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Simplebonecysts (SBC) are pseudocysts occurring less commonly in the maxillofacial region. The uncertain and unclear etiopathogenesis led to numerous synonyms to refer this particular cyst. These cysts are devoid of an epithelial lining and are usually empty or contain blood or straw-colored fluid. In jaws initially it mimics a periapical cyst and later can lead to cortical bone expansion warranting for radical approach, which is seldom required. SBC is predominantly diagnosed in first two decades of life. Here we report a case of solitary bonecyst mimicking a periapical cyst of a mandibular molar in a 37-year-old patient.
Epiphyseal involvement of a simplebonecyst (SBC) is uncommon. Eight patients are reported in whom an SBC was found to cross the growth plate, involving the epiphysis in seven patients and the apophysis in one. All patients had more than two pathologic fractures. In seven patients growth disturbance was found. Functional impairment did not develop in any patient. Radiographically, all lesions presented a characteristic involvement of the epiphysis and metaphysis in various proportions. Only one of four cysts treated with methylprednisolone acetate injections showed incomplete healing; the others failed to respond. After percutaneous grafting of autologous bone marrow, three of seven cysts healed and the others attained incomplete healing. Epiphyseal involvement of SBC should be considered a more aggressive form of an active lesion. PMID:12604955
BACKGROUND: Simple or unicameral bonecysts are common benign fluid-filled lesions usually located at the long bones of children before skeletal maturity. METHODS: We performed demineralized bone matrix and iliac crest bone marrow injection combined with elastic intramedullary nailing for the treatment of simplebonecysts in long bones of 9 children with a mean age of 12.6 years (range,
Anastasios D Kanellopoulos; Andreas F Mavrogenis; Panayiotis J Papagelopoulos; Panayotis N Soucacos
Twenty eight patients with simplebonecyst that were treated by aspiration and percutaneous autogenous bone marrow injection were reviewed to evaluate the treatment outcome. There were 18 boys and ten girls. Their mean age was 10.9?±?2.75 years. Single injection was performed for 16 patients; the rest had double or triple injections. There were no operative complications. The mean follow-up was 34.7?±?6.87 months. The procedure succeeded in obtaining healing in 23 cysts (82%). Cysts with index of more than five and cortical thickness of less than 1 mm were significantly prone to pathological fractures and had significant poor results after treatment. Our results suggested that autogenous bone marrow injection is a safe and effective treatment method for simplebonecysts, but sometimes repeated injections are necessary. Cyst index and cortical thickness are good indicators for cyst aggressiveness and good predictors for treatment outcome.
Simplebonecyst (SBC) is an enigma to the radiologist, pathologist and the orthopaedic surgeon. The etiology of this asymptomatic lesion that frequently causes pathological fracture is still unknown. It is probably self limited in nature, seen in children but rare among adults. The biological behavior is unpredictable as is the clinical course in various anatomical sites. This reflects on the high recurrence rate that has been associated with various treatment modalities. The clinical, radiological and biological features are discussed together with comparative review of treatment options from resection, curettage, and bone grafting to steroid injection and the latest experience of the use of percutaneous autologous marrow grafting in SBC. PMID:9810525
We prospectively evaluated the percutaneous injection of autogenous bone marrow for the treatment of active simplebonecysts in ten consecutive children with cysts in the proximal humerus, proximal femur or tibia. The treatment included percutaneous biopsy, aspiration of fluid and the injection of autogenous bone marrow aspirated from the iliac crest. All the patients became painfree after a mean of two weeks and resumed full activities within six weeks. All ten cysts consolidated radiologically and showed remarkable remodelling within four months. Review at 12 to 48 months showed satisfactory healing without complications. Percutaneous injection of autologous bone marrow appears to be an effective treatment for active simplebonecysts. PMID:8951010
Summary. The results of a single percutaneous aspiration and injection of marrow into active, simplebonecysts are reported in 8\\u000a cases. Slow regression of the cyst was consistently observed except in one lesion in the distal tibia. All the patients have\\u000a been free of symptoms after this treatment after a mean follow up of 31 months. The evolution of
C. Delloye; P. L. Docquier; O. Cornu; P. Poilvache; M. Peters; B. Woitrin; J. J. Rombouts; P. De Nayer
Objective. The unicameral bonecyst (UBC) is a common cystic bone lesion seen in children. We review and summarize its MR findings,\\u000a focusing on their appearance following contrast enhancement, and correlating them to known histologic features of UBC. Subjects and methods. A retrospective review of 20 cases (13 boys, 7 girls; age range, 1–17 years; mean age, 8.9) diagnosed as
Ryan Margau; P. Babyn; William Cole; Charles Smith; Francis Lee
A simplebonecyst of the proximal humeral metaphysis was found to cause growth disturbance with shortening and deformity in four patients. All had one pathological fracture. Three of them were treated with cortisone injections; the fourth patient, who presented an erosion of the physis, was treated with saline solution irrigation. Four hypotheses about the aetiology of growth arrest in the evolution of this benign lesion, are discussed: iatrogenic lesion of the physis, growth plate involvement by fracture, cortisone injection, and increased cyst pressure leading to erosion and even perforation of the growth plate. PMID:15165020
Background The treatment of simplebonecysts (SBC) in children varies significantly among physicians. This study examined which procedure is better for the treatment of SBC, using a decision analysis based on current published evidence. Methods A decision tree focused on five treatment modalities of SBC (observation, steroid injection, autologous bone marrow injection, decompression, and curettage with bone graft) were created. Each treatment modality was further branched, according to the presence and severity of complications. The probabilities of all cases were obtained by literature review. A roll back tool was utilized to determine the most preferred treatment modality. One-way sensitivity analysis was performed to determine the threshold value of the treatment modalities. Two-way sensitivity analysis was utilized to examine the joint impact of changes in probabilities of two parameters. Results The decision model favored autologous bone marrow injection. The expected value of autologous bone marrow injection was 0.9445, while those of observation, steroid injection, decompression, and curettage and bone graft were 0.9318, 0.9400, 0.9395, and 0.9342, respectively. One-way sensitivity analysis showed that autologous bone marrow injection was better than that of decompression for the expected value when the rate of pathologic fracture, or positive symptoms of SBC after autologous bone marrow injection, was lower than 20.4%. Conclusions In our study, autologous bone marrow injection was found to be the best choice of treatment of SBC. However, the results were sensitive to the rate of pathologic fracture after treatment of SBC. Physicians should consider the possibility of pathologic fracture when they determine a treatment method for SBC.
Lee, Seung Yeol; Chung, Chin Youb; Lee, Kyoung Min; Sung, Ki Hyuk; Won, Sung Hun; Choi, In Ho; Cho, Tae-Joon; Yoo, Won Joon; Yeo, Ji Hyun
This paper describes an extremely rare case of a huge aneurysmal bonecyst (ABC) in the pelvis, occurring in the patient’s 5th decade of life. The patient presented with a history of painless huge pelvic mass for 10 years. Plain radiograph and computed tomography showed huge expansile lytic lesion arising from the right iliac bone. A biopsy was performed and histology confirmed diagnosis of aneurysmal bonecyst. Unfortunately, the patient succumbed to profuse bleeding from the tumour.
A 73-year-old man developed an enlarged cystic lesion located in the soft tissues surrounding the left hip. The lesion was surgically removed. The patient was well 1 year after surgery. The lesion was histologically identical to an aneurysmal bonecyst, therefore it was diagnosed as an extraosseous aneurysmal bonecyst. The differential diagnoses and a review of the literature are presented. PMID:9063529
Traumatic (simple) bonecyst (TBC) is an empty nonepithelial-lined cavity of the jaws. The majority of TBCs are located in the body or symphysis of the mandible. Clinically, the lesion is asymptomatic and often discovered incidentally on routine radiographic examination as a noncorticated sharply defined radiolucent area with undulating borders. Because tissues for histologic examination may be scant or nonexistent, the definite diagnosis is invariably achieved during surgery when the lesion is empty. In this report, we present a case of unusual bilateral synchronous TBCs of the mandible with possible traumatic etiology, featuring significant buccolingual expansion of the mandibular ramus and body, presence of septa, and probable displacement of the inferior alveolar canal. PMID:22676831
Mathew, Reji; Omami, Galal; Gianoli, Dennis; Lurie, Alan
Objective and Importance: Aneurysmal bonecysts (ABC) are benign bone neoplasms which typically involve the spine and long bones. We present a rare case of an ABC in the temporal bone with significant cerebellar compression. Clinical Presentation: The patient was a young boy who presented with several weeks of left posterior auricular pain. Computed tomography, magnetic resonance imaging and angiogram
Caleb R. Lippman; George I. Jallo; Joseph G. Feghali; Elpidio Jimenez; Fred Epstein
Aneurysmal bonecyst is a benign proliferative tumefaction of bone. Histologic similarities indicate a kinship among classic aneurysmal bonecysts, essentially 'solid' proliferative lesions in bones; giant cell reparative granulomas of the jaws, at the base of the skull, and in the small bones of the hands and feet; skeletal lesions of hyperparathyroidism; and even pseudosarcomatous myositis ossificans, proliferative myositis, and proliferative fasciitis.
Simple renal cysts are most commonly found in the elderly, male population. The majority of simple renal cysts remain untreated, except on the rare occasion when they become complicated with hemorrhage, infection or rupture. We present the case of a 31-year-old female with a simple renal cyst which was initially treated as acute pyelonephritis. A high clinical suspicion led to the diagnosis of an infected renal cyst which was treated with antibiotic therapy and radiological drainage. There were minimal complications and the patient made an uneventful recovery. PMID:24331349
A 90-year-old woman presented with headache and diplopia, and a mass in the nasal cavity and paranasal sinuses was found on CT scan. The patient underwent examination under anaesthesia showing a mass arising from the ethmoid, apparently from the nasal septum. Biopsies taken showed an aneurysmal bonecyst. The patient opted against surgery and has been managed conservatively. A second CT scan 4 years later showed significant increase in size. PMID:24706701
BACKGROUND: Aneurysmal bonecysts are relatively uncommon in the facial skeleton. These usually affect the mandible but origin from the coronoid process is even rarer. To the best of our knowledge, this is the first reported case of a coronoid process aneurysmal bonecyst presenting as temporal fossa swelling. CASE PRESENTATION: A 17 year old boy presented with a progressively
Amit Goyal; Isha Tyagi; Rajan Syal; Tanu Agrawal; Manoj Jain
A patient is presented with solid aneurysmal bonecyst of the left proximal femur and a pathologic bone fracture in this region. The radiological and histological features of this lesion are described. While a conventional aneurysmal bonecyst is an expanding osteolytic lesion consisting of blood-filled spaces of variable size, separated by connective tissue containing bone trabeculae or osteoid tissue and many osteoclastic giant cells, a solid aneurysmal bonecyst is an unusual solid bone lesion with fibroblastic, osteoclastic, osteoblastic, aneurysmal, and fibromyoxid elements. The differential diagnosis includes giant cell tumor and fibroblastic osteosarcoma as well as specific bone reactions (bone fracture, reparative giant cell granuloma in hyperparathyroidism, giant cell reaction of short tubular bones). Solid aneurysmal bonecyst is a tumor-like lesion and probably a special bone reaction to damage; it has a good prognosis. Usually curettage is curative. PMID:7610415
The incidence of bonecysts in sarcoidosis, a multisystemic disease, varies in different series, and these cysts are generally asymptomatic. We evaluated bonecysts in 516 sarcoidosis patients with available hand X-rays and in 200 patients with foot X-rays. Bonecysts were present in 21 cases (19 females, two males). The cysts were localized in phalanges of the hand in
Solid variant of aneurysmal bonecyst is a variant of aneurysmal bonecyst in which the predominant histology is that of the solid material of a cystic aneurysmal bonecyst. In this article, we present a patient with solid variant of aneurysmal bonecyst of the hamate and discuss the differential diagnosis and current treatment for this lesion. PMID:21113696
Mavrogenis, Andreas F; Skarpidi, Evangelia; Papagelopoulos, Panayiotis J
The treatment of three cases of aneurysmal bonecyst by selective arterial embolism is described. Two cases had involvement of the pelvis and one of the knee. The 2-year follow up has been promising. Radiologically the lesion has been arrested with increased density of the cyst wall and intra-cystic trabecular new bone formation. Pain relief has been complete and up to now no surgical treatment has been required. PMID:7152745
Aneurysmal hone cyst is rare in paranasal sinuses. It may be uni or multilocutar It occurs alone or with other benign bone lesions. The exact pathogenesis of it is still unknown. The aggressiveness of the disease needs early diagnosis and proper management to prevent recurrence. This report describes a case of aneurysmal bonecyst involving the ethmoid and maxillary sinuses which was successfully managed. PMID:23119919
Unicameral bonecysts of the pelvis are extremely rare. This study summarizes the clinical, radiologic and pathologic features of 16 cases. Patients ranged in age from nine to 69. Most lesions were in the anterior portion of the iliac wing; many appeared to be related to an open iliac crest apophysis. This suggests that the pathogenesis of unicameral bonecysts in this portion of the ilium is similar to that seen in the proximal humerus and the proximal femur. The correct diagnosis was made preoperatively in only five cases. This indicates that, although they are well documented, unicameral bonecysts of the pelvis remain a diagnostic problem. Patients received a spectrum of treatments from curettage to observation. There appeared to be no difference in the outcome after any form of treatment. Therefore, unicameral bonecysts of the pelvis can be managed conservatively. The choice to manage patients conservatively depends on making the correct diagnosis based on clinical history and imaging. The most effective imaging is a combination of plain radiographs, computed tomography (CT) and magnetic resonance imaging (MRI).
Hammoud, Sommer; Weber, Kristy; McCarthy, Edward F
Aneurysmal bonecyst 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 bonecyst. 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 bonecyst located in the middle turbinate. We report a case of aneurysmal bonecyst with an atypical location and discuss the treatment of the patient with endoscopic surgery in light of relevant literature. PMID:23780605
Objectives Symptomatic simple renal cysts can be treated by combination of percutaneous aspiration and sclerotherapy. A number of sclerosing\\u000a agents including glucose, phenol, iophendylate, polidocanol, minocycline and pantopaque have been used in the past to prevent\\u000a reformation of cyst. In this study, tetracycline HCL solution is evaluated as a sclerosant for treatment of simple renal cysts.\\u000a \\u000a \\u000a \\u000a Methods Our study treated 76 cysts
Mehmet Kilinc; Osman Tufan; Selcuk Guven; Kemal Odev; Recai Gurbuz
Cystic spinal lesions with characteristic patterns, such as the presence of haematic fluid-fluid levels (H-FFL), have been associated with many tumoral lineages, more frequently with aneurysmal bonecyst (ABC) and exceptionally with metastasis. We present the case of a 60-year-old man with the finding of a sacral cystic bone lesion with H-FFL, with initial suspicion of ABC and confirmed diagnosis of metastasis. The case presented is, to our knowledge, the second case published of spinal cystic bone metastasis with H-FFL pattern with unknown primary tumour at the time of diagnosis and the only one that received resective surgical treatment, achieving pulmonary and metastatic disease control with good quality of life after 1 year of follow up. PMID:23731559
Sanromán-Álvarez, Pablo; Simal-Julián, Juan Antonio; Miranda-Lloret, Pablo; Pérez-Borredá, Pedro; Botella-Asunción, Carlos
Aneurysmal bonecysts predominantly occur in young adults and the long bones, the lumbar spine and the pelvis are mainly affected. This article presents the case of a 22-year-old woman with the very rare localization of an aneurysmal bonecyst of the atlas and an atlas fracture after a minor trauma. The initial radiological diagnosis was a suspicted aneurysmal bonecyst which was confirmed histologically. Due to the unstable fracture it was decided to carry out surgical treatment with occipitocervical stabilization in combination with a transoral bone graft. After a period of 11 months the fracture had completely healed and the implants were removed without any complications. PMID:23887801
Topp, T; Krüger, A; Zettl, R; Figiel, J; Ruchholtz, S; Frangen, T M
Aneurysmal bonecysts (ABCs) are rare benign bone tumours. Scapula is a very rare location, and the relative literature is sparse. The purpose of this study is to present a case of a giant aggressive scapular aneurysmal bonecyst in a child. A 7-year-old boy presented to our hospital with pain and a palpated mass on the right scapula. Imaging studies (radiographs computed tomography scintigraphy) were indicative of aneurysmal bonecyst. We performed curettage and bone grafting after the diagnosis was set by pathological examination through a posterior shoulder approach. Five years later, the patient has only residual signs of the lesion on radiographic control without signs of recurrence.
Beslikas, Theodoros; Chytas, Anastasios; Christodoulou, Andreas; Gigis, Ioannis; Christoforidis, Ioannis
Summary Background: Aneurysmal bonecyst is an expansile bone lesion, non-neoplastic in nature, occurring most commonly in long bones. It is uncommon in facial bones and exceptionally rare in ethmoid bone. Ten cases of aneurysmal bonecysts of ethmoid bone have been reported so far. Case Report: A young adolescent presented with decreased vision and pain in the right eye. MRI revealed an expansile lesion having conspicuous fluid levels with a multiloculated appearance in the right ethmoid bone extending to the right orbit. CT was done to characterize better bone details. Both biopsy of the lesion and histopathology of resected specimen confirmed aneurysmal bonecyst. Conclusions: A characteristic appearance on MRI and CT examinations helped to confidently diagnose a relatively common lesion in an exceedingly rare location.
The purpose of this study was to review longitudinally the clinical features, method of treatment, and recurrence rates of 40 cases of aneurysmal bonecyst in children treated at one institution. Twenty-nine patients with histologic confirmation of the diagnosis and minimum follow-up of 2 years were included. Thirteen patients were less than 10 years of age, and 16 were in the second decade of life. The most frequent location of the lesion was the tibia (seven cases). Patients were treated with curettage, curettage and bone grafting, or resection. The overall recurrence rate was 27.5%. Five lesions recurred once, and three recurred twice. The average time before recurrence was 18.7 months. Complications occurred in six cases, three of them with physeal arrest. The lesion occurred more commonly in females in the second decade of life and was not associated with a pre-existing tumor. The recurrence rate dropped after the use of a high-speed bur. PMID:12131454
We report a case of multiple extraosseous aneurysmal cysts occurring in the muscle and subcutaneous plane of postero-lateral aspects of the upper right leg. They appeared about 15 months after resection of aneurysmal bonecyst of the upper end of the fibula. They varied in size from 2 cm to 5 cm. Radiologically they were well-defined lesions with central septate areas surrounded by a rim of calcification. Histologically they showed central cystic spaces separated by septa consisting of fibroblasts, osteoclast type of giant cells and reactive woven bone. Thus they showed histological similarity with aneurysmal bonecysts, but did not show any connection with the bone. Only very few examples of aneurysmal cysts of soft tissue had been described in the past one decade and they were reported in various locations including rare sites such as arterial wall and larynx. Recent cytogenetic analyses have shown abnormalities involving 17p11-13 and/or 16q22 in both osseous and extraosseous aneurysmal cysts indicating its probable neoplastic nature. Our case had unique features like multiplicity and occurrence after resection of primary aneurysmal bonecyst of the underlying bone.
The traumatic bonecyst (TBC) is an uncommon and poorly understood lesion. First described in 1929, TBCs lack an epithelial lining, typically occur during the second decade of life, and are most frequently located in the jaw. Although the majority of TBCs are asymptomatic, rarely a TBC can cause a pathologic fracture of the mandible. We present a case of an adolescent suffering a sports-related pathologic mandible fracture secondary to a traumatic bonecyst. PMID:24436760
A rare, large pediatric aneurysmal bonecyst with pathologic fracture of the distal tibia of a 4-year-old female was presented. Classic radiographic and magnetic resonance imaging findings have been discussed. In a comprehensive review of the literature, aneurysmal bonecysts are an infrequently reported neoplasm of the foot and ankle bones. Lesions are characteristically seen in patients younger than 20 years of age, but rarely younger than 5 years. The benign cyst has a 2:1 female-to male predilection. In long bones, the lesion is typically metaphyseal in nature. Although the pathogenesis is still unknown, there exists the possibility of two types of aneurysmal bonecysts: a primary type without preexisting lesion and a secondary form associated with some other lesion. The diagnosis of aneurysmal bonecyst can be strongly suspected by correlating the radiographic and magnetic resonance imaging findings. For definitive diagnosis, accurate histologic evaluation is imperative to rule out any confusion or possibility with a malignant tumor. PMID:9086721
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 bonecyst (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. PMID:24179655
Aneurysmal bonecyst (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.
Aneurysmal bonecysts are rare benign lesions of bone tissue, infrequent in craneofacial skeleton with regard to other structures like long bones or the spine. They are composed of sinusoidal and vascular spaces blood-filled and surrounded by fibrous tissue septa. We present a case of a 29-year-old Caucasian male with a big swelling in the left mandible associated to pain and rapid growth. He referred previous extraction of the left inferior third molar. On the X-ray study, an expansive multilocular and high vascularized bony lesion within the mandibular angle was observed. It produced expansion and destruction of lingual and buccal cortex. An incisional biopsy was performed showing a fibrous tissue with blood-filled spaces lesion suggestive of an aneurysmal bonecyst. After selective embolization of the tumour, surgical resection was done with curettage and immediate reconstruction of the defect with an anterior iliac crest graft. Aneurysmal bonecysts are non-neoplastic but locally aggressive tumours with occasional rapid growth that may be differentiated from other multilocular process like ameloblastoma, ossifying fibroma, epithelial cyst, giant cell granuloma and sarcomas. Treatment of choice consists on conservative surgical excision of the mass with curettage or enucleation. When resection creates a big defect, primary surgical reconstruction is recommended. PMID:19242394
A rare case of aneurysmal bonecyst (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
An aneurysmal bonecyst is considered as a locally aggressive benign tumour. Intra-lesional extended curettage and bone-grafting is the mainstay of the treatment for aneurysmal bonecysts. 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 bonecyst of the superior ramus of the pubis.
An aneurysmal bonecyst is considered as a locally aggressive benign tumour. Intra-lesional extended curettage and bone-grafting is the mainstay of the treatment for aneurysmal bonecysts. 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 bonecyst of the superior ramus of the pubis. PMID:24086898
Aneurysmal bonecyst is an uncommon bone lesion which rarely occurs in craniofacial region. Among all the cystic lesions occurring in the jaws, aneurysmal bonecyst is infrequent and it more commonly occurs in the mandible. Most of the cases occur in the first two decades of life, with no gender predilection. Here, we are presenting a case of an aneurysmal bonecyst which occurred in the mandible of a twelve year old female patient. PMID:24551739
S N, Bhavani; Rajesh, A; P, Narendranatha Reddy; Kamal, Firoz
One hundred and forty-four solitary bonecysts were treated by curettage and packing with freeze-dried crushed cortical-bone allograft. One hundred and eight healed primarily. There was a higher rate of recurrence in young patients (less than ten years ol...
K. F. Spence R. W. Bright S. P. Fitzgerald K. W. Sell
Fourteen solitary bonecysts (SBC) with large areas of calcification (7 in the femur, 4 in the humerus, and 1 each in the pelvis, the tibia and the scapula) and 402 SBC from the Hamburg Bone Tumour Registry were reviewed in a retrospective study. The analysis was done with emphasis on the clinical, radiological and histological appearances. SBC are well
M. Amling; M. Werner; M. Pösl; G. Delling; R. Maas; U. Korn
Objective To measure the occurrence and natural history of simple ovarian cysts in a cohort of older women. Study Design Simplecysts were ascertained among a cohort of 15,735 women from the intervention arm of the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial, through 4 years of transvaginal ultrasound screening. Results Simplecysts were seen in 14% of women the first time their ovaries were visualized. The one-year incidence of new simplecysts was 8%. Among ovaries with one simplecyst at the first screen, 54% retained one simplecyst, and 32% had no cyst one year later. Simplecysts did not increase risk of subsequent invasive ovarian cancer. Conclusions Simple ovarian cysts are fairly common among post-menopausal women, and most appear stable or resolve by the next annual exam. These findings support recent recommendations to follow unilocular simplecysts in post-menopausal women without intervention.
Greenlee, Robert T.; Kessel, Bruce; Williams, Craig R.; Riley, Thomas L.; Ragard, Lawrence R.; Hartge, Patricia; Buys, Saundra S.; Partridge, Edward E.; Reding, Douglas J.
A 12-year-old boy had been known to have a small swelling in the left high vertex for several years. After a trivial head hit to the site of the swelling, the swelling enlarged gradually. A bone window CT scan showed a lesion having bubble-like lytic change in the left parietal bone. Similar changes, but small, were able to be pointed out in a CT scan taken seven years previously. In the following 13 months CT scans eventually revealed sequential increases to 3.5 cm in diameter. Surgical exploratory resection of the mass was performed. Intraoperatively, partial destruction of the outer skull table and a simplecyst with serous yellowish brown colored fluid were identified. There was no finding adherent to the diploic structure. The bone defect after excision was reconstructed by using a titanium plate. The patient was followed up for 2 years after the surgery. Bone window CT showed bony development of normal appearance. Histological examination showed the cyst wall consisted of fibrous connective tissue but there were neither epithelial nor endothelial cells. The histopathological diagnosis of SBC was most likely. SBC is relatively common in long bones, but rarely in flat bones. Only several cases of the SBC of cranial bone have been reported. Although a craniectomy for total excision followed by cranioplasty by resin was common, in cases of children, cyst removal with titanium plate application would be an alterative. SBC increasing in size after head injury is extremely rare, but clinicians may need to be aware of cystic skull bone tumors increasing in size after head injury. PMID:22728540
Early onset sarcoidosis is a granulomatous disease which is characterized by synovitis, polyarthritis, skin and eye involvement. We report the skeletal features of one patient with a family history and clinical symptoms suggestive of early onset sarcoidosis (EOS) which was confirmed by skin biopsy. Radiographs reveal postarthritic deformities of the MCP joints, contractures, a coarsened trabecular pattern at the PIP joints and small bonecysts resembling osteitis cystoides multiplex. Similar lesions were described in radiographs of the older sister and an uncle of our patient. This is the first report demonstrating bonecysts and erosions which could be a diagnostic feature in this rare disease and may help to differentiate other rheumatoid disorders. PMID:17492440
Objective Our goal was to document the presentation, location, diagnostic modalities, preoperative embolization status, treatment, histology, complications, and recurrence rates for aneurysmal bonecysts of the mobile spine. Methods We reviewed our institution's database to identify patients diagnosed with aneurysmal bonecysts 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 bonecysts of the spine can be successfully treated with surgical resection and instrumentation.
Mesfin, Addisu; McCarthy, Edward F.; Kebaish, Khaled M.
Chondroblastoma is a relatively rare benign bone tumor. Approximately 7% of chondroblastomas occur in the calcaneus, and 17% of chondroblastoma associated with cystic lesions. We report a case of a chondroblastoma in the calcaneus with a secondary aneurysmal bonecyst treated successfully by endoscopic curettage without bone grafting. New bone formation is facilitated by minimal damage to the bone and
Periorbital dermoid cysts should be removed because they commonly leak their irritant contents into the surrounding tissues. The underlying bone may, however, be involved in patients with dermoid cysts at the outer canthus. Computed tomography studies of 70 patients (43 men and 27 women, aged 30 months to 63 years, mean 29 years) with proved dermoid cysts of this type
Recently, surgical treatment of a symptomatic unicameral cyst of the proximal femur has been achieved with less invasive procedures than traditional open curettage with an autologous bone graft. In this article we introduce endoscopic surgery for a symptomatic unicameral cyst of the proximal femur. The presented technique, which includes minimally invasive endoscopic curettage of the cyst and injection of a bone substitute, not only minimizes muscle damage around the femur but also enables sufficient curettage of the fibrous membrane in the cyst wall and the bony septum through direct detailed visualization by an endoscope. Furthermore, sufficient initial strength after curettage can be obtained by injecting calcium phosphate cement as a bone substitute.
A 12-year-old girl had an aneurysmal bonecyst in the proximal femoral metaphysis simultaneously with an avascular necrosis of the femoral head, as seen on radiological examination. No extension of the lesion across the growth plate into the femoral epiphysis was observed. The expansive behavior of this lesion (ABC) could have compromised the posterosuperior vascular supply of the femoral epiphysis, since no radiographic signs of fractures could be found. Vascular anomalies within the lesion that increase venous pressure could be another factor responsible for the decrease in the blood supply of the femoral epiphysis and could cause necrosis, hence compromising the morphology of the hip joint at maturity. PMID:7719826
Clear cell chondrosarcoma is a rare cartilaginous tumour of low-grade malignancy. Although it has a characteristic histological appearance, its radiological features and clinical presentation often mimic a benign lesion. Herein, we describe the case of a patient with a clear cell chondrosarcoma of the right proximal femur that had an atypical appearance of chronic avascular necrosis on initial plain radiographs, which made preoperative diagnosis a challenge. In addition, the tumour also had extensive areas of aneurysmal bonecyst-like changes, which is not only a rare histologic phenomenon in clear cell chondrosarcoma, but also a confounding factor in the interpretation of the radiologic findings. PMID:24664395
Tay, Timothy; Wong, Steven Bak Siew; Sittampalam, Kesavan so; Lie, Denny Tjiauw Tjoen
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 bonecyst of the left occipital condylar region. The differential diagnosis of bonecysts in the skull is discussed. Six months after the operation, the patient again presented with backache due to adhesive arachnoiditis.
W. G. Bradley; R. M. Kalbag; P. S. Ramani; B. E. Tomlinson
We report a rare case of fibrous dysplasia with the development of a secondary aneurysmal bonecyst presenting as solitary tumor of calvarium. Although fibrous dysplasia with aneurysmal bonecyst is rare, it should be taken into account in differential diagnosis of the osteolytic solitary skull lesion.
Giant cell bone tumors are the most common precursor lesions of aneurysmal bonecysts (ABCs) developing secondarily. In giant cell bone tumors containing an explicit ABC component, the observation of the solid component of the giant cell bone tumor plays a critical role in the separation of the primary ABC. In general, ABC cases together with giant cell tumors in the bone are diagnosed histopathologically. The combination of giant cell bone tumor with superposed ABC and that of painful scoliosis with backache is rarely seen in children. In this case study, we discussed the diagnosis and the treatment of a giant cell tumor and superposed an ABC present in the fifth lumbar spine in a pediatric patient admitted to our clinic with a complaint of acute scoliotic back pain. PMID:24858183
Background A long-term follow up case of hepatobiliary cystadenoma originating from simple hepatic cyst is rare. Case presentation We report a case of progressive morphologic changes from simple hepatic cyst to hepatobiliary cystadenoma by 11 – year follow up imaging. A 25-year-old man visited our hospital in 1993 for a simple hepatic cyst. The cyst was located in the left lobe of the liver, was 6 cm in diameter, and did not exhibit calcification, septa or papillary projections. No surgical treatment was performed, although the cyst was observed to gradually enlarge upon subsequent examination. The patient was admitted to our hospital in 2004 due to epigastralgia. Re-examination of the simple hepatic cyst revealed mounting calcification and septa. Abdominal CT on admission revealed a hepatic cyst over 10 cm in diameter and a high-density area within the thickened wall. MRI revealed a mass of low intensity and partly high intensity on a T1-weighted image. Abdominal angiography revealed hypovascular tumor. The serum levels of AST and ALT were elevated slightly, but tumor markers were within normal ranges. Left lobectomy of the liver was performed with diagnosis of hepatobiliary cystadenoma or hepatobiliary cystadenocarcinoma. The resected specimen had a solid component with papillary projections and the cyst was filled with liquid-like muddy bile. Histologically, the inner layer of the cyst was lined with columnar epithelium showing mild grade dysplasia. On the basis of these findings, hepatobiliary cystadenoma was diagnosed. Conclusion We believe this case provides evidence of a simple hepatic cyst gradually changing into hepatobiliary cystadenoma.
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 simplecysts 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.
Background: The authors present their experience in the laparoscopic management of hepatic cysts and polycystic liver disease\\u000a (PLD). Methods: Between January 1996 and January 2002, 16 patients underwent laparoscopic liver surgery. Indications were\\u000a solitary giant cysts (n = 10) and PLD (n = 6). Data were collected retrospectively. Results: Laparoscopic fenestration was\\u000a completed in 15 patients. Median operative time was
P. Fiamingo; U. Tedeschi; M. Veroux; U. Cillo; A. Brolese; A. Da Rold; C. Madia; G. Zanus; D. F. D'Amico
Objective To evaluate cyst remodeling, including complete healing and recurrence, and its relation to the cyst volume in two groups\\u000a of patients, using curettage and bone grafting or methylprednisolone injection.\\u000a \\u000a \\u000a \\u000a Materials and methods A retrospective analysis was carried out on data from 132 patients with solitary bonecyst, where 79 (59.9%) had undergone\\u000a curettage and bone grafting and 53 (40.1%) had been
Maciej Glowacki; Anna Ignys-O’Byrne; Iwona Ignys; Przemyslaw Mankowski; Piotr Melzer
Background and purpose Recent data suggest that percutaneous sclerotherapy is a safe alternative to surgery for treatment of aneurysmal bonecysts (ABCs). We present our experience of this method. Methods We retrospectively analyzed data from 38 consecutive patients treated with repeated injections of polidocanol. Each injection consisted of 2–4 mg polidocanol per kg body weight. Radiological and clinical assessments were performed until healing. Results All cycts except 1 healed after a median of 4 (1–11) injections. A lesion failed to heal in 1 patient, who was operated. 3 patients experienced minor local inflammatory reactions. Interpretation Our results show that percutaneus sclerotherapy with polidocanol has high efficacy in the treatment of ABCs, with a low frequency of side effects. Our findings corroborate data presented in previous publications. We believe that the method will be especially valuable in ABCs of the pelvis and sacrum, where surgery is associated with considerable morbidity.
