Thoracic arachnoid cyst resection.
Deutsch, Harel
2014-09-01
Arachnoid cysts in the spinal cord may be asymptomatic. In some cases arachnoid cysts may exert mass effect on the thoracic spinal cord and lead to pain and myelopathy symptoms. Arachnoid cysts may be difficult to visualize on an MRI scan because the thin walled arachnoid may not be visible. Focal displacement of the thoracic spinal cord and effacement of the spinal cord with apparent widening of the cerebrospinal fluid space is seen. This video demonstrates surgical techniques to remove a dorsal arachnoid cyst causing spinal cord compression. The surgery involves a thoracic laminectomy. The dura is opened sharply with care taken not to open the arachnoid so that the cyst can be well visualized. The thickened arachnoid walls of the cyst are removed to alleviate the compression caused by the arachnoid cyst. The video can be found here: http://youtu.be/pgUrl9xvsD0.
[Rare location of arachnoid cysts. Extratemporal cysts].
Martinez-Perez, Rafael; Hinojosa, José; Pascual, Beatriz; Panaderos, Teresa; Welter, Diego; Muñoz, María J
2016-01-01
The therapeutic management of arachnoid cysts depends largely on its location. Almost 50% of arachnoid cysts are located in the temporal fossa-Sylvian fissure, whereas the other half is distributed in different locations, sometimes exceptional. Under the name of infrequent location arachnoid cysts, a description is presented of those composed of 2 sheets of arachnoid membrane, which are not located in the temporal fossa, and are primary or congenital. Copyright © 2015 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.
[Arachnoid cysts: Embriology and pathology].
García-Conde, Mario; Martín-Viota, Lucia
2015-01-01
There is still great controversy surrounding the origin of the arachnoid cyst. The most accepted theory in the case of congenital cysts explains how they are formed from an anomalous development of the arachnoid membrane, which is unfolded allowing the accumulation of cerebrospinal fluid inside and creating a cyst. This theory seems to explain the origin of convexity and sylvian cistern arachnoid cysts, whereas those in other locations might be due to other mechanisms. In the anatomopathological analysis, the arachnoid cyst wall can be seen as having few differences from normal, although thickened due to an increase quantity of collagenous material. A description of the embryological development of the arachnoid layer and cyst formation is presented, describing the main anatomopathological findings. Copyright © 2015 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.
Spinal intradural hydatid cyst causing arachnoiditis: A rare etiology of cauda equina syndrome
Singh, Suyash; Sardhara, Jayesh; Singh, Amit Kumar; Srivastava, Arun Kumar; Bhaisora, Kamlesh Singh; Das, Kuntal Kanti; Mehrotra, Anant; Sahu, Rabi N; Jaiswal, Awadhesh Kumar; Behari, Sanjay
2016-01-01
This study aims to focus on a rare presentation of spinal hydatid cyst as cauda equine syndrome and misdiagnosed as intradural extramedullary (IDEM) benign lesion on magnetic resonance imaging. In this article, we report a case of spinal hydatid cyst masquerading as IDEM tumor, and intraoperatively, we accidently find clumped granuloma with severe arachnoiditis and hydatid cyst in lumber region, which was present as bilateral S1 radiculopathy with cauda equina syndrome. An 11-year-old boy who presented with symptoms and signs of cauda equina syndrome and planned for surgical excision. His radiological impression was IDEM possibly neurofibroma. To our surprise, we found multiple intradural cystic lesions with arachnoiditis. Dissecting in plane cyst was flushed out, and surgical cavity was irrigated with 3% saline. Postoperatively histopathology and serum tests confirmed the diagnosis of hydatid cyst. Hydatid disease is rare cause of cauda equine syndrome which can be miss diagnosed on radiological investigations. A high index of suspicion should be kept especially in a young patient from the Indian subcontinent. PMID:27891041
Arachnoid cyst with rupture into the subdural space.
Cullis, P A; Gilroy, J
1983-01-01
Arachnoid cysts which develop in relation to the cerebral hemispheres are usually found in the middle cranial fossa. These cysts are usually asymptomatic but can produce symptoms if there is haemorrhage into the cyst or the development of an associated subdural hematoma. Recent publications have emphasised the association of arachnoid cysts of the middle fossa with subdural haematomas. This report describes a case of an asymptomatic arachnoid cyst which ruptured into the subdural space. This event was followed by the development of symptoms despite the lack of haemorrhage. Images PMID:6101185
Dissapearance of arachnoid cyst after rupturing into subdural space.
