cyst were subjected to various neuroradiological investigations and their results were analyzed in terms of possible mechanisms of cyst expansion. Based on the results of the investigations which strongly suggested that the cyst is an expanding lesion, all cases were surgically treated by the same techniques of craniotomy,
Kiyoshi Sato; Takeyoshi Shimoji; Katsumi Yaguchi; Hirotoshi Sumie; Yutaka Kuru; Shozo Ishii
A case of middle fossa arachnoid cyst is presented, which disappeared after head injury. Five days after the trauma, CT scan revealed subdural fluid collection in addition to an arachnoid cyst in the middle fossa on the same side. As the subdural fluid resorbed, the cyst became smaller and disappeared on the follow-up CT scans without surgical intervention.
Yasuo Yamanouchi; Kuniyuki Someda; Nobuyuki Oka
Cysts of Giardia muris were inactivated using a low pressure ultravolet (UV) light source. Cyst viability was detemined by both in vitro excystation and animal infectivity. Cyst doeses were counted using a flow cytometer for the animal infectivity experiments. Using in vitro excy...
Cysts of Giardia muris were inactivated using a low pressure ultravolet (UV) light source. Cyst viability was detemined by both in vitro excystation and animal infectivity. Cyst doeses were counted using a flow cytometer for the animal infectivity experiments. Using in vitro excy...
We present a case in which a synovial cyst arose from the proximal tibia and expanded in the calf of a patient after total knee arthroplasty. A cystogram showed a direct communication between the joint cavity and the cyst, apparently associated with a screw that penetrated the tibial cortex. Histologic examination of the cyst showed an inflammatory reaction, including macrophages,
Toshihiro Akisue; Masahiro Kurosaka; Nobuzo Matsui; Motoi Yamaguchi; Kei-ichiro Hasuda; Thomas W. Bauer; Shin-ichi Yoshiya
Sonographic and cholangiographic appearances of confirmed intrabiliary rupture of a hepatic hydatid cyst were studied in 15 cases. Sonographic findings included liver cyst in all cases; nonshadowing echogenic structures in the dilated biliary tree representing hydatid material, such as fragmented membranes, sand, matrix, and daughter vesicles, in eight cases; and loss of continuity of the cyst wall adjacent to the
Showkat Ali Zargar; Mohadmmad Sultan Khuroo; Bashir Ahmad Khan; Mohammad Yousuf Dar; Mohammad Sultan Alai; Parvaiz Koul
Congenital laryngeal cyst is a rare cause of airway obstruction that may require urgent diagnosis and treatment. We report a case of a neonate having history of polyhydramnios and severe respiratory distress at birth. A laryngeal cyst detected during intubation. The outcome of laryngoscopic treatment of the cyst was favorable.
Suslu, Nilda; Demirel, Gamze; Celik, Istemihan; Canpolat, Fuat Emre; Erdeve, Omer; Akyol, Umut; Dilmen, Ugur
BackgroundThe clinical presentation and the preoperative and postoperative complications associated with pulmonary hydatid cysts depend on whether the cyst is intact or ruptured. The aim of this study was to review the problems encountered in treating ruptured pulmonary hydatid cysts and to highlight the risks associated with chemotherapy and the delay of surgical treatment in pulmonary hydatid disease.
Ak?n Kuzucu; Ömer Soysal; Mehmet Özgel; Saim Yologlu
A patient with an unusual association of biliary atresia and two intrahepatic cysts is reported. The infant was treated by a hepatoportoenterostomy at 2 months of age and by subsequent drainage of the cysts at 13 months. These cysts were detected by ultrasound during a febrile illness. Images Fig. 1 Fig. 2
Saito, S; Nishina, T; Tsuchida, Y
Background context: Lumbar radiculopathy is commonly caused by degenerative conditions such as a herniated disc or lumbar spinal stenosis. Less common etiologies include intraspinal extradural masses such as synovial cysts and gas-containing ganglion cysts. Intraspinal extradural cysts that communicate with the intervertebral disc are a rare entity and thus, an uncommon cause of lumbar radiculopathy. There are only ten cases
Gerard K Jeong; John A Bendo
In a 41-year old woman complaining of episodic bilateral sciatic pain, MRI showed large sacral cysts developed in the pelvis. The fact that these cysts communicated with the subarachnoidal spaces was not clearly demonstrated by CT. The mechanism underlying the development of this perineural variety of extradural cysts is discussed. PMID:1439457
Thomas, T; Michel, D; Solvet, P; Antoine, J C; Barral, F G
Our aim is to describe a case of acromegaly that was associated with symptomatic Rathke's cyst. We describe a young male student without any significant family history who presented with clinical and biochemical features consistent with growth hormone excess, which was confirmed with dynamic testing. He also described a persistent headache predating symptoms of growth hormone excess by 4 years. Magnetic resonance imaging (MRI) of the pituitary showed a large sellar mass which was thought to be a somatotroph adenoma. Trans-sphenoidal surgery was performed; however, a colloid lesion was identified by the neurosurgeon that proved to be a Rathke's cyst. The association of acromegaly with Rathke's cyst is very rare, with less than 10 cases found to be reported on review of literature. This is the first report from India.
Gupta, Vishal; Grossman, Ashley; Kapadia, Aneesa; Thorat, Kiran
Rathke's cleft cyst (RCC) is a rare sellar tumor that can extend to the retroclival region, resulting in brain stem compression. We report a male with short stature who experienced repeated syncope due to compression of the brain stem by a giant retroclival RCC. MRI revealed a large homogeneous sellar tumor with anterior displacement of the pituitary gland that extended to the left retroclival space. The tumor differed from ordinary RCCs because of its unusual clinical presentation, the direction of extension, and its imaging characteristics. The retromastoid surgical approach was used for cyst marsupialization. Intraoperative appearance and histological examination confirmed the diagnosis. A follow-up MRI, 2years after resection of the cyst, showed no recurrence. PMID:20627584
Chuang, Chi-Cheng; Chen, Yao-Liang; Jung, Shih-Ming; Pai, Ping-Ching
An 86-year-old female patient was transported to our hospital because of progressive dyspnea. Computed tomography revealed a 7-cm-diameter low-density mass located in the upper mediastinum behind the trachea. The mass compressed the trachea and caused severe tracheal stenosis. We diagnosed the tumor as a paratracheal type of bronchogenic cyst. The patient was immediately intubated, and a semiemergent operation was performed. Because of her advanced age, minimally invasive surgery was considered. The cyst was partially resected for fenestration. Just after the operation, the patient was extubated and became asymptomatic. The postoperative course was uneventful, and the patient was discharged from the hospital on the 14th postoperative day. The tumor was histologically diagnosed as a bronchogenic cyst. Six months after the operation, she was still asymptomatic. PMID:23917235
Background. Hepatic hydatid cyst infection is caused by microorganisms named Echinococcus which belong to family Taeniidae. Platelets are considered as a mediator in inflammation and infectious diseases because of the various proinflammatory substances that they contain. Design and Methods. Thirty-three patients who were admitted to Do?ubayaz?t State Hospital's General Surgery Clinic with a diagnosis of hepatic cyst hydatid were enrolled in this retrospective study. Laboratory data of the patients in pre- and postoperative periods were obtained from computerized medical records database of the hospital. Results. Preoperative mean platelet volume (MPV) of the patients was significantly increased compared to postoperative MPV values. Conclusion. We claim that MPV is a useful follow-up marker after surgery in patients with hydatid cyst.
Sit, Mustafa; Aktas, Gulali; Yilmaz, Edip Erdal; Hakyemez, Ismail Necati; Alcelik, Aytekin; Kucukbayrak, Abdulkadir
Objective The purpose of this study is to assess the prevalence of abnormal CT findings in patients with surgically proven ruptured endometriotic cysts, as compared with those abnormal CT findings of ruptured ovarian functional cysts. Materials and Methods This study included 13 retrospectively identified patients with surgically confirmed ruptured ovarian endometriotic cysts and who had also undergone preoperative CT scanning during the previous seven years. As a comparative group, 25 cases of surgically confirmed ruptured ovarian functional cysts were included. We assessed the morphologic features of the cysts and the ancillary findings based on CT. Results For the endometriotic cysts, the mean maximum cyst diameter was significantly larger than that of the functional cysts (70.1 mm versus 36.4 mm, respectively, p < 0.05). The endometriotic cysts frequently had a multilocular shape and a thicker cyst wall, as compared to that of functional cysts, and these differences were statistically significant. Among the ancillary findings, endometriotic cysts showed a significantly higher prevalence of loculated ascites, ascites confined to the pelvic cavity without extension to the upper abdomen, and peritoneal strandings and infiltrations (p < 0.05). Although 11 of the 25 cases of functional cysts showed active extravasation of contrast material at the ovarian bleeding site, only one of 13 cases of endometriotic cysts showed active extravasation. Conclusion The diagnosis of ruptured endometriotic cyst should be suspected for a woman in whom CT reveals the presence of multilocular or bilateral ovarian cysts with a thick wall and loculated ascites confined to the pelvic cavity with pelvic fat infiltrations.