Objective: To investigate whether the space-occupying effect of an endometrioma, rather than endometriosis itself, affects results in in vitro fertilization (IVF) using women with simple ovarian cysts as the control group. Methods: 85 normoresponder patients with endometriomas of 10–50 mm who underwent IVF treatment directly without initial removal were compared with 83 normoresponder patients with simple ovarian cysts of 10–35
Background Symptomatic aneurysmal bonecysts in pediatric age group with an expansile lesion in ilium is a rare occurrence. Case An 11-year-old female presented with a swelling over her right iliac region and numbness along the medial aspect of thigh. Clinicoradiological diagnosis was aneurysmal bonecyst confirmed on fine needle aspiration cytology. Excision curettage (wide margin excision of the soft tissue tumor and intralesional curettage in the region of acetabulum) of the tumor was performed in view of proximity to acetabular roof and endangered hip stability. Result At follow up of 18 months, the child has full painless range of movements in the hip joint with no recurrence. Conclusions Pelvic aneurysmal bonecysts are distinctly rare in pediatric age. The lesion was associated with an atypical symptom of numbness along the femoral nerve distribution. Hip stability and range of movements were major concern in this patient. Although many treatment options are described, surgical excision still remains the mainstay. In our case, we performed excision curettage, with good outcome.
The purpose of this paper is to perform an evidence based review for treatment of unicameral bonecysts. A search of MEDLINE (1966 to 2009) was conducted and the studies were classified according to levels of evidence. This review includes only comparative Level I-III studies. The systematic review identified 16 studies. There is one level I study, one level II study and the remaining 14 studies are level III. Seven of the sixteen studies had statistically different results: three studies indicated that steroid injection was superior to bone marrow injection or curettage and bone grafting; one study indicated that cannulated screws were superior to steroid injections; one study indicated resection and myoplasty was superior to steroid injection; one study indicated a combination of steroid, demineralized bone matrix and bone marrow aspirate, and curettage and bone grafting were superior to steroid injection; and one study indicated that curettage and bone grafting was superior to non-operative immobilization. Based on one Level I study, including a limited number of individuals, steroid injection seems to be superior to bone marrow injection. As steroid injections have already demonstrated superiority over bone marrow injections in a randomized clinical trial, the next step would be a prospective trial comparing steroid injections with other treatments.
Donaldson, Sandra; Chundamala, Josie; Yandow, Suzanne; Wright, James G.
Aneurysmal bonecysts (ABCs) are nonneoplastic bone lesions that may originate of any site of skeleton. The spine can be affect up to 30% of the cases, leading to pain, neurological deficits, and pathological fractures in symptomatic patients. The incidence of craniocervical (occipito-C1-2) occurrence is not known. We describe the surgical technique and clinical results of two patients with craniocervical ABCs that underwent primary surgical resection: An 11-year-old girl with a lesion in the posterior aspect of the atlas, and a 28-year-old man with an important hydrocephalus and a posterior expansible lesion on the left side of his posterior fossa. Total resection was achieved on both lesions, with no surgical morbidity. Even though ABCs are nonneoplastic lesions, subtotal resection is associated with early recurrence. The knowledge of the anatomy of the region in order to achieve the occlusion of arterial feeders prior to surgical resection itself is the key point of the surgical strategy. PMID:24741252
Joaquim, Andrei Fernandes; Giacomini, Leonardo; Ghizoni, Enrico; Tedeschi, Helder
An aneurysmal bonecyst of ethmoid is a rare and distinct clinicopathologic entity. The diagnosis is important in this localization because it requires multidisciplinary approach in its management. We report a case of a 14-year-old woman presenting to our clinic with the complaint of epiphora and proptosis in the right eye, which were the symptomatic findings of aneurysmal bonecyst of ethmoid. PMID:20497081
The existing classifications of simple renal cysts are based on cyst fluid sodium concentration or cyst fluid/plasma sodium ratio. The present study aimed to assess: 1) the usefulness of cyst fluid concentrations of beta-2-microglobulin (beta-2-MG) as a marker of proximal tubules function and Tamm-Horsfall protein (THP) as a marker of distal tubules function to define the origin of renal cysts (proximal or distal); and 2) the function of proximal and distal tubules in patients with simple renal cysts. 31 patients with simple renal cysts and 10 healthy subjects were examined. Basing on the cyst fluid/plasma sodium ratio, 25 cysts were classified as of proximal origin and 6 as of undetermined origin. In all patients cyst fluid and plasma concentrations of beta-2-MG, erythropoietin, sodium, potassium and total protein were assessed. Urinary excretion of beta-2-MG and THP was also estimated and fractional excretion of beta-2-MG was calculated. The concentration of beta-2-MG in fluid obtained from cysts of proximal origin were significantly higher than in fluid from cysts of undetermined origin (2.26 +/- 0.36 vs. 0.65 +/- 0.13 mg/l, p = 0.0004). Concentrations of THP (6.85 +/- 1.21 vs. 3.14 +/- 1.06 micrograms/ml, p < 0.05), erythropoietin (500.6 +/- 176.8 vs. 42.0 +/- 17.7 mU/ml, p < 0.05) and potassium (4.39 +/- 0.07 vs. 3.13 +/- 0.44 mmol/l, p < 0.05) were also higher in fluid from proximal cysts than in fluid from cysts of undetermined origin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7800578
Franek, E; Bar, A; Kokot, F; Du?awa, J; Wiecek, A; Kocha?ska-Dziurowicz, A; Bar, K; Szkodny, A; Paw?owski, W; Myrta, J
Background Distal radius fractures (DRF) are often referred to as osteoporosis indicator fractures as their incidence increases from age 45. In the group of young adults, distal radius fractures normally result from high-energy trauma. Wrist fractures in young patients without adequate trauma thus raise suspicion of a pathologic fracture. In this report we present the case of a fractured unicameral bonecyst (UBC) at the distal radius in a young adult. To the author’s best knowledge, this is the first detailed report in an UBC at the distal radius causing a pathologic DRF in an adult patient. Case presentation A 25-year-old otherwise healthy male presented to our Emergency Department after a simple fall on his right outstretched hand. Extended diagnostics revealed a pathologic, dorsally displaced, intra-articular distal radius fracture secondary to a unicameral bonecyst occupying almost the whole metaphysis of the distal radius. To stabilize the fracture, a combined dorsal and volar approach was used for open reduction and internal fixation. A tissue specimen for histopathological examination was gathered and the lesion was filled with an autologous bone graft harvested from the ipsilateral femur using a reamer-irrigator-aspirator (RIA) system. Following one revision surgery due to an intra-articular step-off, the patient recovered without further complications. Conclusions Pathologic fractures in young patients caused by unicameral bonecysts require extended diagnostics and adequate treatment. A single step surgical treatment is reasonable if fracture and bonecyst are treated appropriately. Arthroscopically assisted fracture repair may be considered in intra-articular fractures or whenever co-pathologies of the carpus are suspected.
OBJECTIVES: To assess the potential of expectant management for simple ovarian cysts diagnosed by transabdominal or transvaginal ultrasonography. To compare the results of needle aspiration with those achieved with simple observation. DESIGN: Randomised trial. SETTING: Hospital department of obstetrics and gynaecology. SUBJECTS: 278 women with simplecysts randomly allocated to simple observation (143) or ultrasound guided fine needle aspiration (135) between 1990 and 1994. MAIN OUTCOME MEASURES: Resolution of cyst or development of malignancy. RESULTS: After six months 269 were available for follow up. The rate of resolution was 46% (59/128) with aspiration and 44.6% (63/141) with observation. Only the diameter of the cyst (P < 0.0001) was a significant independent prognostic factor for resolution in a multivariate analysis. Age and treatment had no significant effect. One woman was subsequently found to have borderline malignant changes on histopathological examination. Her cyst was detected by transabdominal ultrasonography. CONCLUSIONS: Expectant management for up to six months does not cause risks for the patients and allows spontaneous resolution in over a third of cases, avoiding the costs and risks of unnecessary surgery. Aspiration does not provide better results than simple observation.
Zanetta, G.; Lissoni, A.; Torri, V.; Dalla Valle, C.; Trio, D.; Rangoni, G.; Mangioni, C.
The traumatic bonecyst (TBC) is commonly reported on in the dental and medical literature. The lesion is discovered most often, as an incidental finding during intraoral or panoramic radiographic examination. Conservative treatment in the form of needle aspiration or surgical exploration and curettage is generally considered curative as well as diagnostic for the TBC. Some authors suggest that the TBC is a self-limiting entity, as it is rarely seen in patients older than thirty-five years of age. There are very few reports in the literature documenting recurrent TBCs. The patient reported on had a TBC measuring 1.5 cm. treated by surgical curettage in July 1981. There was no clinical or radiographic follow-up for eight years. When the patient presented for an initial examination in July of 1989, the recurrent lesion increased in size to 7cm x 4cm. Retreatment by surgical curettage established a diagnosis consistent with a TBC, and also produced impressive radiographic healing 3.5 years postoperatively. Because of the ability of the TBC to recur, long clinical and radiographic follow-up is recommended. PMID:8046094
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 bonecyst (ABC) of the extremities. Between 1998 and 2006, three patients, aged 6, 8 and 23 years, with giant aneurysmal bonecysts 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.
Nonparasitic hepatic cysts consist of a heterogeneous group of disorders, which differ in etiology, prevalence, and manifestations. Simple hepatic cysts are considered nonparasitic ones. These are a result of congenital anomalies of the biliary system, and these may be single or multiple. Generally, hepatic cysts are incidentally found during occasional laparotomy or laparoscopy, necropsy, and even during routine ultrasound or computerized tomography (CT) scan. Nowadays, with improving diagnostic techniques, hepatic cysts are becoming more common. Generally these lesions are asymptomatic. However, if they grow, they may become symptomatic. Symptoms depend on the size and location. When symptoms developed, these must be treated. Compressive complications due to local "liver mass" effect include: portal hypertension, edema due to caval compression, jaundice and arrhythmia and duodenal obstruction. Gastric extrinsic compression by liver cysts has been poorly described. Herein, we present a case of a female in whom percutaneous drainage of a large simple hepatic cysts not complicated was performed in order to reduce signs of gastric compression. PMID:24770829
Zippi, M; Bruni, A; Scevola, G; Pica, R; Cassieri, C; Marzano, C; Paoluzi, P
Giant cell tumor of bone is a benign, locally aggressive neoplasm that is composed of sheets of neoplastic mononuclear cells interspersed amongst non-neoplastic, uniformly distributed, osteoclast-like giant cells. They represent approximately 4-5 % of primary bone tumors. Rarely, bone tumors have been noted to produce human chorionic gonadotropin, a finding most often reported in osteosarcoma. We present the case of a young woman who presented with a low-level human chorionic gonadotropin level which, after resection of her recurrent giant cell tumor of bone with secondary aneurysmal bonecyst-like change, became undetectable in her blood. Furthermore, cells within the aneurysmal bonecyst component were immunohistochemically positive for ?-human chorionic gonadotropin. This is the first report of such a finding in the literature. PMID:24362936
INTRODUCTION Thrombosis of the inferior vena cava (IVC) is governed by Virchow's triad of stasis of blood flow, endothelial damage and hypercoagulability. Causes may be secondary to malignancy, congenital anomalies or other infrequent events such as external compression. We present a case of external compression of the IVC leading to extensive thrombus burden secondary to a benign hepatic cyst. PRESENTATION OF CASE A 72 year old African American female presented to the emergency department with new onset shortness of breath, right lower extremity weakness and swelling. CT imaging demonstrated multiple hepatic cysts compressing the IVC, leading to extensive clot burden. Treatment with heparin drip was initiated without resolution of her symptoms. Transcatheter mechanical thrombectomy and tPA infusion was performed. After 24 h, swelling and weakness were nearly resolved. The patient was bridged to therapeutic low molecular weight heparin in preparation for surgery. DISCUSSION Management of IVC thrombosis has typically been with a heparin drip and transition to oral anticoagulants. Thrombolysis has been shown to promote complete clot lysis more often than compared to standard anticoagulant therapy. In addition, venous patency was better maintained. CONCLUSION We feel that the added benefit of short term effects of improved venous patency and long term benefits of less post thrombotic syndrome, catheter based tPA administration and mechanical thrombectomy for thrombus offers an adjuvant treatment in the setting of large clot burden refractory to standard treatment.
Musielak, Matthew Christopher; Singh, Ranjodh; Hartman, Elizabeth; Bernstein, Joseph
Intralesional surgery is most commonly used for aneurysmal bonecysts. Rarely is en bloc resection used for active, aggressive, recurrent lesions and those located in expendable bones. However, persistence or recurrence of aneurysmal bonecysts is common. The clinical behavior of aneurysmal bonecysts is more aggressive in younger patients. Selective embolization is used as the primary treatment for aneurysmal bonecysts in surgically difficult anatomical locations and as an adjuvant to surgical treatment to reduce intraoperative blood loss and facilitate curettage.This article describes a 3-year-old boy with an aggressive aneurysmal bonecyst of the pelvis involving the right ischiopubic rami that achieved curative treatment with 3 embolizations with N-2-butyl-cyanoacrylate. Biopsy was diagnostic; however, the clinical course was misleading. Twenty days after the first embolization, despite complete occlusion of the feeding vessels, the patient experienced severe pain, increased size of the lesion, and lateral subluxation of the right hip. Based on the imaging and histological diagnosis, intralesional hemorrhage was assumed, and repeat embolization was performed. After the second embolization, the patient experienced perineal skin necrosis from normal vessel embolization; it was treated with wound dressing changes and healed uneventfully. A third embolization was performed because of a persistent lesion. Six years after treatment, the patient was symptom free, and imaging showed complete ossification of the cyst.Selective catheterization and occlusion of the feeding arteries with the appropriate embolic agent provide tumor devascularization, size reduction, pain relief, and induction of new bone formation. Multiple procedures are often necessary, and complications may occur. PMID:22691676
Rossi, Giuseppe; Mavrogenis, Andreas F; Papagelopoulos, Panayiotis J; Rimondi, Eugenio; Ruggieri, Pietro
The effects of percutaneous Ethibloc (Ethicon/Johnson & Johnson, St-Stevens-Woluwe, Belgium) injection into primary aneurysmal bonecysts were analysed. Two patients with a venous drainage after injection of a medium contrast were excluded. Twelve patients underwent at least one percutaneous injection of Ethibloc. The average follow-up period was 5.1 years. At final follow-up, six patients had complete healing of the cyst, three had partial healing and three, who had no response, were treated by curettage and bone grafting. Complete healing was observed for all the aggressive lesions. No major complications were noted. Ethibloc injection may be performed as a primary treatment of aneurysmal bonecysts if the technique is followed with precision. PMID:16093949
de Gauzy, Jérôme Sales; Abid, Abdelazis; Accadbled, Franck; Knorr, Gorka; Darodes, Philippe; Cahuzac, Jean Philippe
Objective: To present the case of an intercollegiate field hockey player with an aneurysmal bonecyst of the femur and the clinical decision making necessary in the evaluation, management, surgical intervention, and positive outcome of this athlete. Background: A 21-year-old field hockey player presented with signs and symptoms typical of a deep thigh contusion. She had no history of direct or indirect trauma, infection, or previous injury. Differential Diagnosis: Aneurysm, bonecyst, chondroma, giant cell tumor, osteochondroma, osteosarcoma, osteoid osteoma. Treatment: When her symptoms persisted beyond 6 months despite conservative care, she underwent radiographs, magnetic resonance imaging, and bone scan, which revealed a lesion in the right femur. At surgery, the lesion was diagnosed as an aneurysmal bonecyst, and it was excised by an incisional x-ray-guided biopsy followed by curettage and bone grafting. Uniqueness: The aneurysmal bonecyst presented as a typical thigh strain or deep contusion during the athlete's training and conditioning season. After all forms of conservative management proved ineffective, the athlete was referred to her physician. A detailed history and physical examination demonstrated no underlying musculoskeletal pathology coinciding with the athlete's symptoms. Conclusions: Increased clinical awareness is necessary when conservative management fails to resolve an athletic injury in an appropriate length of time. Proper diagnostic tools are essential in determining the pathology of the injury and whether surgical intervention is needed. ImagesFigure 1.Figure 2.Figure 3.
Berry, David C.; Barton, Julie; Deivert, Richard G.
Aneurysmal bonecysts (ABCs) are vascular lesions with well-defined radiological signs. A fairly common MRI finding in both ABC and other primary bone tumors with high vascularity is the presence of cysts with fluid-fluid levels. Metastatic lesions with fluid-fluid leveling have not previously been defined in the literature. We report three cases of fluid-fluid leveling of the axial skeleton in metastatic lesions. Two patients had single-level and one multi-level neoplastic disease with distinctive cysts showing fluid-fluid levels on MRI evaluation. Diagnosis of gastric carcinoma in two patients and breast carcinoma in the third was achieved with trocar biopsies. At the time of this report all patients had completed initial oncologic treatments and were disease free. PMID:24164948
Osteoblastoma is an infrequent benign tumor and skull involvement is extremely rare. The occipital bone is much less frequently involved. We report an unusual case of a huge occipital osteoblastoma with aneurysmal bonecyst in the posterior cranial fossa of a 20-year-old young man. MRI scan and CT three-dimensional reconstruction revealed that the tumor (approximately 8.5cm×6cm×5cm) occupied nearly half volume
A young lady aged 20 presented to us in 2004 with a pathological fracture of the left femoral neck through a large aneurysmal bonecyst. Instead of total hip arthroplasty, we performed one-stage reconstruction surgery combining internal fixation and free vascularized fibular grafting. At 4 years the structure and function of the hip had been preserved. PMID:19462373
Aneurysmal bonecyst (ABC) of the spine can cause acute spinal cord compression in young patients. We report the CT and MRI findings in a histology-proven case of spinal ABC presenting with sudden paraplegia. Typical features of a spinal ABC at the thoracic level with considerable extension into the posterior epidural space and cord compression were demonstrated. Special note was
Monica S. M. Chan; Yiu-Chung Wong; Ming-Keung Yuen; Dicky Lam
A case with a midline dermoid cyst of the frontal bone away from the anterior fontanel is reported. Although a few such cases have been reported, detailed descriptions are not given. Possible intracranial extension of these lesions is discussed with review of the pertinent literature.
Aneurysmal bonecyst is a benign pseudotumoral dystrophy of bone, presenting expansive, destructive, nonresolutive features and often recurrence. A "stand-by" therapeutically attitude, in a survey manner, based on some spontaneous regression of certain areas of the aneurysmal cyst, due to thrombosis and fibrosis, is rarely advocated. When tumoral lesions are located in long bones and the bone length must be preserved, the bioptic curettage, followed or not by auto-grafting or cortical/cancellous allografting to bridge defect, represents the treatment of choice. The inconveniences encountered in using auto- or allografts have raised a growing interest towards synthetic bone substitutes. The most used of them are phosphocalcic ceramics due to their basic properties regarding interaction between bone and the substitution material, especially macroporosity Lately, we started to use (as clinical application) a bone substitute based on synthetic biphasic macroporous ceramic (CERAFORM), covering a wide range of procedures: benign tumors and dystrophies, spinal or joint arthrodesis, periprosthetic fractures, revisions following failures of primary total hip replacements. We obtained promising results, suggesting that in a situation with limited bone defects, as in clinical case presentation, if there exist a good contact and strong mechanical fixation, CERAFORM represents a reliable option comparing to allograft. PMID:14756045
A dermoid cyst is a thin-walled benign tumor formed by the entrapment of ectodermal tissue during embryologic development, resulting in the inclusion of epithelium and adnexal elements within the tumor. Dermoids are not unique to a single anatomic location but are often isolated to the skin and subcutaneous tissue. They may occur intracranially or intra-abdominally, oftentimes associated with the ovary. If presenting as a midline mass of the skull, preoperative imaging with computed tomography and/or magnetic resonance imaging is necessary to evaluate for possible intracranial extension, given the altered embryologic development behind the formation of these cysts. Differential diagnosis of a midline frontonasal mass includes epidermoid or dermoid cyst, encephalocele, glioma, and sinus pericranii. The management of suspected dermoid cysts includes complete surgical excision, which may require a combined intracranial and extracranial approach. We present a 2-year-old boy who presented to our institution with a congenital midline scalp mass separate from the anterior fontanelle with complete underlying bony erosion to the sagittal sinus demonstrated on preoperative imaging, who required early surgical excision and reconstruction of the bony defect. PMID:22337389
Aneurysmal bonecysts are rare lesions that occur more commonly in the first and second decades of life. In children, a juxtaepiphyseal location is associated with increased risk of growth plate damage, skeletal deformity, and recurrence. Different treatments have been reported for the management of aneurysmal bonecysts, including surgical excision with or without adjuvants, intralesional injection of sclerosing agents, radiation therapy, cryotherapy, systemic calcitonin therapy, and selective arterial embolization. The authors present the case of a 5-year-old girl with a large aneurysmal bonecyst at the proximal femur, complicated by a pathologic fracture; treatment with two selective transcatheter arterial embolizations was curative. PMID:20813543
Rossi, Giuseppe; Angelini, Andrea; Mavrogenis, Andreas F; Rimondi, Eugenio; Ruggieri, Pietro
Fibrous dysplasia of bone is a congenital skeletal disorder characterized by proliferation of spindle cells inside an intramedullary collagenous stroma and by formation of metaplastic bone. An aneurysmal bonecyst is a lesion of unknown etiology. Macroscopically it appears like a blood-filled cavity that expands the affected bone. Histologically, fibrous septa are bordered by macrophages, giant cells, inflammatory cells, and areas of bone production. Hemorrhagic areas can rise into fibrous dysplasia. The lesion appears as an aggressive and destructive process that is difficult to diagnose properly. A 29-year-old woman presented with a 2-year history of left inguinal and lumbar pain. She reported increased pain after physical activity. Magnetic resonance imaging of the left femur (without intravenous gadolinium) showed a mass extending 14 cm along the femoral metaphysis. This lesion involved cortical bone that was broken in the posteromedial site. Computed tomography confirmed the osteostructural lytic alteration that "blows up" the proximal femur metaphysis. A trochar biopsy allowed the diagnosis of aneurysmal bonecyst on fibrous dysplasia, excluding malignancy. The lesion was treated with curettage and local adjuvants and filled with bone grafts. Internal fixation with a sliding screw plate was also performed. Radiographs at 1 year postoperatively showed good consolidation of the grafts and absence of local recurrence. The patient achieved active and passive mobilization of the left hip with no pain. PMID:19472953
Montalti, Maurizio; Alberghini, Marco; Ruggieri, Pietro
Background Escherichia coli (E. coli) is the most common causative bacteria of neonatal meningitis, but hematogenous intracranial E. coli infection is rare in adults. Moreover, intracranial abscess formation owing to E. coli, including brain abscesses and subdural empyema formation, is extremely rare. We herein present a case involving a patient with a brain abscess owing to E. coli following a simple renal cyst infection. A review of the literature is also presented. Case presentation A 77-year-old Japanese woman with a history of polymyalgia rheumatica was admitted to our hospital because of persistent fever, right flank pain, and pyuria. Intravenous antibiotics were administered; however, her level of consciousness deteriorated 6 days after admission. Contrast-enhanced magnetic resonance imaging showed a brain abscess in the left occipital lobe and pyogenic ventriculitis. Enhanced abdominal computed tomography revealed a right renal cyst with heterogeneous content. Culture of urine, blood, and aspirated pus from the infected cyst revealed E. coli with identical antibiotic sensitivity in all sites, suggesting that the cyst infection and subsequent bacteremia might have caused the brain abscess. The patient recovered after a 6-week course of meropenem. Conclusion The prognosis of patients with E. coli-associated intracranial abscess is usually poor. Advanced age and immunosuppression may be potent risk factors for intracranial abscess formation owing to the hematogenous spread of E. coli.
Background Unicameral bonecyst (UBC) is the most common benign lytic bone lesion seen in children. The aim of this study is to investigate clinical factors affecting pathological fracture and healing of UBC. Methods We retrospectively reviewed 155 UBC patients who consulted Nagoya musculoskeletal oncology group hospitals in Japan. Sixty of the 155 patients had pathological fracture at presentation. Of 141 patients with follow-up periods exceeding 6 months, 77 were followed conservatively and 64 treated by surgery. Results The fracture risk was significantly higher in the humerus than other bones. In multivariate analysis, ballooning of bone, cyst in long bone, male sex, thin cortical thickness and multilocular cyst were significant adverse prognostic factors for pathological fractures at presentation. The healing rates were 30% and 83% with observation and surgery, respectively. Multivariate analysis revealed that fracture at presentation and history of biopsy were good prognostic factors for healing of UBC in patients under observation. Conclusion The present results suggest that mechanical disruption of UBC such as fracture and biopsy promotes healing, and thus watchful waiting is indicated in these patients, whereas patients with poor prognostic factors for fractures should be considered for surgery.
Chondroblastoma is a rare tumor. It is usually benign; however, it can have an aggressive course before or after operative treatment, even resulting in pulmonary metastases. The foot is a rare location for chondroblastoma, and to our knowledge, chondroblastoma occurring in the navicular bone has not been reported previously in the English literature. We describe a case of navicular chondroblastoma case associated with an aneurysmal bonecyst. Treatment consisted of aggressive curettage, phenolization, and bone allograft. The patient was able to resume normal activities after treatment, and there was no recurrence of the chondroblastoma during a follow-up of 3 years.
Haemorrhagic-aneurismal bonecysts (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. PMID:23814588
Haemorrhagic-aneurismal bonecysts (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.
A 29-year-old woman complained of a 3-month history of left knee pain without trauma history. X-ray showed a well-defined osteolytic lesion with a sclerotic margin in the patella and magnetic resonance imaging showed T1-low and T2-high signal intensity with different fluid level. Our impression was an aneurysmal bonecyst. At surgery, the lesion was a blood-filled cystic cavity, surrounded by a gray or brownish tissue. Hemorrhagic soft tissues with recognizable bone fragments were observed. Curettage and autogenous bone graft was done. Microscopically, sheets of tumor cells were intermingled with some areas of eosinophilic chondroid matrix. The tumor cells showed oval-shaped nuclei with moderate eosinophilic cytoplasm. Several multinucleated giant cells and blood filled cystic cavities were observed. The final diagnosis was a chondroblastoma with a secondary aneurysmal bonecyst. At the post-operative 1.5-year follow-up, grafted bones were well incorporated radiographically and there were no recurrent evidence or any other abnormal symptoms.
A 29-year-old woman complained of a 3-month history of left knee pain without trauma history. X-ray showed a well-defined osteolytic lesion with a sclerotic margin in the patella and magnetic resonance imaging showed T1-low and T2-high signal intensity with different fluid level. Our impression was an aneurysmal bonecyst. At surgery, the lesion was a blood-filled cystic cavity, surrounded by a gray or brownish tissue. Hemorrhagic soft tissues with recognizable bone fragments were observed. Curettage and autogenous bone graft was done. Microscopically, sheets of tumor cells were intermingled with some areas of eosinophilic chondroid matrix. The tumor cells showed oval-shaped nuclei with moderate eosinophilic cytoplasm. Several multinucleated giant cells and blood filled cystic cavities were observed. The final diagnosis was a chondroblastoma with a secondary aneurysmal bonecyst. At the post-operative 1.5-year follow-up, grafted bones were well incorporated radiographically and there were no recurrent evidence or any other abnormal symptoms. PMID:24639947
The trabecular bonecyst (TBC) is the jaws' equivalent of the unicameral cyst of the long bones. A series of 20 TBCs were surgically treated in the jaws (19 in the mandible and one in the maxilla) of 14 Chinese patients (five males and nine females), who could broadly be divided into two age-sex groups; a young group of both sexes and an older, exclusively female group. Three patients in the older group had more than one TBC and the one with initially five separate TBCs (including one in the maxilla) exhibited six episodes of recurrence of the mandibular lesions which finally coalesced to affect the whole body of the mandible bilaterally. PMID:7489631
A patient with polyostotic fibrous dysplasia had several fractures of the right lower limb. An above-knee amputation was eventually performed, followed by arthrodesis of the hip. Five years later the stump became painful and swelled with dramatic rapidity. Biopsy showed that this was not due to malignant change, but that an aneurysmal bonecyst had developed in association with the fibrous dysplasia. PMID:3941131
Aneurysmal bonecyst is a pseudotumoral lesion. Complete resection prior to selective arterial embolization seems to be the treatment of choice for the more extensive and destructive lesions. In these cases maintaining stability of the cervical spine is critical. This can be very challenging in children and adolescents in whom the axial skeleton is still growing. In this case a young girl presented with a voluminous cervical aneurysmal bonecyst encaging both vertebral arteries and spinal cord. The lesion was treated with aggressive surgical resection, followed by cervical vertebral fusion with instrumentation. After nine months the patient referred no pain and no neurological deficit. MRI scans showed an extensive local recurrence. The family of the young girl refused any other therapy and any other followup. The patients returned to our attention after five years with no pain and neurological deficit. Cervical spine radiographs and MRI scans showed a complete regression of the extensive local recurrence. In the literature, the possibility of spontaneous regression of residual part or local recurrence is reported. The case of this young girl provided the chance to attend a spontaneous regression in an extensive recurrence of aneurismal bonecyst. PMID:24707421
Brembilla, Carlo; Lanterna, Luigi Andrea; Bosisio, Michela; Gritti, Paolo; Risso, Andrea; Signorelli, Antonio; Biroli, Francesco
Limited research has analysed paediatric shoulder girdle aneurysmal bonecyst management and outcomes. This study analysed locations affected, investigations, treatments and recurrence in children treated at the London Bone Tumour Unit between 1998 and 2004 and in English and French literature between 1956 and 2004. The proximal humerus and clavicle are most frequently affected whereas scapula involvement is rare. Radiographs, computed tomography and MRI are valuable. Sole curettage of clavicle and scapula lesions has low recurrence rates. Proximal humerus lesions recur most frequently. Curettage alone or with cementation are the most appealing treatments but are associated with significant recurrence. PMID:17909342
Kaila, Rajiv; Ropars, Mickaël; Briggs, Timothy W; Cannon, Steven R
We present a case report of a 33-year-old woman with back pain for several months which was resistant to medical treatment. Thoracolumbar MRI and multidetector CT showed an aneurysmal bonecyst intersecting the body and pedicles of L5. Minimally invasive treatment was performed with percutaneous injection of osteoconductive cement (Cerament) to induce sclerosis and bone remodeling of the bonecyst lesion with an analgesic effect. Before treatment, spinal angiography was performed to exclude arterial afferents. No bone biopsy was done. Under general anesthesia and fluoroscopic guidance, a first vertebroplasty was performed by a bilateral transpedicular approach using the osteoconductive cement followed 2 months later by a second treatment with CT-fluoro-guided direct injection of Cerament. No complications occurred during the procedure. At 4 and 6 months follow-up the MRI/CT showed sclerotic bone remodeling of the walls of the aneurysmal cyst with clinical improvement. PMID:24186854
Guarnieri, Gianluigi; Vassallo, Pasquale; Muto, Massimo; Muto, Mario
BACKGROUND: The different treatment strategies for bonecysts 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 bonecysts
Marion Rapp; Daniel Svoboda; Lucas M Wessel; Martin M Kaiser
We report the case of a 13-year-old boy with bilateral distal femoral unicameral bonecysts (UBCs) associated with acquired generalized lipodystrophy. As opposed to congenital generalized lipodystrophy, cystic bone lesions in acquired generalized lipodystrophy are rare. After radiographic and histologic confirmation of the UBCs, we performed percutaneous intramedullary decompression, curettage, and grafting. UBCs can be an important manifestation of acquired generalized lipodystrophy. Cystic bone lesions appear to be less common in acquired generalized lipodystrophy than in congenital generalized lipodystrophy, and intramedullary adipose tissue loss may be a predisposing factor for the development of bone lesions in patients with acquired generalized lipodystrophy. When evaluating a patient with lipodystrophy, doctors should recognize the clinical course may include the development of UBCs.
Gregory, James M.; Arkader, Alexandre; Bothari, Aqiba
Aneurysmal bonecyst of the foot is extremely rare and the involvement of medial cuneiform has never been reported in the literature. In this report, we describe a 15-year-old boy who presented with a 6-month history of pain and swelling in his left foot. Radiograph demonstrated a lytic lesion in the medial cuneiform extending on to the middle cuneiform, the navicular bone and the base of the first metatarsal. En bloc resection of the lesion was performed using a dorsal longitudinal incision along the first ray. Tricortical iliac crest graft was harvested and shaped to fill the defect. Two drill holes were made and the tibialis anterior tendon was attached to the graft. Prepared, morcellised allograft was placed along the junction of autograft and host bone. At 1-year follow-up, the patient was pain free, the medial arch of the foot was maintained and the graft had united with the host bone. PMID:24563041
Kumar, Venkatesan Sampath; Jalan, Divesh; Khan, Shah Alam; Mridha, Asit Ranjan
Unicameral bonecysts (UBCs) are benign, osteolytic lesions which are often asymptomatic and are commonly seen in the proximal of humerus and femur. The average age at diagnosis is 9-11 years and there is a male preponderance with a male-to-female ratio of approximately 2-2.5 to 1. We describe a case of 5-year-old girl who presented to orthopedic clinic with a 4-month history of painful limping. Plain radiography of the right knee demonstrated a well-defined lytic lesion in the proximal of the tibia. Open biopsy and then curettage and bone grafting with bone- substitute was performed. The diagnosis of this condition requires a high index of suspicion. This report demonstrates that all UBCs do not have the same clinical patterns and with adequate attention good results can be achieved.
Aneurysmal bonecysts arising from tubular bones of the hand occur very rarely and require particular diagnostic and therapeutic management techniques. The authors report the diagnostic and surgical management of a monocentric case series of six aneurysmal bonecysts involving the phalangeal and metacarpal bones. In addition to hightlighting the use of diagnostic MRI and biopsy prior to surgical intervention, the authors describe the favourable outcome of curetage with and without the use of bone graft. An aggressive treatment approach such as cryotherapy or resection with reconstruction should only be used in cases when the articular surface is involved, when full bone invasion of the phalanx or metacarpal has occurred, or in case of more than one recurrence. PMID:17869566
Renal cysts are common in old patients, and usually remain untreated. Giant renal cysts measuring more than 15 cm in greatest diameter are uncommon and the association with hypertension is very rare. We present a case of a 25-year-old woman with a giant right renal cyst associated with hypertension that was treated by laparoscopic excision, followed by resolution hypertension.