Yilmaz, C; Cetinalp, E; Caner, H; Altinors, N
2007-01-01
Arachnoid cysts are developmental anomalies usually diagnosed in childhood. The most important complications of arachnoid cysts are subdural haematomas and hygromas and intracystic haemorrhage. In our case we present a 7-year-old boy whose arachnoid cyst ruptured into the subdural space following a mild head injury and disappeared after draining the subdural haematoma by burr-holes.
Intraoperative Visualization of a Spinal Arachnoid Cyst Using Pyoktanin Blue.
Takamiya, Soichiro; Seki, Toshitaka; Yamazaki, Kazuyoshi; Sasamori, Toru; Houkin, Kiyohiro
2018-01-01
Spinal arachnoid cysts (SACs) are filled with cerebrospinal fluid, and they include the arachnoid membrane, making it difficult to distinguish the walls of the cyst from the arachnoid membrane and excise the cyst as a lump. Here we report a technique for the intraoperative visualization of SACs, involving the use of pyoktanin blue. Four patients with spinal intradural arachnoid cysts underwent total excision of the cysts between October 2016 and April 2017. In 1 case, magnetic resonance imaging revealed the cyst clearly, but in the other cases, the cysts were unclear. All cysts were injected with 1% pyoktanin blue (Wako Pure Chemical Industries, Osaka, Japan) diluted 500 times with physiological saline before excision. When it was difficult to distinguish the cyst from the normal arachnoid membrane, 1% pyoktanin blue diluted 1000 times with physiological saline was injected into both the cyst and the subarachnoid space, and the spread of the stain was observed. The cysts were better visualized after pyoktanin blue injection than before injection. When it was difficult to distinguish the cyst from the normal arachnoid space, pyoktanin blue injection was useful for judging the cyst space. There were no perioperative complications, and the patients' symptoms improved partially or completely after treatment. Our technique of pyoktanin blue injection into SACs could make their excision easy and safe. Copyright © 2017 Elsevier Inc. All rights reserved.
Risk factors for pediatric arachnoid cyst rupture/hemorrhage: a case-control study.
Cress, Marshall; Kestle, John R W; Holubkov, Richard; Riva-Cambrin, Jay
2013-05-01
As the availability of imaging modalities has increased, the finding of arachnoid cysts has become common. Accurate patient counseling regarding physical activity or risk factors for cyst rupture or hemorrhage has been hampered by the lack of definitive association studies. This case-control study evaluated factors that are associated with arachnoid cyst rupture (intracystic hemorrhage, adjacent subdural hematoma, or adjacent subdural hygroma) in pediatric patients with previously asymptomatic arachnoid cysts. Patients with arachnoid cysts and intracystic hemorrhage, adjacent subdural hygroma, or adjacent subdural hematoma treated at a single institution from 2005 to 2010 were retrospectively identified. Two unruptured/nonhemorrhagic controls were matched to each case based on patient age, sex, anatomical cyst location, and side. Risk factors evaluated included arachnoid cyst size, recent history of head trauma, and altitude at residence. The proportion of imaged arachnoid cysts that presented either originally or subsequently with a rupture or hemorrhage was 6.0%. Larger cyst size, as defined by maximal cyst diameter, was significantly associated with cyst rupture/hemorrhage (P < .001). When dichotomized with a 5-cm cutoff, 9/13 larger cysts ruptured and/or hemorrhaged, whereas only 5/29 smaller cysts ruptured/hemorrhaged (odds ratio = 16.5 (confidence interval [2.5, ∞]). A recent history of head trauma was also significantly associated with the outcome (P < .001; odds ratio = 25.1 (confidence interval [4.0, ∞]). Altitude was not associated with arachnoid cyst rupture or hemorrhage. This case-control study suggests that larger arachnoid cyst size and recent head trauma are risk factors for symptomatic arachnoid cyst rupture/hemorrhage.
Spontaneous disappearance of two asymptomatic arachnoid cysts in two different locations.