This seven-case anecdotal report is presented to alert physicians to the possibility of the formation of functional ovarian cysts during use of phasic contraceptive pills. The patients were studied by the combination of history, physical examination, ultrasound examination, and in two cases surgery. The occurrence of functional ovarian cysts during the use of phasic contraceptive pills is well established while not well appreciated by practicing physicians. This seven-case presentation strongly suggests that phasic contraceptive pills may be a threat to patient health and safety. It is suggested that further studies be undertaken to better understand the pathophysiology. PMID:3296761
Caillouette, J C; Koehler, A L
Choledochal cyst is a well-recognised entity, presenting primarily in infants and young children. Where symptoms are delayed until adulthood, associated hepatobiliary pathology may complicate the presentation. These problems may be aggravated by previous treatment with bypass surgery rather than resection. We report seven cases from our recent experience presenting with complications in adulthood. These included cholangitis, hepatic abscess, pancreatitis and malignancy within the cyst. Two patients presented during pregnancy. These complications and their implications for management are discussed. Images Figure 1 Figure 2 Figure 3 Figure 1
Hopkins, N. F.; Benjamin, I. S.; Thompson, M. H.; Williamson, R. C.
Hydatid cyst is a parasitic disease that is commonly seen in certain areas. It may localize in many organs in the body. Pancreas is a rarely involved organ. A 48 years old patient who could not be diagnosed before surgery was then diagnosed with hydatid cyst localized in the uncinate process of the pancreas post-operatively. Albendazole treatment was begun after the operation. No problem was observed in the follow-up ultrasonography. This rare case may be mistaken for cystic malignancies and pseudocysts of pancreas. PMID:22198922
Küçükkartallar, Tevfik; Cak?r, Murat; Tekin, Ahmet; Özalp, Ali Hikmet; Y?ld?r?m, Mehmet Aykut; Aksoy, Faruk
Highlights of histological, electron microscopic and immunohistochemical features of various benign intracranial cysts are reviewed. These include arachnoid, endodermal, ectodermal and colloid cysts of the third ventricle. Certain noteworthy morphological findings are enumerated in these benign congenital neoplasms. Focal necroses and endothelial proliferation and immunoreactivity for alpha B-crystallin in some of the giant cells are observed in subependymal giant cell astrocytomas. The fine structure of Alzheimer's neurofibrillary tangles is examined in meningoangiomatosis. An overview of dysembryoplastic neuroectodermal tumor a recently recognized new entity associated with intractable seizures in young patients is provided. PMID:8162151
The occurrence of symptomatic pituitary hemorrhage into a Rathke's cleft cyst (RCC) is extremely rare. The author reports an interesting case of intra- and suprasellar RCC presented with features of pituitary apoplexy. This 62-year-old woman suffered acute headache, mental confusion, and partial hypopituitarism. The characteristics of the magnetic resonance imaging seemed most compatible with a hemorrhagic pituitary adenoma. Transsphenoidal drainage of the cyst contents confirmed the diagnosis of hemorrhagic RCC and resolved the symptoms. All published data on this rare clinical entity are extracted and reviewed. PMID:23133732
The occurrence of symptomatic pituitary hemorrhage into a Rathke's cleft cyst (RCC) is extremely rare. The author reports an interesting case of intra- and suprasellar RCC presented with features of pituitary apoplexy. This 62-year-old woman suffered acute headache, mental confusion, and partial hypopituitarism. The characteristics of the magnetic resonance imaging seemed most compatible with a hemorrhagic pituitary adenoma. Transsphenoidal drainage of the cyst contents confirmed the diagnosis of hemorrhagic RCC and resolved the symptoms. All published data on this rare clinical entity are extracted and reviewed.
We report the case of a 50-year-old woman who presented with eight digital myxoid cysts (DMCs) involving the fingers of both hands. They developed within 12 months of the patient starting a job that involved pushing a garment into an embroidery mould, thus exerting a downward force on the fingertips. The pressure exerted from this force could have potentially damaged the joint synovial capsule, leading to rupture and loss of synovial gel, thus inducing myxoid cysts. This case suggests that DMCs may be related to occupation, and to our knowledge, this is only the second reported case of occupationally induced DMCs. PMID:16681589
Connolly, M; de Berker, D A R
Bacterial pericarditis is a well-known although rare complication of Staphylococcus aureus infection in modern practice. We present a rare case of Staphylococcus pericarditis caused by an infected trichilemmal cyst present on patient's scalp. Our case emphasizes that all cases of bacterial pericarditis should be thoroughly investigated for a source of infection. Constrictive changes can be seen in the pericardium postinfection, as in our patient, and should be treated aggressively. To our knowledge, a case of an infected cyst causing bacterial pericarditis has never been reported previously in the literature. PMID:21915636
Lodha, Ankur; Enakpene, Evbu; Haran, Mehandi; Sadiq, Adnan; Shani, Jacob
Mesenteric cysts are rare abdominal tumors of unclear histologic origin, usually asymptomatic. Post-traumatic mesenteric cyst usually results as a consequence of a mesenteric lymphangitic rupture or a hematoma followed by absorption and cystic degeneration. The preoperative histological and radiological diagnosis is difficult. We present the case of a 45-year-old male patient with sizable, palpable abdominal tumor, the gradual swelling of which the patient himself combined with the blunt abdominal trauma he acquired from an opponent's knee in a football game 5 months ago.
Falidas, Evangelos; Mathioulakis, Stavros; Vlachos, Konstantinos; Pavlakis, Emmanouil; Anyfantakis, Georgios; Villias, Constantinos
A 35-year-old male patient presented with a right upper eyelid mass with mechanical ptosis. The patient gave no history of trauma or surgery. On examination, there was a huge cystic mass fixed to the tarsal plate. Excisional biopsy with tarsectomy was done. Histopathology sections demonstrated a keratin-filled cyst arising from the tarsus. A thorough Pubmed search did not reveal an epidermal cyst of the tarsal plate of this size which was successfully managed. The incision was made in such a way that postoperative ptosis would be avoided. Excess skin was removed during the surgery.
Majumdar, Mohana; Khandelwal, Rekha; Wilkinson, Anne
There is continuing controversy regarding the potential for inflammatory apical cysts to heal after nonsurgical endodontic therapy. Molecular cell biology may provide answers to a series of related questions. How are the epithelial cell rests of Malassez stimulated to proliferate? How are the apical cysts formed? How does the lining epithelium of apical cysts regress after endodontic therapy? Epithelial cell
Louis M. Lin; George T.-J. Huang; Paul A. Rosenberg
We recently demonstrated that insulin growth factor-I (IGF-I) co- segregates with bone mineral density (BMD) in progenitor crosses of two inbred strains of mice. Additionally, we reported that men with idiopathic osteoporosis (IOM) have low serum IGF-I levels, which can be related to BMD and bone turnover. In this study, we considered the possibility that serum IGF-I levels are influenced
C. J. ROSEN; E. S. KURLAND; D. VEREAULT; R. A. ADLER; P. J. RACKOFF; W. Y. CRAIG; S. WITTE; J. ROGERS; J. P. BILEZIKIAN
We recently demonstrated that insulin growth factor-I (IGF-I) cosegregates with bone mineral density (BMD) in progenitor crosses of two inbred strains of mice. Additionally, we reported that men with idiopathic osteoporosis (IOM) have low serum IGF-I levels, which can be related to BMD and bone turnover. In this study, we considered the possibility that serum IGF-I levels are influenced by
C. J. Rosen; E S Kurland; D Vereault; R A Adler; P J Rackoff; W Y Craig; S Witte; J Rogers; J P Bilezikian
Background The category B agent of bioterrorism, Entamoeba histolytica has a two-stage life cycle: an infective cyst stage, and an invasive trophozoite stage. Due to our inability to effectively induce encystation in vitro, our knowledge about the cyst form remains limited. This also hampers our ability to develop cyst-specific diagnostic tools. Aims Three main aims were (i) to identify E. histolytica proteins in cyst samples, (ii) to enrich our knowledge about the cyst stage, and (iii) to identify candidate proteins to develop cyst-specific diagnostic tools. Methods Cysts were purified from the stool of infected individuals using Percoll (gradient) purification. A highly sensitive LC-MS/MS mass spectrometer (Orbitrap) was used to identify cyst proteins. Results A total of 417 non-redundant E. histolytica proteins were identified including 195 proteins that were never detected in trophozoite-derived proteomes or expressed sequence tag (EST) datasets, consistent with cyst specificity. Cyst-wall specific glycoproteins Jacob, Jessie and chitinase were positively identified. Antibodies produced against Jacob identified cysts in fecal specimens and have potential utility as a diagnostic reagent. Several protein kinases, small GTPase signaling molecules, DNA repair proteins, epigenetic regulators, and surface associated proteins were also identified. Proteins we identified are likely to be among the most abundant in excreted cysts, and therefore show promise as diagnostic targets. Major Conclusions The proteome data generated here are a first for naturally-occurring E. histolytica cysts, and they provide important insights into the infectious cyst form. Additionally, numerous unique candidate proteins were identified which will aid the development of new diagnostic tools for identification of E. histolytica cysts.
Ali, Ibne Karim M.; Haque, Rashidul; Siddique, Abdullah; Kabir, Mamun; Sherman, Nicholas E.; Gray, Sean A.; Cangelosi, Gerard A.; Petri, William A.