Giant cell tumors of the talus are very uncommon. Secondary aneurysmal bonecyst changes are well documented in the literature with giant cell tumors being one of the most common underlying lesions. However, no previous case of this combination has been documented in the podiatric literature. The diagnosis of these lesions can be very challenging since they share many common features. Although previous reports describe a higher recurrence rate of giant cell tumors when found in the small bones of the hands and feet, reported cases of this entity in the talus indicate a less aggressive natural history with rare malignant transformation. A case report and review of the literature are presented. PMID:8318960
Purpose To evaluate the efficacy of decompression of unicameral bonecysts (UBCs) of the long bones with intramedullary nailing and to compare responses to treatment according to location. Materials and methods We evaluated 48 consecutive patients treated between January 1988 and June 2000. Mean age was 10.3 years. Mean follow-up was 9.8 years. Evaluation was performed according to the radiographic criteria of Capanna. Results UBCs were located in the proximal humerus (n = 24), humeral shaft (n = 2), proximal femur (n = 19), distal tibia (n = 2) and fibula (n = 1). A total of 62.5% presented a pathological fracture. Successful results were observed in 89.5% (26 total healing, 17 healing with residual radiolucent areas), and there were four recurrences and, in one case, no response to treatment. There was more healing in the humerus than in the femur (92.3% versus 84.2%), and more tendency to restitution ad integrum, although the difference was not statistically significant (P = 0.1499). Conclusions Intramedullary nailing is a minimally invasive method, which permits early stability and decompresses the cyst allowing healing. Significant differences were not observed among results from different locations.
With greater than 500,000 orthopaedic procedures performed in the United States each year requiring a bone graft, the development of novel graft materials is necessary. We report that some porous polymer/ceramic composite scaffolds possess intrinsic osteoinductivity as shown through their capacity to induce in vivo host osteoid mineralization and in vitro stem cell osteogenesis making them attractive synthetic bone graft substitutes. It was discovered that certain low crystallinity ceramics partially dissociate into simple signaling molecules (i.e., calcium and phosphate ions) that induce stem cells to endogenously produce their own osteoinductive proteins. Review of the literature has uncovered a variety of simple signaling molecules (i.e., gases, ions, and redox reagents) capable of inducing other desirable stem cell differentiation through endogenous growth factor production. Inductive simple signaling molecules, which we have termed inducerons, represent a paradigm shift in the field of regenerative engineering where they can be utilized in place of recombinant protein growth factors.
Nelson, Stephen J.; Deng, Meng; Sethuraman, Swaminathan; Doty, Stephen B.; Lo, Kevin W. H.; Khan, Yusuf M.; Laurencin, Cato T.
Background The different treatment strategies for bonecysts 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 bonecysts 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 bonecysts. Five patients suffered from persistent cysts following earlier unsuccessful treatment of humeral bonecyst 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 bonecysts in children, with no resulting complications.
USP6 (also known as TRE17) is a ubiquitin-specific protease that was identified as an oncogene in transfection experiments with Ewing sarcoma DNA 2 decades ago. Until recently, little was known about USP6 function and mechanisms of oncogenic activation. The identification of USP6 fusion genes in aneurysmal bonecyst (ABC) and, more recently, in nodular fasciitis led to a better understanding of the pathogenesis of these lesions. Furthermore, the detection of USP6 genomic rearrangements or USP6 fusion genes may be used as a diagnostic tool for these lesions. In this review, we discuss the clinicopathologic features, molecular pathology, and pathogenesis of ABC and nodular fasciitis. We also discuss the possible line of differentiation of ABC and its relationship to nodular fasciitis and other lesions. PMID:23769422
The aneurysmal bonecyst is a rare tumor. Its treatment is complex when localized to the lumbar spine, with neurological, mechanical, and tumoral complications. The aim of this study is to describe these tumors, their treatment, and their long-term evolution, as well as to define an appropriate therapeutic strategy. Four of the five cysts had anterior and posterior extension. Three patients had neurological symptoms at diagnosis and two of them presented with pathological fracture. Surgical treatment was performed by intralesional resection. Long-term progress was always favorable, without recurrence or functional limitation. Two patients had a stable, mild spine deformity. PMID:22158055
Aneurysmal bonecysts (ABCs) are destructive cystic lesions of the bone and are common in children. They are expansile in nature and, therefore, may become symptomatic. These have traditionally been treated surgically; but recently, endovascular embolization has shown promise as a stand-alone therapy. The authors describe a case of an ABC highlighting the effectiveness and efficiency of endovascular treatment. A 16-year-old boy was referred for a 4-month history of radiating back pain and urinary hesitancy. Findings from his neurological examination were normal, but he had problems ambulating because of pain. Magnetic resonance imaging and CT scanning showed a cystic mass in the sacrum; a biopsy was performed and diagnosis of ABC was confirmed. Treatment options were then discussed with the family. The patient underwent 2 endovascular embolizations in approximately 1 month: Onyx 18 was involved in the first session, and N-butyl cyanoacrylate glue was used in the second session. After the first treatment, the patient experienced a dramatic decrease in pain and concomitant improvement in function. The patient went from being mildly symptomatic after the first treatment to completely asymptomatic after the second treatment. Clinical and radiographic follow-up obtained at 2, 6, and 18 months after initial treatment revealed the patient to be asymptomatic with progressive ossification. Endovascular treatment can be effective in treating symptomatic cases of ABC in which surgery would carry significant risk. Selective arterial embolization can promote sclerosis and result in an immediate and significant decrease in pain. PMID:24328760
Doss, Vinodh T; Weaver, Jason; Didier, Scott; Arthur, Adam S
Objective: Mesenteric cysts are rare intra-abdominal masses generally omited or briefly reported in textbooks. Their rarity had fostered a lack of information and difficulty in classification. The goal of the study is to present a simple, comprehensive, and reproducible classification of mesenteric cysts. Methods: A large review of the literature with particular attention to recent series was performed in order
Marc de Perrot; Marie-Anne Bründler; Martin Tötsch; Gilles Mentha; Philippe Morel
\\u000a The majority of patients affected by intraosseous cysts are children or adolescents. The most commonly noted forms are vascular\\u000a anomalies (including aneurysmal bonecysts), unicameral bonecysts and histiocytosis. Percutaneous treatment of intraosseous\\u000a cysts is an alternative to surgical treatment. It minimizes the risk of bleeding, avoids immobilization and prevents disfiguration\\u000a or dysfunction particularly when the lesion is located in
Treatment of hepatic cysts should be considered only for those patients who are symptomatic. For simplecysts, percutaneous aspiration invariably leads to recurrence; laparoscopic deroofing is usually curative. Open deroofing (fenestration) should be reserved for cysts inaccessible by laparoscopy. Percutaneous instillation of sclerosing agents (ethanol, iophendylate, minocycline) into nonbiliary and nonparasitic cysts is an alternative therapeutic option in certain cases. Due to increased morbidity, hepatic resection should be reserved for polycystic liver disease, diffuse hepatic involvement, or recurrence after a deroofing procedure. Patients with congenital fibropolycystic disorders (eg, congenital hepatic fibrosis) with evidence of hepatic decompensation, should be considered for liver transplantation. For hepatic hydatid cysts, simple cystectomy or the PAIR (puncture, aspirate, inject, and reaspirate) technique with albendazole treatment have been shown to be equally successful. In the case of alveolar echinococcosis, hepatic resection and liver transplantation are the only effective modalities for localized and extensive hepatic disease, respectively. PMID:11096603
The authors make comparison of conformity between clinical and radiological diagnosis of cystic bone defects compared to outcomes of histopathological examination. It was based on clinical material from 1996-2006. 37 patients were included to the study, 19 women (51.4%) and 18 men (48.6%) aged between 17-72 years (average 42.5 years). The most frequent diagnosed cystic bone defects in analyzed clinical material were simplebonecysts, aneurismal bonecysts and primary, metastatic neoplastic pathology. Performed analysis has shown incoherent diagnosis of simplebonecyst and nonossifying fibroma. This confirms the need for clinical and radiological diagnosis verification by outcomes of histopathological examination. PMID:18669106
The traumatic bonecyst (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.
The traumatic bonecyst (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. PMID:17096860
Background:?Aneurysmal bonecysts are rare occurrences in the cervical spine. Surgical treatment in pediatric patients is a challenge. Complete tumor resection offers the best chance for cure. Description:?Diagnosis and surgical management of an expansile aneurysmal bonecyst of the cervical spine involving all three spinal columns in a 10-year-old boy. Results:?Surgical treatment included tumor excision and circumferential fusion, and produced no neurological or vascular sequelae. This approach minimizes the risk of recurrence and the possibility of postoperative spinal instability. Conclusion:?Spinal instability is preferably addressed with reconstruction and stabilization. Cervical aneurismal bonecyst lesions are ideally treated with complete resection to minimize the chance of recurrence. In pediatric cases, defects created by resection should be corrected by fusion to minimize the risk of postoperative instability and growth abnormality.
Gurjar, Hitesh Kumar; Sarkari, Avijit; Chandra, P. Sarat
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
Aneurysmal bonecyst (ABC) is an aggressive, pediatric bone tumor characterized by extensive destruction of the surrounding bone. Though first described over 60 years ago, its molecular etiology remains poorly understood. Recent work revealed that ABCs harbor translocation of TRE17/USP6, leading to its transcriptional upregulation. TRE17 encodes a ubiquitin-specific protease (USP), and a TBC domain that mediates binding to the Arf6 GTPase. However, the mechanisms by which TRE17 overexpression contributes to tumor pathogenesis, and the role of its USP and TBC domains are unknown. ABCs are characterized by osteolysis, inflammatory recruitment, and extensive vascularization, processes in which matrix proteases play a prominent role. This led us to explore whether TRE17 regulates the production of matrix metalloproteinases (MMPs). In the current study, we demonstrate that TRE17 is sufficient to induce expression of MMP-9 and MMP-10, in a manner requiring its USP activity, but not its ability to bind Arf6. TRE17 induces transcription of MMP-9 through activation of NF?B, mediated in part by the GTPase RhoA and its effector kinase, ROCK. Furthermore, xenograft studies demonstrate that TRE17 induces formation of tumors that reproduce multiple features of ABC, including a high degree of vascularization, with an essential role for the USP domain. In sum, these studies reveal that TRE17 is sufficient to initiate tumorigenesis, identify MMPs as novel TRE17 effectors that likely contribute to ABC pathogenesis, and define the underlying signaling mechanism of their induction.
Ye, Ying; Pringle, Lashon M.; Lau, Alan W.; Riquelme, Daisy N.; Wang, Hongxin; Jiang, Tianying; Lev, Dina; Welman, Arkadiusz; Blobel, Gerd A.; Oliveira, Andre M.; Chou, Margaret M.
Aneurysmal bonecyst (ABC) is a pediatric osseous tumor characterized by extensive destruction of the surrounding bone. The molecular mechanisms underlying its pathogenesis are completely unknown. Recent work showed that translocation of the TRE17/USP6 locus occurs in over 60% of ABC cases resulting in TRE17 overexpression. Immature osteoblasts are presumed to be the cell type harboring translocation of TRE17 in at least a subset of ABCs. However, the effects of TRE17 overexpression on transformation and osteoblast function are unknown. TRE17 encodes a ubiquitin-specific protease (USP) and a TBC (TRE2-Bub2-Cdc16) domain that promotes activation of the Arf6 GTPase. Here we report that TRE17 potently inhibits the maturation of MC3T3 pre-osteoblasts in a USP-dependent and Arf6-independent manner. Notably, we find that TRE17 function is mediated through an autocrine mechanism. Transcriptome analysis of TRE17-expressing cells reveals dysregulation of several pathways with established roles in osteoblast maturation. In particular, signaling through the bone morphogenetic protein (BMP) pathway, a key regulator of osteogenesis, is profoundly altered. TRE17 simultaneously inhibits the expression of BMP-4 while augmenting the BMP antagonist, Gremlin-1. Osteoblastic maturation is restored in TRE17-expressing cells by the addition of exogenous BMP-4, thus establishing a functional role for BMP-4 during TRE17-induced transformation. Because bone homeostasis involves a precise balance between the activities of osteoblasts and osteoclasts, our studies raise the possibility that attenuated osteoblast maturation caused by TRE17 overexpression may contribute to the bone loss/destruction observed in ABC.
Lau, Alan W.; Pringle, Lashon M.; Quick, Laura; Riquelme, Daisy N.; Ye, Ying; Oliveira, Andre M.; Chou, Margaret M.
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…
A case of lytic lesion of the pelvis in a 23-year-old woman is presented. A biopsy led to the diagnosis aneurysmal bonecyst (ABC). Due to the histologically very aggressive growth of the tumor, a low malignant osteosarcoma could not be excluded. In an initial operation the tumour, affecting the sacrum, the iliac crest and the lower lumbar spine was resected. Temporary restabilisation of the pelvic ring was achieved by a titanium plate. The histological examination of the entire tumour confirmed the diagnosis ABC. After 6 months, the MRI showed no recurrence. The observed tilt of the spine to the operated side on the sacral base prompted a second surgical procedure: a transpedicular fixation of L5 and L4 was connected via bent titanium stems to the ischium, where the fixation was achieved by two screws. This construction allowed the correction of the base angle and yielded a stable closure of the pelvic ring. The patient has now been followed for 6 years: the bone grafts have been incorporated and, in spite of radiological signs of screw loosening in the ischium, the patient is fully rehabilitated and free of symptoms. Pedicle screws in the lower spine can be recommended for fixation of a pelvic ring discontinuity.
Aneurysmal bonecysts (ABCs) are benign osteolytic lesions that occur rarely in the jaws. The aim of this study was to investigate the clinical, radiographical and pathological features of ABCs of the jaws. A retrospective analysis of the content of a 39-year database, including nine cases of ABCs of the jaws diagnosed from the archives of the Oral Pathology Service. Nine patients (3 males and 6 females), ranging in age from 5 to 33 years were included. Seven (7/9) lesions were located in the mandible and two (2/9) in the maxilla. A painful swelling was the most common clinical finding (n = 4, 4/9). Radiologically, the lesions frequently presented as multilocular (5/9), well defined (4/9), bone expansion and perforation (2/9). Pathological analysis revealed that two cases were associated with central ossifying fibroma and one case with central giant cell lesion. Histomorphology showed a predominance of the solid type (5/9) and of sinusoidal pseudocystic spaces (4/9). Giant cells, osteoid material, calcified material, blood vessels and hemosiderin deposits were observed in 6/9, 7/9, 8/9, 9/9 and 7/9, respectively. The patients with ABCs presented clinical and radiographical features, which often posed a diagnostic dilemma. Knowledge about the most common characteristics of ABCs may contribute to the establishment of a more accurate diagnosis. PMID:21769447
Henriques, Aguida Cristina Gomes; Carvalho, Marianne de Vasconcelos; Miguel, Márcia Cristina da Costa; Queiroz, Lélia Maria Guedes; da Silveira, Ericka Janine Dantas
Hydatid cyst is a zoonotic disease that is common in the Mediterranean region. Thoracic wall, rib or extrapulmonary intrathoracic localization of the cysts is very rare. Giant extrapulmonary intrathoracic hydatid cysts can lead to both diagnostic and treatment difficulties and can be confused with tumor. We present a case of a hydatid cyst with thoracic wall involvement mimicking tumor. We confirmed diagnosis only by surgical exploration and histopathological examination because radiology is not conclusive .Surgical treatment involved the total extirpation of cyst together wide debridement and resection of affected tissue. Primary thoracic wall closures were performed. In thoracic wall localization of cyst, post-operative course of albendazole for 6 weeks associated with surgery can help in sterilizing the cyst and reduce the recurrence rate. In this article, we presented a thoracic wall hydatidosis which is very uncommon asymptomatic presentation of hydatid cyst disease with its surgical management. PMID:24349755
Hydatid cyst is a zoonotic disease that is common in the Mediterranean region. Thoracic wall, rib or extrapulmonary intrathoracic localization of the cysts is very rare. Giant extrapulmonary intrathoracic hydatid cysts can lead to both diagnostic and treatment difficulties and can be confused with tumor. We present a case of a hydatid cyst with thoracic wall involvement mimicking tumor. We confirmed diagnosis only by surgical exploration and histopathological examination because radiology is not conclusive .Surgical treatment involved the total extirpation of cyst together wide debridement and resection of affected tissue. Primary thoracic wall closures were performed. In thoracic wall localization of cyst, post-operative course of albendazole for 6 weeks associated with surgery can help in sterilizing the cyst and reduce the recurrence rate. In this article, we presented a thoracic wall hydatidosis which is very uncommon asymptomatic presentation of hydatid cyst disease with its surgical management.
We report on a 15-year-old girl with a secondary aneurysmatic bonecyst of the thoracic spine with extension into the spinal canal on the basis of an osteoblastoma. Surgical treatment was facilitated by preoperative embolization of the highly-vascular tumor. Excision of the tumor was performed without extensive intraoperative blood loss. Following excision, transpedicular-stabilization of the spinal column was achieved using
Sascha Meyer; Harald Reinhard; Norbert Graf; Bernhard Kramann; Günther Schneider
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
... watch the cyst over a period of time. Shoe modifications. Wearing shoes that do not rub the cyst or cause ... advised. In addition, placing a pad inside the shoe may help reduce pressure against the cyst. Aspiration ...
Surgery for Ganglion Cysts Introduction Ganglion cysts are common. They may cause pain and discomfort in the ... motion. The cyst may also recur. After the Surgery Your hand will be bandaged. Your doctor will ...
This report presents results in 4 cases of aneurysmal bonecyst of the thoracic- and lumbar spine with inclusion of the vertebral body. A new own modified radical method of resection (transthoracic or retroperitoneal) for the total resection of the lesion is described. The defect created after vertebral body resection is filled with a homologous femoral head transplant (prepared from material removed during total hip replacement). For correction of the deformity (kyphosis) and stabilisation of the area of VDS-Implant System of Zielke is used. The results thus obtained are excellent, complications or recurrences of the lesion have not been observed. PMID:6666245
Ganglion cysts are very common lumps within the hand and wrist that occur adjacent to joints or tendons. ... joint of the finger (see Figure 2). The ganglion cyst often resembles a water balloon on a stalk ( ...
... skin), and they may or may not be tender. Pilar cysts may run in families. Rarely, these ... they may become quite large. Occasionally, they are tender to the touch. The cysts may spontaneously burst ...
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.
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
It has been shown that bone marrow (BM)-derived cells are involved in repaired endothelium induced by a model such as neointima-produced\\u000a wire injury in mice. This has not been shown in a less invasive model that results in simple reendothelialization. A new wire-induced\\u000a simple endothelial denudation model of the common carotid artery (CCA) of mice, which did not form neointima
Probe-to-bone test and simple X-rays are both standard tests for the diagnosis of diabetic foot osteomyelitis. This study demonstrates the importance of considering jointly clinical information (probe-to-bone test) and diagnostic tests (simple radiography) to increase agreement among clinicians on diagnosis of diabetic foot osteomyelitis. PMID:24857262
Alvaro-Afonso, Francisco Javier; Lázaro-Martínez, José Luis; Aragón-Sánchez, Javier; García-Morales, Esther; García-Álvarez, Yolanda; Molines-Barroso, Raúl J
Pathologic dilatation of the maxillary sinus by air is a rare condition with unclear etiology. We present a case of a 17 year old male with a maxillary air cyst diagnosed by computed tomography. The CT demonstrated air-filled expansion of the maxillary sinus beyond the normal anatomical limits with associated cortical bone thinning. The case report highlights the pathognomonic computed tomography findings of this rare entity and discusses the perplexing nomenclature, proposed etiologies and various treatment options.
The commonest type of simple vaginal cyst is the Mullerian cyst. These are typically lined by columnar epithelium and contain serous or mucinous fluid. If blood is found in the cyst, the source is usually due to the presence of endometrial elements in the cyst wall. The cyst is then termed an endometriotic cyst. In this case report, we have described a woman with a symptomatic 3 cm upper vaginal cyst who underwent surgical excision of the cyst. The cyst cavity was found to be full of old dark blood and mucous, however the wall contained no endometrial tissue and was lined by columnar epithelium which stained positive for mucous with mucicarmine. No cause for the intracystic hemorrhage was identified. We conclude that intracystic hemorrhage can occur in a simple Mullerian vaginal cyst in the absence of endometrial components. PMID:24303459
Rivlin, Michel E; Meeks, G Rodney; Ghafar, Mohamed A; Lewin, Jack R
The commonest type of simple vaginal cyst is the Mullerian cyst. These are typically lined by columnar epithelium and contain serous or mucinous fluid. If blood is found in the cyst, the source is usually due to the presence of endometrial elements in the cyst wall. The cyst is then termed an endometriotic cyst. In this case report, we have described a woman with a symptomatic 3 cm upper vaginal cyst who underwent surgical excision of the cyst. The cyst cavity was found to be full of old dark blood and mucous, however the wall contained no endometrial tissue and was lined by columnar epithelium which stained positive for mucous with mucicarmine. No cause for the intracystic hemorrhage was identified. We conclude that intracystic hemorrhage can occur in a simple Mullerian vaginal cyst in the absence of endometrial components.
Rivlin, Michel E; Meeks, G Rodney; Ghafar, Mohamed A; Lewin, Jack R
... or inflamed, other symptoms may include: Skin redness Tender or sore skin Warm skin in the affected ... that reduces swelling. If the cyst becomes swollen, tender, or large, your doctor may drain it or ...
The nasolabial cyst is an uncommon midfacial cyst. Twenty-six patients with nasolabial cysts were treated at the New York Eye and Ear Infirmary from 1969 to 1986. Most of these lesions manifested facial deformity, unilateral nasal obstruction, and pain when infected. The nasolabial cyst is often unrecognized or confused with other intranasal masses, or fissural and odontogenic cysts. Infection of these lesions--which occurred in 50% of the patients--may mimic facial cellulitis, periodontal abscess, acute maxillary sinusitis, or nasal furuncles. This cyst is considered to be a hamartoma because of its developmental origin from entrapped epithelium in an embryonic fusion plane. Simple aspiration invariably leads to recurrence, and complete surgical excision is the accepted treatment. The nasolabial cyst should be considered in the differential diagnosis of intranasal masses, midface infections, and swelling in the nasolabial area. PMID:3108810
The diagnosis of a simple hepatic cyst is not difficult, but diagnostic confusion occurs when atypical features such as intracystic debris or extremely large size are present. In children, simple liver cysts are described as small, asymptomatic, and rarely hemorrhagic. We report an adolescent male presenting with an unusually large hepatic cyst that did not have typical imaging characteristics. The imaging findings and histology are displayed along with the differential diagnoses of complex liver cysts.
Objective: The present study was undertaken to identify patient populations at high risk for bone metastases (BM) at any time after diagnosis of operable breast cancer. Subjects and methods: A total number of 59 cases with breast cancer after mastectomy was subdivided into two main groups that included 30 patients with radiologically confirmed BM and 29 patients with no bone metastasis (NBM). Patients with NBM were formerly observed for a one-year follow-up interval to monitor the development of bone metastasis (new BM). Parameters included a full blood picture, tumour markers (carcinoembryonic antigen and CA 15.3) and some biochemical markers (vascular endothelial growth factor and zinc levels, as well as tartrate-resistant acid phosphatase and alkaline phosphatase activities). Results: A significant elevation was recorded in carcinoembryonic antigen level and alkaline phosphatase activity, as well as inflammation and vascularisation markers at the time of primary diagnosis in patients with BM, compared with those without BM. CA 15.3 was significantly higher in the new BM group as compared with the other two groups (patients free of bone metastasis [free BM] and BM). According to the likelihood ratio, a panel of single, calculated as well as combined markers was proposed to predict BM within one year in breast cancer patients. Conclusion: Vascularisation and inflammation markers, as well as CA 15.3 are predictive of bone recurrence within one year in breast carcinoma patients. We suggest that in cancer validation studies it is imperative to search for markers that link to the premetastatic process and to determine what type of mechanism is active in each stage.
Morcos, Nadia YS; Zakhary, Nadia I; Said, Mahmoud M; Tadros, May MM
Much about the etiology, pathophysiology, natural course and optimal treatment of cystic disease of the biliary tree remains under debate. Gastroenterologists, surgeons and radiologists alike still strive to optimize their roles in the management of choledochal cysts. To that end, much has been written about this disease entity, and the purpose of this 3-part review is to organize the available literature and present the various theories currently argued by the experts. In part 1, we discuss the background of the disease, describing the etiology, classification, pathogenesis and malignant potential of choledochal cysts.
Singham, Janakie; Yoshida, Eric M.; Scudamore, Charles H.
Much about the etiology, pathophysiology, natural course and optimal treatment of cystic disease of the biliary tree remains under debate. Gastroenterologists, surgeons and radiologists alike still strive to optimize their roles in the management of choledochal cysts. To that end, much has been written about this disease entity, and the purpose of this 3-part review is to organize the available literature and present the various theories currently argued by the experts. In part 3, we discuss the management of choledochal cysts, thus completing our comprehensive review.
Singham, Janakie; Yoshida, Eric M.; Scudamore, Charles H.
Summary Four cases of spinal cysts lined by simple columnar epithelium of endodermal origin, without associated vertebral or other congenital anomalies, are reported. Pathology, pathogenesis and nomenclature of such cysts are discussed. Misplacement of endodermal cells is though to be the common developmental error leading to the formation of such cysts, as well as of those replicating intestinal wall or
Nasolabial cysts are painless, submucosal, non-odontogenic jaw cysts presenting as soft tissue swellings in the maxillary anterior mucolabial fold lateral to midline, leading to elevation of nasal ala. Present case documents bilateral nasolabial cysts in a 69-year-old Asian female patient. In the present case, extraoral swelling of maxillary lip and elevation of nasal ala was observed on right side of the face. Intraorally, soft and fluctuant bilateral cysts were observed. Straw-colored fluid was aspirated from the right cyst. Radiographically, erosion of bone in a “cupping” fashion was observed in the region of left cyst. The cysts were enucleated using intraoral approach. Histopathology of the right-sided cyst revealed a cystic cavity lined by stratified squamous cells along with a few mucosal cells. At few places, stratified squamous and pseudostratified columnar epithelia with many cilia and goblet cells were also evident. Capsule was loosely arranged with fibrous tissue and chronic inflammatory infiltrate. Left-sided cystic specimen showed two or more layered stratified squamous lining epithelium with thin capsule. Diagnosis of bilateral nasolabial/nasoalveolar cysts was confirmed.
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: firstname.lastname@example.org
Bronchogenic cysts arise from an abnormal budding of the ventral diverticulum of the foregut or the tracheobronchial tree, during embryogenesis. Intrapericardial cysts are rare, accounting for 27% of bronchogenic cysts. In this case report, we present a young woman with a symptomatic intrapericardial bronchogenic cyst compressing the superior vena cava. The cyst was resected via median sternotomy, alleviating the patients' preoperative symptoms. PMID:24729202
Although simplecysts are easily identified using sonography, description and management of nonsimple cysts remains uncertain. This study evaluated whether the correlation coefficient differences between breast tissue and lesions, obtained from 2D breast elastography, could potentially distinguish nonsimple cysts from cancers and fibroadenomas. We hypothesized that correlation coefficients in cysts would be dramatically lower than surrounding tissue because noise, imaging
Rebecca C. Booi; Paul L. Carson; Matthew O’Donnell; Marilyn A. Roubidoux; Anne L. Hall; Jonathan M. Rubin
Alpha isoform of smooth muscle actin (SMA) expression has been reported in giant cell tumour of bone (GCTB) and other benign and malignant bone tumours, but the pattern of SMA expression and the precise nature of SMA-expressing cells in these lesions is uncertain. We determined by immunohistochemistry the expression of SMA and other muscle and vascular markers in normal bone, GCTB and a wide range of primary benign and malignant bone tumours. Cultured stromal cells of GCTB, chondroblastoma (CB), and aneurysmal bonecyst (ABC) were also analysed for SMA expression. SMA was only noted in blood vessels in normal bone. SMA was expressed by mononuclear stromal cells (MSC) cultured from GCTB, ABC and CB. SMA was strongly and diffusely expressed by MSC in non-ossifying fibroma, fibrous dysplasia, and "brown tumour" of hyperparathyroidism. SMA expression was also noted in GCTB, ABC, CB, chondromyxoid fibroma, malignant fibrous histiocytoma of bone and osteosarcoma. Little or no SMA was noted in Langerhans cell histiocytosis, simplebonecyst, Ewing's sarcoma, osteoblastoma, osteoid osteoma, enchondroma, osteochondroma, chondrosarcoma, myeloma, lymphoma, chordoma and adamantinoma. Our findings show that there is differential SMA expression in primary bone tumours and that identifying the presence or absence of SMA is useful in the differential diagnosis of these lesions. The nature of SMA-expressing cells in bone tumours is uncertain but they are negative for desmin and caldesmon and could represent either myofibroblasts or perivascular cells, such as pericytes. PMID:22543453
Hemingway, F; Kashima, T G; Mahendra, G; Dhongre, A; Hogendoorn, P C W; Mertens, F; Athanasou, N A
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 function related to skeletal morphology in animals. The model used in this demonstration can be adapted to plant flower, fruit, leaf, and stem morphology.
Cysts are entities encountered frequently in dermatological clinics. Various types of cysts have been described and include trichilemmal cysts, epidermoid cysts, steatocystomas, and the myriad of developmental cysts (branchial cleft cyst, thyroglossal duct cysts, bronchogenic cysts). Moreover, not all lesions that appear clinically as cystic structures are, in fact, cysts. Increased awareness of these mimickers and a systematic approach to the evaluation of these cases is essential. The authors report seven cases, over the course of six years, presenting to their dermatology department, all of which were originally clinically diagnosed as “cysts” and referred to the authors for management. In this article, the authors review seven cyst mimickers and describe important aspects of these diagnoses to increase awareness of the importance of a preoperative biopsy and evaluation. It is important to have a thorough understanding of the wide differential diagnosis of cutaneous nodules and to consider other causes of lesions that appear to be cysts, particularly in the anatomical locations described.
OBJECTIVE: To determine the optimal management of symptomatic non-parasitic liver cysts. SUMMARY BACKGROUND DATA: Management options for symptomatic nonparasitic liver cysts lack substantiation through comparative studies with respect to safety and long-term effectiveness. METHODS: A retrospective review of the surgical management of patients with hepatic cysts between October 1988 and August 1997 was undertaken to determine morbidity rates and to assess long-term recurrence. RESULTS: Thirty-eight patients (35 women, 3 men) underwent 48 operations for symptomatic hepatic cysts of mean diameter 12 cm, with a mean follow-up of 41 months. Twenty-three patients had simplecysts, and 15 patients had polycystic liver disease (PCLD). The symptomatic recurrence rates after laparoscopic or open deroofing for simplecysts were 8% and 29%, and for PCLD 71% and 20%, respectively. There were no symptomatic recurrences after 14 hepatic resections. There were no perisurgical deaths; however, morbidity rates were significant after laparoscopic deroofing, open deroofing, and hepatic resection (25%, 36%, and 50%, respectively). CONCLUSIONS: Selection of patients with truly symptomatic hepatic cysts is crucial before considering interventional techniques. For simplecysts, radical laparoscopic deroofing is usually curative; open deroofing should be reserved for cysts inaccessible by laparoscopy. The latter technique is well tolerated; however, long-term symptom control is unpredictable in patients with PCLD. Hepatic resection for PCLD provides satisfactory long-term symptom control but has an appreciable morbidity rate. Although laparoscopic and open deroofing procedures are less reliable in the long term for solitary cysts, they might be useful steps before embarking on this major procedure. Images Figure 1. Figure 2.
Martin, I J; McKinley, A J; Currie, E J; Holmes, P; Garden, O J
Hydatid disease mostly caused by Echinococcus granulosus is a common parasitic infestation of the liver. Most common sites are liver (70%) and lungs (25%). Intraperitoneal hydatid cyst is found in 13% and it is usually secondary to rupture of primary hepatic cyst. Primary intraperitoeal hydatid cyst is rare (2%). Primary hydatid cyst in mesentery is very rare. In this article, the author presents a case of primary mesenteric hydatid cyst with chronic pain in lower abdomen.
Dentigerous cysts are uncommon, yet are being reported with increasing frequency in the veterinary literature. Dentigerous cysts are a type of benign odontogenic cyst associated with impacted teeth, most commonly the mandibular first premolar tooth. Significant bone destruction can occur secondary to the expansion of a dentigerous cyst. The expanding cyst can lead to pathology of neighboring teeth, which can include external root resorption or pulpitis. Intraoral dental radiographs are imperative to properly assess the presence and extent of a dentigerous cyst, as well as the status of the neighboring teeth. This case report describes treatment for dentigerous cyst including cyst lining curettage, mandibular bone regeneration, and endodontic therapy for a canine tooth with irreversible pulpitis. PMID:24902411
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.
We describe a very rare case of mature posterior fossa teratoma in an adult who presented with clinico-radiological findings consistent with a dermoid cyst. A computed tomography scan showed a hypodense mass in the cistern magna with calcification and a sinus tract in the occipital bone. Magnetic resonance imaging revealed a hypo- to hyperintense mass without contrast enhancement. The intraoperative picture showed a dermal sinus and a cyst containing lipid, keratin and hair. Histopathological examination showed a tumor with components of all the three germ layers; thereby, a diagnosis of mature teratoma was made. The histopathological differentiation between teratoma and dermoid cyst is very valuable for ruling out the presence of immature/malignant or germinomatous components that would require further adjuvant therapies. Thus, we here present a rare case of posterior fossa teratoma mimicking dermoid cyst and emphasize the importance of histopathological differentiation between these entities. PMID:23263509
The hemorrhagic simple hepatic cyst is extremely rare and can sometimes be confused with biliary cystadenoma or cystadenocarcinoma. Here we present two cases of huge hemorrhagic simple hepatic cysts. Case 1 was a 43-year-old man with a cystic lesion measuring 13 cm × 12 cm in the right hepatic lobe. Ultrasound and computed tomography showed several mural nodules on the irregularly thickened wall and high-density straps inside the cyst. Case 2 was a 60-year-old woman with a huge cyst measuring 15 cm × 14 cm in the central liver. Ultrasound and magnetic resonance imaging showed the cystic wall was unevenly thickened and there were some flame-like prominences on the wall. The iconographic representations of the two cases mimicked biliary cystadenoma. Cystectomy and left hepatectomy were performed for the two patients, respectively. Both patients recovered quickly after their operations and showed no recurrence.