Cokluk, C; Senel, A; Celik, F; Ergür, H
2003-04-01
We report two children with asymptomatic arachnoid cysts which resolved spontaneously without any surgical intervention and history of major head and body trauma. The first child was a 10-year-old boy with an arachnoid cyst in the right sylvian fissure. The second child was a 1-year-old girl with a right cerebral convexity arachnoid cyst. Both of them were asymptomatic. Arachnoid cysts spontaneously disappeared within 2 years following initial diagnosing. There was no major head and body trauma except usual home, school and sports activity. We speculated that the cysts ruptured into cerebrospinal fluid circulation by the mechanical effects of some forced activities to the brain tissue and cyst, such as excessive breathing, coughing and sport activities. These factors may change the balance between intracystic and pericystic pressure and facilitate the rupturing of the cyst into subdural, subarachnoid and intraventricular spaces. These cases demonstrate that neurosurgical intervention of asymptomatic arachnoid cysts is not absolutely indicated in the paediatric age group. Close follow up with computerized tomography (CT) and magnetic resonance imaging (MRI) is a treatment option in the patient with arachnoid cysts located in the middle cranial fossa and cerebral convexity.
Intracranial aneurysm and arachnoid cyst: just a coincidence? A case report.
Aguiar, Guilherme Brasileiro de; Santos, Rafael Gomes Dos; Paiva, Aline Lariessy Campos; Silva, João Miguel de Almeida; Silva, Rafael Carlos da; Veiga, José Carlos Esteves
2017-12-18
Presence of an arachnoid cyst and a non-ruptured intracystic brain aneurysm is extremely rare. The aim of this paper was to describe a case of a patient with an arachnoid cyst and a non-ruptured aneurysm inside it. Clinical, surgical and radiological data were analyzed and the literature was reviewed. A patient complained of chronic headache. She was diagnosed as having a temporal arachnoid cyst and a non-ruptured middle cerebral artery aneurysm inside it. Surgery was performed to clip the aneurysm and fenestrate the cyst. This report raises awareness about the importance of intracranial vascular investigation in patients with arachnoid cysts and brain hemorrhage.
Dual lumbar bronchogenic and arachnoid cyst presenting with sciatica and left foot drop.
Candy, Nicholas; Young, Adam; Devadass, Abel; Dean, Andrew; McMillen, Jason; Trivedi, Rikin
2017-10-01
Spinal bronchogenic cysts are rare findings, with only four cases of lumbar bronchogenic cysts reported in the literature. All of these bronchogenic cysts involved the conus medullaris. We present the first case of a lumbar bronchogenic cyst and arachnoid cyst arising from the cauda equina in a 68-year-old male. Uniquely, this bronchogenic cyst also contained components of an arachnoid cyst. Magnetic resonance imaging (MRI) demonstrated a compressive cystic lesion at the level of the L3 vertebra splaying the cauda equina. An L3/L4 laminectomy was performed with marsupialisation of the cyst. Histological examination revealed pseudostratified ciliated columnar epithelium confirming the diagnosis of a bronchogenic cyst, as well as a pleated fibrovascular tissue lined by sparsely spaced small monomorphic arachnoidal cells, indicating an arachnoid cyst. We demonstrate that bronchogenic cysts can be successfully treated with marsupialisation.
Zekaj, Edvin; Saleh, Christian; Servello, Domenico
2016-01-01
Background: A rare cause of spinal cord compression is spinal arachnoid cysts. Symptoms are caused by spinal cord compression, however, asymptomatic patients have been also reported. Treatment options depend upon symptom severity and clinical course. Case Description: We report the case of a 47-year-old patient who developed an intramedullary arachnoid cyst after removal of an intradural extramedullary cyst. Conclusion: Surgery should be considered early in a symptomatic disease course. Longstanding medullary compression may reduce the possibility of neurological recovery as well as secondary complications such as intramedullary cyst formation. PMID:27512608
Takayasu, Takeshi; Harada, Kunyu; Nishimura, Shigeru; Onda, Jun; Nishi, Tohru; Takagaki, Hisashi
2012-01-01
Arachnoid cysts are well known to induce chronic subdural hematoma (CSDH) after head injury. However, histological observations of the arachnoid cyst and hematoma membrane have only been rarely described. An 8-year-old boy and a 3-year-old boy presented with CSDH associated with arachnoid cyst. Surgical removal of the hematoma and biopsy of the hematoma membrane and cyst wall were performed. Clinical courses were good and without recurrence more than 1.5 years after surgery. Histological examination suggested that the cysts did not contribute to hematoma development. Pediatric hematoma membranes, similar to adult hematoma membranes, are key in the growth of CSDH. Therefore, simple hematoma evacuation is adequate as a first operation for CSDH associated with arachnoid cyst.