The life cycle of dinoflagellates of the genus Alexandrium includes sexual reproduction followed by the formation of a dormant hypnozygote cyst, which serves as a resting stage. Negatively buoyant cysts purportedly fall to the benthos where they undergo a mandatory period of quiescence. Previous reports of cysts in the surficial sediments of the Gulf of Maine, where Alexandrium blooms are well documented, show a broad distribution of cysts, with highest concentrations generally in sediments below 100 m depth. We report here an exploration of cysts suspended in the water column, where they would be better positioned to inoculate springtime Alexandrium populations. During cruises in February, April, and June of 2000, water samples were collected at depths just off the bottom (within 5 m), at the top of the bottom nepheloid layer, and near the surface (1 m) and examined for cyst concentrations. Suspended cysts were found throughout the Gulf of Maine and westernmost Bay of Fundy. Planktonic cyst densities were generally greater in near-bottom and top of the bottom nepheloid layer samples than in near-surface water samples; densities were of the order of 10 2 cysts m -3 in surface waters, and 10 2-10 3 cysts m -3 at near-bottom depths. Temporally, they were most abundant in February and least abundant in April. Reports by earlier workers of cysts in the underlying sediments were on the order of 10 3 cysts cm -3. We present calculations that demonstrate the likelihood of cyst resuspension from bottom sediments forced by swell and tidal currents, and propose that such resuspended cysts are important in inoculating the seasonal bloom. We estimate that suspended cysts may contribute significantly to the annual vegetative cell population in the Gulf of Maine.
Kirn, Sarah L.; Townsend, David W.; Pettigrew, Neal R.
Arachnoid cysts of the quadrigeminal cisterna are infratentorial cystic lesions located between the collicular plate and the incisural notch of the tentorium. We report here five cases of quadrigeminal cisterna arachnoid cysts in dogs. In this study, four of the five dogs were male, three showed signs of seizures, and one dog was over 10 years of age. In two of the dogs, cysts were discovered incidentally. In previous reports, most intracranial arachnoid cysts were located in the quadrigeminal cisterna. The presence of cysts should be considered in toy breeds presenting for seizures or ataxia. PMID:15080455
Kitagawa, M; Kanayama, K; Sakai, T
Gastric duplication cysts are rare variety of gastrointestinal duplications. Sometimes they may present with complications like hemorrhage, infection, perforation, volvulus, intussusception and rarely neoplastic changes in the gastric duplication cyst. We present one and half year old male child who developed sudden abdominal distension with pain and fever for two days. Ultrasound revealed a cystic mass in the hypochondrium and epigastric regions. On exploration an infected and perforated gastric duplication cyst was found. Surgical excision of most part of cyst wall with mucosal stripping of the rest was performed. Histopathology confirmed the diagnosis of gastric duplication cyst. Early surgical intervention can result in good outcome.
Lumbosacral perineural cysts are formed by the arachnoid membrane of the nerve root at the lumbosacral level. Most of these cysts are asymptomatic and are found incidentally during computed tomography (CT) or magnetic resonance imaging (MRI) for other causes of chronic lower back pain. This type of cyst requires a differential diagnosis to distinguish it from other causes of radiating pain and neurological symptoms. In the present case, a symptomatic lumbosacral perineural cyst was found, and pain relief was achieved by non-surgical treatment. A lumbosacral perineural cyst was identified from a differential diagnosis of a lumbar disc disorder that presented as radiating pain and neurological symptoms.
Choi, Byung Hee; Kim, Jin Mo
Lumbosacral perineural cysts are formed by the arachnoid membrane of the nerve root at the lumbosacral level. Most of these cysts are asymptomatic and are found incidentally during computed tomography (CT) or magnetic resonance imaging (MRI) for other causes of chronic lower back pain. This type of cyst requires a differential diagnosis to distinguish it from other causes of radiating pain and neurological symptoms. In the present case, a symptomatic lumbosacral perineural cyst was found, and pain relief was achieved by non-surgical treatment. A lumbosacral perineural cyst was identified from a differential diagnosis of a lumbar disc disorder that presented as radiating pain and neurological symptoms. PMID:22679550
Choi, Byung Hee; Kim, Sae Young; Kim, Jin Mo
Rathke's cleft cysts arise from remnants of Rathke's pouch and are usually found incidentally on MRI or autopsy. In childhood, the most common presenting symptoms of Rathke's cleft cysts are endocrine abnormalities, such as reduced growth hormone secretion, hyperprolactinemia, or diabetes insipidus. Non-specific symptoms, such as headache and visual disturbance, may also occur. Although precocious puberty has occasionally been described in association with suprasellar lesions, such as hamartomas, arachnoid cysts, and craniopharyngiomas, to our knowledge there have been no documented cases secondary to Rathke's cleft cysts. We report here two patients, both of whom presented with precocious puberty, and were found to have Rathke's cleft cysts. PMID:15237714
Monzavi, Roshanak; Kelly, Daniel F; Geffner, Mitchell E
Hydatid cysts commonly affect liver and lung but it can also affect the brain in rare cases. We report a case of 22 year female with history of headache for one and half years. Intracranial hydatid cyst was diagnosed on computed tomography scan and magnetic resonance imaging. The cyst was delivered without rupture using hydrostatic dissection followed by post-operative anthelminthic medication. Surgery remains to be the standard management. Amongst the surgical techniques described, Dowling's technique is the most acceptable. However, care must be taken in to avoid rupture of the cyst peroperatively which can result in subsequent complications and recurrence. Albendazole and corticosteroids can be used as adjunct to surgical treatment in selective cases.
Umerani, Muhammad Sohail; Abbas, Asad; Sharif, Salman
Over 1 or 2 days, learners use vinegar to remove the calcium from a chicken bone. They then explore how the bones have changed. An accompanying video with Mr. O further explores the relationship between cartilage and bone and explains how bones grow.
Houston, Children'S M.
We report a patient with a cystic structure in the nasopharynx mimicking a Tornwaldt's cyst, which was felt to represent a different entity owing to the lack of the distinct features of a typical Tornwaldt's cyst. It was associated with a bony cleft in the basiocciput that was considered to be a canalis basilaris medianus (CBM), thought to represent an embryological vestige of the cephalic end of the notochord along its course within the basiocciput.
Lohman, B D; Sarikaya, B; McKinney, A M; Hadi, M
Splenic cysts of all types are a relatively rare entity. The origin of epithelial cysts of the spleen is controversial, most probably congenital in origin. Generally, epithelial cysts of the spleen are asymptomatic and discovered incidentally. We present the case of a 40-year-old woman with a 3.5 cm splenic cyst diagnosed four years before. The cyst raised progressively in dimension, the actual size being of 6.5 cm. Computed tomography scan and magnetic resonance showed a central splenic cyst in close relations with main splenic vessels. An initial indication of partial splenectomy was established, eventually a total splenectomy being performed by laparoscopy due to close relations of the cyst with the main hilar splenic vessels. The hemostasis was assured with the aid of Ligasure Atlas 10 mm instrument. The pathology examination revealed a multilocular splenic cyst with a cuboidal epithelial lining. Central localization of splenic cysts represents an indication for total splenectomy. Laparoscopy provides a minimal access method of obtaining pathological confirmation of diagnosis, reduction of cyst complications, and a short hospital stay. This article discusses different aspects of epithelial cysts related to pathology, diagnostic and indications for operative treatment, a review of the literature being also presented. PMID:16607748
Lunc?, S; Boura?, G; Dumitru, L
Objective To estimate the prevalence of Bartholin gland cysts in asymptomatic women serving as control participants who underwent pelvic magnetic resonance imaging (MRI) as part of research studies. The secondary aim was to investigate potential demographic characteristics associated with Bartholin gland cysts. Methods Pelvic MRIs from 430 control participants enrolled in five research projects were evaluated. All images were evaluated by at least two authors. The presence, laterality, and size of Bartholin gland cysts were recorded. Demographic information for each participant was obtained at the time of enrollment in the respective parent study. Results Approximately 3% of the participants had visible Bartholin gland cysts in MRI scans. Fifty-percent of the cysts were identified on the right side, 42.9% were seen on the left side, and 7.1% were bilateral. The cysts were, on average, 1.3 × 1.2 × 1.3 cm, with dimensions ranging from 0.5 – 2.7 cm. There were no demographic differences between women with and without visible Bartholin gland cysts. Conclusion Bartholin gland cysts occur in 3% of adult women. The cysts affect women of broad ranges of age and parity. Women with visible Bartholin gland cysts are demographically similar to women without cysts on pelvic imaging.
Berger, Mitchell B.; Betschart, Cornelia; Khandwala, Nikhila; DeLancey, John O.; Haefner, Hope K.