The hemorrhagic simple hepatic cyst is extremely rare and can sometimes be confused with biliary cystadenoma or cystadenocarcinoma. Here we present two cases of huge hemorrhagic simple hepatic cysts. Case 1 was a 43-year-old man with a cystic lesion measuring 13 cm x 12 cm in the right hepatic lobe. Ultrasound and computed tomography showed several mural nodules on the irregularly thickened wall and high-density straps inside the cyst. Case 2 was a 60-year-old woman with a huge cyst measuring 15 cm x 14 cm in the central liver. Ultrasound and magnetic resonance imaging showed the cystic wall was unevenly thickened and there were some flame-like prominences on the wall. The iconographic representations of the two cases mimicked biliary cystadenoma. Cystectomy and left hepatectomy were performed for the two patients, respectively. Both patients recovered quickly after their operations and showed no recurrence. PMID:19777623
In the present study, we had introduced polyurethane (PU) nanofibers that contain hydroxyapatite (HAp) nanoparticles (NPs) as a result of an electrospinning process. A simple method that does not depend on additional foreign chemicals had been employed to synthesize HAp NPs through the calcination of bovine bones. Typically, a colloidal gel consisting of HAp/PU had been electrospun to form nanofibers. In this communication, physiochemical aspects of prepared nanofibers were characterized by FE-SEM, TEM and TEM-EDS, which confirmed that nanofibers were well-oriented and good dispersion of HAp NPs, over the prepared nanofibers. Parameters, affecting the utilization of the prepared nanofibers in various nano-biotechnological fields have been studied; for instance, the bioactivity of the produced nanofiber mats was investigated while incubating in simulated body fluid (SBF). The results from incubation of nanofibers, indicated that incorporation of HAp strongly activates the precipitation of the apatite-like particles, because of the HAp NPs act as seed, that accelerate crystallization of the biological HAp from the utilized SBF.
Sheikh, F. A.; Kanjwal, M. A.; Macossay, J.; Barakat, N. A. M.; Kim, H. Y.
Abstract In our study, we evaluate the diagnostic and therapeutic efficacy of transvaginal ultrasound-guided aspiration of benign ovarian cysts in selected patients. A total of 46 women with benign ovarian cysts were referred to our outpatient clinic. The aspirated fluid was collected and sent for cytological analysis. All women were re-evaluated at 1, 3 and 6 months after the procedure. The cytological analysis was negative for malignancy in all cases. Our study showed an overall recurrence rate for ovarian cysts of 39.1%. Women with endometriotic ovarian cysts have an increased incidence of recurrence, 62.5% (n = 5), in comparison with serous cysts, 35.2% (n = 12) and serous-haemorrhagic cysts, 15% (n = 1), ?(2) = 9.913, df = 2, p = 0.007. The results of our study reveal that transvaginal ultrasound-guided aspiration of benign ovarian cysts is a simple, safe and effective procedure. PMID:24483623
Nikolaou, M; Adonakis, G; Zyli, P; Androutsopoulos, G; Saltamavros, A; Psachoulia, C; Tsapanos, V; Decavalas, G
A 5 year 4 months old male child presenting with pain abdomen and jaundice was diagnosed to have type 1 choledochal cyst on ultrasonography and magnetic resonance cholangio pancreatography. On exploration, the cystic dilatation of common bile duct was found to have a hydatid cyst (HC) inside it. The per-operative findings were confirmed by histopathology. Association of HC within a choledochal cyst is extremely rare and has been reported only twice before in the available English literature. PMID:24347872
According to the literature authors describe the etiopathology and symptoms of a case of uncomplicated mesenteric cyst observed and treated by simple enucleation. Therefore after describing the peculiarity of this disease, authors underline the difficulty of diagnosis also using instrumental devices such as ultrasound and CT scan. In particular complicated mesenteric cyst is pointed out because it may be responsible of acute abdomen. About treatment of uncomplicated mesenteric cyst the always more frequent use of laparoscopy is underlined. PMID:9036829
Spinal hydatid cysts are very rare and comprise only 1% of all bony involvement. Intradural hydatid cysts are extremely rare\\u000a compared to other types of spinal hydatid cysts. We report the case of a 19-year-old man with lumbar intradural hydatid cysts.\\u000a He complained of paraparesis and urinary hesitancy. Myelography revealed a block of the contrast medium at the L4 level
Epidermoid cyst of intrapancreatic spleen is described but epidermoid cyst occurring in the pancreas itself is not documented. We report a 36-year-old man who presented with abdominal pain radiating to the back. On ultrasonography, a multilocular cyst was seen in the head of the pancreas. Fine-needle aspiration cytology suggested a diagnosis of epidermoid cyst, which was confirmed on histology of the resected specimen. PMID:17558078
The authors describe a case report of idiopathic asymptomatic giant retinal cyst with underlying hyperpigmentation. Low- and high-frequency ultrasound (ultrasound biomicroscopy) revealed an anechoic giant cyst with two hyper-reflective traction bands between the ciliary body and the anterior base of the retinal cyst. There was no retinal detachment. PMID:24840531
Chen, Carlos Y; Semenova, Ekaterina; Cohen, Ben Z; Finger, Paul T
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 simplecyst 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
Single energy X-ray imaging, due to its low cost and flexibility, is one of the most used and common technique to assess bone state and bone remodeling over time. Standardized X-ray images are needed to compare sets of radiographs for semi-quantitative analyses of tissue remodeling. However, useful mathematical modeling for the analysis of high level radiographic images are not easily available. In order to propose a useful evaluation tool to a wide clinical scenario, we present an innovative calibration algorithm for a semi-quantitative analysis of non-standardized digitized X-ray images. For calibration on a unique standardization scale, three time invariant regions (ROI) of radiographs were selected and analyzed. The accuracy of the normalization method for X-ray films was successfully validated by using an aluminum step wedge for routine X-ray exposures as tool to standardize serial radiographs (Pearson correlation test: R(2) = 0.96). This method was applied to investigate the progression of the new bone deposition within ceramic scaffolds used as osteoconductive substitute in large bone defects taking advantage of a large animal model. This innovative image-processing algorithm allowed the identification and semi-quantification of the bone matrix deposited within the implant. The osteo-integration at the bone-implant interface was also investigated. A progressively increasing bone tissue deposition within the porous bioceramic implant and a progressive osteo-integration was observed during the 12 months of the trial. PMID:16007593
Intrasellar arachnoid cyst is very rare. We report a case of intrasellar arachnoid cyst. A 44-year-old male was admitted for evaluation of his headache and visual disturbance on August 6, 1993. Neurological examination revealed bilateral decreased visual acuity and visual field defect. Endocrinological examination showed panhypopituitarism. Other neurological findings were normal. X-ray film of the skull showed a ballooning dilation of the sella turcica with thinning of the sellar floor. CT scan showed a cystic lesion with CSF-density occupied the sella. After intravenous administration of contrast medium, the cyst showed no enhancement. MRI showed the intrasellar mass had the same characteristics as the surrounding subarachnoid space. Bilateral carotid angiographies demonstrated that the carotid siphons were stretched and displaced laterally, and the A1 portions of the anterior cerebral arteries were raised. We made a diagnosis of intrasellar cystic lesion. On August 18, the sella turcica was opened via the transsphenoidal rhinoseptal approach. The cyst contained CSF-like fluid, and a part of the cyst wall was resected. The cavity was filled with Gelfoam and the sellar floor was repaired with bone flap. Postoperatively, the patient's visual disturbance improved, but diabetis insipidus appeared and required hormonal replacement. The patient was discharged on September 27 with improvement of visual acuity and visual field. Histological examination demonstrated that the cyst wall consisted of thick arachnoidal cells with fibrous connective tissue. The arachnoidal cells with oval nuclei was stained with epithelial membrane antigen. Symptoms, signs and radiological findings of intrasellar arachnoid cyst are similar to those of various sellar lesions including pituitary adenoma, craniopharyngioma, empty sella, Rathke's cleft cyst, epidermoid et al.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7566427
Tanaka, Y; Hayashi, S; Nakai, M; Ryujin, Y; Uematsu, Y; Nakai, K; Itakura, T
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.
Summary The application of hyperthermia to the treatment of neoplastic disease has focused on solid tumors. Since the hyperthermic sensitivity of human B-cell lymphoma cells is not known, we have examined the effect of hyperthermia on the growth of B-cell lymphoma cell lines (Raji and Daudi) in vitro to evaluate the ability to purge tumor cells from normal bone marrow
Y. Moriyama; T. Goto; S. Hashimoto; T. Furukawa; K. Kishi; M. Takahashi; A. Shibata
Background There are few, limited, and to some extent contradictory, reports on the cellular and subcellular morphology of arachnoid cysts. In the literature cyst membranes are described as similar to, or as vastly different from, normal arachnoid membranes. Methods This paper reports electron microscopic analyses of symptomatic cysts from 24 patients (12 males and 12 females; age 10–79), that underwent fenestration surgery. Fourteen cysts were located in the middle cranial fossa (temporal), one in the interpeduncular cistern, five in the posterior fossa, and four were overlying the frontal cortex. Results Microscopic findings confirmed the diverse nature of this clinical condition. Twelve cyst walls resembled normal arachnoid, four had a conspicuous core of dense fibrous tissue with a simple epithelial lining, and the remaining aberrant cysts exhibited non-arachnoid luminal epithelia with plentiful microvilli and/or cilia, and also nervous tissue components in the wall. The possible identity and origin of various cyst types are discussed. We hypothesize that cysts are formed mostly at an early stage of embryonic development, as a teratological event. Conclusions Cysts with various epithelial linings and extracellular components most likely have different barrier properties and fluid turnover characteristics. Further studies are needed to elucidate relations between cyst morphology, fluid composition, pathogenesis, and clinical behaviour including growth rate and relapse tendency.
Ti15Zr4Nb4Ta and Ti29Nb13Ta4.6Zr, which do not contain the potentially cytotoxic elements V and Al, represent a new generation of alloys with improved corrosion resistance, mechanical properties, and cytocompatibility. Recently it has become possible for the apatite forming ability of these alloys to be ascertained by treatment with alkali, CaCl2, heat, and water (ACaHW). In order to confirm the actual in vivo bioactivity of commercially pure titanium (cp-Ti) and these alloys after subjecting them to ACaHW treatment at different temperatures, the bone bonding strength of implants made from these materials was evaluated. The failure load between implant and bone was measured for treated and untreated plates at 4, 8, 16, and 26 weeks after implantation in rabbit tibia. The untreated implants showed almost no bonding, whereas all treated implants showed successful bonding by 4 weeks, and the failure load subsequently increased with time. This suggests that a simple and economical ACaHW treatment could successfully be used to impart bone bonding bioactivity to Ti metal and Ti-Zr-Nb-Ta alloys in vivo. In particular, implants heat treated at 700 °C exhibited significantly greater bone bonding strength, as well as augmented in vitro apatite formation, in comparison with those treated at 600 °C. Thus, with this improved bioactive treatment process these advantageous Ti-Zr-Nb-Ta alloys can serve as useful candidates for orthopedic devices. PMID:20883837
Fukuda, A; Takemoto, M; Saito, T; Fujibayashi, S; Neo, M; Yamaguchi, S; Kizuki, T; Matsushita, T; Niinomi, M; Kokubo, T; Nakamura, T
Benign simple breast cysts are commonly seen in female breasts and can present as palpable masses. They are distinctly uncommon, however, in the male breast. We report a case of simple benign cyst of the breast in a 58-year-old man newly diagnosed with mantel cell lymphoma. The cyst was first identified incidentally on a staging contrast-enhanced chest computed tomography. Further evaluation with mammography and ultrasound revealed a mass that would be typically characterized as a benign simplecyst, but was biopsied since cysts are not known to occur in male breasts. Pathology results from ultrasound-guided core needle biopsy revealed benign cyst and focal fibrosis which was concordant with the imaging findings. In this case report, we will briefly discuss breast cysts in men and their imaging features including mammography and ultrasound.
Parsian, Sana; Rahbar, Habib; Rendi, Mara H.; Lehman, Constance D.
Postoperative maxillary cyst is a quite rare delayed complication of surgical intervention associated with maxillary sinuses. It occurs many years after surgery. This paper describes a 54-year-old woman presenting with swelling of left cheek for seven-years duration. The orthopantomograph revealed a unilocular cystic radiolucency with well-defined margins in left maxillary sinus. In the computerized tomography, the cyst had a sclerotic wall with bony condensations. Aspiration cytology revealed many neutrophil leukocytes. Cyst was drained and enucleated. Histopathologically, it had a fibrous wall with inflammation and focal reactive bone formation and lined by a respiratory-type epithelium. In the clinical history, it is learned that she had a maxillary sinus surgery 8 years ago and the diagnosis was made considering the clinical and histopathological findings.
Bulut, Asiye Safak; Sehlaver, Celal; Percin, Alp Korkut
Dermoid cysts are rare congenital tumors that occur primarily at the midline at a characteristic intradural location. However, dermoid cysts located at extradural and lateral regions have been rarely reported until now. In the present study, the authors demonstrate the unusual instance of an intracranial extradural dermoid cyst at the lateral sphenoid ridge. A 53-year-old woman admitted because of progressive headache and dizziness. The patient had no neurologic deficits, and magnetic resonance imaging with no contrast enhancement revealed a mass at the right sphenoid ridge. The mass was accompanied with sphenoid bone erosion visible on computed tomography. The patient underwent right pterional craniotomy, and the tumor including the capsule was totally resected. Presence of a dermoid cyst was confirmed with histopathological examination. The patient had no complications during the postoperative period. This study suggests that dermoid cyst should be considered for differential diagnosis of extradural and lateral intracranial masses.
Arachnoid cysts of the posterior fossa are rare lesions that are considered to be mostly congenital in origin. In this article, we retrospectively review 12 patients who underwent surgical treatment for their symptomatic posterior fossa arachnoid cysts. The most common presenting symptoms were gait disturbances and headache. The diagnosis was established on computed tomography or magnetic resonance imaging. Surgery consisted of cyst wall excision with fenestration in nine cases and shunting procedures in three cases. In all cases except one who-died, the postsurgical follow-up neuroradiological investigations showed that the cysts had decreased in size, the cerebellum had re-expanded, and if there was preoperative hydrocephalus, the ventricular size was decreased. The follow-up period ranged from 1 to 11 years. All surviving cases are free of symptoms and no arachnoid cysts recurred. The classification, pathophysiology, differential diagnosis and surgical treatment of infratentorial arachnoid cysts are discussed and the relevant literature is reviewed. PMID:10492679
Hydatid disease caused by echinococcus granulosus is still a serious problem in both underdeveloped and developing countries. Clinical signs of the disease are not specific. Most patients have a few symptoms when a hydatid cyst is discovered. Symptoms depend on its location, size and complications. Parasite can settle in every organ and tissue in the human body. We report two cases with intrathoracic extrapulmonary hydatid cyst with multiple cysts. Pathophysiology of the mode of dissemination, and surgery are discussed.
The term "paramesencephalic" is proposed to describe the location of a general class of arachnoid cysts observed in four patients. These cysts, which appear to arise within the subarachnoid space, are characterized by a lack of communication with the ventricular system. Usually, the arachnoid tissue is normal, and the cyst fluid resembles cerebrospinal fluid both macroscopically and microscopically. Hydrocephalus is variably accompanied by localizing signs. Problems may be encountered in the diagnosis of suprasellar (case 4), parapineal (case 3), incisural (case 1), and interpeduncular (cases 2 and 4) arachnoid cysts. Early surgical exploration is strongly recommended. PMID:943067
Mesenteric cysts are uncommon benign abdominal lesions with no classical clinical features. The preoperative diagnosis requires the common imaging modalities but the final diagnosis is established only during surgery or histological analysis. The treatment of choice is complete surgical excision. We report an 18-year-old female with a non-specific abdominal pain and discomfort since 3 weeks. Her CT scan showed a huge cystic swelling, which necessitated surgical exploration. Preoperatively, a giant cyst was encountered with displacement of bowel loops. The cyst was completely removed and histology report confirmed mesenteric cyst without evidence of malignancy.
Guraya, Salman Yousuf; Salman, Shaista; Almaramhy, Hamdi H.
The authors present a case of a hemorrhagic adrenal cyst, one of the tumors known in literature as incidentalomas, emphasizing the clinical characteristics, since adrenal cysts or pseudocysts are generally rare and observed by chance during imaging procedures. Traditionally they are classified as pseudocysts, endothelial, epithelial or parasitic cysts. Laparoscopic adrenalectomy has been considered the treatment of choice for benign, functioning or non-functioning adrenal lesions. Small cystic adrenal tumors can be managed conservatively by laparoscopic decortication or marsupialization, but larger cysts should be treated by total or partial adrenalectomy. PMID:23045835
da Silva, Elsa Cristina Fontes Pires; Viamontez, Francisco; Silva, Vasco Sabino; Andrade, Artur; Júlio Neto, Gonçalo; Gomes, Constança de Palma; Neto, Sérgio; Quitembo, Mateus; Dimbany, Higino; Van-Dunem, Joaquim Carlos Vicente Dias; de Miranda, Sandra Maria da Rocha Neto; Bastos, Fernando; Cordeiro, Lemuel Bornelli; Guilherme, Mateus
Intraspinal extradural synovial cysts are quite common in the lumbar spine. With respect to clinical presentation and surgical treatment, juxta-facet cysts (ganglion and synovial cysts) share identical characteristics and results. Nowadays, current treatment strategies of intraspinal juxta-facet cysts continue to inspire controversy regarding appropriate surgical approaches, and include many technical options. The purpose of this report is to illustrate the advantage of minimally invasive approaches in 3 cases of lumbar synovial cysts. We performed a small flavectomy in the 1st case, a transarticular partial facectomy, followed by etherologous bone graft fusion in the 2nd case, and a flavectomy and partial facectomy in the 3rd case. In our cases, a microsurgical approach to lumbar synovial cysts yielded to complete excision of the lesions and excellent pain relief, with early mobilization and hospital discharge of the patients. In our opinion, minimally invasive approaches and microsurgical excision of lumbar juxta-facet cysts are advantageous over conventional lumbar laminectomy because they reduce later development of segmental instability at the operative level, and therefore a less invasive strategy for intraspinal synovial cysts removal should be recommended. PMID:15257263
Oculomotor cistern is normal anatomic structure that is like an arachnoid-lined cerebrospinal fluid-filled sleeve, containing oculomotor nerve. We report a case of arachnoid cyst in oculomotor cistern, manifesting as oculomotor nerve palsy. The oblique sagittal MRI, parallel to the oculomotor nerve, showed well-defined and enlarged subarachnoid spaces along the course of oculomotor nerve. Simple fenestration was done with immediate regression of symptom. When a disease develops in oculomotor cistern, precise evaluation with proper MRI sequence should be performed to rule out tumorous condition and prevent injury of the oculomotor nerve.
Kim, Min-Kyun; Jeun, Sin-Soo; Jung, So-Lyung; Ahn, Kook-Jin; Kim, Bum-soo
We present the second case of an enterogenous cyst of the third ventricle. This is a 28-year-old woman who presented with a 2 year 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
The clinical features and management of 14 adults with choledochal cysts who presented to our hospital are discussed. There were 10 Todani type I, and four type IV cysts. The cysts were fusiform in all but three cases. The pancreatobiliary junction was abnormal in only two patients. Ten patients had cystolithiasis. Six patients had undergone previous biliary surgery, three of whom presented with biliary strictures. We recommend that choledochal cyst be considered as a differential diagnosis in all patients with dilated bile ducts, especially when symptoms persist after biliary surgery. In two patients who had undergone endoscopic sphincterotomy and stone clearance, and in whom the diagnosis was still in doubt after cholangiography, hepatic iminodiacetic acid (HIDA) scan confirmed the diagnosis of choledochal cyst by showing persistent biliary stagnation despite free flow of bile across the sphincter of Oddi. Complete resection of the cyst was achieved in all cases with one postoperative death. A modification of the standard surgical technique is described which makes mobilisation of the cyst easier. The need to demonstrate the pancreatobiliary ductal confluence as an aid to complete excision of the cyst is emphasised. Images Figure 1 Figure 2 Figure 4
Jesudason, S. R.; Govil, S.; Mathai, V.; Kuruvilla, R.; Muthusami, J. C.
Synovial spinal cysts are typically found in the lumbar spine, most often at the L4-L5 level. Magnetic resonance imaging is the diagnostic imaging of choice in the workup of suspected synovial cysts. This study consisted of 24 patients with lumbar synovial cysts treated by cyst excision and nerve root decompression through partial or complete facetectomy and primary posterolateral fusion. The most common location of the cysts was the L4-L5 segment. Synovial tissue was found in histological sections of 18 cysts. At a mean follow-up of 12 (range, 8 to 24) months, 20 patients (83%) had excellent or good results; two patients (8.3%) had fair and two patients (8.3%) had poor improvement. Operative complications included dural tear in two patients and postoperative wound dehiscence in one patient, which were treated accordingly. To eliminate the risk of recurrence synovial cyst excision through partial or complete facetectomy is required. In addition, since synovial cysts reflect disruption of the facet joint and some degree of instability, primary spinal fusion is recommended. PMID:23327848
Mavrogenis, Andreas F; Papagelopoulos, Panayiotis J; Sapkas, George S; Korres, Demetrios S; Pneumaticos, Spyridon G
BACKGROUNDIntracranial dermoid cysts are rare congenital neoplasms that are believed to arise from ectopic cell rests incorporated in the closing neural tube. The rupture of an intracranial dermoid cyst is a relatively rare event that typically occurs spontaneously. In the past it was believed that rupture is always fatal, a hypothesis that is not supported by more recently reported cases.
Ruediger Stendel; Terttu Aulikki Pietilä; Kerstin Lehmann; Ralf Kurth; Olaf Suess; Mario Brock
We report a case of epidermal inclusion cyst in a 32-year-old male. This was a complication of circumcision that was neglected over years to form stones and urethrocutaneous fistula. Complete excision of the cyst and repair of the fistula were performed successfully. Histopathological examination confirmed our diagnosis.
El-Shazly, M.; Ghobashy, A.; Allam, A.; Alenezy, T.; Alenezy, N.; Yordanov, E.; Hathout, B.; Albunnai, R.
We report a case of epidermal inclusion cyst in a 32-year-old male. This was a complication of circumcision that was neglected over years to form stones and urethrocutaneous fistula. Complete excision of the cyst and repair of the fistula were performed successfully. Histopathological examination confirmed our diagnosis. PMID:22693677
El-Shazly, M; Ghobashy, A; Allam, A; Alenezy, T; Alenezy, N; Yordanov, E; Hathout, B; Albunnai, R
Subcutaneous dermoid cysts were identified in eight wild caribou (Rangifer tarandus) from widely dispersed locations in northern Canada and in one wild caribou from Alaska. The dermoid cysts from Canadian caribou were found among 557 diagnostic specimens that had been detected by hunters and submitted by resource officers and biologists between 1 January 1966 and 15 May 2007. All of the cysts were located in the cervical region, and five of nine cysts were found in the throat area. All of the animals for which the age was known were adult; males and females were equally represented. Dermoid cysts were not diagnosed in any of 1,108 white-tailed deer (Odocoileus virginianus), 293 mule deer (Odocoileus hemionus), 174 elk (Cervus elaphus), or 529 moose (Alces alces) examined during the same period at the Canadian laboratory. PMID:19395761
Wobeser, G; Bollinger, T; Neimanis, A; Beckmen, K B
Ganglion cysts are soft tissue swellings occurring most commonly in the hand or wrist. Apart from swelling, most cysts are asymptomatic. Other symptoms include pain, weakness, or paraesthesia. The two main concerns patients have are the cosmetic appearance of the cysts and the fear of future malignant growth. It has been shown that 58% of cysts will resolve spontaneously over time. Treatment can be either conservative or through surgical excision. This review concluded that nonsurgical treatment is largely ineffective in treating ganglion cysts. However, it advised to patients who do not surgical treatment but would like symptomatic relief. Compared to surgery, which has a lower recurrence rate but have a higher complication rate with longer recovery period. It has been shown that surgical interventions do not provide better symptomatic relief compared to conservative treatment. If symptomatic relief is the patient's primary concern, a conservative approach is preferred, whilst surgical intervention will decrease the likelihood of recurrence.
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.
For on-site detection of cysts, a portable cyst extraction kit was constructed from nine readily available items. The portable cyst extractor detected cysts in a range of 1-117 cysts/100 g soil from 42 fields. Samples processed by this kit in fields were clean and easy to examine, possibly because the kit is a compact version of the standard wet-sieving technique used in the laboratory. The portable cyst extractor has several advantages over traditional survey methods: i) diagnosis of cyst infestations in the field accurately and rapidly most of the year and ii) reduction in the labor of samplings and transportation of soil samples.
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 simplebonecyst, aneurysamal bonecyst, 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
Background It is acknowledged that total cyst excision is a safe and ideal surgical treatment for congenital biliary duct cyst, compared to simple internal drainage. The aim of this study was to determine the optimal operation occasion and the effect of laparoscopy on congenital biliary duct cyst based upon total cyst excision. Methods From January 2002 to January 2011, 217 patients were admitted to Southwest Hospital for congenital biliary duct cyst. To determine the optimal surgery occasion, we divided these subjects into three groups, the infant group (age ? 3 years), the immaturity group (3 < age ? 18 years), and the maturity group (age > 18 years), and then evaluated the feasibility, risk and long-term outcome after surgery in the three groups. To analyze the effect of laparoscopic technique on congenital biliary duct cyst, we divided the patients into the laparoscopy and the open surgery groups. Results Among the three groups, the morbidity from cholangiolithiasis before surgical treatment had obvious discrepancy (p < 0.05) (lowest in the infant group), and intraoperative blood loss also had apparent diversity (p < 0.05). Furthermore, long-term outcomes (secondary cholangiolithiasis, stoma stenosis and cholangiocarcinoma) showed no significant difference between different groups (p > 0.05). Similarly, no significant discrepancy was observed in the morbidity from postoperative complications or long-term postoperative complications (p > 0.05) between the laparoscopic and the open surgery groups. Conclusions We conclude that total cyst excision should be performed as early as possible. The optimal treatment occasion is the infant period, and laparoscopic resection may be a new safe and feasible minimally invasive surgery for this disease.
Purpose: The incidence of painful bone metastases increases with longer survival times. Although 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 with pretreatment pain scores. The majority of patients (71%) were treated to 30 Gy (range, 20-37.5) in 10 fractions (range, 8-15 fractions). Results: One hundred nineteen 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. [University of Pittsburgh Cancer Institute, UPMC Shadyside Hospital, Radiation Oncology Department, Pittsburgh, PA (United States); UPMC Radiation Oncology Outreach Program (ROCOG), UPMC McKeesport Hospital, McKeesport, PA (United States); Proctor, Julian W., E-mail: email@example.com [UPMC Jameson Cancer Center, Radiation Oncology Department, New Castle, PA (United States); UPMC Radiation Oncology Outreach Program (ROCOG), UPMC McKeesport Hospital, McKeesport, PA (United States); Slack, Robert; Marlowe, Ursula [UPMC Jameson Cancer Center, Radiation Oncology Department, New Castle, PA (United States); Ashby, Karlotta R. [University of Pittsburgh Cancer Institute, UPMC Shadyside Hospital, Radiation Oncology Department, Pittsburgh, PA (United States); UPMC Radiation Oncology Outreach Program (ROCOG), UPMC McKeesport Hospital, McKeesport, PA (United States); Schenken, Larry L. [UPMC Radiation Oncology Outreach Program (ROCOG), UPMC McKeesport Hospital, McKeesport, PA (United States)
In a wide variety of organisms, gametes develop within clusters of interconnected germline cells called cysts. Four major principles guide the construction of most cysts: synchronous division, a maximally branched pattern of interconnection between cells, specific changes in cyst geometry, and cyst polarization. The fusome is a germline-specific organelle that is associated with cyst formation in many insects and is likely to play an essential role in these processes. This review examines the cellular and molecular processes that underlie fusome formation and cyst initiation, construction, and polarization in Drosophila melanogaster. The studies described here highlight the importance of cyst formation to the subsequent development of functional gametes. PMID:9442902
We present a 52-year-old gentleman with an unusual cause of progressive dysphagia, namely due to extrinsic lower oesophageal compression from a cystic mass of the posterior mediastinum. Cystic masses in adults are uncommon, and there is a wide differential diagnosis. This includes neoplastic, such as germ cell tumour (cystic teratoma), and non-neoplastic aetiologies. The later include foregut duplication cysts, lymphatic malformations, infective (hydatid), simple mediastinal cysts or pseudocysts. Management is principally surgical with complete excision, or alternatively, in cases of benign cysts, marsupialization or decompression. In our patient, a simple mediastinal cyst was diagnosed and this case is the first description of a totally transabdominal approach to mediastinal cyst decompression by a Roux-en-Y cyst-jejunostomy.
Baker, Cara R.; Gossage, James A.; Mason, Robert C.
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.
Hydatid disease is still an important health problem in the world. Mediastinal localization of hydatidosis is very rare. We report the case of a 19-year-old man who presented with right chest wall pain and cough. Chest X-Ray and computed tomography showed a mediastinal cystic mass. A right posterolateral thoracotomy was performed and the cystic mass was identified. Daughter cysts were seen within the cyst when the lesion was accidentally opened during the procedure. Cyst mass was radically resected. No complication or recurrence was seen in the follow-up period. PMID:24444071
A Rathke cleft cyst is considered to arise from the remnants of the Rathke pouch, and it consists of single cuboidal or columnar epithelium including cilia and goblet cells, which secrete mucus into the cyst. Magnetic resonance imaging characteristically shows a thin membranous cystic wall that enhances with Gd, and homogeneous intensity of the content suggesting fluid collection. Cases with an irregularly thickened and/or calcified cyst wall, presumably due to chronic inflammation of the wall, are rare. A 21-year-old woman presented with an extremely rare case of a solid and cystic Rathke cleft cyst with partial ossification, manifesting as bitemporal hemianopia. Magnetic resonance imaging showed a massive solid sellar lesion extending upward and compressing the optic chiasm and floor of the third ventricle. Transsphenoidal surgery was performed, resulting in total removal of the lesion and immediate recovery of visual function. Postoperative histological examination disclosed that the major part of the lesion consisted of various phases of clotting and granulation with significant fibrosis. Mature bone formation and abundant cholesterin clefts were also seen. Single cuboidal epithelium including goblet cells and cilia was found along this granulation, and the diagnosis was a Rathke cleft cyst. An ossified Rathke cleft cyst is extremely rare, and a solid Rathke cleft cyst has not before been reported. This case illustrates the extremely long and complex nature of this disease. PMID:19961317
INTRODUCTION Splenic cyst during pregnancy is rare and may result in spontaneous rupture during the third trimester, which increases perinatal morality. PRESENTATION OF CASE We present a 27-year-old healthy Caucasian female who presented at 18 weeks gestation with left flank pain, early satiety and weight loss. Imaging studies demonstrated a large complex multiloculated splenic cyst. The patient underwent a successful laparoscopic splenectomy and delivered a healthy child at term without complication. DISCUSSION Spontaneous rupture of a splenic cyst during the third trimester incurs a perinatal mortality rate as high as 70%. Surgical management includes open or laparoscopic splenectomy or fenestration and preservation of the spleen. CONCLUSION Laparoscopic splenectomy during the second trimester appears to be safe and offers definitive management of a large symptomatic splenic cyst during pregnancy.
Summary Based on the study of 8 cases of spinal intradural arachnoid cysts, the authors underline that the diagnosis is sometimes difficult because of the limitations of the paraclinical examination. They discuss aetiopathological problems.
F. Lesoin; D. Leys; M. Rousseaux; A. Cama; M. Jomin; H. Petit
In this activity, learners examine how brine shrimp populations can survive in some of the harshest environments. Learners subject brine shrimp cysts to extreme conditions to evaluate the hardiness of these creatures.
To present 58 cystic space-occupying formations of the spinal canal in 53 cases; these formations are called "juxtafacet cysts". Fifty-Three patients (33 women and 20 men, with an average age of 60.8 years) were evaluated retrospectively by neurosurgery. All of the patients had received simple X-P, computed tomography (CT) and magnetic resonance imaging (MRI) before surgery. The neurological findings were evaluated on admission and in a follow-up review. Surgical intervention was performed on all patients and they underwent gross-total cyst removal. During surgery, the origin of a cyst was well observed. Follow-up data ranged from 6 to 46 months. Patient outcome was graded on a scale of excellent, good, or poor. Histological findings were evaluated. In 53 patients 58 cysts were identified. Four of the patients had multiple cysts. All cysts were associated with mobile spine. Fifty-five cysts were found in the lumbo-sacral region, two cysts were found in the cervico-thoracic region and one cyst in the thoracic region. Forty-two patients presented back pain and 52 patients presented radicular pain. Four patients had a cauda equina syndrome. Sensory disturbance was observed in 24 cases and motor weakness was observed in 21 cases. Claudication was observed in 19 cases. All cases with cervico-thoracic or thoracic cysts presented myelopathy. The duration of these clinical symptoms ranged from 10 days to 10 years. After surgery there was no case of a recurrent cyst during the follow-up period. Thirty-four cases had an excellent outcome, 18 a good outcome, and one a poor outcome. Out of 58 cysts 32 were joint cysts (11 synovial cysts, 21 ganglion cysts). A further 19 were flavum cysts, one was a posterior longitudinal ligament (PLL) cyst and six others were unknown pseudo cysts. In 34 of the cysts we found hemosiderin deposits and in eight amyloid deposits. Present investigation and findings in literature show a clear comparison of these cystic formations and the mobile part of the spine. An anatomical relation to a vertebral joint ("facet") is only found in some of the cases (32 of 58). Further to that, the name "cyst" is not correct either, because most of the cystic formations are presented without a cell lining on their internal wall and therefore they are pseudo-cystic. We think that these cystic formations should be called "cystic formations of mobile spine" (CYFMOS) rather than "juxtafacet cysts". A surgical intervention is the best treatment for these cysts if they cause a compression of nerve roots or/and of the spinal cord. PMID:17203271
Christophis, Petros; Asamoto, Shunji; Kuchelmeister, Klaus; Schachenmayr, Walter
Summary Rupture of intracranial dermoid cysts (RICDC) is a rare phenomenon. The mechanism of rupture, pathophysiology of fat in the\\u000a ventricles and subarachnoid spaces, possible complications, and proper management of such conditions are proposed on the basis\\u000a of a review of the literature and experience with two cases of ruptured intracranial dermoid cysts (One was in the pineal\\u000a region, while another
Periscapular location of bronchogenic cysts is extremely rare with four cases reported in literature. We report a relatively\\u000a late presentation in a ten-year-old boy that was clinically mistaken for a typical sebaceous cyst. The definitive treatment\\u000a is total excision after preoperative imaging to detect the occassional intrathoracic extension. Histologically they are lined\\u000a by pseudostratified ciliated columnar epithelium, which can rarely
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.