Helland, Christian A; Lund-Johansen, Morten; Wester, Knut
2010-11-01
The aim of this study was to examine the distribution of intracranial arachnoid cysts in a large and unselected patient population with special emphasis on sidedness and sex distribution. In total, 299 patients with 305 arachnoid cysts were studied. These patients were consecutively referred to our department during a 20-year period from a well-defined geographical area with a stable population. There was a strong predilection (198 patients [66.2%]) for intracranial arachnoid cysts in the temporal fossa. Forty-two patients had cysts overlying the frontal convexity, 36 had cysts in the posterior fossa, and 23 patients had cysts in other, different locations. Of 269 cysts with clearly unilateral distribution, 163 were located on the left side and 106 on the right side. This difference resulted from the marked preponderance of temporal fossa cysts on the left side (left-to-right ratio 2.5:1; p < 0.0001 [adjusted < 0.0005]). For cysts in the cerebellopontine angle (CPA), there was preponderance on the right side (p = 0.001 [adjusted = 0.005]). Significantly more males than females had cysts in the temporal fossa (p = 0.002 [adjusted = 0.004]), whereas in the CPA a significant female preponderance was found (p = 0.016 [adjusted = 0.032]). For all other cyst locations, there was no difference between the 2 sexes. Arachnoid cysts have a strong predilection for the temporal fossa. There is a sex dependency for some intracranial locations of arachnoid cysts, with temporal cysts occurring more frequently in men, and CPA cysts found more frequently in women. Furthermore, there is a strong location-related sidedness for arachnoid cysts, independent of patient sex. These findings and reports from the literature suggest a possible genetic component in the development of some arachnoid cysts.
Surgically treated de novo cervico-medullary arachnoid cyst in a symptomatic adult patient.
Clifton, William; Rahmathulla, Gazanfar; Tavanaiepour, Kourosh; Alcindor, Dunbar; Jakubek, George; Tavanaiepour, Daryoush
2018-05-16
Arachnoid cysts are a relatively common finding in adult patients, especially with the advent of advanced imaging techniques. The overall incidence ranges from 1-2%, and the majority are clinically silent 1,2 . Arachnoid cysts are postulated to arise by congenital anomalies or trauma 1 . De novo formation of arachnoid cysts has been reported, but is exceptionally rare and mostly found in the pediatric population after head trauma 3-5 . There have only been two reported cases of symptomatic de novo arachnoid cyst formation in adult patients to date, both with histories of head trauma 6,7 . We present a case of a 71-year-old male patient with progressive vertigo who had previous brain MRI studies without abnormalities. Another MRI was performed three years from the last study that showed interval development of a large cystic lesion compressing the right cervicomedullary junction, as well as radiologic evidence of neurosarcoidosis. Intraoperative findings showed a cystic mass with clear, gelatinous fluid. The cyst was drained and the walls were resected and sent to pathology. Histopathologic testing confirmed the lesion was an arachnoid cyst. The patient's vertiginous symptoms improved after surgery. This case represents the first incidence of a pathology proven, non-traumatic de novo arachnoid cyst. Copyright © 2018 Elsevier Inc. All rights reserved.