Three cases of symptomatic extradural arachnoid cyst were treated by surgery. Total excision of the cyst followed by tight closure of the fistula by suture was achieved in all 3 cases. Surgery improved the neurological deficits but urinary incontinence persisted in all three patients. Obliteration of the fistula is considered to be important at surgery from the etiological perspective of the cyst. There are many surgical options, but surgical removal of the cyst and obliteration of the communication usually leads to prompt improvement in neurological deficits. Instability, malalignment, and worsening scoliosis are well-recognized postoperative complications of excessive laminotomy, but the exposure should be wide enough to cover the cyst completely at the operation. Wide exposure of the entire cyst is preferable to avoid missing the fistula and to identify any adhesions or fistula between the cyst and the dura. Identification of the fistula location based on preoperative imaging studies is also important. PMID:23438668
Tomii, Masato; Mizuno, Junichi; Takeda, Masaaki; Matsushima, Tadao; Itoh, Yasunobu; Numazawa, Shinichi; Matsuoka, Hidenori; Watanabe, Kazuo
Studies have demonstrated favorable outcomes of arthroscopic decompression for ganglion cyst in the supraspinous fossa; however, little attention has been paid to the difficulty in detecting these cysts during arthroscopy. In this report, we present 2 cases in which ganglion cysts in the supraspinous fossa were undetectable during arthroscopy. The ganglion cysts were not identified in these cases during surgery despite arthroscopic decompression being performed through the area in which the cyst was expected until the suprascapular nerve was entirely exposed. After surgery, magnetic resonance imaging (MRI) confirmed the disappearance of the ganglion cyst and external rotation strength was fully improved, without shoulder pain. We emphasize here that surgeons should be aware of this difficulty when performing arthroscopic decompression of ganglion cysts in the supraspinous fossa. PMID:23925157
Shimokobe, Hisao; Gotoh, Masafumi; Mitsui, Yasuhiro; Yoshikawa, Eiichiro; Kume, Shinichiro; Okawa, Takahiro; Higuchi, Fujio; Nagata, Kensei; Shiba, Naoto
The KAI-1 tumor suppressor gene is widely distributed in normal tissues and its down-regulation may be correlated with the invasive phenotype and metastases in several different epithelial tumors. The aim of the present study was an evaluation of KAI-1 expression in radicular cysts (RC), follicular cysts (FC), orthokeratinized keratocysts (OOKC), and parakeratinized keratocysts (POKC). Eighty-five odontogenic cysts, 28 RC, 22 FC, and 35 OKC (16 OOKC, 19 POKC) were selected. All the POKC were negative and only four of 16 of the OOKC were positive for KAI-1. On the contrary, all RC and FC cases were positive and immunoreactivity for KAI-1 was detected throughout all the layers of the cyst epithelium. The lack of KAI-1 expression in POKC could help to explain the differences in the clinical and pathologic behavior of OKC and, according to what has been reported for epithelial tumors, could be related to the increased aggressive behavior and invasiveness of OKC. PMID:17320703
Iezzi, Giovanna; Piattelli, Adriano; Artese, Luciano; Goteri, Gaia; Fioroni, Massimiliano; Rubini, Corrado
The occurrence of a symptomatic Rathke's cleft cyst without extension into the sella turcica is rare. The purpose of this report is to present such a case, with its clinical manifestation, diagnostic imaging characteristics, operative approach, pathology and review of the literature. ImagesFigure 1Figure 2Figure 3Figure 4
Rincon, Jorge L.; Nunes, J.; Camuto, P.; Goodrich, I.
Between 1980 and 1982, 8 children with congenital arachnoid cysts were treated at the University of Florida, 2 patients presented with unusual clinical syndromes, including isosexual precocity and a cephalic movement disorder. Cystoperitoneal shunting in combination with ventriculoperitoneal shunting for associated hydrocephalus was employed in the treatment of all supratentorial lesions, and proved to be a safe, efficacious mode of
Barry J. Kaplan; J. Parker Mickle; Robert Parkhurst
Summary Four cases of large suprasellar arachnoid cysts in children are described. The authors propose a large fenestration into the lateral ventricles and into the basal cisterns as the treatment of choice. A specific multipurpose cerebral endoscope has been designed by the first author. The endoscopic technique with different instruments and with the use of a laser is illustrated. Results
J. Caemaert; J. Abdullah; L. Calliauw; D. Carton; C. Dhooge; R. van Coster
Symptomatic Tarlov cysts typically cause chronic pelvic and lower extremity pain and sacral nerve root radiculopathy. Historically, open surgical treatment involved significant patient morbidity, particularly postoperative cerebrospinal fluid (CSF) leaks and infection. These CSF leaks often required multiple surgical procedures to seal. Over the past 20 years, there have been two or three isolated case reports of computed tomography (CT)-guided needle aspirations that offered limited evidence of treatment efficacy and safety. Some have reported high rates of postprocedure aseptic meningitis that were not well explained. These poor results dissuaded physicians from caring for these patients. As a group these patients are usually treated dismissively and told their cysts are asymptomatic and their pain must be coming from somewhere else. Many of them have had an unnecessary discectomy or a spinal fusion, and when these procedures did not relieve their pain they were told they are a "failed back patient." We have treated more than a hundred patients with symptomatic Tarlov cysts by CT fluoroscopic-guided needle aspiration and fibrin injection and have had excellent results with no meaningful complications and never a case of aseptic meningitis. We believe this is a safe, highly effective first-line treatment for symptomatic Tarlov cysts. PMID:21500136
Murphy, Kieran J; Nussbaum, David A; Schnupp, Susan; Long, Donlin
The retroperitoneal bronchogenic cyst is an extremely rare anomaly. During the examination of an 18-year-old female patient due to her extreme thinness, the abdominal ultrasound and later the CT indicated as an accidental finding--a left side adrenal/suprarenal adenoma, which turned out to be hormonally inactive. But while we were doing a laparoscopic surgical intervention we found a 6-8-cm cyst in the retroperitoneum, between the greater curvature and the spleen. It contained light grey, mucinous liquid. The left suprarenal gland had normal size and appearance. During the microscopic examination the removed terime showed cystic structures, which were covered inside with multilayer ciliated columnar epithelium, mucous excretory glands, a whole layer of connective/interstitial and smooth muscle tissue. Neither cartilage, nor gastrointestinal epithelium was found. Only a few publications have reported about retroperitoneal bronchogenic cyst so far. These lesions occur very rarely at the greater curvature. Although this alteration is really unusual, bronchogenic cysts have to be expected in the differential diagnostics of the retroperitoneal tumors. PMID:16637389
Akos, Molnár Béla; Péter, Kaliszky; Edina, Nagy; János, Horányi; Eszter, Székely
Potato cyst nematodes (PCN; G. rostochiensis and G. pallida) are internationally-recognized quarantine pests and considered the most devastating pests of potatoes due to annual worldwide yield losses estimated at 12.2%. PCNs continue to spread throughout North America and were recently detected in I...
Vitreous cysts are very rare ocular malformations. In this observational case study, we report on an unusual case of a pigmented free-floating vitreous cyst and discuss its differential diagnosis. A 14-year-old male was referred to ophthalmology for a pigmented lesion in his left eye. He complained of an intermittent floater in the left eye. Visual acuity was 20/20 in the right eye and 20/40 in the left eye. Fundus examination was unremarkable bilaterally, except for a piece of brownish oval material floating in the vitreous in the left eye. He had received a knock on the left side of his head a few days before the visual discomfort of the left eye. Real-time ultrasound of the left eye detected a piece of hyperechogenic spherical material with no internal reflectivity, floating in the middle of the vitreous. The first use of color Doppler ultrasound in this context indicated no arterial flow, ruling out the presence of a persistent hyaloid artery. Intraocular cysts are rare ocular disorders, which have been divided into clear and pigmented cysts, and into those that occupy the anterior chamber, the retrolental space, and the vitreous cavity. This last is extremely rare. We describe such a case.
Brue, Claudia; Mariotti, Cesare; De Franco, Edoardo; De Franco, Nicola; Giovannini, Alfonso
Nevus comedonicus is a type of hamartoma that arises from a developmental anomaly of the mesodermal part of the pilosebaceous gland. In most cases of nevus comedonicus, an acne-like skin condition develops. Repeated inflammation can cause a morphological change to the cyst, papule, to abscess. We experienced a case of congenital nevus comedonicus, which led to the formation of large multiple cysts. A 50-year-old man was referred with a 12.5×10 cm lobulated mass on the posterior neck and upper back. The patient had a widespread presence of nevus comedonicus in the region ranging from the right superior chest to the posterior neck. The patient had a 30-year history of six prior excisions. A magnetic resonance imaging review led to a diagnosis of nevus comedonicus. Surgical treatment consisted of excision of the mass and wide excision for the patch type of nevus comedonicus around the neck. On histopathology, multiple masses were diagnosed as typical cysts containing keratinized tissue. The diffuse comedone lesions were diagnosed as nevus comedonicus. This case shows that large, multiple cysts can occur as a long-term complication of nevus comedonicus, and also highlights the importance of radical resection to prevent its further invagination. PMID:22783495
Jeong, Hii-Sun; Lee, Hye-Kyung; Lee, Seung-Hyun; Kim, Hyoung-Suk; Yi, Sang-Yeop
Dermoid cysts (DCs) are subcutaneously located cystic masses that contain epithelium and adnexal structures. They are most commonly located in the ovaries and sacral region. Seven percent of DCs are found in the head and neck. Sublingual DCs may develop above the mylohyoid, presenting in the floor of the mouth or below it, causing a submental or submaxillary mass. We
Mustafa Tuz; Harun Dogru; Kemal Uygur; Bahattin Baykal
We report a 33-year-old woman who presented with a breast lump which, on pathological examination, was found to be a hydatid cyst. There was no evidence of any coexistent lesion elsewhere. To our knowledge, this represents the first case of hydatid disease of the breast reported from Nepal. PMID:11023090
Sah, S P; Agrawal, C S; Khan, I R; Rani, S
The presence of cysts within the sacral spinal canal, so-called sacral cysts, is described in literature. These include 'sacral perineural cyst', 'sacral extradural cyst', 'occult intrasacral meningocele' and 'anterior sacral meningocele'. Sacral perineural cyst in these cystic disorders was first described as an incidental autopsy finding by Tarlov in 1938. Since then, several reports have been made describing the sign and symptom, neurological findings, roentgenographic diagnosis and cause and origin of the sacral perineural cysts, although many problems are not yet solved satisfactorily. This cyst occurs on the extradural components of sacral or coccygeal nerve roots. Although most are asymptomatic, these occasionally cause low back pain, sciatic and sacrococcygeal pain, sensory and motor disturbance in the lower extremities, and urinary dysfunction, which symptoms are similar to those brought on by lumbar disc herniation. In 1948, Tarlov reported a case of sciatic pain due to a perineural cyst, the removal of which relieved the symptoms. Symptoms occur because adjacent nerve roots are impinged upon by the thin-walled, fluid-filled cysts, which are formed in a space between the endoneurium and the perineurium. Microscopically, the cyst walls consist of peripheral nerve fibers or ganglionic cells covered with meningeal epithelium. Communication of the cyst with subarachnoid cerebrospinal fluid may be poor, but myelogram and CT myelogram demonstrate the cysts filling with contrast media. With the advent of magnetic resonance imaging (MRI), imaging of the sacral perineural cysts has improved. Recently we had the opportunity to evaluate a patient in whom perineural cysts had caused considerable erosion of the sacrum.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3221973
Kato, T; Takamura, H; Goto, S; Sasaki, H; Makino, K; Ozaki, N; Hodozuka, A
Inactivation of Giardia lamblia and Giardia muris cysts was compared by using an ozone demand-free 0.05 M phosphate buffer in bench-scale batch reactors at 22 degrees C. Ozone was added to each trial from a concentrated stock solution for contact times of 2 and 5 min. The viability of the control and treated cysts was evaluated by using the C3H/HeN mouse and Mongolian gerbil models for G. muris and G. lamblia, respectively. The resistance of G. lamblia to ozone was not significantly different from that of G. muris under the study conditions, contrary to previously reported data that suggested G. lamblia was significantly more sensitive to ozone than G. muris was. The simple Ct value for 2 log unit inactivation of G. lamblia was 2.4 times higher than the Ct value recommended by the Surface Water Treatment Rule.