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
Nine cases of cysts on the male urethral meatus are reported. These cysts are easily traumatized, occur early in life, enlarge slowly and apparently are not associated with infection, circumcision or trauma. These round, smooth, symmetrical and usually unilateral cysts do not interfere with urinary or sexual function except for an occasional irregularity of the urinary stream. Simple aspiration of the cyst results in recurrences. Marsupialization or unroofing of the cyst, especially if it is large, results in a gaping sinus, which is cosmetically unsatisfactory and should be avoided. Complete excision of the cyst is cosmetically excellent and there have been no recurrences in my cases. The cause of these cysts is postulated as a blockage of the paraurethral ducts. PMID:1235377
Renal bone disease: Radiological investigation. The bone disease associated with chronic renal impairment is complex and multifactorial, and has changed over past decades. Whereas originally features of vitamin D deficiency (rickets\\/osteomalacia) and secondary hyperparathroidism (erosions, osteosclerosis, brown cysts) predominated, improvement in management and therapy have resulted in such readiographic features being present in a minority of patients. Metastatic calcification and
Primary posterior mediastinal hydatid cyst is a serious health problem for the Mediterranean countries. We diagnosed a case of a 46-year-old female with a primary posterior mediastinum hydatid cyst on CT and MRI. It was provisionally identified as either a hydatid cyst or bronchogenic cyst or neuroenteric cyst. CT guided aspiration with 18 gauge needle confirmed as hydatid sand. This is very rare in this population but it should be kept in mind when one is looking at any cyst in the posterior mediastinum. PMID:24709247
Ahmed, Mughis Uddin; Eid, Ahmed Fathi; Al-Hawashim, Nadia; Sheikh, Mohammed Younus; Yiannakou, Nearchos
This paper describes a case of an epidermoid cyst arising in the anterior wall of the coecum. Epidermoid and dermoid cysts of the coecum are exceptionally rare. These cysts arise by the sequestration of squamous epithelium during embryological development, or following trauma or surgery. The true cysts are the result of inclusion or sequestration of ectodermal elements at the time of closure of the neural groove. Acquired epidermoid cysts are of traumatic or iatrogenic origin, due to implantation of the epidermis. In this reported case the patient had no previous abdominal surgery which is why this cyst represents the congenital variant of the disease. PMID:11494750
Hydatid disease is a cyclozoonotic infection caused by the cestode genus Echinococcus. It occurs throughout the world and is especially common in sheep- and cattle-raising regions of Africa, Australia, New Zealand, India, the Middle East, South America, and the Mediterranean. The incidence of humans infected with hydatid disease is approximately 1-2:1000. It is higher in rural areas. Infection occurs via ingestion of infected meat. Hydatidosis is caused by sheep and cattle ingesting tapeworm eggs in dog feces. These eggs hatch in the duodenum and invade the liver, lungs, or bones of sheep and cattle. Humans are infected by ingesting the infected meat from these animals. In the organs, the embryo transforms into a cyst, which develops the germinal epithelium that produces capsules, larval forms, and eventually the infectious scolices. Although hydatid cyst of the pancreas is rare, it must be considered in the differential diagnosis of pancreatic lesions. We present a rare case. PMID:24906281
Hydatid disease (Echinococcosis) is a common parasitic infection caused by Echinococcus granulosus mainly in sheep-raising areas of the world. Liver, lungs and brain are the predominantly involved organs. However, 0.5-1% of the hydatid disease involves the spine and in 90% of the cases it is confined to the bone and the epidural space. Although intramedullary involvement is extremely rare, in this report, we present a 55-year-old female patient who was diagnosed with a cervical intramedullary hydatid cyst during magnetic resonance imaging of the cervical vertebrae. Accordingly, we imply that particularly in endemic areas, hydatid cyst disease should be kept in mind for the differential diagnosis of spinal mass lesions. PMID:23183479
Senol, M G; Güney, Mehmet; Tekeli, H; Kendirli, M T; Kendirli, Hakan; Tansel, Mustafa; Kaya, S; Turhan, V; Vedat, Turhan; Sonmez, G; Güner, Sonmez; Saracoglu, M
An 8-year-old girl presented with a free-floating pigmented cyst in the anterior vitreous causing a large, visually disturbing floater. A simple laser photocystotomy with a single-frequency Nd:YAG laser resulted in a reduction in the size of the cyst but persistence of the floater. An attempt at further laser fragmentation of the cyst resulted in iatrogenic cataract formation. PMID:12757093
Gupta, Rajeev; Pannu, Bir Kamal Singh; Bhargav, Sonia; Narang, Subina; Sood, Sunandan
The intracranial, liquid-containing cysts in children (excluding tumor and parasitic cysts) are relatively frequent in neurosurgical practice. They raise several problems about their nosology, etiology, clinical and radiological diagnosis, and treatment which are analyzed in a series of 36 cases of supratentorial cysts. The most frequent clinical feature is increased head circumference (22 cases) followed by epileptic fits (18 cases),
Maurice Choux; Charles Raybaud; Nicole Pinsard; Jacques Hassoun; Danièle Gambarelli
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.
Rathke cleft cysts (RCC) are uncommon intrasellar lesions. Although their clinical manifestations, radiological features and treatment are frequently reported, controversy remains as a result of their rarity. We reviewed the preoperative clinical manifestations, neurological examination findings, visual acuity and fields, endocrinological function, radiographic study findings, surgical and pathological records, and prognosis of 45 patients with RCC (21 males, 24 females, average age: 47 years) admitted to our department between January 2002 and January 2011. The most common clinical manifestations included headaches, and visual and hormonal disturbances. Most RCC were intrasellar with a suprasellar extension. The most common MRI patterns were hypointense on T1-weighted and hyperintense on T2-weighted images, isointense on T1-weighted and hyperintense on T2-weighted images, and hyperintense on T1-weighted and hyperintense on T2-weighted images. Aspiration and biopsy of the cyst wall were performed in most patients. Most patients experienced improved headaches and visual disturbance, but the hormonal disturbance rarely returned to normal, especially in those patients with a serious preoperative hormonal disturbance. The recurrence rate was 14%, which was associated with the extent of cyst removal, inflammation and rim enhancement, as well as the surgical approach. Aspiration and biopsy of the cyst wall still seems to be an effective treatment for most RCC for its low morbidity and good prognosis. Conservative treatment and close follow-up may be suitable for small cysts with subtle clinical manifestations. PMID:22336224
In the treatment of the liver hydatid cyst, many surgical techniques have been used, from aspiration, drainage, marsupialization to the complete excision of the cyst with segmentary liver resection. With the appearance of laparoscopic surgery, new chances for the treatment of liver hydatidoses come to us in this frequent pathology in our country. In this paper we show the laparoscopic technique used in some patients seen by us in the last years. After we made the diagnosis, we gave medical treatment with albendazol 400 mg per day during 90 days, prior to surgery. We also used antibiotic prophylaxis with wide spectrum antibiotics. Surgery was performed with the patient in dorsal decubitus with ports: umbilical; 10 mm for angled optics (30-45 ), epigastric;10 mm, for right subcostal in the mid collar bone position. 5 mm for aspiration and forceps and right subcostal and front axillar line. We performed a diagnostic laparoscopy to visualize the cyst. We introduced soaked gauzes with ClNa 21% surrounding the cyst specially in the more protruded zone. Afterwards we punctured the cyst and took laboratory samples searching for the scolex in the direct exam, then we injected ClNa 21% in the cyst. It stay for 5 minutes and we made rechanges for 4-5 times. We take a piece of the wall cyst and adventicy for pathological examination. We take out the germinative layer and the daughter s hydatides with care to put them in extraction bags to leave out their content in a ClNa 21% recipient. Finally we retrieved the gauzes previously introduced, we suck the remaining fluid and introduce a piece of epiplon inside the residual cavity, fixed with suture points to the border and left a 16F fenestrated probe that is left outside by a lateral port. The postoperative management is the same as the laparoscopic colecystectomy. The oral route begins when the postoperative ileum is over (12 to 24 hours), treatment of the pain, prompt deambulation and discharge in relation of the external drainage (on average after 48 to 72 hours). PMID:11818992
Salinas Sedó, G; Velásquez Hawkins, C; Saavedra Tafur, L
Nasal dorsal cyst formation after rhinoplasty is considered a rare complication. These cysts are due to entrapment of mucosal remnants in the subcutaneous space. Meticulous surgical technique aimed at preserving the mucosal lining may prevent cyst formation. Surgical excision with the open approach is a reliable treatment. A case of nasal dorsal cyst after previous rhinoplasty is presented. After four years no sign of recurrence is noted. PMID:8362177
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
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 840nm in the phosphate concentration range,
Branchial cleft cysts are benign lesions caused by anomalous development of the brachial cleft. This report describes a 20-year-old girl with swelling on the right lateral aspect of the neck, which expanded slowly but progressively. The clinical suspicion was that of a branchial cleft cyst. Sonography revealed a homogeneously hypo- to anechoic mass with well-defined margins and no intralesional septa. Color Doppler reviewed no internal vascularization. The ultrasound examination confirmed the clinical diagnosis of a second branchial cleft cyst, demonstrating the cystic nature of the mass and excluding the presence of complications. For superficial lesions like these, ultrasound is the first-level imaging study of choice because it is non-invasive, rapid, low-cost, and does not involve exposure to ionizing radiation. PMID:24046795
While common in adult teeth, radicular cysts are uncommon in deciduous teeth. When they do occur, they are associated with non-vital teeth and typically present 6 months to 5 years after vitality is lost. They cause swelling, bone-loss and permanent tooth bud displacement. Often, they are incidental findings. A case involving radicular cysts on the left and right sides of the mandible is presented. If non-vital deciduous teeth receive pulp therapy, regular post- operative reviews are recommended. PMID:23019771
Cysts of the vitreous are an unusual clinical finding, with only about 50 such cases reported in the literature. The sizes of the cyst may vary from 0.15 to 12 mm, and they have been found in the anterior and posterior vitreous. The etiology has been theorized to be both congenital and acquired. Acquired cysts may be due to trauma or other forms of intraocular inflammation. Pigmented cysts are believed to originate from the pars ciliaris and nonpigmented cysts are likely to be derived from the remnants of the hyaloidal artery system. The appearances of the cysts are striking and are often seen as clear spherical bodies in the vitreous with interesting interlacing surface patterns. The cysts are benign and are of little significance, except when they encroach on the visual axis and produce visual disturbances (usually floater symptoms). PMID:9547797
A relatively unusual cause of progressive paraparesis is a spinal arachnoid cyst. The following is a case report of this lesion in an adolescent. The CT-myelographic and MR features, as well as the management of this case are discussed, followed by a review of the pertinent English literature on this topic.
The case of 16-year-old boy with a spinal extradural arachnoid cyst is presented. An extradural arachnoid diverticulum extending from T10 to L1 was excised totally with hemilaminectomy. Surgery caused prompt improvement of the neurological deficit. The pertinent literature is reviewed.
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.
Rupture of an intracranial dermoid cyst is a rare event with considerable associated morbidity and potential mortality. We present a case of intracranial rupture of a dermoid cystic tumor with consequent dissemination of subarachnoid fat droplets resulting in acute aseptic chemical meningitis. Radiographic findings, operative treatment, and pathologic features are described.
Barnett, David W.; Snipes, George J.; Layton, Kennith F.; Opatowsky, Michael J.
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
What is the optimal environment for hatching brine shrimp? Using a scaffold, learners design and conduct experiments testing the effect of a single abiotic factor on brine shrimp cyst hatch rate. Pool results from the group to determine the optimal environment for hatching these resilient organisms.
Bone hydatid disease lacks a typical clinical appearance and image characteristics on x ray or CT are similar to those of tuberculosis, metastases and giant cell tumour or bonecysts. However, MRI does show distinctive diagnostic features of bone hydatid disease, especially in the spine. Until recently, treatment of osseous hydatid disease has been entirely surgical. Effective chemotherapy using benzimidazoles, particularly mebendazole, albendazole and combination treatments, has now been achieved in experimental studies and clinical practice. However, most of these drugs are still in the experimental stage or are in the early stages of clinical use.
Background Compared with many protists, Giardia lamblia has a simple life cycle alternating between cyst and trophozoite. Most research on the molecular biology of Giardia parasites has focused on trophozoites and the processes of excystation and encystation, whereas cysts have attracted less interest. The striking morphological differences between the dormant cyst and the rapidly dividing and motile trophozoite implies profound changes in the metabolism as the parasite encysts in the host's intestine and excysts upon ingestion by a new host. Results To investigate the magnitude of the transcriptional changes occurring during the G. lamblia life cycle we compared the transcriptome of G. lamblia trophozoites and cysts using single-color oligonucleotide microarrays. Cysts were found to possess a much smaller transcriptome, both in terms of mRNA diversity and abundance. Genes encoding proteins related to ribosomal functions are highly over-represented. The comparison of the transcriptome of cysts generated in culture or extracted from feces revealed little overlap, raising the possibility of significant biological differences between the two types of cysts. Conclusions The comparison of the G. lamblia cyst and trophozoite transcriptome showed that transcripts of most genes are present at a lower level in cysts. This global view of the cyst and trophozoite transcriptome complements studies focused on the expression of selected genes during trophozoite multiplication, encystation and excystation.
Background: The most common benign lesions of the kidney are simplecysts. They are acquired lesions and mostly affect the elderly population. Objectives: To describe the usage of choice-lock catheter and trocar technique in percutaneous renal cyst treatment and determining long-term outcomes. Patients and Methods: This retrospective study was carried out between February 2000 and July 2011. Eighty-eight cysts all of which were Bosniak type-1 cysts were selected in 75 patients. The treatment indications were flank pain, hydronephrosis and hypertension. The choice-lock catheter was used for 84 cysts with the trocar technique. Ninety-five percent ethanol was used as the sclerosing agent. Maximum volume of the injected ethanol was 175 ml. The mean follow-up time after the treatment procedure was 23 months. Sixty-four cysts were located in the cortical and 24 cysts were located at the parapelvic region. Results: Fifty-seven cysts had complete regression, while 31 cysts regressed partially. After the procedure, pain was relieved in 44 (82%) patients and the pain alleviated in four (8%). Normotension was obtained in five (62.5%) of the eight hypertensive patients and no hydronephrosis was detected in nine patients. There were no relationship between the localization and the regression rate. No major complications occurred. Conclusions: Percutaneous ethanol sclerotheraphy in simplecysts is a safe, cost-effective and minimally invasive method. We consider that this technique may be an alternative solution in the percutaneous cyst treatment.
Background Bone grafting is used to enhance healing in osteotomies, arthrodesis, and multifragmentary fractures and to replace bony loss\\u000a resulting from neoplasia or cysts. They are source of osteoprogenitor cells and induce bone formation and provide mechanical\\u000a support for vascular and bone ingrowth. Autografts are used commonly but quantity of harvested bone is limited. The aim of\\u000a this study is to
A. S. Bigham; S. N. Dehghani; Z. Shafiei; S. Torabi Nezhad
Postsurgical MR scans had a lower incidence of pulsatile cysts. In five patients with both pre- and postoperative MR scans, shunting of the cyst reduced the size of the pulsating cyst (two patients) or reduced the size of the cyst and eliminated pulsation altogether (three patients). Axial, T2-weighted images are recommended in the investi- gation of spinal cord cysts to
Dieter R. Enzrnann; James O'Donohue; Jeremy B. Rubin; Larry Shuer; Phil Cogen; Gerald Silverberg
Quantification of Alexandrium cyst fluxes through the Gulf of Maine water column is central to understanding the linkage between the source and fate of annual Alexandrium blooms in the offshore waters. These blooms often lead to paralytic shellfish poisoning (PSP) and extensive closures of shellfish beds. We report here on time-series sediment trap deployments completed at four offshore locations in the gulf between 2005 and 2010 as components of two ECOHAB-GOM field programs. Data presented documents the substantial spatial and temporal fluctuations in Alexandrium fundyense cyst fluxes in the gulf. Cyst delivery out of the euphotic zone peaked primarily between July and August following annual spring-summer Alexandrium blooms and was greatest in the western gulf. At all sites, cyst flux maxima to the subsurface waters were rarely coincident with seasonal peaks in the total mass export of particulate material indicating that cyst delivery was primarily via individually sinking cysts. Where persistent benthic nepheloid layers (BNLs) exist, significant sediment resuspension input of cysts to the near-bottom water column was evidenced by deep cyst fluxes that were up to several orders of magnitude greater than that measured above the BNL. The largest cyst fluxes in the BNL were observed in the eastern gulf, suggesting greater resuspension energy and BNL cyst inventories in this region. Temporal similarities between peak cyst export out of the upper ocean and peak cyst fluxes in the BNL were observed and document the contribution of seasonal, newly formed cysts to the BNL. The data however also suggest that many Alexandrium cells comprising the massive, short-lived blooms do not transition into cysts. Time-series flow measurements and a simple 1D model demonstrate that the BNL cyst fluxes reflect the combined effects of tidal energy-maintained resuspension, deposition, and input of cysts from the overlying water column.
Pilskaln, C. H.; Anderson, D. M.; McGillicuddy, D. J.; Keafer, B. A.; Hayashi, K.; Norton, K.
Pigmented follicular cyst is a rare disorder which typically presents as a pigmented papule on the head or neck and which, histologically, exhibits terminally differentiated, pigmented hair shafts in an epidermoid cyst. We report a 22-year-old man with the multiple variant of this disorder. Clinically he had numerous brown-blue to flesh-coloured, domed-shaped papules, on the anterior chest and abdomen, of 10 years duration. Histologically, hybrid cysts exhibiting trichilemmal and epidermoid keratinization were seen. The cysts contained numerous pigmented, terminally differentiated hair shafts and, embedded in the wall of one cyst, was a sebaceous gland. The condition of multiple pigmented follicular cysts, is thought to represent a distinct subtype within the spectrum of multiple pilosebaceous cystic disorders. PMID:8733387
Background The presence of primary aneurysmal cyst in soft tissues is a extremely rare and its presence in the soft tissues of hand has never been reported in literature before. We report the first ever case of extraosseous aneurysmal cyst in hand. Case Presentation A twelve years old girl presented with a swelling in the thenar region on palmer aspect of right hand growing slowly since three months. On X ray, CT scan and excision biopsy the lesion was found to be separate from bone and located in the soft tissue. Its diagnosis was confirmed on histopatholgical examination. Conclusion Previously few authors have reported extraosseous aneurysmal cyst in the soft tissues of shoulder, hip and pelvic girdle but nobody has reported its presence in the soft tissues of hand.
A hydatid cyst is a parasitic disease which is caused by a cestode named Echinococcus and often located in the liver. Localization in the bone and soft tissue is rarely seen. In this article, we present a 64-year-old male case with a hydatid cyst located in the soft tissue of the left anterolateral aspect of the thigh. The hydatid cyst starting from the gluteal region proximally into the pelvis, the femoral head and the hip joint leading to the spread of secondary protrusio acetabuli and extending distally to the popliteal region formed a massive lesion. In addition to medical treatment followed by repeated surgeries, the patient with relapses is still under surgical follow-up and medical treatment. PMID:25036401
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.
Introduction Non-parasitic hepatic cysts are benign entities, occur rarely (5% of the population), and in the majority of cases, are asymptomatic. Cysts can cause symptoms when they become large and produce bile duct compression or portal hypertension, and also when complications such as rupture, infection or hemorrhage take place. Case presentation We present the case of a 70-year-old Greek-Caucasian man with a large, asymptomatic and non-parasitic liver cyst that presented as an acute surgical abdominal emergency after spontaneous rupture into the peritoneal cavity. Conclusions We present an extremely rare complication of simple liver cyst, its rupture in the free abdominal cavity, and its presentation as an acute abdomen. Large simple liver cysts should be treated with intervention at early recognition as conservative management usually results in their recurrence.
Background and Objectives: In this study, we evaluated the safety and efficacy of using the LigaSure sealing system (Valleylab, Boulder, Colorado) for laparoscopic decortication of symptomatic hilar renal cysts. Methods: Seventeen patients underwent laparoscopic decortication of hilar renal cysts with the LigaSure system. Our study included only symptomatic, Bosniak type 1, simple and symptomatic renal cysts. The operative route, transperitoneal or retroperitoneal, was planned according to the location confirmed by computed tomography. The patients' symptoms were preoperatively and postoperatively evaluated by the Wong-Baker visual pain scale. Operative measures and radiologic outcomes were prospectively evaluated. Results: The mean age of the patients was 56.4 years, and the mean follow-up period was 12.5 months. Preoperative computed tomography showed only a single cyst in 15 patients (88.2%) and showed two separate cysts in 2 cases (11.8%). The cysts were located in the perihilar region close to the vascular structure in all patients. A transperitoneal approach was used in 9 patients, and a retroperitoneal approach was used in 8 patients. The mean operative time and hospitalization time were 56.4 minutes and 1.2 days, respectively. Minor complications were observed in 3 patients. Symptomatic and radiologic success rates of 94.2% and 100%, respectively, were achieved. Conclusion: Laparoscopic decortication of symptomatic hilar renal cysts—first reported in the literature in this study—using the LigaSure sealing system is feasible, effective, and safe, even if the cyst is located in the perihilar area.
The pathogenesis of juxtafacet cysts is closely related to degenerative instability of the lumbar spine and degenerative changes in the ligamentum flavum and the facet joint. A 56-year-old man presented with severe right thigh pain and numbness for 1 month after a laminar fracture of the L4 spine. Magnetic resonance imaging revealed a heterogenous cystic mass surrounding the facet joint between the fourth and fifth lumbar vertebrae on the right side. Conservative therapy was unsuccessful and the lesion was removed by surgical decompression alone without fusion. The histological examination showed a fragmented, cystic wall-like structure composed of myxoid degenerative tissue without lining epithelium. Here we present this case of a ganglion cyst that appeared to be associated with facet joint instability.
Mun, Jong Hyeon; Lim, Byung Chan; Lim, Jun Seob; Cho, Kyu Yong
Tuberculous infection of the oral tissues is a rare finding. An interesting case of primary tuberculosis of mouth is described, presenting as persistent discharge of pus from the lower wisdom tooth region. Incisional biopsy revealed features of an infected dentigerous cyst while histopathological examination of the excised lesion showed keratinizing cyst with secondary infection. Non-healing of the bony defect prompted curettage of the area and the submitted sample microscopically showed granuloma with characteristic Langhans' giant cells, raising the suspicion of underlying systemic tuberculosis. The importance to the dental surgeon in the recognition, especially by use of pathological examination, is emphasized and also the value of diagnosis for the patients and the community. PMID:23540089
Two pediatric patients (4 and 5 years of age) with spinal intramedullary ependymal cysts located at the cervical and dorsal cord are reported here. One patient was admitted with subtle signs, while the other had disabling spastic quadriparesis. In both patients, MRI depicted a well-demarcated, localized, nonenhancing intramedullary lesion isointense with CSF on T1- and T2-weighted images. Total excision of
Raj Kumar; Suresh R. Nayak; N. Krishnani; D. K. Chhabra
We studied 37 intradiploic epidermoid cysts, reviewing typical and atypical radiological features and the differential diagnosis. The most common clinical feature was a long standing lump in the scalp, occurring in 25 patients (67.7 %). Plain films were the most cost-effective radiological technique in diagnosis. The typical finding was a well-defined lytic lesion with sclerotic border, seen in 29 cases
E. Arana; F. F. Latorre; A. Revert; F. Menor; P. Riesgo; F. Liaño; C. Diaz
We studied 37 intradiploic epidermoid cysts, reviewing typical and atypical radiological features and the differential diagnosis. The most common clinical feature was a long standing lump in the scalp, occurring in 25 patients (67.7%). Plain films were the most cost-effective radiological technique in diagnosis. The typical finding was a well-defined lytic lesion with sclerotic border, seen in 29 cases (78%).
E. Arana; F. F. Latorre; A. Revert; F. Menor; P. Riesgo; F. Liaño; C. Diaz
A rare case of lymphoepithelial cyst of the pancreas is reported. Microscopically the cyst content consisted of keratinous material and the walls were lined by mature squamous epithelium surrounded by dense lymphoid tissue. Immunohistochemistry showed diffuse reactivity for CD20 and CD3 in the lymphoid tissue and uniform positivity for cytokeratins in the squamous epithelium. Although the histogenesis of lymphoepithelial cysts of the pancreas is not understood, awareness of this lesion is helpful in differentiating it from other pancreatic cystic lesions. Images
Optimal radiologic investigation greatly improves surgical outcome in cases of epidermoid cyst. As the lesion is benign but will recur if total excision is not accomplished, the surgeon must be prepared to resect the entire capsule and not simply drain the cyst. The contribution of neuroimaging and other diagnostic procedures to the preoperative evaluation of a man with posterior fossa cyst is reported. ImagesFigure 1Figure 2Figure 3Figure 4
Summary A young women presented with chronic headaches associated with a cyst of the right lateral ventricle. The diagnosis of intraventricular\\u000a so-called “arachnoid” cyst was supported by CT scan, MRI and stereotactic puncture. MRI was of great value for demonstrating\\u000a that the cyst was located within the lateral ventricule, that it was delinated by a thin wall adherent to the choroid
J. Pelletier; L. Milandre; J. C. Péragut; S. Crongvist
Bronchogenic cyst, also known as inclusion cyst, is a type of congenital endodermal heterotropia derived from an abnormal development of the ventral diverticulum of the foregut or the tracheobronchial tree during embryogenesis. Its interatrial localization is extremely rare and making a final diagnosis without surgery challenges the clinician. Herein, we report a 58-year-old male patient who had an interatrial bronchogenic cyst related to transient ischemic attack. PMID:22089816
We present the second case of Klippel-Feil syndrome in association with a posterior fossa dermoid cyst extending through\\u000a the occipital bone and presenting as a suboccipital subcutaneous mass. We describe its radiographic, CT, and MRI appearances\\u000a as well as on MRI diffusion-weighted images. Posterior cranial fossa dermoid cysts and sinuses should be added to the list\\u000a of congenital abnormalities which
Nasoalveolar cysts are uncommon nonodontogenic and developmental cysts with an uncertain pathogenesis. This cyst has been reported to occur bilaterally in 10-11% of cases. This case report describes a 45-year-old woman in whom the clinicopathologic findings were consistent with bilateral nasoalveolar cysts. The authors report a new, less invasive method for transnasal endoscopic marsupialization of bilateral nasoalveolar cysts. Transnasal endoscopic marsupialization has benefits for the treatment of bilateral and unilateral nasoalveolar cysts. PMID:19604675
... new treatments for the disease. Are there other names for Megalencephalic Leukoencephalopathy with subcortical Cysts (MLC)? Other names for Megalencephalic Leukoencephalopathy with subcortical Cysts (MLC) include: ...
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
Epidermoid cysts are rare lesions in the oral cavity. They usually present early in life and are confined to one anatomical area. Simple excision is all that is needed. However, they may present late in life and be large in size, making their excision a real challenge. We present a case of congenital epidermoid cyst of the sublingual space that presented late, at the age of 17 years, after it plunged into the submental area. The presentation of the patient and the surgical approach are discussed. PMID:12709808
Summary We report 2 cases of arachnoid cysts, one with a retrocerebellar and the other with a left temporal localization, in which immunohistochemical studies had been conducted. The results of the immunohistochemistry on the presence of carcino-embryonic antigen (CEA) and glial fibrillary acidic protein (GFAP), and of the scanning- and transmission electron microscopy revealed the cyst lining to be identical
K. G. Go; M. A. Blankenstein; T. M. Vroom; E. H. Blaauw; F. Dijk; H. Hollema; A. Verhagen
The Rathke's pouch cysts are a relatively common autopsy finding, but rarely have they been reported as a clinical entity. We report a Rathke's pouch cyst patient's case with visual impairment and emphasize aspects like clinical presentation, radiological studies and treatment. Many published series about this pathology have been reviewed and compared with the present case. PMID:12806513
Falavigna, Asdrubal; Ferraz, Fernando Antonio Patriani; Madalosso, Fabiola A; Hohmann, Fábio B
The gross and histological appearances of intrahepatic cysts in red and roe deer are described. It is suggested that the structures arise as anomalous developments of the biliary tree. Although not of clinical significance, these cysts may pose a problem at meat inspection. PMID:1918448
We report an unusual patient with multiple infected cerebral hydatid cysts. A 20-year-old man presented with a 2-month history of headache and progressive left-sided hempiparesis. A cerebral CT scan showed a large and heterogeneous parieto-occipital lesion. During surgery an infected hydatid cyst was discovered with multiple daughter vesicles. Post-operatively the patient was treated with albendazol, cefotaxime and metronidazole. The clinical course was good with total recovery of the hemiparesis. A follow-up CT scan showed persistence of some small deep-seated cysts. Multiple infected cerebral hydatid cyst is uncommon and can be confused with other cystic brain lesions. The aim of surgery is to remove the cyst unruptured and this should be followed by antihelminthic and antibiotic treatment in order to avoid recurrences. PMID:18342511
Background: Despite the increasing use of laparoscopic techniques, the optimal surgical approach for cystic liver disease has not been well defined. This study aims to determine the optimum operative approach for these patients. Methods: Data were identified from the Lothian Surgical Audit, case note review and general practitioner contact. Patients were contacted and asked to complete the SF-36 questionnaire on quality of life. Results: A total of 102 patients (67 with simplecysts, 31 with polycystic liver disease [PCLD], four with cystic tumours) underwent 62 laparoscopic deroofings, 15 open deroofings, 36 resections and one liver transplant between June 1985 and April 2006. The median follow-up was 77 months (range 3–250 months). Morbidity and recurrent symptom rates after laparoscopic surgery were greater in PCLD patients compared with simplecyst patients, at 31% (four patients) vs. 15% (seven patients) and 85% (11 patients) vs. 29% (24 patients), respectively. Four patients with simplecysts and eight with PCLD required further surgery. All patients with simplecysts had comparable quality of life after surgery. Patients with recurrent symptoms after surgery for PCLD had a significantly better quality of life following laparoscopic deroofing than after resection. Conclusions: Most simplecysts can be managed laparoscopically, but there is a definite role for open resection in some patients. Open deroofing is the preferred approach for a dominant cyst pattern in PCLD, whereas resection is necessary for diffuse cystic disease.
Gall, Tamara M H; Oniscu, Gabriel C; Madhavan, Krishnakumar; Parks, Rowan W; Garden, O James
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
Dermoid cysts are uncommon tumors, and posterior fossa dermoid cysts may rarely cause abscess formation or formation of daughter abscesses within the cerebellum. At present, there are only 16 cases with posterior fossa dermoid cysts causing cerebellar abscesses reported in the literature. Two cases, 22 and 14 months old, with posterior fossa dermoid cysts and dermal sinus causing multiple cerebellar
Feyza Karagöz Güzey; N. Serdar Bas; Altay Sencer; Erhan Emel; M. Kemal Hamamcioglu; Nezih Özkan; Kemal Hepgul; Abdurrahman Aycan
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
Summary 20 cases of operated developmental CSF cysts are surveyed: 8 Dandy-Walker syndromes and 12 extraaxial “arachnoid” cysts. A CSF shunt is the only possible operation for Dandy-Walker syndrome and a single shunt from the cyst is preferable to a double shunt; the success rate is 50%. Congenital extraaxial “arachnoid” cysts, which arise from a developmental anomaly of the roof
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.
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
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, bonecysts.
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.
Background: Hepatic cysts are detected incidentally in 2.5–5% of the population. Only about 15% of such cysts are symptomatic. Since laparoscopic deroofing for liver cysts was first described in 1991 there have been a number of reports of successful laparoscopic management of hepatic cysts, including the laparoscopic management of complex and parasitic cysts. Methods: A systematic review of English-language articles
Cervical thymic cysts are rare lesions often misdiagnosed clinically as branchial cyst. Here we report a rare case of multiloculated thymic cyst in a young 8 year old male child on the left side of the neck. Histopathology of the excised cyst revealed mural nodules of thymic tissue with prominent Hassal's corpuscles associated with multiloculated cyst. This case is presented here for its rarity. It should be included in the differential diagnosis of neck masses in children. PMID:24427638
Prabhakar, Gundala; Santhosh, A N; Manjunath, S S; Santosh, K V
Popliteal cysts, although commonly seen, are rarely associated with motion restriction or calcification. Radiological features are of soft-tissue swelling, with occasional reports of calcifications or small osteochondral bodies inside the cysts. We report a giant osteochondral body in a popliteal cyst, with significant mechanical block to flexion. This type of mass has to be differentiated from synovial osteochondromatosis, calcifications in the cyst, extraosseous and intraarticular osteochondromas. Complete excision of the cyst resulted in complete recovery of range of motion.
On HRCT scans, lung cysts are characterized by rounded areas of low attenuation in the lung parenchyma and a well-defined interface with the normal adjacent lung. The most common cystic lung diseases are lymphangioleiomyomatosis, Langerhans cell histiocytosis, and lymphocytic interstitial pneumonia. In a retrospective analysis of the HRCT findings in 50 patients diagnosed with chronic paracoccidioidomycosis, we found lung cysts in 5 cases (10%), indicating that patients with paracoccidioidomycosis can present with lung cysts on HRCT scans. Therefore, paracoccidioidomycosis should be included in the differential diagnosis of cystic lung diseases.
Costa, Andre Nathan; Marchiori, Edson; Benard, Gil; Araujo, Mariana Sponholz; Baldi, Bruno Guedes; Kairalla, Ronaldo Adib; Carvalho, Carlos Roberto Ribeiro
Background: Liver cysts have been estimated to occur in 5% of the population. Multiple liver cysts can also be part of the polycystic disease complex. Only symptomatic or complicated cysts need surgery. Traditionally, laparotomy is the procedure of choice. We present our experiences with laparoscopic management of both symptomatic multiple liver cysts and polycystic liver disease. Methods: Between 1995 and 2006, we treated 12 patients with large, multiple liver cysts, including 4 cases of polycystic liver disease. Most of the patients were elderly males. The lung and other organs were not involved in any case. Laparoscopic deroofing or radical excision with omentoplasty was successfully performed in these patients. Results: Postoperatively, 4 patients had fluid draining through the drainage tube for an average of 10 days. One patient had ascites that resolved spontaneously. Cysts recurred in 5 patients. Discussion: There are not many reports in the literature regarding large series of patients, further confirming the rarity of the disease. Liver cysts can occur as a part of polycystic renal and lung disease or isolated to the liver alone. Laparoscopic deroofing is the ideal treatment for nonpolycystic liver disease, and laparoscopic radical excision is ideal for polycystic liver disease. Simple needle aspiration or sclerotherapy is inadequate as recurrence is almost 100%. Conclusion: Currently, laparoscopy scores over laparotomy for the treatment of nonparasitic liver cysts as evidenced by this and other studies.