Arachnoid cyst in a patient with psychosis: Case report
da Silva, Joaquim Alves; Alves, Alexandra; Talina, Miguel; Carreiro, Susana; Guimarães, João; Xavier, Miguel
2007-01-01
Background The aetiology of a psychotic disturbance can be due to a functional or organic condition. Organic aetiologies are diverse and encompass organ failures, infections, nutritional deficiencies and space-occupying lesions. Arachnoid cysts are rare, benign space-occupying lesions formed by an arachnoid membrane containing cerebrospinal fluid (CSF). In most cases they are diagnosed by accident. Until recently, the coexistence of arachnoid cysts with psychiatric disturbances had not been closely covered in the literature. However, the appearance of some references that focus on a possible link between arachnoid cysts and psychotic symptoms has increased the interest in this subject and raised questions about the etiopathogeny and the therapeutic approach involved. Clinical presentation We present the clinical report of a 21-year-old man, characterised by the insidious development of psychotic symptoms of varying intensity, delusional ideas with hypochondriac content, complex auditory/verbal hallucinations in the second and third persons, and aggressive behaviour. The neuroimaging studies revealed a voluminous arachnoid cyst at the level of the left sylvian fissure, with a marked mass effect on the left temporal and frontal lobes and the left lateral ventricle, as well as evidence of hypoplasia of the left temporal lobe. Despite the symptoms and the size of the cyst, the neurosurgical department opted against surgical intervention. The patient began antipsychotic therapy and was discharged having shown improvement (behavioural component), but without a complete remission of the psychotic symptoms. Conclusion It is difficult to be absolutely certain whether the lesion had influence on the patient's psychiatric symptoms or not. However, given the anatomical and neuropsychological changes, one cannot exclude the possibility that the lesion played a significant role in this psychiatric presentation. This raises substantial problems when it comes to choosing a
Krauer, Fabienne; Ahmadli, Uzeyir; Kollias, Spyros; Bleisch, Jörg; Wüthrich, Rudolf P.; Serra, Andreas L.; Poster, Diane
2012-01-01
Background Autosomal dominant polycystic kidney disease (ADPKD) is an inherited disorder that results in the growth of cysts in the kidneys and other organs. Multisystemic involvement is common including affection of the central nervous system with cerebral aneurysms and arachnoid cysts. Methods This is a prospective cohort study to investigate the prevalence and growth rate of arachnoid cysts in ADPKD patients. Participants enrolled in the SUISSE ADPKD cohort were offered cranial imaging for the detection of intracranial alterations. In the case of identified arachnoid cysts, patients were suggested to undergo follow-up imaging to assess the growth rate of the cysts. Volume of arachnoid cysts at the baseline and at follow-up visits was assessed by manual segmentation on a dedicated workstation. Results A total of 109 ADPKD patients agreed to undergo cranial imaging. In 14 (12.8%) patients (9 males and 5 females), 18 singular arachnoid cysts were identified. The baseline volumes of individual cysts ranged from 1.8 to 337.6 cm3. During a mean follow-up period of 24 months, the volume changes of 12 individual arachnoid cysts of nine patients ranged from −3.1 to 3.7 cm3. Cystic lesions were mostly localized in the middle fossa. All affected patients were clinically asymptomatic. Conclusions We found a higher prevalence of arachnoid cysts in ADPKD patients with more advanced disease. There was a large variability in size and growth. These arachnoid cysts were clinically silent and their growth pattern was subtle and unpredictable, in contrast to the much more foreseeable growth of the renal cysts. PMID:26019816
Wester, K
1999-10-01
To study the distribution of intracranial arachnoid cysts in a large and nonbiased patient population. One hundred twenty-six patients with 132 arachnoid cysts were studied. Patients were consecutively referred to our department during a 10-year period from a well-defined geographical area with a stable population. The cysts had a strong predilection for the middle cranial fossa; 86 patients (65.2%) had cysts in this location. Of 106 cysts with clearly unilateral distribution, 64 were located on the left side and 42 on the right side. This significant difference resulted solely from the marked preponderance of middle fossa cysts for the left (left-to-right ratio, 2.1:1). There were significantly more males than females (92 males/34 females). This difference was exclusively due to male preponderance of unilateral middle fossa cysts (66 males/14 females; ratio, 4.7:1). For all other cyst locations, there was no difference between the two sexes (26 males/20 females) or the two sides (10 left, 16 right). The marked left-sidedness for middle fossa cysts was found only in males. Females had an even distribution between the two sides. Arachnoid cysts have a strong predilection for the middle cranial fossa that may be explained by a meningeal maldevelopment theory: the arachnoid coverings of the temporal and frontal lobes fail to merge when the sylvian fissure is formed in early fetal life, thereby creating a noncommunicating fluid compartment entirely surrounded by arachnoid membranes. Why males develop more middle fossa cysts on the left side remains a mystery.