Finch, G R; Black, E K; Labatiuk, C W; Gyurek, L; Belosevic, M
Odontogenic cysts arise from tooth-forming epithelial residues. The stimulus for the formation of radicular cysts is thought to be endotoxin released from the infected necrotic tooth pulp. However, in keratocysts and follicular cysts, such a stimulus is not present. In order to investigate what drives the cyst epithelium to proliferate, explant media and fluids from 16 radicular cysts, eight keratocysts
S. Meghji; W. Qureshi; B. Henderson; M. Harris
Aim: Though many studies have examined cysts of the jaws, most of them focused on a group of cysts and only few have examined cysts based on a particular classification. The aim of this study is to review cysts of the oro-facial region seen at a tertiary health centre in Ibadan and to categorize these cases based on Lucas, Killey and Kay and WHO classifications. Materials and Methods: All histologically diagnosed oro-facial cysts were retrieved from the oral pathology archives. Information concerning cyst type, topography, age at time of diagnosis and gender of patients was gathered. Data obtained was analyzed with the SPSS 18.0.1 version software. Results: A total of 92 histologically diagnosed oro-facial cysts comprising 60 (65.2%) males and 32 (34.8%) females were seen. The age range was 4 to 73 years with a mean age of 27.99 ± 15.26 years. The peak incidence was in the third decade. The mandible/ maxilla ratio was 1.5:1. Apical periodontal was the most common type of cyst accounting for 50% (n = 46) of total cysts observed. Using the WHO classification, cysts of the soft tissues of head, face and neck were overwhelmingly more common in males than females with a ratio of 14:3, while non-epithelial cysts occurred at a 3:1 male/female ratio. Conclusion: This study showed similar findings in regard to type, site and age incidence of oro-facial cysts compared to previous studies and also showed that the WHO classification protocol was the most comprehensive classification method for oro-facial cysts.
Lawal, AO; Adisa, AO; Sigbeku, OF
The life cycle of the toxic dinoflagellate Alexandrium minutum consists of an asexual stage, characterized by motile vegetative cells, and a sexual stage, a resting cyst that once formed remains dormant in the sediment. Insight into the factors that determine the distribution and abundance of resting cysts is essential to understanding the dynamics of the vegetative phase. In investigations carried out between January 2005 and January 2008 in Arenys de Mar harbor (northwestern Mediterranean Sea), the spatial and temporal distribution patterns of A. minutum resting cysts and of the sediments were studied during different bloom stages of the vegetative population. Maximum cyst abundance was recorded mainly in the innermost part of the harbor while the lowest abundance always occurred near the harbor entrance, consistent with the distribution of silt-clay sediment fractions. The tendency of cysts in sediments to increase after bloom periods was clearly associated with new cyst formation, while cyst abundance decreased during non-bloom periods. Exceptions to this trend were observed in stations dominated by the deposition of coarse sediments. High correlation between the presence of cysts and clays during non-bloom periods indicates that cysts behave as passive sediment particles and are influenced by the same hydrodynamic processes as clays. In Arenys de Mar, the main physical forcing affecting sediment resuspension is the seiche, which was studied using in situ measurements and numerical models to interpret the observed distribution patterns. During non-bloom periods, cyst losses were smaller when the seiche was more active and at the station where the seiche-induced current was larger. Thus, seiche-forced resuspension appears to reduce cyst losses by reallocating cysts back to the sediment surface such that their burial in the sediment is avoided. The observed vertical profiles of the cysts were consistent with this process.
Anglès, Sílvia; Jordi, Antoni; Garcés, Esther; Basterretxea, Gotzon; Palanques, Albert
This is an outline of radiologic assessment of cortical bone resorption for improved diagnosis of metabolic bone diseases by simple radiographic means: microradioscopy and morphometry. The methodology permits separate assessment of endosteal, intracortical, and periosteal resorption and an evaluation of both the quantity and the quality of cortical bone.
H. E. Meema
Hydatid cysts commonly affect the liver and the lung. However, they rarely involve bones with vertebral column. We hereby report a case of a female patient with cystic echinococcosis of the hip bone and ilium. She presented with a long history of frequent recurrences highlighting the dismal prognosis at this rare site. Resection of the hydatid cyst from the sacroiliac region was done with allograft and autograft (rib graft) with lumbosacroiliac fixation. Follow-up of the patient at 6 months showed no detectable abnormality on radiology and the patient was doing well.
Atrophic maxilla rehabilitation has been the subject of several studies for decades; despite this, there are still many different therapeutic choices for the best way to treat maxillary resorption in order to enable implant placement and integration. These possibilities include the optimal use of remaining bone structures, such as the pterygoid processes or zygomatic arch, which involves using zygomaticus and pterygoid implants in combination with standard implants placed in the residual bone; alternatively, regenerative techniques, alveolar bone expansion/distraction or bone grafting techniques may be used. Severe maxillary atrophy has a multifactorial aetiology; the most important factors being long evolution edentulism, hyperpneumatization of the maxillary sinus, post-traumatic deficit, bone loss after surgery (tumours, cysts) and periodontal problems or infection. In this report, we present a clinical case of onlay block reconstruction in an atrophic maxilla with harvested cranial calvarium bone grafts for successful future implant-supported oral rehabilitation. PMID:19767715
Díaz-Romeral-Bautista, Migugel; Manchón-Miralles, Angel; Asenjo-Cabezón, Jorge; Cebrián-Carretero, José-Luis; Torres-García-Denche, Jesús; Linares-García-Valdecasas, Rafael
This is an activity (on page 2 of the PDF) about the two main components of bone - collagen and minerals (like calcium) - and how they each contribute to its flexibility and strength. Learners will submerge 3 chicken bones in water, bleach, and vinegar, wait 24 hours, then observe and test each bone. This resource includes information about how nanoscientists are trying to produce artificial analogs to these components and relates to linked video, DragonflyTV Nano: Bone Regrowth.
Twin Cities Public Television, Inc.
Intradural extramedullary epidermoid (EC) cysts are uncommon (0,2–1%). Acquired tumors appear more frequently as a late complication of lumbar punctures (40%). The authors present three cases of epidermoid cysts of the cauda equina which were surgically treated in their department during the past five years. All three had suffered lumbar punctures for rachianesthesia 6–9 years prior to their presentation. The patients' ages ranged between 19 and 31. Surgical treatment was deemed necessary because of the space–occupying nature of this slow–growing lesion, and this indication was supported by the MRI findings. Two–level laminectomy and microsurgical total tumor ablation were performed in all three cases. There were no postoperative complications.