Most surgeons agree that complex neonatal ovarian cysts, regardless of size, warrant operative intervention. Management of simplecysts >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 simplecyst 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
Laparoscopic cystectomy has become a common procedure for choledochal cysts. The cyst should be removed completely just above the confluence of the common biliopancreatic channel at the distal end and approximately 5 mm from the confluence of the right and left hepatic ducts at the proximal end to avoid complications of the cystic remnant. The operation is feasible and safe. The rate of conversion to open surgery is low. The rate of complication under skill laparoscopic surgeons is also low, even lower than in open surgery. There was no difference between hepaticoduodenostomy and hepaticojejunostomy concerning the rate of cholangitis. Gastritis due to bilious reflux occurred with a low rate in hepaticoduodenostomy. Both techniques could be used for choledochal cysts; however, hepaticoduodenostomy should be applied for choledochal cysts without intrahepatic dilatation of biliary tract. PMID:23572286
Summary Based on the study of 10 cases of post traumatic spinal arachnoid cysts (SAC), acute and chronic clinical variants are individualized. A physiopathological hypothesis is advanced to explain their mechanism of formation.
One of the rarest situations regarding an adrenal incidentaloma is an adrenal cyst. We present the case of a 61Z–year old male patient diagnosed with peritonitis. During surgery, a right adrenal tumor of 2 cm is discovered. The patient was referred to endocrinology. 6 months later the diameter of the tumor is 7 times bigger than the initial stage. It has no secretory phenotype, except for the small increase of serum aldosterone and the 24–h 17–ketosteroids. Open right adrenalectomy is performed and a cyst of 15 cm is removed. The evolution after surgery is good. The pathological exam reveals an adrenal cyst with calcifications and osteoid metaplasia. The immunohistochemistry showed a positive reaction for CD34 and ACT in the vessels and VIM in the stroma. The adrenal cysts are not frequent and represent a challenge regarding the preoperative diagnostic and surgical procedure of resection. The pathological exam highlights the major aspects.
Carsote, M; Chirita, P; Terzea, D; Paun, S; Beuran, M
One of the rarest situations regarding an adrenal incidentaloma is an adrenal cyst. We present the case of a 61-year-old male patient diagnosed with peritonitis. During surgery, a right adrenal tumor of 2 cm is discovered. The patient was referred to endocrinology. 6 months later the diameter of the tumor is 7 times bigger than the initial stage. It has no secretory phenotype, except for the small increase of serum aldosterone and the 24-h 17-ketosteroids. Open right adrenalectomy is performed and a cyst of 15 cm is removed. The evolution after surgery is good. The pathological exam reveals an adrenal cyst with calcifications and osteoid metaplasia. The immunohistochemistry showed a positive reaction for CD34 and ACT in the vessels and VIM in the stroma. The adrenal cysts are not frequent and represent a challenge regarding the preoperative diagnostic and surgical procedure of resection. The pathological exam highlights the major aspects. PMID:20945822
To improve the cosmetic results of removing epidermal cysts, minimally invasive methods have been proposed. We proposed a new minimally invasive method that completely removes a cyst through a small hole made by a CO2 laser. Twenty-five patients with epidermal cysts, which were 0.5 to 1.5 cm in diameter, non-inflamed, and freely movable, were treated. All of the patients were satisfied with the cosmetic results. This method is simple and results in minimal scarring and low recurrence rates without complications.
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
Most reports regarding synovial cysts of the spinal canal have been presentations identifying an unusual pathological entity that is to be included in the differential diagnosis of cauda equina compression syndromes. Most of the 26 cases reported represent isolated examples of this pathological process. We present five cases of lumbar synovial cysts encountered in our practice in the past 8 years. Patients with lumbar synovial cysts do not demonstrate any predictable clinical picture. They may present with a unilateral sciatica or neurogenic claudication. Lumbar extension is usually restricted, whereas flexion is full. Mechanical signs of nerve root entrapment or lumbosacral plexus irritation are unimpressive. Neurological deficits are usually mild, if present. Radiological findings include degenerative spondylosis, spondylolisthesis, and a rounded posterolateral extradural mass of low attenuation value adjacent to a facet shown on computed tomographic scan. The etiology of lumbar synovial cysts is not known. Histological findings of myxoid degeneration, microcystic change, calcification, and hemosiderin deposits suggest that chronic microtrauma with occasional focal hemorrhage may play a major role in the etiology of the cysts. With resection of the cyst, the postoperative course is usually uneventful. Recurrences have not yet been encountered in our patients. PMID:3489903
\\u000a This paper presents a combined method of content-based retrieval and classification of ultrasound medical images representing\\u000a three types of ovarian cysts: SimpleCyst, Endometrioma, and Teratoma. Combination of histogram moments and Gray Level Co-Occurrence Matrix (GLCM) based statistical texture descriptors has been\\u000a proposed as the features for retrieving and classifying ultrasound images. To retrieve images, relevance between the query\\u000a image
Prabir Bhattacharya; Sudhir P. Mudur; Srinivasan Krishnamurthy; Lucy Gilbert
A rapid high performance liquid chromatographic method was developed including an internal standard for the measurement of mature and senescent crosslinks concentration in non-demineralized bone hydrolysates. To avoid the demineralization which is a tedious step, we developed a method based on the use of a solid-phase extraction procedure to clean-up the samples. It resulted in sensitive and accurate measurements: the
S. Viguet-Carrin; E. Gineyts; C. Bertholon; P. D. Delmas
Congenital bile duct cysts are rare in adulthood. The most frequently used classification was proposed by Todani in 1977. However, in rare cases, not all the bile duct cysts are suitable to this classification. Hereby, we describe the case of an unclassified and very rare form of congenital bile duct cyst--isolated cystic duct cyst. En-block resection of the cyst, along with gallbladder, is the treatment of choice. Although exceptional, cystic duct cysts should be included in Todani classification so that the surgeons to be aware for this variation. PMID:24720146
Neurenteric cysts in the central nervous system are rare developmental malformations. Usually the cysts are located ventral to the high thoracic or low cervical spinal cord. Only a few cases of intracranial neurenteric cysts have been reported in the literature to date. We report two cases of intracranial neurenteric cysts in the cerebellopontine angle with totally different radiographic, macroscopic, and microscopic appearance. As seen in these cases, the imaging spectrum of neurenteric cysts can be diverse, including malignancy-suspecting partial rim-enhancement or low-grade glioma features. Microsurgical therapy should include endoscopic assistance to ensure complete removal of cyst content. PMID:23397125
Roder, Constantin; Ebner, Florian H; Schuhmann, Martin U
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.
Pycnodysostosis is a rare autosomal recessive disorder caused by mutations in the cysteine protease Cathepsin K gene located on chromosome 1q21. It has a well characterized skeletal phenotype which include short stature, generalized increased bone density with propensity of fractures, open calvarial sutures and fontanelle, dental abnormalities, obtuse mandibular angle, resorption of lateral end of clavicle, acro-osteolysis, and in some cases visceromegaly. Central nervous system involvement is very rare and porencephalic cysts has been reported only once, the cause being hypothesised to be an imbalance between the growing brain, its vascular supply and intraventricular fluid pressure. We had a patient with bilateral frontal lobe porencephalic cysts; the patient presenting with complex partial seizures. Cathepsins have been found to be involved in neurological diseases and role of proteases has been well established in gliosis.
Dentigerous cyst is one of the most prevalent types of odontogenic cysts and is associated with crown of an unerupted or developing tooth. Dentigerous cysts are usually asymptomatic, so facial swelling may be the first clinical sign of a dentigerous cyst. A dentigerous cyst forming a septal abscess is uncommon. We report a case of dentigerous cyst presenting as a septal abscess. PMID:16823561
Online Simple Machines Assignment OBJECTIVES: Student\\'s will be able to name and describe all seven simple machines. Students will be able to identify simple machines that they use everyday. Example: Clock = Gear INSTRUCTIONS: 1. Click on the Simple Machines Glossary page and familiarize yourself with the seven simple machines. Simple Machines Glossary Page 2. Students are to click on ...
A rapid high performance liquid chromatographic method was developed including an internal standard for the measurement of mature and senescent crosslinks concentration in non-demineralized bone hydrolysates. To avoid the demineralization which is a tedious step, we developed a method based on the use of a solid-phase extraction procedure to clean-up the samples. It resulted in sensitive and accurate measurements: the detection limits as low as 0.2 pmol for the pyridimium crosslinks and 0.02 pmol for the pentosidine. The inter- and intra-assay coefficients of variation were as low as 5% and 2%, respectively, for all crosslinks. PMID:19027371
Viguet-Carrin, S; Gineyts, E; Bertholon, C; Delmas, P D
The authors report a mediastinal cyst treated by aspiration and ethanol sclerosis, which were performed under ultrasonographic guidance. Mediastinoscopy and thoracotomy were thus avoided. One year later there had been no recurrence of the cyst or any symptoms. PMID:8348365
We report an extremely rare case of isolated enteric cyst in the neck region which was diagnosed on the histopathological examination. It was suspected to be duplication cyst on radiology. We have also evaluated the differential diagnosis and management issues.
BACKGROUND: Hydatidosis is a common zoonosis that affects a large number of humans and animals, especially in poorly developed countries. The infesting parasite has four forms named Echinococcus granulosis, E. multilocularis, E. vogeli and E. oligarthrus (very rare in humans). The most frequently involved organs are liver followed by the lung. The involvement of the genital tract is rare and the occurrence in the uterus is an extreme rarity. We report a case of hydatid cyst in the uterus. CASE: A 70-year-old female with a history of hydatid cysts of the liver, was admitted to hospital after complaining of low abdominal pains. On physical and gynecological examinations, no pathological finding was detected. However, the uterus was significantly large for a postmenopausal patient. Transvaginal sonography (TS) revealed a cystic mass in the uterus with a size of 7 x 6 cm. After further examinations a subtotal hysterectomy was performed. Microscopic examination showed scolices of Echinococcus granulosis. CONCLUSION: Hydatid cysts in the genital tract are rare and the occurrence in the uterus is an extreme rarity. Differentiation between hydatid cyst and malignant disease of the related organ is difficult. To avoid misdiagnosis, a careful examination of pelvic masses should be carried out in endemic areas for detection of hydatid cysts.
Non-parasitic liver cysts are seen in up to 5% of the population. They become symptomatic when they are large and can cause pain, nausea, vomiting, early satiety and obstructive jaundice. Treatment modalities include percutaneous drainage, open deroofing, hepatic resection and lately, laparoscopic deroofing. We assessed our management of eleven symptomatic patients over the last five years between May 1996 and August 2001. Two of these had mild symptoms and were kept under review. The remaining nine were treated surgically. Of these, eight were treated by laparotomy and open deroofing with argon laser coagulation of the cut edges while one was treated with left hepatic resection. Three of these had been previously treated with laparoscopic deroofing at other hospitals and had been referred after having developed recurrent symptomatic cysts. Two patients developed post-operative complications--bile leakage that resolved with conservative management. The patients were followed up for a median period of twelve months ranging from 3-62 months. One patient died of liver failure 12 months after surgery. There was no symptomatic recurrence. We conclude that open cyst deroofing gives marked symptomatic relief with a very low complication rate. In today's era of laparoscopic surgery, it has a definite role in the management of symptomatic liver cysts, more so in recurrent cysts following laparoscopic treatment. Images Fig 1 Fig 2
BACKGROUNDSpinal intramedullary ependymal cysts are extremely rare. Only seven pathologically proven cases have been reported in the literature.METHODWe present an 18-month-old female with thoracic spinal intramedullary ependymal cyst that was diagnosed pathologically.RESULTSHistological diagnosis was made by light microscopy after immunostaining. After partially removing the cyst wall and establishing communication between the cyst and the subarachnoid space, the patient improved neurologically.CONCLUSIONSFor
Snapping phenomenon around the medial aspect of the knee is rare. We present this case of snapping knee caused by the sartorius muscle over a large medial meniscal cyst in a 66-year-old female. Magnetic resonance images demonstrated a large medial meniscal cyst with a horizontal tear of the medial meniscus. Arthroscopic cyst decompression with limited meniscectomy resulted in the disappearance of snapping, and no recurrence of the cyst was observed during a 2-year follow-up period.
2 cases of posterior fossa arachnoid cyst are discussed. In the first, it is likely that perinatal factors were responsible for the temporal lobe pathology and the formation of the cyst. Progressive dilatation of the temporal horn may have then been caused by obstruction from the cyst. In the second case, minor head trauma was a possible mechanism for the cyst production, although it seemed irrelevant to the mode of clinical presentation. PMID:756011
Intraneural ganglion cysts are nonneoplastic, mucinous cysts within the epineurium of peripheral nerves which usually involve the peroneal nerve at the knee. A 37-year-old female presented with progressive left buttock and posterior thigh pain. Magnetic resonance imaging revealed a sciatic nerve mass at the sacral notch which was subsequently revealed to be an intraneural ganglion cyst. An intraneural ganglion cyst confined to the proximal sciatic nerve has only been reported once prior to 2009.
Swartz, Karin R.; Wilson, Dianne; Boland, Michael; Fee, Dominic B.
The removal of Giardia cysts by three small (0.01-to 0.57-mgd) treatment plants—one with conventional filtration, one with in-line filtration, and one with diatomaceous earth filtration— was studied. Turbidity and cyst removals for each were compared with those of parallel pilot filters (1 gpm) seeded with Giardia cysts and with and without optimization of chemical treatment. Cyst removal efficiencies ranged from
We report a case of ciliated cutaneous cyst located on the dorsal side of the right shoulder in a 22-years old woman. The anatomoclinical features of this rare variety of cyst are described and compared with those of the 17 published cases. The differential diagnosis with other glandular cysts is presented. The mullerian duct origin of ciliated cutaneous cysts is controverted, and the starting point of this lesion remains mysterious. PMID:8257032
We report a case of mesothelial cyst protruding from the right femoral ring with suspected endometriosis in a 35-year-old woman, who complained of a lump with a diameter of 6 cm in the right inguinal region. Although she had the hormone therapy during the next 8 months for the diagnosis of extragenital endometriosis, her symptoms did not improve. The clinical suspicion of a Nuck cyst with endometriosis, supported by ultrasonography and magnetic resonance imaging, was confirmed by histopathological examination of the surgical specimen. Authors herein report this unusual case and review the literature.
Symptomatic lumbar synovial cysts (LSCs) are a rare cause of degenerative narrowing of the spinal canal, with thecal sac or nerve root compression. True synovial cysts have a thick wall lined by synovial cells, containing granulation tissue, numerous histiocytes, and giant cells. In contrast, pseudo-cysts lack specialized epithelium, have a collagenous capsule filled with myxoid material, and may be classified into ganglion cysts, originating from periarticular fibrous tissues, and ligamentous cysts, arising from the ligamentum flavum or even from the posterior longitudinal ligament. Here we present the surgical series of the Chair of Neurosurgery at the University of Cagliari (Italy) including a total of 17 LSCs. Surgical technique consisted of facet sparing excision of LSC, achieved by simple hemilaminectomy/laminectomy, and diagnosis was always confirmed by histological specimen examination, which detected the typical synovial epithelium, the intracystic presence of hemosiderin, histiocytes, and calcifications. Further immunohistochemical investigation revealed positive staining for cytokeratin: CK5, CK6, and AE1/AE3. Clinically, our cohort experienced rapid and complete resolution of symptoms, without perioperative complications, or recurrence of cysts or vertebral instability at a median follow up of 28 months, when the MacNab score was generally excellent. A review of the literature, retrieving articles published from 1973, collected a total of 101 articles concerning all the cases of LSC scientifically described to date. Both clinical and histological findings described in our study support the theory of degenerative microtraumatic pathogenesis of synovial cysts. PMID:23438660
The presentation and management of a patient with symptomatic hydrocephalus from a cyst of the septum pellucidum is described and the underlying pathophysiology in relation to treatment is considered. The cyst appeared to cause intermittent obstruction of the foramina of Munro according to the degree of ventricular dilatation. Drainage and collapse of the cyst by fenestration reestablished continuous drainage of
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
Dermoid cysts of the posterior fossa are uncommon. When associated with a dermal sinus, these cysts are often diagnosed during early childhood. The main risk of such an association is contamination of the cyst leading to abscedation of the dermoid itself or formation of daughter abscesses within the cerebellar hemisphere. We recently treated a 20-month-old girl who had a congenital
I. H. Tekkök; M. J. Higgins; E. C. G. Ventureyra; S. S. Baeesa
Spinal neurenteric (NE) cyst is an uncommon congenital cyst and frequently found in the cervical region. The clinical symptoms associated with this entity depend on the site of the lesion and are not typical for all such cysts. A definitive diagnosis can only be made by biopsy and histological examination. MRI can confirm these cystic masses and is the method
Meniscus cysts are mostly seen with meniscus tears, and arthroscopic decompression of cysts is gaining great importance in their treatment. In this study, we present a medial meniscus anterior horn cyst without an accompanying tear in the meniscus. A 33-year-old male patient was seen with pain and a palpable mass in his right knee. He complained that the severity of
Only solitary ganglion cysts within the knee have been reported. Multiple ganglion cysts within the same knee have not been reported. The author describes a patient with 2 ganglion cysts, one in the anterior cruciate ligament and one in the lateral meniscus of the same knee. Surgery was performed because of recurrent pain and functional disability.
We report a case of solitary, primary intraorbital hydatid cyst in a elderly female aged 80 years who presented with nontender, nonpulsatile proptosis of left eye with diminution of vision. MRI scan of the head and the orbits, revealed a retro-bulbar cyst. Surgical excision was performed by employing a lateral orbitotomy approach. Histopathology report confirmed hydatid cyst.
Carcinomatous change of commonly encountered, benign epidermoid cysts, is a very rare event. Two cases of squamous cell and one case of basal cell carcinoma arising in the cyst wall and invading adjacent dermis were diagnosed in three epidermoid cysts in a review of 386 cases. The frequency of carcinomatous change has been reported to be as much as 9%.
I. Öztek; L. Bas; E. Uçmakli; K. Dogruöz; F. Yavuz
The aim of this study was to assess the effect of simple renal cysts on extracorporeal shockwave lithotripsy (SWL) in patients with calyceal renal calculi. Patients with simple renal cysts >35?mm and ipsilateral renal calculi <20?mm that were treated with SWL constituted group 1 (cyst + calculi). The control group included patients aged >40 years that had renal calculi <20?mm and no cysts that were treated with SWL. The 2 groups were compared according to age, gender, body mass index, calculi size, localization, and density, the calculi fragmentation rate, and the percentage of stone-free patients. Mean cyst size in group 1 was 44.04 ± 9.08?mm. Mean age in group 1 was 61.4 ± 10.2 years versus 56.9 ± 8.2 years in the control group; the difference was significant (P = 0.045). There were not any other significant differences between the 2 groups, except for the stone-free rate (P > 0.05), which was 33.3% in group 1 and 68.2% in the control group (P = 0.017). The presence of renal cysts in a patient with calculi requires that an individualized treatment plan be devised, so as to provide the patient with the most effective treatment.
Gucuk, Adnan; Ozturk, Ufuk; Uyeturk, Ugur; Kemahl?, Eray; Ak?n, Guven; Imamoglu, M. Abdurrahim; Metin, Ahmet
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 6 cases. Ultramicroscopic examinations of the cyst wall (4 cases) suggest alterations in the anatomical arrangement of the arachnoid membrane, which supports the hypothesis of maldevelopment as the origin of the lesion. PMID:7249813
The subject of this report is a rare case of a 5-year-old girl who developed an arachnoid cyst with a bony and dural defect in the parietal convexity. She had no history of head trauma or infection. Surgical exploration revealed the bulging lesion to consist of cerebrospinal fluid-containing spongy subcutaneous tissue and to extend into the bony and dural defect. The arachnoid cyst cavity was found beneath the subcutaneous lesion and was not connected to the adjacent subarachnoid space. Histologically, the subcutaneous tissue contained a complex of sinusoidal channels formed by an abundance of migrating arachnoidal cells, thus mimicking meningocele. PMID:12077478
Hayashi, Y; Futami, K; Munemoto, S; Hamada, Y; Soma, M; Yamashita, J; Hasegawa, M
Ring Fixator With Pins and Wires Intramedullary Nail Cast Internal Fixation External Fixation Simple Fracture, Displaced Comminuted Fracture Simple Fracture, Undisplaced Long-Leg Plaster Cast Types of Treatment for Bone Fractures B O ...
Purpose Laparoscopy is considered the treatment of choice for hepatic cysts, especially those located in anterolateral segments (AL; segments II, III, IVb, V, and VI) because of the ease of laparoscopic access. Here, we evaluated the feasibility and safety of laparoscopic treatment of hepatic cysts in posterosuperior segments (PS; segments I, IVa, VII, and VIII). Methods We retrospectively analyzed clinical data for 34 patients who underwent laparoscopic treatment of hepatic cysts between September 2004 and December 2012. Patients were divided into two groups depending on whether the main largest cyst was located in AL (n = 20) or PS (n = 14). Laparoscopic cyst unroofing was performed in 29 patients with symptomatic simplecysts. Laparoscopic resection was performed in 5 patients with suspected cystic neoplasms. Results There were no deaths or major complications. The mean operation time was 110 minutes and the mean hospital stay was 4.4 days. The mean cyst size was not significantly different (P = 0.511) but the frequency of multiple cysts was significantly greater in group PS (P = 0.003). The predominant type of resection was unroofing in both groups (P = 0.251). The mean blood loss (P = 0.747), mean hospital stay (P = 0.812), mean operation time (P = 0.669), morbidity rate (P = 0.488), and relapse rate (P = 0.448) were not significantly different. Relapse occurred in one patient who underwent reunroofing 17 months later. The median follow-up is 62 months. Conclusion Laparoscopy is a safe procedure for hepatic cysts located in posterosuperior segments.
Lee, Doo-Ho; Han, Ho-Seong; Yoon, Yoo-Seok; Hwang, Dae Wook; Jung, Kyuwhan; Kim, Young Ki; Shin, Hong Kyung; Lee, Woohyung
Hydatic cyst of the Fallopian tube is an exceptional localization, the diagnosis of which is frequently confirmed preoperatively. A 44-year-old woman was addressed for pelvic mass with fortuitous discovery. The diagnosis preoperatively confirmed by the extemporaneous histological study was hydatic cyst of the Fallopian tube. Salpingectomy was required. The pelvic hydatic cyst, particularly in the Fallopian tube, is a rare complaint. Clinics and biology were very important for diagnosis but only anatomopathology can confirm diagnosis of hydatic cyst. The treatment of Fallopian tube hydatic cyst is surgival and often radical (salpingectomy). PMID:22440619
Achour, R; Daaloul, W; Ben Hamouda, S; Bouguerra, B; Sfar, R
The authors present the case of a patient with relapsing parasitic cyst of the liver and a parasitic cyst of the lungs. The patient was treated by surgery. The cystectomy of the echinococcus cyst in the liver was made in the first stage and subsequently a resection of the lung tissue containing another echinococcus cyst was made. Pharmacological therapy by the anti-helmintic drug albendazol was a part of the treatment. There were no complications during both surgical interventions and the subsequent treatment. In the scolocidal liquid of the liver cyst, echinococcus organisms were diagnosed by microscopy and documented by photography. PMID:14502882
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.
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
We present the second case of Klippel-Feil syndrome in association with a posterior fossa dermoid cyst extending through the occipital bone and presenting as a suboccipital subcutaneous mass. We describe its radiographic, CT, and MRI appearances as well as on MRI diffusion-weighted images. Posterior cranial fossa dermoid cysts and sinuses should be added to the list of congenital abnormalities which must be sought in patients with Klippel-Feil syndrome. Diffusion-weighted images of brain may differentiate these masses from cerebral spinal fluid collections. PMID:11194906
Non-neoplastic cysts of the salivary glands are uncommon and represent 2-5% of all salivary gland lesions. They are mainly mucoceles or salivary duct cysts. Unlike a mucocele, which is surrounded by granulation tissue, the salivary duct cyst is lined by epithelium. Salivary duct cysts are more common in the oral minor salivary glands and rarely occur in the major salivary glands, show a marked predilection for the superficial lobe of the parotid, and represent 10% of all salivary gland cysts. Neoplastic differentiation of the lining of the salivary duct cyst has been reported. We report a case of a salivary duct cyst of the left parotid gland, with a review of radiographic and histopathologic features.
Encephalocele represents one end of the spectrum of open neural tube defects. We report an infant with Chiari type 3 malformation manifesting as infratorcular occipital meningoencephalocele with dermoid cyst. To our knowledge, this is the first time that this association is described. The pathogenesis, surgical treatment, prognosis and management difficulties are also being discussed.
Encephalocele represents one end of the spectrum of open neural tube defects. We report an infant with Chiari type 3 malformation manifesting as infratorcular occipital meningoencephalocele with dermoid cyst. To our knowledge, this is the first time that this association is described. The pathogenesis, surgical treatment, prognosis and management difficulties are also being discussed. PMID:20516737
Suprapatellar bursa is located between the quadriceps tendon and femur, and it develops before the birth as a separate synovial compartment proximal to the knee joint. By the fifth month of fetal life there is a suprapatellar septum between the knee joint cavity and suprapatellar bursa which later perforates and involutes in a way that a normal communication between the cavity of bursa and knee is established. A small portion of the embrionic septum can later lag as more or less expressed suprapatellar plica. In case when suprapatellar plica has a small communication with valve mechanism or in case of complete septum, bursa becomes a separate compartment and potential location for the suprapatellar cyst development. Magnetic resonance imaging is recognised as the gold standard in diagnosis of knee cysts because of its ability to show cystic nature of the lesion, its relationship with other anatomic structures, as well as to establish whether other knee pathologies are present. Considering treatment possibilities, majority of cysts around the knee resolve spontaneously and should be treated by aspiration and application of corticosteroids. Suprapatellar cyst is a very rare knee pathology and it can in some occasions be treated using open or arthroscopic surgery.
Crnkovic, Tomislav; Gaspar, Drago; ?urovic, Drazen; Podsednik, Dinko; Slisuric, Ferdinand
We report a gastric duplication cyst in an undernourished 5-month-old child suffering from anorexia, vomiting, and melena. Clinical presentation was consistent with a Meckel's diverticulum, which, however, was not found at laparotomy. Scintigraphy and ultrasound, performed 4 months later, suggested gastric duplication, which was confirmed by surgery.
L. Cruz; M. Gonçalo; J. Leão; J. Reis; I. Lourenço; A. Machado
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 simplecysts 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
Mesenteric cysts are heterogeneous groups of lesions. Most of them are developmental cysts of lymphatic and enteric origin or cystic neoplasm such as mesothelioma or cystic teratoma. Urogenital cysts are a subcategory of developmental cysts of the mesentery. They are thought to arise from vestigial remnants of urogenital apparatus. These cysts may show evidence of mesonephric or metanephric differentiation. An 11 -year -old boy was presented with undescended testis. During preoperative work- up, an incidental cystic lesion was discovered which was attached to the ileum. Aspiration cytology of the cyst content revealed cuboidal to columnar cells; some of them were ciliated. Histologic examination showed a cyst with fibromuscular wall, lined by Mullerian type ciliated epithelium; so the diagnosis of urogenital mesenteric cyst of Mullerian type was made. Urogenital cysts are rare lesions, but they should be considered in differential diagnosis of any cystic lesion of the mesentery. Cytology could be a useful method for evaluation and revealing the nature of these cysts. PMID:23808784
\\u000a Bone neoplasms consist of mesenchymal tumors, hematopoietic tumors, and metastasis from mainly epithelial carcinomas. Also\\u000a non-neoplastic bone lesions that mimic true tumors, including bonecysts and Langerhans cell histiocytosis, need to be included\\u000a in the differential diagnosis. Classic analyses on tumor margin, mineralized matrix, and periosteal reaction, based on plain\\u000a radiography, are important for differential diagnoses. CT provides greater morphological
Langerhans' cell histiocytosis (LCH) is a rare immunologic disorder characterized by histiocyte proliferation in multiple organ systems. Eosinophilic granuloma, a benign bone lesion, represents a focal form of LCH. We experienced a case of Langerhans' cell histiocytosis in a patient who presented with intracranial epidural hematoma and cyst on the midline of the frontal skull. A 10-year-old boy presented with a rapidly growing large scalp mass on the midline frontal area after mild head trauma. The scalp mass was painless and immobile. Plain skull x-ray showed a punched-out bone lesion. Computed tomography and magnetic resonance imaging showed a non-enhancing osteolytic lesion presenting with an epidural hematoma and cyst on the midline of the frontal skull. The lesion of the skull was completely resected and the patient's recovery was uneventful. The acute presentation of a solitary eosinophilic granuloma of skull with an epidural hematoma has been described in only five cases in the literature and we report the first case of LCH presenting as an intracranial epidural hematoma on frontal area.
Introduction. Large maxillary cysts occasionally expand into the maxilla and erode the maxillary sinus and nasal cavity. The Caldwell-Luc procedure is the recommended treatment for large maxillary sinus cysts. However, it is hard to preserve the nasal space in the case of large maxillary sinus cysts that penetrate into the nasal cavity. Methods. A 22-year-old man who had large maxillary sinus cysts was referred to our department for a surgical treatment. After removing the cyst from the maxillary sinus using the Caldwell-Luc procedure, we used nasal airway and balloon catheter devices to preserve the space of the inferior nasal meatus and maxillary sinus. These devices were removed 10 days postoperatively. Insertion and removal of both devices were simple and painless. Findings. The nasal airway and balloon catheter devices were useful for performing maxillary sinus surgery to remove large cysts. Our method was satisfactorily safe and was an effective minimally invasive treatment that preserved the space of the inferior nasal meatus and maxillary sinus.
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 everyday lives.
The findings of a clinicopathological and biochemical study of epidermal cysts and a review of the relevant literature are presented. A punctum was found in 40% of 34 epidermal cysts that were studied in detail. The findings of the histological study were in favour of the punctum being the orifice of an obstructed hair follicle from which at least a proportion of the epidermal cysts are likely to develop. The biochemical analysis of the contents of the cysts revealed a very low protein and lipid content, thus ruling out any "sebaceous' contribution. Bacteriological study of clinically inflamed cysts showed that inflammation in these lesions was usually aseptic unless there was a communication between the cyst cavity and the exterior. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6
The flagellated protozoan Giardia lamblia is a recognized public health problem. Intestinal infection can result in acute or chronic diarrhea with associated symptoms in humans. As part of a study to evaluate removal of G. lamblia cysts from drinking water by the processes of coagulation and dual-media filtration, we developed a methodology by using 5.0-microns-porosity membrane filters to evaluate the filtration efficiency. We found that recovery rates of G. lamblia cysts by membrane filtration varied depending upon the type and diameter of the membrane filter. Examination of membrane-filtered samples by scanning electron microscopy revealed flexible and flattened G. lamblia cysts on the filter surface. This feature may be responsible for the low recovery rates with certain filters and, moreover, may have implications in water treatment technology. Formation of the cyst wall is discussed. Electron micrographs of cysts apparently undergoing binary fission and cysts exhibiting a possible bacterial association are shown. Images
Hydatid cyst disease (Echinococcosis) is a parasitic illness that is rarely located in the brain. Primary cerebral hydatid cyst disease is rarely seen. We report here rare two cases presenting with sixth cranial nerve palsy with increased intracranial pressure syndrome due to primary cerebral hydatid cyst. A 5-year-old female and a 13-year-old boy complained of headache, strabismus, nausea, and vomiting. Neurological examination revealed sixth nerve palsy and papilloedema. The diagnosis was cerebral hydatid cyst disease and was confirmed with radiological and pathological investigations. Both cases were operated on. The cysts were removed without rupture, and therapy was completed with albendazole for a period of six months. They were symptom-free during the follow-up period. In conclusion, cerebral hydatid cyst disease should be kept in mind in the differential diagnosis of increased intracranial pressure syndrome. PMID:22450921
Glandular odontogenic cyst (GOC) is an uncommon developmental odontogenic cyst of jaws with a relative frequency between 0.012 and 1.3%. GOC is very rare and only 111 cases have been documented in the English literature so far. Generally, this cyst is encountered in the anterior areas of the mandible and is more common with a wide age range, the mean age being 49.5 years and has a tendency to recur. GOC is often misdiagnosed because of its overlapping histopathological features with that of other odontogenic cysts such as lateral periodontal cyst (LPC) or botryoid cyst and central low-grade Mucoepidermoid carcinoma. Histopathological diagnosis and differential diagnosis of GOC is challenging for pathologist. Here, we present a case of GOC in a 40 year old male patient in left mandibular region that crossed the midline.