Klekamp, Jörg
2017-08-01
Spinal intradural arachnoid cysts are rare causes of radiculopathy or myelopathy. Treatment options include resection, fenestration, or cyst drainage. To classify intradural spinal arachnoid cysts and present results of their treatment. Among 1519 patients with spinal space occupying lesions, 130 patients demonstrated intradural arachnoid cysts. Neuroradiological and surgical features were reviewed and clinical data analyzed. Twenty-one patients presented arachnoid cysts as a result of an inflammatory leptomeningeal reaction related to meningitis, subarachnoid hemorrhage, intrathecal injections, intradural surgery, or trauma, ie, secondary cysts. For the remaining 109 patients, no such history could be elucidated, ie, primary cysts. Forty-six percent of primary and 86% of secondary cysts were associated with syringomyelia. Patients presented after an average history of 53 ± 88 months. There were 122 thoracic and 7 lumbar cysts plus 1 cervical cyst. Fifty-nine patients with primary and 15 patients with secondary cysts underwent laminotomies with complete or partial cyst resection and duraplasty. Mean follow-up was 57 ± 52 months. In the first postoperative year, profound improvements for primary cysts were noted, in contrast to marginal changes for secondary cysts. Progression-free survival for 10 years following surgery was determined as 83% for primary compared to 15% for secondary cysts. Despite differences in clinical presentation, progression-free survival was almost identical for patients with or without syringomyelia. Complete or partial resection leads to favorable short- and long-term results for primary arachnoid cysts. For secondary cysts, surgery can only provide clinical stabilization for a limited time due to the often extensive arachnoiditis. Copyright © 2017 by the Congress of Neurological Surgeons
[Suprasellar arachnoid cyst--report of a case (author's transl)].
Takahashi, T; Kawai, S; Kaminoh, T; Hiramatsu, K; Maekawa, M; Yuasa, T; Miyamoto, N; Hattori, Y
1982-04-01
A 4-year-old boy with suprasellar arachnoid cyst was reported. At the age of 30-month-old his aunt was aware of his squint. During the observation by ophthalmologists from the age of 1y. to 3y., enlargement of the head and impairment of the visual acuity were manifested. Cranial CT scan revealed the enlargement of the ventricular system and a round low density area located superior to the sella. Absorption coefficient of the lesion was similar to that of the cerebrospinal fluid. No abnormal contrast enhancement was seen. Examination revealed the head circumference of 53.3 cm larger than doubled standard deviation, the right external strabismus, impaired vision (R:0.03, L:0.3) and optic atrophy but no other neurological signs. Cerebral angiography showed suprasellar mass lesion. After the ventriculography with water-soluble contrast medium, V-P shunt operation was performed and then the patient was transferred to the CT room. CSF enhanced CT scan showed no communication between the ventricles and the cyst. By frontotemporal approach, microsurgical removal of the cystwall was performed and the histological diagnosis was arachnoid membrane. Several days after the operation, bilateral subdural effusion was seen on CT scan and was treated with bilateral S-P shunt and the removal of V-P shunt. Follow up CT scan disclosed the disappearance of the subdural effusion and the suprasellar cyst. The visual acuity was improved well and the endocrinological study was normal. Analysis of the 45 reported cases of suprasellar arachnoid cyst suggested that direct removal of the cyst wall is better than the V-P shunt operation and the cyst shunting is advisable for repeat recurrence of the cyst. Removal of the ventricular shunting system may be effective for the prevention of the subdural effusion as a complication after direct operation.
Zara, Gabriella; Ponza, Isabella; Citton, Valentina; Manara, Renzo
2010-11-01
We present a patient who showed MRI evidence of a giant temporo-sylvian arachnoidal cyst of the left hemisphere and an extreme pneumatization of the sphenoid and frontal sinuses. No sign of mass effect or cerebral atrophy was detected. This patient presented a deficit of memory and control functions, but quality of life was not affected. Surgery was not performed. Arachnoidal cyst and anatomic variants of the sinus region have not a common etiology. This is the first report that describes a giant temporo-sylvian arachnoidal cyst with anatomic variants of the paranasal sinuses. Copyright © 2010 Elsevier B.V. All rights reserved.
Clinical and radiological outcomes of surgical treatment for symptomatic arachnoid cysts in adults.