Strambu, VED; Rosca, T; Cioti, D; Copaciu, R; Stroi, M; Ciurea, AV; Popa, F
An eight-year-old, male Siberian husky cross was referred with a history of an acute onset of pelvic-limb ataxia and paraparesis. Radiography and subsequent myelography of the spine revealed an extradural compression of the spinal cord at the level of the 13th thoracic (T13) to first lumbar (L1) vertebrae. Hemilaminectomy resulted in the successful removal of an extradural cystic lesion. The morphological diagnosis based on histopathology was a synovial cyst with chondromatosis. There were no postoperative complications, and the dog's condition improved markedly. At two years postoperatively, the animal remains normal on both physical and neurological examination. To the authors' knowledge, this article is the first report of an intraspinal synovial cyst in a dog. PMID:10825095
Perez, B; Rollan, E; Ramiro; Pumarola, M
Lumbar epidural varices are rare and usually mimick lumbar disc herniations. Back pain and radiculopathy are the main symptoms of lumbar epidural varices. Perineural cysts are radiologically different lesions and should not be confused with epidural varix. A 36-year-old male patient presented to us with right leg pain. The magnetic resonance imaging revealed a cystic lesion at S1 level that was compressing the right root, and was interpreted as a perineural cyst. The patient underwent surgery via right L5 and S1 hemilaminectomy, and the lesion was coagulated and removed. The histopathological diagnosis was epidural varix. The patient was clinically improved and the follow-up magnetic resonance imaging showed the absence of the lesion. Lumbar epidural varix should be kept in mind in the differential diagnosis of the cystic lesions which compress the spinal roots.
Pusat, Serhat; Kural, Cahit; Aslanoglu, Atilla; Kurt, Bulent
Purpose. This paper presents a modification of the known method for percutaneous treatment of hydatid cyst, the PAIR technique. It aimed to achieve safe aspiration of large symptomatic cysts and cysts with a danger of impending rupture. Methods. We designed a coaxial catheter system to achieve concomitant evacuation of cyst contents while infusing scolicidal agent. Hypertonic saline is used to wash out cyst contents and to kill protoscolices. This was followed by injection of a sclerosant (ethyl alcohol 95%) into the residual cyst cavity to prevent formation of a cyst collection after the procedure. Seventeen cysts in 14 patients were successfully aspirated. Follow-up plain radiographs, ultrasonography and CT were performed weekly in the first 4 weeks and then at 3, 6 and 12 months for all patients. Seven patients (9 drained cysts) were followed up for 2 years and 1 patient for 3 years. Results. All cysts were successfully aspirated. The following morphologic changes were noticed: a gradual decrease in cyst size (17 cysts, 100%), thickening and irregularity of the cyst wall due to separation of endocyst from pericyst (7 cysts, 41%), development of a heterogeneous appearance of the cyst components (8 cysts, 47%) and development of pseudotumor (2 cysts, 12%). None of the treated cysts disappeared completely. No significant procedure-related complications were encountered. Conclusion. This modified PAIR technique is a reliable method for percutaneous treatment of risky and symptomatic hydatid cysts.
Gabal, Abdelwahab M. [King Fahad Hospital, Department of Radiology (Saudi Arabia)], E-mail: email@example.com; Khawaja, Fazal I. [King Fahad Hospital, Department of Gastroenterology and Gastrointestinal Endoscopy (Saudi Arabia); Mohammad, Ghanem A. [Al-azhar University Medical Center, Department of Chest Diseases (Egypt)
We present a 62-year-old male with a recurrent cyst in the left posterior chest. MRI demonstrated a fluid-filled cavity measuring 23 cm in length and 11 cm in width. The cyst was aspirated demonstrating clear serous fluid. However, the cyst returned and he was referred to us for further treatment. The cyst was excised through a minimally invasive approach using a combination of blunt and electrocautery dissection. The cystic lesion was circumferentially freed from the trapezius muscle and cervical structures. Pathologic examination revealed a benign, fibrous-walled cyst without a true epithelial lining. There are no published reports of a deep thoracic wall cyst resembling this case in terms of histology or location. This patient is free of recurrence 1 year later.
AlJamal, Yazan N.; Siroy, Alan E.; Farley, David R.
The lymphoepithelial cyst has been commonly termed branchial cleft cyst or branchial cyst. Although many theories, including the branchial apparatus theory, thymic duct theory, and inclusion theory, have been put forward, the etiology is still controversial. Parotid lymphoepithelial cysts are rare and could be divided into two groups, AIDS-related and non-AIDS related, by the relationship with HIV infection. A non-AIDS related lymphoepithelial cyst of left parotid gland in an 81-year-old man presenting as a parotid tumor is described. A left partial parotidectomy was carried out to remove the lesion. There was no recurrence after 2 years. Lymphoepithelial cysts of the parotid gland are often misdiagnosed as other benign tumors in spite of detailed preoperative investigations. Thus a pathological proof is needed for precise diagnosis. In addition, we also need to take the possibility of HIV infection into consideration, although Taiwan is not an AIDS epidemic area. PMID:9838771
Chiang, C H; Chiang, F Y; Lin, C H; Juan, K H
Scrotal calcinosis has been classified as a form of idiopathic calcinosis cutis. However, the pathogenesis of the calcified nodules has not been fully elucidated: it is still unclear whether the condition is truly idiopathic, or the result of breakdown of calcified epithelial cysts. We describe a 29-year-old Japanese patient with scrotal calcinosis originating from epithelial cysts. Light microscopy revealed a large epithelial cyst containing von Kossa-positive material and several small dilated ductal structures beside the cyst. The epithelia of the cyst and ductal structures were connected, showing similar eccrine duct differentiation on immunohistochemical staining and electron microscopy. In the cyst lumen, calcium was present as needle-shaped crystals. The pathogenetic mechanism of calcium deposition seemed to be due to excessive production and discharge of matrical debris and sulphated mucopolysaccharides, which derived from luminal cells, and their accumulation in the lumina. PMID:11167697
Ito, A; Sakamoto, F; Ito, M
Histopathologic features of hepatic peribiliary cysts were described in a young slaughtered pig. The animal was an apparently healthy 6-month-old pig of mixed breed. Macroscopically, all lobes of the liver contained numerous cysts of varying size containing serous fluid in all lobes. Histopathologically, the cysts were located mainly around the large bile duct and in the connective tissue of the portal tracts. Within serial sections, these cysts were assumed to be solitary or multilocular, but they were separated from the bile duct. The cysts were lined by a single layer of columnar, cuboidal, and flattened epithelial cells. Occasionally, goblet cells were observed. The epithelial cells were stained with periodic acid-Schiff/alcian blue and high-iron diamine/alcian blue, indicating the presence of neutral mucin, sialomucin, and sulfomucin. Grimalius' method revealed the presence of endocrine cells in the lining epithelium. There was no bile pigment in the cysts by the Hall method. PMID:17846247
Komine, M; Kawasako, K; Akihara, Y; Shimoyama, Y; Okamoto, M; Matsuda, K; Hirayama, K; Taniyama, H
Rathke's cleft cysts (RCCs) are benign epithelium-lined intrasellar cysts containing mucoid material and are believed to originate from the remnants of Rathke's pouch. Most are asymptomatic but may cause symptoms secondary to compression of adjacent structures such as visual disturbances and endocrinopathies, especially hypopituitary. Furthermore, inflammation such as an aseptic meningitis syndrome may be associated with these tumors, presumably resulting from leakage of cyst material into the subarachnoid space. We present a unique case of spontaneous rupture and complete disappearance of a known sella-suprasellar cyst associated with a severe headache syndrome, followed by cyst reaccumulation requiring surgery. Although this phenomenon is well accepted, to our knowledge, this is the first report of the complete disappearance of a Rathke's cyst presenting with the classic syndrome. Furthermore, it was remarkable how quickly it recurred and became symptomatic, providing evidence that an “empty sella syndrome” may indeed need clinical follow-up.
Maniec, Katrina; Watson, Joe C.
Rathke's cleft cysts (RCCs) are benign epithelium-lined intrasellar cysts containing mucoid material and are believed to originate from the remnants of Rathke's pouch. Most are asymptomatic but may cause symptoms secondary to compression of adjacent structures such as visual disturbances and endocrinopathies, especially hypopituitary. Furthermore, inflammation such as an aseptic meningitis syndrome may be associated with these tumors, presumably resulting from leakage of cyst material into the subarachnoid space. We present a unique case of spontaneous rupture and complete disappearance of a known sella-suprasellar cyst associated with a severe headache syndrome, followed by cyst reaccumulation requiring surgery. Although this phenomenon is well accepted, to our knowledge, this is the first report of the complete disappearance of a Rathke's cyst presenting with the classic syndrome. Furthermore, it was remarkable how quickly it recurred and became symptomatic, providing evidence that an "empty sella syndrome" may indeed need clinical follow-up. PMID:22937285
Maniec, Katrina; Watson, Joe C
Heterotopic gastrointestinal cysts are rarely found in the oral cavity. Most of these cysts are lined with gastric mucosa and involve the tongue. There have been no reported heterotopic intestinal cysts of the submandibular gland that are completely lined with colonic mucosa. An 8-year-old girl presented with an enlarging swelling in the left submandibular area, and a 4-cm unilocular cyst was fully excised. The cyst was completely lined with colonic mucosa that was surrounded by smooth muscle layer, and the lining cells were positive for CDX-2, an intestinal marker, indicating a high degree of differentiation. The pathogenesis remains unclear, but it may be related to the misplacement of embryonic rests within the oral cavity during early fetal development. Although heterotopic intestinal cysts rarely occur in the submandibular gland, they should be considered in the differential diagnosis of facial swellings in the pediatric population. PMID:23837022
Kwon, Mi Jung; Kim, Dong Hoon; Park, Hye-Rim; Min, Soo Kee; Seo, Jinwon; Kim, Eun Soo; Kim, Si Whan; Park, Bumjung
A 4-year-old Andalusian horse was presented for examination following a 3-month history of exophthalmos of the right eye and a soft swelling of the right supraorbital fossa noted after blunt head trauma. Ultrasonographic examination of the swelling showed an anecogenic mass of 5 cm in diameter involving the retrobulbar space. Centesis of the mass through the supraorbital fossa was performed and yielded a serous fluid with 7.2 g/dL of total protein and density of 1040. No cells were seen in the sample. A tentative diagnosis of cyst was made. The cyst was surgically removed and the definitive histologic diagnosis was retrobulbar dermoid cyst. No recurrence has developed 18 months following the complete removal of the cyst capsule. To the authors' knowledge, there are no previous reports of retrobulbar dermoid cysts in horses. Localization, causes and success of surgical treatment of dermoid cysts are discussed. PMID:17971003
Muñoz, E; Leiva, M; Naranjo, C; Peña, T
Cysts of the genus Spironucleus share many common morphological features with Giardia cysts including: 2-4 nuclei, flagellar axonemes, a distinct cyst wall, and they even display the same immunostaining as Giardia cysts when labeled with antibodies specif...