Epidermoid cysts are benign lesions, characterized by cystic spaces lined by simple squamous epithelium (epidermoid cyst), containing skin adnexa ("true" dermoid cyst) or tissues of all three germ layers (teratoid cyst). Head and neck constitute ~7% of all cases of epidermoid and dermoid cysts. There is often a diagnostic dilemma with the more common cystic lesions of this region. A retrospective case-series study of histologically proved epidermoid cysts in the head-neck region, from February 2008 to January 2011, in the Department of Otorhinolaryngology and Head-Neck Surgery of a tertiary Government teaching hospital in eastern India. The diagnosis was reached by fine needle aspiration cytology FNAC and subsequent histopathology where feasible. Necessary imaging was done for evaluation and management. A total of 28 cases were analyzed. 5 were female, with a male: female ratio of 4.6. Age range was from 2 to 60 years (mean = 30). Excision was the preferred treatment in 20 cases (71.4%). Various sites like the submandibular region (5), pinna (5), sublingual region (1), periorbital (6), suprasternal (6), along the anterior border of sternocleidomastoid (1) and glabella (3) were involved, along with an iatrogenic implantation epidermoid cyst in a tracheostomy scar. Some of the interesting cases presenting with clinical dilemma have been emphasized. Epidermoid cysts are relatively less common in the head-neck region, hence are liable to be misdiagnosed. In this case-series, few cases presenting with enough elements of confusion and dilemma are discussed with overall analysis and review of the related literature. PMID:24427609
Eighty-six mucous cysts in 79 patients were surgically excised. Follow-up was carried out at an average of 2.6 years. Fifteen digits (17%) had a residual loss of extension of 5 to 20? at the IP or DIP joints. One patient developed a superficial infection and two developed a DIP pyarthrosis, which eventually required DIP arthrodesis. Nail deformities were present in
PURPOSE: To report complete removal of conjunctival cyst using indocyanine green solution to facilitate visualization.DESIGN: Interventional case report.METHODS: A 71-year-old woman referred with the diagnosis of severe conjunctival chemosis of her right eye of several months’ duration was found to have a large conjunctival cyst. After informed consent was obtained, surgical resection of the cyst was performed.RESULTS: Under topical anesthesia,
Though a rare lesion, non-functioning parathyroid cyst is of clinical significance because it usually mimics a thyroid nodule. The cyst can be ectopic in location and therefore constitutes a differential diagnosis to a bronchial or thymic cyst. Two recent cases of non-functioning parathyroid assay are reported. Needle puncture with estimation of the level of parathyroid hormone in the aspirate allows the diagnosis to be made before surgery. PMID:11109882
Cases of cardiac hydatid cyst disease are uncommon, occurring in approximately 0.5% to 2% of patients with hydatid disease. Most cardiac hydatid cysts are located in the left ventricle and interventricular septum. Cardiac involvement may have serious consequences. Both the disease and its surgical treatment carry a high complication rate, including rupture leading to cardiac tamponade, anaphylaxis and also death. In the present report, a 10-year-old girl with cardiac tamponade secondary to a pericardial hydatid cyst is described.
Intraspinal synovial cysts presenting with lower back pain and radiculopathy are well known but rare. They are associated with facet joint arthopathy, generally degenerative in nature. Spinal synovial cysts have not been described in spondyloarthropathies (SpA). We report a case of a 66-year-old man with a chronic undifferentiated SpA who presented with severe weakness of both legs. A centrally located spinal cyst was encountered on MRI and led to excision of a highly inflammatory synovial cyst. This association may not be fortuitous and be related to inflammation of the facet joint in SpA. PMID:12605323
Introduction: Renal involvement by hydatid disease is uncommon. The patients may be asymptomatic or present with flank pain, hematuria, and hypertension. Surgery is the mainstay of treatment, and options include cyst deroofing, partial nephrectomy, and total nephrectomy. We share our experience of laparoscopic management of 3 patients with large hydatid cysts of the kidney and review the literature. Case Description: Three patients with hydatid cysts of the kidney were treated at our institution between 2008 and 2010. In all 3 patients, hydatid disease involved the left kidney. One of the three cases also had concomitant liver involvement. Abdominal pain was the predominant symptom. A flank mass was palpable in 2 patients. The diagnosis was confirmed on abdominal ultrasonography and computed tomography in all 3 patients. Laparoscopic management was successfully completed in 2 patients. A large intrahepatic cyst in 1 patient prompted conversion to an open procedure. A special hydatid trocar-cannula system helps in eliminating the possibility of spillage from the cyst while puncturing and aspirating the cyst. Discussion: There are few reports on laparoscopic management of this uncommon disease of the kidney. In our series the laparoscopic management was attempted in all 3 cases. The procedures included laparoscopic aspiration of the cyst contents along with subtotal excision of the ectocyst in 2 patients and nephrectomy in 1 patient. The latter case had to be converted to an open procedure because of inaccessibility of the intrahepatic liver hydatid cyst. Laparoscopic management of renal hydatid cysts is feasible and safe.
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
Hydatid disease is the most common infections worldwide, but it rarely involves multiple organs. Herein, a 12-year-old boy is presented, who was admitted to Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran with symptoms of irritability, sleepless, and weakness of the extremities. Patient's brain computed tomography (CT) scan with contrast media showed large multilocular cystic lesions in right temporal lobe associated with two other smaller similar cystic lesions in centrum semiovale bilaterally. Abdominal sonography revealed intestinal mesenteric and a cardiac cyst. Abdomino-pelvic CT scan showed a cyst medial to the cecum and a cortical cyst in the left kidney as well as a heart cyst. The echocardiography confirmed hydatid cysts at apical and interventricular septum. Serology test was positive for hydatid cyst. Albendazole and praziquantel were started for the patient immediately and right temporal lobe lesions were removed via neurosurgery intervention. After one month, cardiac and mesenteric cysts were operated during two separate surgeries. Pathologic findings of all cysts were compatible with hydatid cyst. Cystic hydatidosis should be suspected in any cystic mass, whilst prompt diagnosis and appropriate treatments are the keys in management of affected patients.
Sabouni, F; Ferdosian, F; Mamishi, S; Nejat, F; Monnajemzadeh, M; Rezaei, N
BACKGROUND: Residual ovarian function after laparoscopic excision of endometriotic ovarian cysts is a major and still unsolved topic. Ultrasonographic evaluation of ovarian response to ovulation stimulation represents a simple yet poorly employed tool to assess residual ovarian function after surgery. METHODS: Data from patients referred for IVF or ICSI between January 2001 and December 2002 were reviewed. Patients were included
E. Somigliana; G. Ragni; F. Benedetti; R. Borroni; W. Vegetti; P. G. Crosignani
Bronchogenic cysts originate from anomalous development of the ventral foregut. Although treatment of asymptomatic bronchogenic cysts remains controversial, symptomatic bronchogenic cysts should be surgically removed. We report a case of a 62-year-old man with an infected bronchogenic cyst. We drained the cyst using transesophageal endoscopic ultrasonography to control the inflammation and decrease the size of the cyst; we subsequently resected the cyst. Five months after resection, the patient was well, and computed tomography showed no evidence of cyst recurrence. PMID:24996718
Background: An epidermoid cyst is a common epithelial-lined cyst. There have been many studies on epidermoid cysts, but few focused on ruptured epidermoid cyst and its histopathologic characteristics. Objective: We evaluated the histopathologic differences between ruptured and unruptured epidermoid cysts, and their relationships. Methods: We retrospectively examined 359 excision biopsy specimen diagnosed as epidermoid cyst from 1991 to 2011 at Department of dermatology at Daegu Catholic University Hospital. Results: The mean cyst area was 38.89 mm2 and the mean cyst area of the unruptured group was larger than that of the ruptured group. The mean wall thickness was 90.15 ?m and was thicker in ruptured group than in unruptured group. The correlation between cyst diameter and wall thickness had statistically negative correlation in unruptured and in ruptured group. In ruptured group, the cystic size of the cases with rete ridge was smaller than that of without rete ridge. The cyst wall thickness of the cases with rete ridge was thicker than that of the cases without rete ridge. Limitations: For comparative evaluation of sizes, randomly shaped cysts are assumed to be perfectly elliptic. And only those with more than 3/4 cystic wall remaining were included in the subject. Conclusion: When comparing the ruptured and the unruptured cyst, the rupture of cyst had significant relationship with increased cyst diameter and area, increased wall thickness, more cyst contents, and more wall changes. Moreover, the presence of rete ridge in ruptured cystic wall is a valuable variable to recognize the duration of the rupture.
ABSTRACT ABSTRACT ABSTRACT ABSTRACT The first prenatal detection of an ovarian cyst was by Valenti in 1975. Since then antenatal and neonatal ovarian cysts are encountered more frequently due to the improvement of imaging techniques as well as routine antenatal ultrasound scanning. We discuss here the laparoscopic management of three cases of neonatal ovarian cysts. This approach is well tolerated
S. N. Oak; S. V. Parelkar; T. Akhtar; R. Pathak; N. Vishwanath; K. V. Satish; R. Kiran
An 18-month-old, intact male Akita presented with a 12-month history of progressive ataxia, hypermetria, and loss of conscious proprioception of the thoracic and pelvic limbs. Neurological examination and myelography localized a lesion at cervical vertebrae 1 and 2 consistent with an arachnoid cyst. Hemilaminectomy and cyst fenestration led to virtually full recovery. Images Figure 1.
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.
Synovial cyst herniations, typically observed in the lumbar region in conjunction with degenerative changes of the facet joints, only rarely present as space occupying lesions in the cervical spine. The case of a 47-year-old white man with a C7-T1 synovial cyst impinging on the spinal cord and right C8 nerve root is presented. PMID:8504232
A large (165 × 235 × 250 mm) solitary, unilocular cyst with a thin, smooth wall and homogeneous anechoic content was detected during a routine ultrasound scan at 24 weeks of gestation in an asymptomatic 39-year-old woman with a singleton pregnancy. The cyst was aseptate, lacked mural blood flow and was not associated with ascites. It was located in the central abdominal area above and anterior to the uterus. Gradually increasing abdominal discomfort developed, and a laparotomy was performed at 27 weeks; the cyst was removed after aspiration of 6.3 L of serous fluid and the ipsilateral ovary was preserved. Pathological examination indicated a large luteinized follicular cyst of pregnancy. A healthy male infant was delivered vaginally at term. A rapidly enlarging ovarian mass in pregnancy poses significant diagnostic problems. Large luteinized cysts of pregnancy are uncommon and thought to involve stimulation by human chorionic gonadotropin (hCG), or increased tissue sensitivity to hCG. A literature search identified four previous cases that had been detected prenatally. With one exception, the cysts appeared to enlarge during pregnancy, eventually becoming symptomatic, and two previous cases also required removal of the cyst before birth. Adverse pregnancy outcome was only reported in one of the previous cases. In summary, large luteinized cysts of pregnancy are an uncommon type of cystic mass particular to pregnancy, characterized by the combination of a benign appearance and a tendency to enlarge rapidly, eventually becoming symptomatic and most often necessitating surgery. PMID:20499403
Mavromatidis, G; Sotiriadis, A; Dinas, K; Mamopoulos, A; Rousso, D
A congenital dermoid together with a bronchogenic cyst at the base of the tongue is extremely rare. We describe a 5-year-old boy who presented with an enlarged anterior segment of mandible, slight swelling of the left submandibular region, and a large swelling of the floor of the mouth that was displacing the tongue posteriorly. Both cysts were successfully excised and
Solitary non-parasitic cysts of the liver (NPHC) are rare. The incidence of NPHC on autopsy is 0.2% to 0.5% and on imaging from 2.5 to 4.6% of the population. They are more common in females than males. Congenital cysts can be solitary, multiple or involve the whole liver which is referred to as polycystic liver disease (PCLD). Post-traumatic, neoplastic and echinococceal cysts are acquired lesions. Imaging procedures (USS, CT, MRI) are essential in diagnosis of hepatic cysts. Further diagnostic procedures include cytological, bacteriological and biochemical analysis of cystic fluid. Cystography can exclude communication of the cyst with the ductal system. Serologic tests are used in hydatid disease and serum tumour markers (CEA, CA 19-9) are measured to aid in differential diagnosis of suspected neoplastic cysts. Various therapeutic methods are used in the treatment of solitary non-parasitic hepatic cysts. The simplest is percutaneous obliteration with, for example ethyl alcohol. Fenestration (deroofing) with excision of the cyst wall is increasingly more often performed laparoscopically. Conventional open deroofing is used exceptionally, mainly in complicated cases. PMID:11761829
Gross cystic breast disease is a common benign disorder in which palpable cysts occur in the breast and are normally treated by aspiration of the contents. The cysts are classified as either Type 1, containing a high level of potassium ions and a low level of sodium ions, or as Type 2, with low potassium and high sodium ion concentrations.
David C. Parish; Margaret W. Ghilchik; Joanna M. Day; James Eaton; Atul Purohit; Michael J. Reed
A primary intramuscular hydatid cyst should be considered for the differential diagnosis of cystic soft tissue masses especially in endemic areas, although primary muscular hydatidosis is a rare clinical entity. A case of a 48-year-old male patient with a primary intramuscular hydatid cyst located in the deltoid muscle is reported. PMID:23986127
Boyaci, Nurefsan; Boyaci, Ahmet; Karakas, Ekrem; Altay, Mehmet Akif
Background: Because of limited experience worldwide, controversies about the laparoscopic treatment of liver hydatid cysts have not been resolved. The aim of this study was to describe the technical details of a laparoscopic method we developed in 1992 and report the initial results from an endemic area. Methods: Of the 30 consecutive patients with 33 liver hydatid cysts considered for
Ridvan Seven; Eren Berber; Selcuk Mercan; Levent Eminoglu; Demir Budak
In this short note, we demonstrate a simple and practical ORAM that enjoys an extremely simple proof of security. Our construction is based on a recent ORAM due to Shi, Chan, Stefanov and Li SCSL11, but with some crucial modifications, which significantly...
BACKGROUND: Cluster headache is a primary headache by definition not caused by any known underlying structural pathology. However, symptomatic cases have been described, e.g. tumours, particularly pituitary adenomas, malformations, and infections/inflammations. The evaluation of cluster headache is an issue unresolved. CASE DESCRIPTION: We present a case of a 43-year-old patient who presented with a 2-month history of side-locked attacks of pain located in the left orbit. He satisfied the revised International Classification of Headache Disorders criteria for cluster headache. His medical and family histories were unremarkable. There was no history of headache. A diagnosis of cluster headache was made. The patient responded to symptomatic treatment. Computer tomography and enhanced magnetic resonance imaging after 1 month displayed a supra- and intrasellar arachnoid cyst with mass effect on adjacent structures. After operation, the headache attacks resolved completely. DISCUSSION AND EVALUATION: Although we cannot exclude an unintentional comorbidity, in our opinion, the co-occurrence of an arachnoid cyst with mass effect with unilateral headache, in a hitherto headache-free man, points toward the fact that in this case the CH was caused or triggered by the AC. The headache attacks resolved completely after the operation and the patient also remained headache free at the follow-up. The response of the headache to sumatriptan and other typical CH medications does not exclude a secondary form. Symptomatic CHs responsive to this therapy have been described. Associated cranial lesions such as tumours have been reported in CH patients and the attacks may be clinically indistinguishable from the primary form. CONCLUSIONS: Neuroimaging, preferably contrast-enhanced magnetic resonance imaging should always be considered in patients with cluster headache despite normal neurological examination. Late-onset cluster headache represents a condition that requires careful evaluation. Supra- and intrasellar arachnoid cyst can present as cluster headache. PMID:23419954
This retrospective study describes a series of 191 children treated for congenital cysts and fistulas of the neck between 1984 and 1999 in the pediatric ORL Department of La Timone Children's Hospital. Preauricular fistulas and cystic hygromas were not included. The anomalies in this series were classified as either malformations of the midline or malformations of laterocervical region. Malformations of the midline included the thyroglossal duct cysts (n=102) and dermoid cysts (n=21). The most common malformations of the laterocervical region were cysts and fistulas of the second cleft (n=37) followed by those of the first cleft (n=20),those of the fourth pouch (n=7), and thymic cysts (n=4). Diagnosis of malformations of the midline is usually straightforward. However, diagnosis of malformation of the laterocervical region can be problematic. Misdiagnosis often leads to inadequate treatment with recurrence and functional as well as cosmetic sequelae. PMID:11006451
Oral foregut cysts are congenital choristomas that arise in the oral cavity during embryonic development from remnants of foregut-derived epithelium. This is an unusual report of a neonate with a large congenital sublingual cystic lesion, extending superficially from the left ventral tongue to the anterior floor of the mouth, impeding breast-feeding. The differential diagnosis included dermoid cyst, epidermoid cyst, mucous retention cyst, and oral lymphangioma. The treatment of choice was enucleation under general anesthesia. Histology showed a cystic lesion with a ciliated pseudostratified columnar epithelium with numerous goblet cells. Immunohistochemistry was positive for cytokeratin 7 and thyroid transcription factor 1 and negative for cytokeratin 20, resulting in a final diagnosis of an oral foregut cyst. Three weeks after surgery, the tongue had healed with good mobility, and breast-feeding could be established. No recurrence was present at 6 months of follow-up. PMID:24220427
Rosa, Ana Cláudia Garcia; Hiramatsu, Daniel Martins; de Moraes, Fábio Roberto Ruiz; Passador-Santos, Fabrício; de Araújo, Vera Cavalcanti; Soares, Andresa Borges
Epidermoid cysts are most commonly located in the cerebellopontine angle and the parasellar regions. The authors report a case of an epidermoid cyst of unusual location: it arises in the midline and involves the body of the corpus callosum with interhemispheric exophytic growth. Reviewing the literature they did not find any similar report. C.T. scan and M.R.I. are the methods of choice for establishing the diagnosis and differentiating between epidermoid cyst, dermoid cyst, lipoma and arachnoid cyst. M.R.I. is highly sensitive and is especially useful in determining tumour extension, particularly in the sagittal and coronal planes, essential for surgical treatment planning. Treatment should be complete surgical resection in order to avoid recurrence and chemical meningitis. PMID:1299776
Hydatid cyst in the breast is rare. We report a case of hydatid cyst in the breast in a 30-year-old Indian rural woman who presented with a lump in her left breast. MRI findings showed a cystic lesion in the breast. Histopathological examination showed features consistent with hydatid cyst with surrounding adherent pericystic breast tissue showing fibrocollagenisation and inflammatory response. ELISA for echinococcal antigen was also found to be positive. This case emphasises that preoperative diagnosis of hydatid cyst in the breast is difficult and often missed as the breast is a rare site of echinococcal infection and clinical and imaging findings are wide and non-specific. Cytological diagnosis by fine-needle aspiration may not always be possible. Therefore, hydatid cyst in the breast should always be considered in the differential diagnosis of a breast lump and histopathological confirmation is necessary for early and appropriate treatment. PMID:24729121
Afroz, Nishat; Chaurasia, Jai Kumar; Maheshwari, Veena; Singh, Geetika
Dermoid cyst of the nose may present difficult management problems if inadequately evaluated preoperatively or if incompletely excited. The most important is to differentiate them from nasal gliomas, meningocoeles et encephalocoeles. The Otolaryngological Clinic of Jagiellonian University in Cracow presented a review of the congenital midline nasal mass during 1945 and 1992 year. If a dermal fistule appears, it may be identified as a cutaneous defect leading from the midline of the nose. If this dermal fistule is connected with the skin of the nose it is called a dermal fistula dorsi nasi. PMID:7644222
Epidermolytic hyperkeratosis (EH) is a well-described histopathologic pattern characteristic of bullous congenital ichthyosiform erythroderma, an autosomal dominant genodermatosis. It is also noted in cutaneous disorders where mosaicism leads to containment of the clinical and histopathologic changes. EH has been observed as an incidental finding in tissue adjacent to and within lesions such as nevi, scars, malignant melanoma, squamous cell carcinoma, basal cell carcinoma, and seborrheic keratoses. We present two cases of EH within infundibular type follicular cysts, a rare finding only once otherwise reported in 1978. PMID:17381810
Steele, Chynna L; Shea, Christopher R; Petronic-Rosic, Vesna
Cysts of Giardia lamblia and Entamoeba histolytica and oocysts of Toxoplasma gondii and Cryptosporidium parvum are the infectious and sometimes diagnostic forms of these parasites. To discover the structural components of cyst and oocyst walls, we have developed strategies based upon a few simple assumptions. Briefly, the most abundant wall proteins are identified by monoclonal antibodies or mass spectrometry. Structural components include a sugar polysaccharide (chitin for Entamoeba, ?-1,3-linked glucose for Toxoplasma, and ?-1,3-linked GalNAc for Giardia) and/or acid-fast lipids (Toxoplasma and Cryptosporidium). Because Entamoeba cysts and Toxoplasma oocysts are difficult to obtain, studies of walls of nonhuman pathogens (E. invadens and Eimeria, respectively) accelerate discovery. Biochemical methods to dissect fungal walls work well for cyst and oocyst walls, although the results are often unexpected. For example, echinocandins, which inhibit glucan synthases and kill fungi, arrest the development of oocyst walls and block their release into the intestinal lumen. Candida walls are coated with mannans, while Entamoeba cysts are coated in a dextran-like glucose polymer. Models for cyst and oocyst walls derive from their structural components and organization within the wall. Cyst walls are composed of chitin fibrils and lectins that bind chitin (Entamoeba) or fibrils of the ?-1,3-GalNAc polymer and lectins that bind the polymer (Giardia). Oocyst walls of Toxoplasma have two distinct layers that resemble those of fungi (?-1,3-glucan in the inner layer) or mycobacteria (acid-fast lipids in the outer layer). Oocyst walls of Cryptosporidium have a rigid bilayer of acid-fast lipids and inner layer of oocyst wall proteins.
Bushkin, G. Guy; Chatterjee, Aparajita; Robbins, Phillips W.
Cysts in the organs of the abdominal cavity revealed in ultrasonographic examinations in patients with none or with unclear clinical symptoms cause diagnostic and fitness for work assessment problems. The aim of the study was to evaluate the usefulness of ultrasonography of cysts, combined with biochemical, bacteriological, cytological examinations and analysis of markers CEA and AFP of the fluid collected with fine needle aspiration biopsy (FAB). The study material examined were maritime workers who were submitted to these examinations for diagnostic purposes and/or previous to issue of certificate of health for work at sea. Examinations results provided support for usefulness of the method discussed in diagnosis and differentiation of inflammatory and neoplastic processes with simplecysts. This was crucial for final diagnosis, for decision about treatment and recognizing fitness for work at sea. It was concluded that the method FAB is safe both in hospital as well as in ambulatory conditions. PMID:7580347
Bartelik, W; Jaremin, B; Smoli?ska, D; G?ombiowski, P
The follicular hybrid is composed of more than two components of pilosebaceous unit. There are several studies of hybrid cyst, combination of trichilemmal and epidermoid cyst was the most frequently reported. In this paper, we reported one case of hybrid cyst composed of bullous pilomatricoma and epidermoid cyst. A 14-year-old girl was complaint of a solitary flesh-colored to erythematous nodule with flaccid appearance sized 3.2×1.8 cm in diameter on her right upper back for one year. The histologic findings showed there were edema and proliferation of capillaries in the superficial dermis, a cyst in the middle to deep dermis. There were laminated keratins in the cystic space. The cyst wall was composed of two different components, one was composed of epithelial cells containing of granular layer, and another consisted of basophilic cells, transient cells and shadow cells. The cyst not related with Gardner’s syndrome. Hybrid cyst such as trichilemmal cyst, epidermoid and pilomatricoma cysts maybe have same clinical features or mimicking each others, but we can distinguish them from histopathology evaluation.
We describe MR imaging features of discal cyst of the lumbar spine in nine patients who presented with low back pain and leg pain.Discal cyst of the lumbar spine has characteristic MR imaging features different from other epidural cysts: a ventrolateral extradural cyst attached to a herniated lumbar disc, consisting of a thick fibrous capsule without disc material, and having
Introduction Urachal cysts are rare congenital anomalies that often prompt referral to the paediatric general surgeon because of their associated complications such as infection, abdominal pain and the young age at presentation. In this report we describe a rare case of fever of unknown origin caused by an urachal cyst which was successfully treated with incision and drainage only. Since the first description of urachal anomalies by Cabriolus in 1550, few cases have been reported and, until now, only one case of infected urachal cyst presenting as fever of unknown origin has been described in the literature. Moreover, the spontaneous resolution of an urachal cyst without excision is extremely rare. Case presentation We report our experience in the management and treatment of an infected urachal cyst that occurred in a 12-year-old Caucasian girl who presented to our Department of Paediatric Surgery with a 30-day history of evening fever. The urachal cyst was treated only with incision and drainage through a minimally invasive laparoscopic approach. Conclusions The incision and drainage of an infected urachal cyst is a simple and safe procedure. It assures a complete recovery and avoids potential surgical complications related to the total excision of the urachal cyst. This report may provide important clues regarding the management of this rare anomaly and we emphasise the importance for paediatricians, who should consider the possibility that a fever of unknown origin can be caused by an urachal cyst, and for surgeons and urologists, because it suggests that conservative treatment of this rare anomaly should be considered when possible.
... be due to, for example, a lack of iodine in a person's diet. To make up for ... nodules. These nodules produce too much thyroid hormone. Iodine is needed to produce thyroid hormone. Simple goiters ...
Ciliated hepatic foregut cysts are uncommon solitary cysts of the liver that originate from the embryologic foregut. Clinically and radiographically, these lesions can be difficult to distinguish from neoplasms. Recent reports have demonstrated that ciliated hepatic foregut cysts may undergo dysplastic progression, supporting the argument to excise these cysts when discovered. Fewer than 100 cases have been described in the literature since the first description of a ciliated hepatic foregut cyst in 1857. We present a patient who recently underwent laparoscopic excision of a ciliated hepatic foregut cyst, review the literature, and propose the rationale for attempting removal of these cysts via a laparoscopic approach.
Mak, Grace Z.; Reynolds, Jordan P.; Tevar, Amit D.; Pritts, Timothy A.
The lack of quick, simple, and sensitive quantitative tests has impeded studies on infection patterns and treatment of Giardia spp. and Cryptosporidium spp. A quantitative direct immunofluorescence assay (FA) using a commercial FA kit was developed and evaluated. Recovery rates of the FA for Cryptosporidium oocysts in calf feces seeded with 1,000, 10,000, 100,000, and 1,000,000 oocysts per g were 14.8, 40.8, 84.2, and 78.2%, respectively. Interassay coefficients of variation were 10.6 to 47.1%. Recovery rates of the FA for Giardia cysts in feces seeded with 1,000, 10,000, and 100,000 cysts per g were 76.4, 96.9, and 89.6%, respectively. Interassay coefficients of variation were 7.4 to 22.1%. By comparison, recovery rates of Giardia cyst by sucrose gradient flotation were only 20.5, 51.2, and 42.9%, respectively. Counts of cysts-per-gram obtained by sucrose gradient flotation with samples from calves, lambs, and ewes were only 49.1 to 54.8% of those obtained by the FA. Zinc sulfate flotation detected only 36.4% of infections when there were < or = 1,000 cysts per g. The quantitative FA offers a useful technique for epidemiological and control studies of these two parasites.
Commonly encountered in the general population, in the vast majority of cases nonhereditary developmental liver cysts are asymptomatic, not associated with altered hepatic function and confidently diagnosed on imaging studies, and do not require further workup, follow-up, or treatment. However, particularly in women, simple hepatic cysts may reach large sizes and cause symptoms and signs resulting from mass effect, vascular compression, and biliary obstruction. Furthermore, although rarely compared to the incidence observed in patients with adult polycystic kidney and liver disease, sporadic hepatic cysts sometimes undergo life-threatening complications such as intracystic hemorrhage, infection, or rupture, which require prompt imaging triage and appropriate interventional, laparoscopic, or open surgical treatment. This pictorial essay reviews with examples the cross-sectional imaging findings of symptomatic and complicated nonhereditary liver cysts, aiming to provide radiologists with an increased familiarity with these uncommon, challenging occurrences. Emphasis is placed on the role of MRI as a useful problem-solving modality to elucidate the complex imaging appearances resulting from intracystic bleeding and superinfection, and to differentiate complicated cysts from other hemorrhagic liver lesions and biliary cystic tumors. PMID:24249390
Bone metastases are usually seen on imaging studies as lytic lesions and less often as sclerotic or mixed lesions. We report an exceedingly unusual case of breast cancer identified after magnetic resonance imaging showed bone metastases with fluid-fluid levels in the spine and sacrum. Bone images containing fluid-fluid levels are usually solitary abnormalities produced by aneurismal bonecysts. The fluid-fluid level is due to bleeding within the tumor followed by layering of the blood components based on density differences. Only two other cases of bone metastases with multiple fluid-fluid levels have been reported. Although fluid-fluid levels are exceedingly rare, clinicians should be aware that they might indicate a malignancy, particularly when they are multiple. PMID:20194045
Frenzel, Laurent; Javier, Rose-Marie; Eichler, Francoise; Zollner, Goerg; Sibilia, Jean
Tornwaldt's cyst is an uncommon type of nasopharyngeal cyst that may cause clinically significant symptoms. We reviewed reports of 31,855 computed tomography (CT) scans and 21,158 magnetic resonance imaging (MRI) scans to ascertain how many Tornwaldt's cysts were discovered incidentally. These images had been obtained between Jan. 1, 1994, and Dec. 31, 1999, at the University of Virginia Health Sciences Center. We found that 32 Tornwaldt's cysts had been incidentally detected in 20 women and 12 men. Four of these cysts had been found on CT (0.013%; mean size: 0.66 cm3) and 28 on MRI (0.13%; mean size: 0.58 cm3). The overall rate was 0.06% (32/53,013). The most common indications for imaging in these patients were headache, seizures, dizziness/vertigo, and pharyngeal symptoms. We also report the case of a patient with a symptomatic Tornwaldt's cyst whose symptoms resolved after treatment with endoscopic marsupialization. Tornwaldt's cyst should be remembered as an uncommon but potentially treatable cause of many symptoms seen in a typical otolaryngology practice. PMID:17315835
Moody, Marcus W; Chi, David H; Chi, David M; Mason, John C; Phillips, C Douglas; Gross, Charles W; Schlosser, Rodney J
Introduction. Hydatid disease (HD) is an infestation that is caused by the larval stage of Echinococcus granulosus. The liver is affected in approximately two-thirds of patients, the lungs in 25%, and other organs in a small proportion. Primary retroperitoneal hydatid cyst is extremely rare. The most common complaint is abdominal pain; however, the clinical features of HD may be generally dependent on the location of the cyst. Case Presentation. A 43-year-old female was admitted with the complaint of abdominal pain. Her physical examination was normal. Computed tomography (CT) revealed a 17 × 11?cm cystic lesion, with a thick and smooth wall that is located among the left liver lobe, diaphragm, spleen, tail of the pancreas, and transverse colon and invading the splenic hilum. Total cystectomy and splenectomy were performed. Pathological examination was reported as cyst hydatid. Discussion. Cysts in the peritoneal cavity are mainly the result of the spontaneous or traumatic rupture of concomitant hepatic cysts or surgical inoculation of a hepatic cyst. Serological tests contribute to diagnosis. In symptomatic and large hydatid peritoneal cysts, surgical resection is the only curative treatment. Total cystectomy is the gold standard. Albendazole or praziquantel is indicated for inoperable and disseminated cases. Percutaneous aspiration, injection, and reaspiration (PAIR) technique is another nonsurgical option.
Summary Background: Massive unilocular intraabdominal cysts in children are rare. Alimentary tract duplications can present diagnostic and therapeutic difficulties. Although they can occur anywhere from the mouth to the anus, they are commonly seen in relation to the ileum. We herein present an unusual case of duplication cyst itself occupying virtually all of the available intraabdominal volume. It appeared to be an enteric duplication cyst of ileal origin. Case Report: A 3-month-old girl was admitted to our hospital for investigation of progressive abdominal distension and biliary vomiting. Plain radiography of the abdomen showed normal air-fluid level in the stomach and paucity of gases in rest of the abdomen. Magnetic resonance imaging showed a huge, homogenous cyst extending from the xiphisternum down to the pelvis. The cyst was excised completely. Macroscopic examination and histologic findings confirmed the diagnosis of a huge enteric duplication cyst arising from the ileum. Conclusions: Enteric duplication cyst should be considered in a patient with an abdominal cystic mass. Radiologist must take into account patient age, clinical parameters, and imaging findings to identify the likely etiology of a cystic mass.
Atalar, Mehmet H.; Cankorkmaz, Levent; Ozer, Hatice; Koyluoglu, Gokhan
Primary splenic cyst is a relatively rare entity; they comprise only about 10% of benign non-parasitic cysts. Most of these are asymptomatic and are observed incidentally during abdominal ultrasonography. The number of diagnosed splenic cyst cases seems to have risen because of the increasing use of abdominal imaging techniques. However, definite diagnosis is possible only after splenectomy when epithelial lining is confirmed histologically. We report a case of a 14-year-old child who presented with fullness of abdomen and pain in the left hypochondrium since last few months. First impression made was in favor of a splenic lymphangioma of size 8 × 8 cm which was based on a Computerized tomography scan and the sonographic findings. Splenectomy was performed and was sent for histopathological examination which in combination with immunohistochemistry revealed findings suggestive of primary epithelial cyst. A large cystic mass with a relatively thin wall localized in the spleen is likely to be a primary or secondary cyst. The diagnosis of false cyst should be favored if there is a clear history of trauma, if the patient is older than fourth decade, if there is a hematoma elsewhere in spleen, or if cyst wall is calcified. This rare entity should be considered in the differential diagnosis in a patient presenting with left hypochondrial pain. PMID:24516849
Garg, Monika; Kataria, Sant P; Sethi, Divya; Mathur, Satyavir Kumar
Purpose To detect predominant bacteria associated with radicular cysts and discuss in light of the literature. Material and methods Clinical materials were obtained from 35 radicular cysts by aspiration. Cultures were made from clinical materials by modern laboratory techniques, they underwent microbiologic analysis. Results The following are microorganisms isolated from cultures: Streptococcus milleri Group (SMG) (23.8%) [Streptococcus constellatus (19.1%) and Streptococcus anginosus (4.7%)], Streptococcus sanguis (14.3%), Streptococcus mitis (4.7%), Streptococcus cremoris (4.7%), Peptostreptococcus pevotii (4.7%), Prevotella buccae (4.7%), Prevotella intermedia (4.7%), Actinomyces meyeri (4.7%), Actinomyces viscosus (4.7%), Propionibacterium propionicum (4.7%), Bacteroides capillosus (4.7%), Staphylococcus hominis (4.7%), Rothia denticariosa (4.7%), Gemella haemolysans (4.7%), and Fusobacterium nucleatum (4.7%). Conclusions Results of this study demonstrated that radicular cysts show a great variety of anaerobic and facultative anaerobic bacterial flora. It was observed that all isolated microorganisms were the types commonly found in oral flora. Although no specific microorganism was found, Streptococcus spp. bacteria (47.5%) – especially SMG (23.8%) – were predominantly found in the microorganisms isolated. Furthermore, radicular cysts might be polymicrobial originated. Although radicular cyst is an inflammatory cyst, some radicular cyst fluids might be sterile.