M. M. Januschka S. L. Erlandsen W. J. Bemrick D. G. Schupp D. E. Feely
Palynological studies of cored lacustrine sediments from the late Quaternary of Lake Kastoria, northern Greece, revealed a Late Glacial interval with abundant dinoflagellate cysts. Cyst assemblages include two identifiable species, Spiniferites cruciformis and Gonyaulax apiculata. The presence of the fresh water species G. apiculata is consistent with the lacustrine setting of these deposits, but that of S. cruciformis is anomalous. Previously, this species has only been recorded in abundance from presumed brackish marine sediments from the Black Sea and Marmara Sea sediments where geochemical data clearly record brackish salinities. Therefore, it has been regarded as a low salinity cyst type with a wide range of morphological variation that some workers have suggested to reflect salinity fluctuations. Specimens from Greece display only part of the range of morphological variability previously described from these (brackish) marine settings. Encountered morphological variation includes ellipsoidal/pentameral and cruciform endocyst shapes with rare intermediate shapes, and highly variable septa development. Specimens characterized by extremely reduced ornamentation known from (brackish) marine environments have not been recorded. Our records of S. cruciformis indicate that: (1) it could thrive in fresh water conditions; and (2) that apparently most of the strong morphological variations of the cysts are an intrinsic phenomenon for this taxon, and may only partly be linked to salinity variations as suggested earlier. We suggest that S. cruciformis essentially is a fresh water taxon, and that its records in (brackish) marine environments, with the exception of specimens with strongly reduced ornamentation, may be due to transportation, to short-lived fresh water surface conditions in such environments, or to tolerance of the species to brackish conditions. PMID:11179717
Kouli, K; Brinkhuis, H; Dale, B
This case of 52-year male with swelling in the left submandibular area for 1 year came to ENT OPD of Patna medical college,\\u000a Patna. Clinical examination showed swelling to be multiple nontender cysts with enlarged submandibular salivary gland. CT-scan\\u000a revealed large well-defined encapsulated multicystic lesions in the left submandibular gland. FNAC was suggestive of aspirate\\u000a to be ectopic to that
Parmanand Prasad Pal; Siddharth Shankar
Summary Intraneural ganglion cyst of the tibial nerve is very rare. To date, only 5 cases of this entity in the popliteal fossa have\\u000a been reported. We report a new case and review the previously reported cases. A 40-year-old man experienced a mild vague pain\\u000a in the medial half of his right foot for 3 years. Magnetic resonance imaging scan demonstrated
M. Adn; A. Hamlat; X. Morandi; Y. Guegan
An 11-year-old Caucasian girl was investigated for a clitoromegaly that had increased in size over 5 weeks. Clitoromegaly is a rare condition in childhood. Among nonhormonal causes are tumours, both benign and malignant. Evaluation of the adrenal glands and ovaries was performed by US. An epidermoid cyst was suggested by MRI including diffusion-weighted imaging, and this was confirmed histopathologically. PMID:22138865
Beurdeley, Marion; Cellier, Cécile; Lemoine, Françoise; Dacher, Jean-Nicolas; Vivier, Pierre-Hugues
The benefit of total resection of the dilated bile duct has remained unclear. We describe here our surgical management of\\u000a 13 patients with type IV choledochal cysts. All six younger patients (25–35 years old) underwent resection of the extrahepatic\\u000a bile duct (EHBD) and hepaticojejunostomy (HJ), whereas three of the seven older patients (50–68 years old) underwent resection\\u000a of the EHBD resection and
Yoshifumi Kawarada; Bidhan C. Das; Masami Tabata; Shuji Isaji
Bronchogenic mediastinal cysts (BMC) represent 18% of primitive mediastinal tumors and the most frequent cystic lesions in this area. Nowadays, BMC are usually treated by VATS. However, the presence of major adhesions to vital structures is often considered as an unfavourable condition for thoracoscopic treatment. The authors report the thoracoscopic treatment of a BMC having dense adhesions to the aortic arch. Diagnosis and surgical treatment is described. Review of the literature and surgical options on this topic are discussed.
Bronchogenic mediastinal cysts (BMC) represent 18% of primitive mediastinal tumors and the most frequent cystic lesions in this area. Nowadays, BMC are usually treated by VATS. However, the presence of major adhesions to vital structures is often considered as an unfavourable condition for thoracoscopic treatment. The authors report the thoracoscopic treatment of a BMC having dense adhesions to the aortic arch. Diagnosis and surgical treatment is described. Review of the literature and surgical options on this topic are discussed. PMID:20950466
Mondello, Baldassare; Lentini, Salvatore; Familiari, Dario; Barresi, Pietro; Monaco, Francesco; Sibilio, Michele; La Rocca, Annunziata; Micali, Vincenzo; Acri, Ignazio Eduardo; Barone, Mario; Monaco, Maurizio
Swelling of the upper lip can result from various diseases such as salivary tumors, infectious and inflammatory diseases and cysts. Among the latter, dentigerous cysts, typically involving unerupted teeth, are sometimes associated with supernumerary teeth in the maxillary anterior incisors region called the mesiodens. We report an unusual case of a large dentigerous cyst associated with an impacted mesiodens in a 42-year-old male who presented with a slow-growing swelling in the upper lip. PMID:15133687
Scolozzi, Paolo; Lombardi, Tommaso; Richter, Michel
The widespread use of MRI in the assessment of low back pain has led to increased detection of degenerative cysts of the spine, which was essentially a surgical diagnosis earlier. The awareness of degenerative cysts, the significance of their role in the etiology of radicular and back pain and their effective management is evolving. We describe a case of bilateral, gas-filled lumbar facet synovial/ ganglion cysts causing focal arachnoid inflammation and lateral lumbar canal stenosis. PMID:23859245
El Beltagi, A H; Swamy, N; Dashti, F
Intracranial neurenteric cysts are exceedingly rare congenital intracranial lesions that result from disorder of gastrulation. Still, more rarely, the cyst contents may leak into the CSF and give rise to recurrent episodes of chemical meningitis. We present a case of chemical meningitis due to a leaking posterior fossa neurenteric cyst in a young female, with emphasis on its imaging features. The final diagnosis was achieved by sufficiently characteristic imaging features; histopathologic documentation could not be achieved as the patient denied surgery.
Choh, Naseer A; Wani, Maqbool; Nazir, Parvez; Saleem, Sheikh M; Shaheen, Feroze; Rabbani, Irfan; Gojwari, Tariq
Spinal epidermoid cyst is less than 1% of the entire spinal cord tumor and a rare tumor. It is a slowly proliferating benign tumor and can be a result of either congenital or acquired factors. In particular, reports of acute paraplegia due to spinal epidermoid cyst rupture are very rare. Since authors experienced paraplegia resulting from congenital spinal epidermoid cyst rupture during an asthma attack, it is reported with a review of literature.
Kim, Kweon Young; Kang, Jung Hun; Choi, Dae Woo; Lee, Min Hong
Cardiac ecchinococcosis is a rare disease. Its incidence varies from 0.02-2%. Commonly seen in the left ventricle arising from the myocardium in the subepicardial region.We report a 15-year-old boy presented with a rare combination of a left ventricular subendocardial hydatid cyst associated with multiple cysts in the left cerebral hemisphere and right posterior occipital lobe. The patient underwent successful surgical excision of the left ventricular hydatid cyst using cardiopulmonary bypass. PMID:23601473
Darwazah, Ahmad K; Zaghari, Mahmoud; Eida, Mohammed; Batrawy, Mohammed
Pericardial cysts are rare benign congenital malformations, usually small, asymptomatic and detected incidentally on chest X-ray as a mass located in the right costophrenic angle. Giant pericardial cysts are very uncommon and produce symptoms by compressing adjacent structures. In this report, the authors present a case of a symptomatic giant pericardial cyst incorrectly diagnosed as dextrocardia on chest X-ray. PMID:23237843
Hamad, Hamad M; Galrinho, Ana; Abreu, João; Valente, Bruno; Bakero, Luis; Ferreira, Rui C
Popliteal cyst is a rare finding after total knee arthroplasty (TKA), but when present, it might indicate a malfunction of\\u000a the TKA related to generation of wear-particles, or loosening. We present a case of a multilobulated popliteal cyst developing\\u000a in a patient 8 years after primary TKA. The cyst was associated with a mechanical prosthetic loosening. The primary complaint\\u000a of the
Biagio Moretti; Vittorio Patella; Elyazid Mouhsine; Vito Pesce; Antonio Spinarelli; Raffaele Garofalo
Radicular cyst arising from deciduous teeth is exceedingly rare accounting for <1% of all radicular cysts. A total of 122 cases have been reported to date in the English language literature. We present a rare case of a radicular cyst associated with a decayed deciduous maxillary molar tooth without any history of prior pulp therapy. Our aim is to emphasize the recognition of inflammatory radicular lesions associated with deciduous teeth which may adversely impact underlying permanent successor.