Chloride secretion driven by calcium-dependent chloride channels has a major impact on cyst enlargement in polycystic kidney disease. Buchholz et al. studied the functional role of anoctamin 1 (ANO1), a recently identified calcium-activated chloride channel, in kidney cyst growth, using principal-like cells forming cysts within a collagen matrix and an embryonic kidney cyst model. Their results support a potential role for this chloride channel in cyst generation. PMID:24786872
Two cases of spontaneous resolution of large ovarian cysts in newborns are presented. In both cases the cysts were detected\\u000a prenatally with ultrasound. In one case the cyst disappeared before birth; in the other, the cyst resolved several weeks postnatally.\\u000a Both infants also displayed labial, uterine and vaginal enlargement, signs of maternal estrogen stimulation. These large ovarian\\u000a cysts are also
J. Amodio; S. Abramson; W. Berdon; J. Bell; P. Winchester; C. Stolar; P. Liebert
We treated 35 patients who had hepatic cysts (30 congenital cysts, 5 hydatid cysts) with percutaneous puncture and sclerotherapy.\\u000a After puncture and drainage of the cyst, a 95% alcohol solution was instilled as sclerosing agent into the cystic cavity.\\u000a In all the patients, cyst puncture and drainage was successful. Follow-up in all cases was at least 12 months. In three
Giovanni Simonetti; Stefano Profili; Gian Luigi Sergiacomi; Giovanni Battista Meloni; Antonio Orlacchio
Congenital pericardial diverticula and cysts are extremely uncommon lesions within the anterior mediastinum. Both lesions derive from the pericardial celom and represent different stages of a common embryogenesis. Initial reports date from the 19th century. Surgical pioneers were Otto Pickhardt, who removed a pericardial cyst at Lenox Hill Hospital in New York in 1931, and Richard Sweet, who accomplished the first resection of a pericardial diverticulum at Massachusetts General Hospital in Boston in 1943. These lesions were also called spring water cysts because they usually contain watery, crystal-clear fluid. This history outlines the milestones of evolving surgical management, from the first report in 1837 up to the present time.
Cardiac hydatid cyst is life threatening but rare. It is usually asymptomatic and has potentially lethal complications, so early diagnosis with definitive treatment is life-saving. In the present article, we report two cases. The first is a 30-year-old woman with a primary large multivesicular hydatid cyst in the left ventricle. The second is a 17-year-old woman who had multivisceral involvement with a cardiac hydatid cyst, a congenital cardiac anomaly that was an atrial septal defect complicated by pulmonary hypertension. 2-D echocardiography and magnetic resonance imaging confirmed the diagnosis. Surgical treatment was performed using extracorporeal circulation and adjunctive albendazol therapy. PMID:16352080
To present a novel modification of the surgical technique for open excision of type I choledochal cysts. The treatment of choice for choledochal cyst is surgical excision because such cysts are associated with an increased incidence of cancer. The commonly used operative technique provides poor access to the structures posterior to the cyst, principally the portal vein, and poor visibility of the junction of the cyst with the hepatic ducts and the pancreatic duct. The modification reduces these problems. The key operative step involves early transection of the choledochal cyst near its midpoint. This provides improved access to the back of the cyst. Slitting the sides of the cyst allows clear visibility from within the cyst of the union of the hepatic ducts with the cyst, and the entrance of the pancreatic duct, thus protecting them. Excision of type I choledochal cysts using the described method was completed in 11 adult patients between 2003 and 2012. One patient (9 %) was found to have a concurrent gallbladder cancer and underwent an R0 resection at the time of choledochal cyst excision. No patients experienced any intraoperative complications. One patient (9 %) developed a portal vein thrombosis postoperatively. The described technique is a safe and feasible method for the excision of extrahepatic choledochal cysts, and provides an advantage in allowing the surgeon to visualize the hepatic and pancreatic ducts from within the cyst and thus protect them during cyst excision. PMID:24222324
Jin, Linda X; Fields, Ryan C; Hawkins, William G; Linehan, David C; Strasberg, Steven M
The teaching of surgical anatomy is an important aspect of an orthopedic training program. The fabrication of polyurethane bones by the authors' staff has proved to be a simple, inexpensive, and rapid means of duplicating bones, permitting the orthopedic surgeons to experiment with new surgical techniques as well as to teach surgical skills. Polyurethane bones may be purchased commercially but are much less costly and more instructive when made by staff members. PMID:6194926
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We present the case of a woman who suffered from an acutely infected diffuse mass in the right neck. This mass had grown rapidly after difficult extraction of a tooth. Histologic analysis of the excised material revealed a lateral neck cyst with a lymph node that showed signs of an acute inflammation near the cyst. These findings support the theory that a preexisting lateral neck cyst may be "activated" by an intraoral inflammation. The different theories of the origin of lateral neck cysts are presented and discussed in the context of the case description. PMID:7699278
New bone tissue can be induced anywhere in the animal organism, i.e. even at a site distant from actual bone, by the implantation of demineralised bone powder (DBP). Basic implantation experiments were first carried out and tested in the rat (Bettex-Galland 1985). The results led us to use the experience gained to treat four patients with bone defects with DBP (one bonecyst, and 3 chronic skull defects). The DBP used was prepared aseptically from fresh cadaver bone. The results were assessed by means of x-ray films and/or CT-scan, and the preliminary evaluation is encouraging. PMID:3526741
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…
A webquest about simple machines Please open microsoft word and re-type or copy and paste each question and then type your answer. Be sure to include your name at the top of the page!!! . . Follow the link below and click on the Start button. Go to either the house or the tool shed and go ...
Purpose To report two cases of solitary unilateral vitreous cyst. Methods A complete ocular examination, fundus photography, B-scan ultrasound and spectral-domain optical coherence tomography were performed in both patients. Results The first patient (a 39-year-old man) presented with transient blurred vision in the right eye. The second patient (a 78-year-old man) reported transient blurred vision in the right eye when changing head position. He was referred to the Eye Hospital because of vitreomacular traction in the other eye. After examination, a diagnosis of vitreous cyst was made in both cases. Conclusions Vitreous cysts are rare clinical findings. They can occur in normal eyes or in eyes with certain ocular pathologies. When a cyst floats into the visual axis area, it can disturb visual function; therefore, patients usually report transient blurring of vision. A prompt clinical examination is necessary for differentiating this rare condition.
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.
Choledochal cyst disease is uncommon. The presentation of the disease is being seen more commonly in the adult population than in the pediatric population, particularly in the West, making this a diagnosis a general surgeon should consider when evaluating a patient with biliary disease. The diagnosis of this disease has been greatly facilitated by improving technologies, particularly MRCP and interventional techniques of PTC. The consequences of not treating choledochal cysts can result in malignant transformation. When possible, complete surgical excision of the cyst is recommended and should be performed as early as possible to prevent complications and the progression of liver fibrosis. Long-term follow-up is required for surveillance for late complications and for cancer, particularly in type IV and V choledochal cysts where complete excision is not possible. PMID:19845181
We report the case of a myodil cyst causing a thoracic radiculopathy in a patient who had undergone a myelogram 30 years previously. Although myodil is no longer used, sequelae can continue to be seen for many years. PMID:11045204
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.
We report a case of a mediastinal bronchogenic cyst with back pain. The rarity of this lesion and even the more uncommon association of this lesion with symptoms of back pain prompted the report of this case. PMID:20935427
Ibinaiye, P O; Adeyinka, A O; Sogaolu, M; Kajogbola, G A
Intracranial dermoid cysts with hemorrhage are fairly rare. Herein, we reported a 28-year-old female patient with a cerebellar dermoid cyst, which was found accidently on neuro-imaging after head trauma. MR scanning revealed that the lesion was located within the cerebellar vermis and was measured 3.5cm×3.9cm×3.0cm, with hyper-intensity on T1WI and hypo-intensity on T2WI. However, on CT imaging, it showed hyper-dense signals. It was removed completely via midline sub-occipital approach under surgical microscope. Histological examination proved it was a dermoid cyst with internal hemorrhage. In combination with literature review, we discussed the factors that might be responsible for the hemorrhage within dermoid cysts. PMID:22211083
Intracranial dermoid cysts with hemorrhage are fairly rare. Herein, we reported a 28-year-old female patient with a cerebellar dermoid cyst, which was found accidently on neuro-imaging after head trauma. MR scanning revealed that the lesion was located within the cerebellar vermis and was measured 3.5cm×3.9cm×3.0cm, with hyper-intensity on T1WI and hypo-intensity on T2WI. However, on CT imaging, it showed hyper-dense signals. It was removed completely via midline sub-occipital approach under surgical microscope. Histological examination proved it was a dermoid cyst with internal hemorrhage. In combination with literature review, we discussed the factors that might be responsible for the hemorrhage within dermoid cysts.
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
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.
Background and Objectives: The aim of this report is to document the feasibility and safety of umbilical single-incision laparoscopic liver cyst unroofing in the treatment of simple hepatic cysts in a retrospective case-control study. We also introduce some operative skills for single-incision laparoscopic surgery. Methods: From May 2009 to July 2011, 15 patients underwent umbilical single-incision laparoscopic liver cyst unroofing. All the clinical data were retrospectively analyzed. Another 15 simple liver cyst patients who received standard laparoscopic liver cyst unroofing at our hospital during the same period—with a similar age, nature of the cyst, and position to the single-incision group—were selected to undergo a case-control study. The operative time, blood loss, recovery time of gastrointestinal function, volume of postoperative drainage, postoperative drainage time, postoperative hospitalization time, and postoperative recurrence rate were compared between the two groups. Results: There was no significant difference between the single-incision group and standard group in operative time (58.3 ± 7.43 minutes vs 58.7 ± 6.14 minutes), blood loss (17.0 ± 3.19 mL vs 14.7 ± 1.86 mL), recovery time of gastrointestinal function (2.5 ± 0.22 days vs 2.4 ± 0.22 days), volume of postoperative drainage (408.0 ± 119.5 mL vs 450.0 ± 89.5 mL), postoperative drainage time (2.6 ± 0.55 days vs 3.7 ± 0.59 days), or postoperative hospitalization time (4.8 ± 0.44 days vs 5.2 ± 0.56 days) (P > .05). The postoperative follow-up period was 1 to 24 months. Conclusions: Compared with standard laparoscopic liver cyst unroofing, single-incision laparoscopic liver cyst unroofing shows no significant difference during the overall treatment process. In addition to the advantages of less trauma, more rapid recovery, and shorter hospital stay, single-incision laparoscopic surgery can reach the effect of “no scar” and can be safely and effectively carried out.
Vertebrates, or animals that have a skeletal structure for body support, leave bones behind after their death. These bones can be placed together to recreate the skeletal frame of that animal. Bones can be examined to determine what animal the bones came from.
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.
Epidermal inclusion cysts are uncommon in the breast, but the consequences can be severe when these cysts occur in the breast\\u000a parenchyma. Here, we report two such cases. The patient in case 1 was an 85-year-old woman with a 3-cm palpable mass in the\\u000a right breast. Mammography revealed a round and smoothly outlined mass, which indicated a benign tumor, and
We report a rare complication of extradural arachnoid cyst following percutaneous vertebroplasty in a spinal metastasis patient.\\u000a Percutaneous vertebroplasty has been established as a safe and effective treatment for osteoporotic vertebral fractures and\\u000a vertebral metastatic lesions. To our knowledge, extradural arachnoid cyst following vertebroplasty has not been reported in\\u000a literature. A 48-year-old woman diagnosed with adenocarcinoma underwent percutaneous vertebroplasty at
We report a rare case of cervical dermal sinus associated with a dermoid cyst in a 10-month-old infant, who presented with a 1-month history of motor weakness of the right upper extremity. Magnetic resonance imaging showed an intradural extramedullary dermoid cyst extending from C3 to C4, which was connected with the skin dimple along the sinus tract. Total excision of
The peritoneal inclusion cyst is a rare, probably congenital, pathology of the mesothelium that develops on coelomatic residues. A case is reported of an unusual location of peritoneal cyst, in which the increase in volume, associated with the patient's concern and the presumed anatomic site of the lesion led to its removal by the laparoscopic route. The type of location and the relative inaccuracy of preoperative imaging are discussed. PMID:19859042
Fronticelli Baldelli, C M; Seghesio, R M; Giaccone, M; Scuderi, S; Senetta, R
We experienced a case of bronchogenic cyst located on the left lower pleural space extending into the retroperitoneum in a 33-year-old man with left chest pain. Preoperative imaging studies and operative findings showed a broad-based cystic mass on the left lower posterior pleura and diaphragmatic pleura extending into the retroperitoneal region across the diaphragm. Histologic studies proved this mass to be a bronchogenic cyst. PMID:16368412
An unilateral maxillary sinusitis is frequently caused by dental pathology. An odontogenic cyst in the maxillary sinus usually lacks accompanying symptoms of infection. In three patients, a 35-year-old man and two women aged 16 and 28, an odontogenic cyst in the maxillary sinus was diagnosed. Consultation of a maxillofacial surgeon is needed because orthopantomographic imaging is diagnostically most helpful. In these patients combined treatment by an ENT surgeon and a maxillofacial surgeon is important. PMID:9550780
Hydatid cyst disease is a rare parasitic infestation caused by larvae of Echinococcus granulosus. Although larval stage of this parasite can thrive in any part of the body, especially lungs and liver; head and neck involvement is rare. Pterygopalatine fossa involvement is reported in two cases in the literature. In this report we represent a case with solitary, secondary pterygopalatine fossa hydatid cyst extending in to the maxillary sinus, orbita, sphenoid sinus and skull base. PMID:22075139
Yumusakhuylu, Ali Cemal; Yilmaz, Asli Sahin; Devecioglu, Ibrahim; Oysu, Cagatay
Background There is little knowledge concerning the content and the mechanisms of filling of arachnoid cysts. The aim of this study was to compare the protein content of arachnoid cysts and cerebrospinal fluid by quantitative proteomics to increase the understanding of arachnoid cysts. Methods Arachnoid cyst fluid and cerebrospinal fluid from five patients were analyzed by quantitative proteomics in two separate experiments. In a label-free experiment arachnoid cyst fluid and cerebrospinal fluid samples from individual patients were trypsin digested and analyzed by Orbitrap mass spectrometry in a label-free manner followed by data analysis using the Progenesis software. In the second proteomics experiment, a patient sample pooling strategy was followed by MARS-14 immunodepletion of high abundant proteins, trypsin digestion, iTRAQ labelling, and peptide separation by mix-phase chromatography followed by Orbitrap mass spectrometry analysis. The results from these analyzes were compared to previously published mRNA microarray data obtained from arachnoid membranes. Results We quantified 348 proteins by the label-free individual patient approach and 1425 proteins in the iTRAQ experiment using a pool from five patients of arachnoid cyst fluid and cerebrospinal fluid. This is by far the largest number of arachnoid cyst fluid proteins ever identified, and the first large-scale quantitative comparison between the protein content of arachnoid cyst fluid and cerebrospinal fluid from the same patients at the same time. Consistently in both experiment, we found 22 proteins with significantly increased abundance in arachnoid cysts compared to cerebrospinal fluid and 24 proteins with significantly decreased abundance. We did not observe any molecular weight gradient over the arachnoid cyst membrane. Of the 46 proteins we identified as differentially abundant in our study, 45 were also detected from the mRNA expression level study. None of them were previously reported as differentially expressed. We did not quantify any of the proteins corresponding to gene products from the ten genes previously reported as differentially abundant between arachnoid cysts and control arachnoid membranes. Conclusions From our experiments, the protein content of arachnoid cyst fluid and cerebrospinal fluid appears to be similar. There were, however, proteins that were significantly differentially abundant between arachnoid cyst fluid and cerebrospinal fluid. This could reflect the possibility that these proteins are affected by the filling mechanism of arachnoid cysts or are shed from the membranes into arachnoid cyst fluid. Our results do not support the proposed filling mechanisms of oncotic pressure or valves.
Survival rates for infants and children who have choledochal cyst with or without spontaneous rupture have improved dramatically in the past decades. Despite excellent long-term survival for patients with choledochal cyst who undergo elective surgery, many significant complications can occur in the patients being operated in emergency for rupture of the cyst. Spontaneous rupture of the cyst is one such problem resulting in considerable morbidity and mortality in these patients. Majority of surgeons manage these cases with T-tube external drainage. The conventional methods of T-tube placement for long period has remained simple as described in choledochotomies where there is no deficit of the walls of common bile duct (CBD). The present technique has been designed specially for the cases of ruptured choledochal cyst, where the wall of the CBD gets necrosed leaving behind a long gap between the two ends. In these cases, placement of T-tube with conventional method is not possible because there is no wall to suture together, and make the CBD water tight again to prevent leakage of bile. We found only two patients of spontaneous rupture of choledochal cyst with a long gap between two ends of CBD because of necrosed anterior wall. In both of these patients, it was not possible to put T-tube with traditional method and one would have to opt for primary definitive repair despite poor general condition of patients. PMID:21196660
Sellar arachnoid cysts are rare; an infected arachnoid cyst is extremely rare as only one case has been reported to date in the literature. Here, we report a patient with an infected or inflamed sellar arachnoid cyst that was successfully treated with transsphenoidal surgery (TSA). A 53-year-old female with a history of chronic sinusitis developed a headache 5 months ago, and one month before admission polyuria, polydipsia, and abnormal vaginal bleeding occurred. The magnetic resonance imaging (MRI) showed a sellar cystic mass with a thickened pituitary stalk. Preoperative hormonal study revealed normal pituitary hormone levels except for a moderate elevation of prolactin. She was diagnosed with diabetes insipidus of the central nervous system origin based on a water-deprivation test. TSA was performed under an impression of symptomatic Rathke's cleft cyst according to the MRI findings. Intraoperative findings showed confirmation of turbid intracystic contents, but micro-organisms were unidentified on microbial culture. Pathology of the cyst wall revealed inflamed meningoepithelial lining cells compatible with an arachnoid cyst.
Sellar arachnoid cysts are rare; an infected arachnoid cyst is extremely rare as only one case has been reported to date in the literature. Here, we report a patient with an infected or inflamed sellar arachnoid cyst that was successfully treated with transsphenoidal surgery (TSA). A 53-year-old female with a history of chronic sinusitis developed a headache 5 months ago, and one month before admission polyuria, polydipsia, and abnormal vaginal bleeding occurred. The magnetic resonance imaging (MRI) showed a sellar cystic mass with a thickened pituitary stalk. Preoperative hormonal study revealed normal pituitary hormone levels except for a moderate elevation of prolactin. She was diagnosed with diabetes insipidus of the central nervous system origin based on a water-deprivation test. TSA was performed under an impression of symptomatic Rathke's cleft cyst according to the MRI findings. Intraoperative findings showed confirmation of turbid intracystic contents, but micro-organisms were unidentified on microbial culture. Pathology of the cyst wall revealed inflamed meningoepithelial lining cells compatible with an arachnoid cyst. PMID:24904886
Park, Kwang Hyon; Gwak, Ho-Shin; Hong, Eun Kyung; Lee, Sang Hyun
Can you identify the six types of simple machines? 1. What do you know about Inclined Planes? Draw an example on your graphic organizer and state one fact.Inclined Plane 2. What do you know about levers? Draw an example on your graphic organizer and state one fact.Lever. 3. What do you know about pulleys? Draw an example on your graphic organizer and ...
ABSTRACT A 10-year-old, neutered male Labrador retriever presented with progressive left hind lameness. Ultrasonography revealed large, subcutaneous, ovoid cysts around the stifle joint. Radiographic and computed tomographic images revealed periosteal reaction of the distal femur. Magnetic resonance (MR) imaging showed a large cyst that was hypointense in T1-weighted images, hyperintense in T2-weighted images and had a thin lining that was enhanced by intravenous gadonium injection. The cyst communicated with the joint cavity and other small cysts around the joint. Histopathology of an excisional biopsy specimen led to diagnosis of ganglion cyst. This report provides MR images of a ganglion cyst in a canine stifle.
A residual cyst, as the name implies, is a radicular, lateral periodotal, dentigerous or any other cyst that has persisted after it's associated tooth has been lost. Residual cysts show more predilection in males and they commonly affect the maxillary region. Usually, residual cysts are asymptomatic and calcifications occurring in the residual cysts are quite rare. We are reporting a case of symptomatic residual cyst, associated with calcifications involving the anterior region of the body of the mandible in a 60-year-old male patient. The pathogenesis, clinical, radiological features and differential diagnosis have been discussed. PMID:24701547
Sridevi, K; Nandan, S Ratheesh Kumar; Ratnakar, P; Srikrishna, K; Vamsi Pavani, B
A residual cyst, as the name implies, is a radicular, lateral periodotal, dentigerous or any other cyst that has persisted after it’s associated tooth has been lost. Residual cysts show more predilection in males and they commonly affect the maxillary region. Usually, residual cysts are asymptomatic and calcifications occurring in the residual cysts are quite rare. We are reporting a case of symptomatic residual cyst, associated with calcifications involving the anterior region of the body of the mandible in a 60-year-old male patient. The pathogenesis, clinical, radiological features and differential diagnosis have been discussed.
Sridevi, K; Nandan, S. Ratheesh Kumar; Ratnakar, P.; Srikrishna, K.; Vamsi Pavani, B.
To understand the process that leads to breakdown of a plant resistance gene, we need to understand the processes that govern pathogen evolution. By studying two of the main evolutionary forces (migration and mutation) operating on nematode populations, we show that cyst nematodes appear to present a higher risk than previously thought. In particular we showed that cyst nematodes exhibit
A 39-year old woman presented with cough. Computed tomography showed a mass in the lower lobe of the right lung. Although bronchofiberscope was performed, accurate diagnosis of the tumor was not obtained. Based on the characteristics of the tumor from the results of chest MRI and PET-CT, a diagnosis of bronchogenic cyst with infection was suspected. Therefore, surgical resection was performed, revealing an intrapulmonary bronchogenic cyst and another tumor of the pleura on the vertebral body. Pathological findings demonstrated that the wall of the intrapulmonary tumor was covered with many ciliated epithelia and bronchial cartilages, suggesting a diagnosis of bronchogenic cyst. The tumor on the pleura was also diagnosed to be bronchogenic cyst based on pathological findings. Therefore, we diagnosed both intrapulmonary and pleural cysts. PMID:19198233
Thyroglossal duct cysts are one of the most common congenital abnormalities of the cervical region. Complications of these swellings are rare, and among these, appearance of a carcinoma has also been noted. We present a case of papillary carcinoma arising in a thyroglossal duct cyst in 20-year-old woman with a swelling of about 4 cm, located at the middle region of the neck over the hyoid bone. Our patient was treated using a modified Sistrunk operation, in which thyroidectomy proved crucial for the correct diagnosis and continuation of appropriate treatment. Our case confirms the difficulty in distinguishing a primitive thyroglossal duct carcinoma from a synchronous metastatic papillary carcinoma of the thyroid. This dilemma often remains unresolved. PMID:24882933
Proia, G; Bianciardi Valassina, M F; Palmieri, G; Zama, M
Background: Lumps arising in the head and neck constitute an important diagnostic category in children. As malignancy in this age group is relatively rare, lumps that are not due to inflammatory or infective causes often prove to be cysts. Correct diagnoses of the different subcutaneous lumps are often missed because of the lack of recognition or uncertainty with management. Objectives: The purpose of this study was to review the characteristics of most common pediatric cysts appearing in the head. Methods: A retrospective study was designed to review all the children treated for a cyst in the head during the 12-year period from 1995 to 2007. Study patients had a preoperative diagnosis of a cyst in the head, were younger than 11 years at the time of the diagnosis, and had received a surgical treatment for the condition. The pathological specimens were revised with an expert dermatopathologist, and the clinical data were statistically analyzed. Results: Of the 90 cysts, 53 were dermoid cysts (58.88%), 16 were diagnosed as pilomatrixomas (17.77%), 5 cysts were diagnosed as branchial cysts (5.55%), and 12 were diagnosed as epidermal cyst (13.33%). Male gender and younger age were significantly associated with correct diagnosis of dermoid cysts (P <.05). Conclusions: Ninety-five percent of the cysts fell in 1 of the 4 following categories: dermoid cyst, pilomatrixoma, epidermal cyst, and branchial arch cyst. Dermoid cysts were the most common facial cysts (60%). Correct preoperative diagnosis was more accurate in cases of dermoid and branchial cysts.
Armon, Noam; Shamay, Sivan; Maly, Alexander; Margulis, Alexander
In this activity about engineering, nutrition, and physical activity, learners design and build a healthy bone model of a space explorer which is strong enough to withstand increasing amounts of weight. This activity contains several engaging mini-activities and stresses the importance of the scientific method. Learners can complete this activity as part of NASA's Fit Explorer Challenge, in which learners train like astronauts, set goals, track their progress, and accumulate points to progress through Exploration Levels and earn certificates.
A qualitative and semi-quantitative study of recent dinoflagellate cysts has been undertaken in the NW part of Aegean Sea, Thermaikos Gulf (Eastern Mediteranean), before (September 2001), during (October 2001) and after 120 days (February 2002) of intensive trawling activities. This is the first survey of recent dinoflagellate cysts from Greek marine coastal environments. Sediment samples were collected with a corer and the vertical distribution of the cysts was studied at five different layers, from 0 to 10 cm. Dinoflagellate cysts were both abundant and diverse. Cysts were found over the whole sampling area and periods, with concentrations ranging between 247-3202 cysts cm -3. Thirty-six cyst types were encountered, of which 32 were identified to species level, representing 12 genera. It seems that significant local resuspension, related to the onset of the trawling period and stirring up of the sediment, contributed to mixing of the upper layers, resulting to more homogenous cyst profiles in the sediment. Viable cysts constituted 16-60% of the total cyst abundance. The abundance peaks of viable cysts within the subsurface sediment layers, observed during the undisturbed period, disappeared during October. In February, the reduction of cyst concentration was associated to a loss of viable cysts, whilst the ratio of viable/empty cysts ranged between 0.30 and 0.67. The abundance of the different dinoflagellate species, in their active form, was monitored in order to detect any relationship between the concentration of cysts in the top 10 cm of sediment and blooms of algae in the water column. Cysts of potentially toxic species, causing Paralitic Shellfish Poisoning (PSP), such as Alexandrium cf. tamarense, A. cf. affine, A. cf. minutum, as well as Gymnodinium catenatum, were detected in the cyst survey.
Giannakourou, A.; Orlova, T. Y.; Assimakopoulou, G.; Pagou, K.
Liver cysts in the newborn often pose significant diagnostic challenges. Described herein is a case of large congenital liver cyst that was difficult to diagnose both antenatally and postnatally and which was later diagnosed as Caroli disease. PMID:24730630
Choledochal cysts are rare cystic transformations of the biliary tree that are increasingly diagnosed in adult patients. We report here a case of spontaneous rupture of a choledochal cyst in a pregnant young lady with chronic pancreatitis. PMID:23238690
To report on an epithelial inclusion cyst of the iris that was successfully treated with needle aspiration and Ab externo laser photocoagulation. A 6-year-old boy was treated for a 6.0 mm fluid-filled cyst in the anterior chamber of the right eye. Thirteen months previously, he had undergone primary closure of a 6 mm full-thickness corneal laceration. The subsequent cyst was diagnosed as an epithelial inclusion cyst of the iris. His vision decreased to finger-count at 30 cm as the cyst grew over the pupil. We performed needle aspiration of the cyst and Ab externo laser photocoagulation of the cyst wall. The treated lesion was completely removed. The patient's visual acuity recovered to 20/40 without complications. There was no recurrence as determined by slit lamp examination up to 6 months after treatment. Needle aspiration and Ab externo laser photocoagulation can be used to effectively treat epithelial inclusion cysts of the iris.
A case of congenital vitreous cyst is presented. An optical coherence tomography scan has been performed, which has shown that the cyst is free floating and is multilobular. Its content was hyper-reflective. PMID:24962488
Concomitant pulmonary and liver hydatid cysts occur in 4% 25% of patients with echinococcosis. To evaluate the safety of a single-stage operation, experience with this procedure between 1992 and 2005 was reviewed. Of 152 patients who underwent surgery for pulmonary hydatid cyst, 30 had an additional hepatic cyst that was located on the upper dome of the liver in all cases. Pulmonary cysts were excised first via a posterolateral thoracotomy. After phrenotomy, the hepatic hydatid cyst was evacuated without capitonnage, and a Folly catheter was left in the cavity. Postoperative complications in the 30 patients with cysts in both locations included empyema in 2, bronchopleural fistula in 1, excessive biliary discharge in 3 and hemorrhage in 1. Hepatic hydatid cysts recurred in 2 patients. There was no hospital death. A single-stage posterolateral thoracotomy for extraction of pulmonary and liver hydatid cyst is an effective and safe surgical technique with few complications. PMID:18812348
Aghajanzadeh, Manucher; Safarpoor, Fizolah; Amani, Hussein; Alavi, Ali
The nasopalatine duct cyst (NPDC) is the most common of the non-odontogenic cyst of the jaws. This cysts are usually central or unilateral with no prevalence of side occurrence. The NPDC is the most frequent developmental, nonodontogenic cyst of the jaws. This cyst originates from epithelial remnants from the nasopalatine duct. The cells could be activated spontaneously during life, or are eventually stimulated by the irritating action of various agents (infection, etc.). Generally, patients present without clinical signs and symptoms. Therefore, the tentative diagnosis "nasopalatine duct cyst" is often based on a coincidental radiological finding on a routine panoramic view or occlusal radiograph. The definite diagnosis should be based on clinical, radiological and above all histopathologic findings. The therapy of nasopalatine duct cysts consists of an enucleation of the cystic tissue, only in rare cases a marsupialization needs to be performed. This report describes the appearance and treatment of a rare case of bilateral nasopalatine duct cyst. PMID:20386720
Cicciù, Marco; Grossi, Giovanni Battista; Borgonovo, Andrea; Santoro, Giacomo; Pallotti, Francesco; Maiorana, Carlo
Spinal arachnoid cyst is a rare cause of myelopathy secondary to spinal cord compression. We report a case presenting extradural arachnoid cyst of probable traumatic origin leading to irreversible neurological deficits including paraparesis and neurogenic bladder. The patient presented progressive paraparesis and voiding difficulty. Magnetic resonance imaging (MRI) of the spine revealed long segmental cystic lesion of cerebrospinal fluid (CSF) signal intensity at dorsal extramedullary space of T11 to L3 level suggesting arachnoid cyst with diffuse cord compression. On the operation, an ovoid shaped dural defect was identified at right sided dorsolateral aspect of the dura mater between nerve root sleeves at T11 and T12 level. The patient was treated by microsurgical repair of the dural defect and intraoperative findings revealed no further leakage of CSF. The neurological status of the patient was stationary on follow-up examination postoperatively. We postulate that delayed-onset post-traumatic extradural arachnoid cyst should be taken into consideration on the differential diagnosis of intrapinal cysts. PMID:24757455
A 68-year-old female had a three-week history of severe low back pain radiating down the posterior left buttocks and left leg exacerbated by standing and walking. Lumbar spine MRI revealed cystic mass with similar intensity to cerebrospinal fluid located on dorsolateral left side of the sacral spinal canal inferior to the S1 pedicle. There was compression of left exiting S1 and traversing S2 nerve roots. Neurosurgery consult was requested to evaluate the cystic mass in the sacral spinal canal. After clinical evaluation, an unusually located synovial cyst was thought possible. Cyst contents were heterogeneous, suggestive of small hemorrhage and acute clinical history seemed reasonable. Left S1 and partial left S2 hemilaminectomy was performed and an epidural, partially hemorrhagic cyst was removed. There was no obvious connection to the ipsilateral L5-S1 facet joint. Pathology revealed synovial cyst, and the patient's leg pain was improved postoperatively. This synovial cyst was unusual as it had no connection with the facet joint intraoperatively and its location in the sacral canal was uncommon.
Objective Evaluate incidence, etiology, and sonographic features of Baker’s cyst in children. Materials and methods We examined 16 pediatric patients, with the clinical diagnosis of Baker’s cyst. The possibility to confirm or to exclude the presence of the lesion, assess the structure, presence of bilateralism and joint effusion were considered. Three subjects had known juvenile arthritis, 2 hemophilia, 11 a popliteal swelling in the absence of concomitant diseases. Results In all patients it was possible to confirm (11) or to exclude (5) the presence of Baker’s cyst. The idiopathic forms (6) exhibited anechoic structure; in patients with arthritis (3) there was hypertrophic synovium; in hemophilic patients at the presentation (2) anechoic structure with layering (serum and red blood cells); in chronic hemophilia synovial hypertrophy was seen. Joint effusion was constantly present in children with hemophilia and arthritis and in 1 case of idiopathic cyst. Conclusion Baker’s cysts in children are rare. Ultrasound is able to confirm or to exclude the presence of the lesion and it is able to evaluate characteristics, bilateralism and association with joint effusion.
Alessi, S.; Depaoli, R.; Canepari, M.; Bartolucci, F.; Zacchino, M.; Draghi, F.
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... the bloodstream. People who are at risk for bone infections include those with diabetes, poor circulation, or recent ... risk if you are having hemodialysis. Symptoms of bone infections include Pain in the infected area Chills and ...
The experience with treatment of 97 patients with non-parasitary liver cysts by means of percutaneous puncture under guidance of ultrasound investigation and computed tomography has been summarized. The techniques for puncture of non-parasitary liver cysts with drainage and irrigation of a cyst cavity with the solutions of sclerosing substances are presented. The independence of a puncture method of treatment of non-parasitary liver cysts is stressed. A high effectiveness of the method is emphasized. PMID:8046864
Vecherko, V N; Gredzhev, F A; Zubov, A D; Goz, B M; Makarov, V Iu; Shatalov, A D
Parathyroid cysts are a rare situation, unusually in the mediastinum. The preoperative diagnosis could be more difficult in some atypical topographies and imaging characteristics in particular in case of huge mediastinal cyst. In the following years traditionally, in case of intrathoracic parathyroid cysts, sternotomy or thoracotomy have been the preferred approaches. We report a case of an older patient with a huge mediastinal parathyroid cyst removed successfully using videothoracoscopy. PMID:23625377
Intramedullary epidermoid cysts of the spinal cord are rare lesions. The authors report a case of giant intramedullary epidermoid cyst at the cervicothoracic region. A 6-year-old boy presented with motor and sensory loss related to a spinal intramedullary epidermoid cyst. Almost all cyst content was liquid and it was surgically removed totally in two successive operations. To the author’s knowledge,
Neurenteric cysts are rare developmental cysts lined by endodermal derived epithelium. We present the case of a 68-year-old patient presenting with seizures who was found to have an extra-axial low density lesion with associated wall calcification on CT. Aspiration and biopsy of the cyst revealed a neurenteric cyst. Such lesions of the lateral supratentorial convexity are extremely rare and calcification