Shetty, Shibani; Rekha, K.
An 89 year old gentleman awaiting surgery for carcinoma of caecum presented with sudden back pain and developed foot drop two weeks later. MRI revealed multiple spinal metastases with a cyst in the canal at L4/5 causing spinal canal stenosis. Surgery revealed a juxta articular synovial cyst with haemorrhage in it. We discuss the presentation and management of juxtarticular cysts with a review of the literature.
George, KJ; Roy, D; Shad, A
In polycystic kidney disease (PKD), intracellular cAMP promotes cyst enlargement by stimulating mural epithelial cell proliferation and transepithelial fluid secretion. The proliferative effect of cAMP in PKD is unique in that cAMP is anti-mitogenic in normal renal epithelial cells. This phenotypic difference in the proliferative response to cAMP appears to involve cross-talk between cAMP and Ca2+ signaling to B-Raf, a kinase upstream of the MEK/ERK pathway. In normal cells, B-Raf is repressed by Akt (protein kinase B), a Ca2+-dependent kinase, preventing cAMP activation of ERK and cell proliferation. In PKD cells, disruption of intracellular Ca2+ homeostasis due to mutations in the PKD genes relieves Akt inhibition of B-Raf, allowing cAMP stimulation of B-Raf, ERK and cell proliferation. Fluid secretion by cystic cells is driven by cAMP-dependent transepithelial Cl? secretion involving apical cystic fibrosis transmembrane conductance regulator (CFTR) Cl? channels. This review summarizes the current knowledge of cAMP-dependent cyst expansion, focusing on cell proliferation and Cl?-dependent fluid secretion, and discusses potential therapeutic approaches to inhibit renal cAMP production and its downstream effects on cyst enlargement.
Wallace, Darren P.
Among the many tissues in the human body, bone has been considered as a powerful marker for regeneration and its formation serves as a prototype model for tissue engineering based on morphogenesis. Therefore, collagen type I is one of the most useful biomaterials used in tissue engineering as extracellular matrix components capable to promote bone healing. The literature reveals excellent biocompatibility and safety due to its biological characteristics, such as biodegradability and weak antigenicity, making collagen type I the primary resource in medical applications. Thus, it was also used for tissue engineering including skin replacement, bone substitutes, and artificial blood vessels and valves. The authors describe the treatment of an abscessed apical periodontal cyst and show good outcomes of bone healing, using tissue engineering, as collagen type I matrix. PMID:23851732
Oliveira, Marina Reis; Martins, Elisa das Graças; Célio-Mariano, Ronaldo; Sonoda, Celso Koogi; Rangel Garcia, Idelmo; de Melo, Willian Morais
Objective: The authors present a novel method of the recapping hemilaminoplasty in a retrospective study of patients with spinal surgical disorders. This report describes the surgical technique and the results of hemilaminoplasty using an ultrasonic bone curette. The aim of this study was to examine the safety and effectiveness of the hemilaminoplasty technique with ultrasonic bone curette. Methods: Between April 2003 and July 2011, 33 patients with various spinal diseases (17 spinal tumors, 5 dural arteriovenous fistulas, 3 syringomyelia, 2 sacral perineural cysts, and 2 arachnoid cysts) were treated microsurgically by using an ultrasonic bone curette with scalpel blade and lightweight handpiece. The ultrasonic bone curette was used for division of lamina. After resection of the lesion, the excised lamina was replaced exactly in situ to its original anatomic position with a titanium plate and screw. Additional fusion technique was not required and the device was easy to handle. All patients were observed both neurologically and radiologically by dynamic plain radiographs and computed tomography (CT) scan. Results: The operation was performed successfully and there were no instrument-related complications such as dural laceration, nerve root injury, and vessels injury. The mean number of resected and restored lamina was 1.7. CT confirmed primary bone fusion in all patients by 12 months after surgery. Conclusion: The ultrasonic bone curette is a useful instrument for recapping hemilaminoplasty in various spinal surgeries. This method allows anatomical reconstruction of the excised bone to preserve the posterior surrounding tissues.
Matsuoka, Hidenori; Itoh, Yasunobu; Numazawa, Shinichi; Tomii, Masato; Watanabe, Kazuo; Hirano, Yoshitaka; Nakagawa, Hiroshi
Dentigerous cysts are always associated with an embedded or unerupted tooth; involvement of more than one permanent tooth in a single cyst follicle is exceedingly rare and only a few such cases can be found in the literature. The cysts reported in the literature involving multiple teeth typically consist of mesiodens or odontomas. Here we report a rare case of dentigerous cyst associated with two permanent teeth causing displacement of maxillary canine into the osteo meatal complex and maxillary premolar to lateral nasal wall. The possible etiopathogenesis of such cases is also discussed here.
Agrawal, Mamta; Raghavendra, Pramod D. S.; Singh, Bhawana; Agrawal, Neha
Dentigerous cysts are always associated with an embedded or unerupted tooth; involvement of more than one permanent tooth in a single cyst follicle is exceedingly rare and only a few such cases can be found in the literature. The cysts reported in the literature involving multiple teeth typically consist of mesiodens or odontomas. Here we report a rare case of dentigerous cyst associated with two permanent teeth causing displacement of maxillary canine into the osteo meatal complex and maxillary premolar to lateral nasal wall. The possible etiopathogenesis of such cases is also discussed here. PMID:23483109
Agrawal, Mamta; Raghavendra, Pramod D S; Singh, Bhawana; Agrawal, Neha
A 60-year-old woman presented with a swelling in right paraumbilical region of one-year duration. Examination revealed a painless cystic swelling 15 × 10?cm with cough impulse. Ultrasound and CECT abdomen showed a subcutaneous cystic swelling with intramuscular extension. No other intraabdominal cystic lesions were found. Surgical exploration showed a cystic lesion adherent to peritoneum without any intraperitoneal extension. Cyst was carefully excised without any spillage. Gross specimen on opening showed multiple daughter cysts consistent with hydatid cyst, confirming the diagnosis of solitary abdominal wall hydatid cyst.
Abhishek, V.; Patil, Vijayraj S.; Mohan, Ullikashi; Shivswamy, B. S.
Mineralization of paraprostatic cysts is reported to be uncommon. This retrospective study was performed to review the imaging findings of eight histologically confirmed canine paraprostatic cysts. Radiographic patterns of mineralization seen are described. Four of the eight dogs had mineralized cysts. Mineralization seen on radiography was not consistently seen on ultrasonography, probably due to the lack of acoustic shadowing artefact from the small depth of mineralized tissue. It is thus concluded that mineralization of paraprostatic cysts is more common than implied in the literature, and that radiography is superior to ultrasonography in identifying its presence. PMID:18833951
Renfrew, Helen; Barrett, Esther L; Bradley, Kate J; Barr, Frances J
Epidermoid cyst is a frequent benign cutaneous tumor. The pelvic localization does not occur very often. The literature that taps into such cases is very limited in scope. Here is a report of a 27-year-old woman with a giant pelvic retroperitoneal epidermoid cyst. The use of ultrasound exploration and computed tomography has indicated ovarian origins. The surgery also revealed a retroperitoneal epidermoid cyst, uterus and ovaries were all intact. The evacuation of a cyst was found to contain lamellas of keratin. Histology permitted us to confirm the diagnosis. The patient was faring well after two years of followup.
Fdili Alaoui, F. Z.; Oussaden, A.; Bouguern, H.; El Fatemi, H.; Melhouf, M. A.; Amarti, A.; Ait Taleb, K.
Conjunctival dermoid cysts are a rare subtype of dermoid cyst usually presenting in adulthood. The authors report a case of a recurrent conjunctival dermoid cyst with reactive lymphoid hyperplasia that was immunohistochemically demonstrated to be polyclonal. Follicular centers that were present within the cyst wall were negative for Bcl-2 and positive for the immunohistochemical markers CD20, Bcl-6, CD10, and Ki67, which helped to differentiate the lesion from a follicular lymphoma. The lesion did not recur after 14 months of follow-up. PMID:20562661
Stacy, Rebecca C; Jakobiec, Frederick A; Sutula, Francis C
A case of thoracic intradural extramedullary arachnoid cyst is presented in which an intramedullary low grade glioma was suspected preoperatively. The cyst was widely fenestrated and postoperatively, the patient experienced considerable improvement in her symptoms. As postoperative MRI studies also showed resolution of the intramedullary changes we regard the intramedullary changes as a result of the cyst, without the existence of primary medullary pathology. To our knowledge an arachnoid cyst, to date, has not been described as the cause of syringomyelia. As radiological findings can be misleading, extramedullary pathology, located more cranially, should be ruled out when treating cystic medullary changes.??
Willems, P; van den Bergh, W M; Vandertop, W