Wang, Yongqian; Wang, Fei; Yu, Mingkun; Wang, Weiping
2015-09-01
We retrospectively analyzed 63 patients (31 males and 32 females) with arachnoid cysts managed over a 15 year period at our institution. Surgical indications and modalities for the treatment of intracranial arachnoid cysts are controversial, although endoscopic fenestration is often recommended as a standard procedure. In our cohort, clinical postoperative results and radiological assessments based on the presenting symptoms, cyst location, cyst volume and surgical modalities were recorded. The most common symptoms included headaches (66.7%), dizziness (46%) and seizures (36.5%). Cyst wall excision with microsurgical craniotomy was carried out in 28 patients (44.4%), cyst fenestration in 16 (25.4%), cystoperitoneal or ventriculoperitoneal shunting in 15 (23.8%) and endoscopic fenestration in four patients (6.3%). A satisfactory clinical outcome was achieved in 51 patients (80.9%) and cyst reduction was achieved in 49 (77.8%), at the last follow-up. Clinical improvement correlated significantly with volume reduction in patients with suprasellar and infratentorial cysts (r=0.495; p=0.022) while a similar result was not found after surgery in patients with frontal and temporal cysts. Surgical complications were not correlated with surgical modalities, occurring in only seven patients (11.1%). The various surgical modalities did not influence outcomes. Patients with nonspecific symptoms such as headache may obtain favourable outcomes from surgical treatment with no severe complications, although, intracranial hypertension and neurological deficits are more definite surgical indications for arachnoid cysts. Copyright © 2015 Elsevier Ltd. All rights reserved.
Jeltema, Hanne-Rinck; Kuijlen, Jos M A; Hoving, Eelco W
2014-06-01
We present a 2.5-year-old child suffering from acute hydrocephalus. First, the child was diagnosed with aseptic viral meningitis. The PCR of the cerebrospinal fluid (CSF) was positive for enterovirus. Subsequently, MRI revealed that the hydrocephalus was caused by a cyst in the third ventricle. During ventriculoscopy, the cyst had all aspects of an arachnoid cyst. An endoscopic fenestration and partial removal of the cyst was performed, combined with a ventriculocisternostomy. The coincidental finding of viral meningitis and a third ventricle arachnoid cyst in a patient with acute hydrocephalus has, to our knowledge, not been described in literature before. If there is a relation between the enteroviral meningitis, the arachnoid cyst (possibly causing a pre-existing subclinical hydrocephalus) and the rapidly evolving neurological deterioration, remains speculative. Proposed mechanisms, by which the viral meningitis could accelerate the disease process, are slight brain swelling or increased CSF production. This rare combination of diagnoses could also be coincidental.
Germanò, Antonino; Caruso, Gerardo; Caffo, Mariella; Baldari, Sergio; Calisto, Amedeo; Meli, Francesco; Tomasello, Francesco
2003-03-01
This retrospective case series examines 7 infants with large supratentorial arachnoid cysts who underwent cyst-peritoneal shunting and insertion of a Hakim programmable valve. Comparing pre- and postoperative clinical data, neuroradiological and regional cerebral blood flow (rCBF) findings we evaluated the efficacy of the surgical procedure. Infants, ranging in age from 1 to 55 days (mean age 29.5 days), were assessed pre- and postoperatively by neurological examination, developmental profile and neuroimaging. Post procedure, all patients showed a significant reduction in the cyst/brain ratio on neuroimaging (p<0.001), 6 had a normal developmental profile (p<0.001) and 5 cases showed a significant amelioration of clinical symptoms and neurological signs. Two patients underwent preoperative SPECT scans, which showed hypoperfusion in the area surrounding the cyst; this decreased rCBF also improved post shunting. Large supratentorial arachnoid cysts in infants can be successfully treated with cyst-peritoneal shunting and insertion of a Hakim programmable valve. This is the first study specifically aimed at evaluating the long-term results of these conditions.
Elkheshin, Sherif; Soliman, Ahmed
2017-01-01
To investigate the impact of endoscope-assisted microsurgical fenestration on temporal arachnoid cysts, and to determine the advantages and limitations of the technique. Twenty-five children with symptomatic temporal arachnoid cysts were operated via eyebrow supraorbital keyhole microsurgical fenestration targeting the medial cyst wall. Preoperative magnetic resonance imaging (MRI) of the brain was done for all patients. Preoperative clinical presentation of the patients included headache (80%), nausea & vomiting (64%), drug resistant epilepsy (52%), macrocephaly (12%) papilledema (28%), motor weakness in the form of right-sided hemiparesis (12%) and cranial nerve palsy. Postoperative complete subsidence of headache was noted in 50%, while 20% remained unchanged. Drug resistant epilepsy improved in 69% of the patients. Postoperative MRI showed initial decrease in cyst volume as early as 3 months, only in a range of 5-12% volume reduction, and the late follow-up done at 6 and 18 months continued to show further reduction reported to be significant (p < 0.001). Transient subgaleal cerebrospinal fluid (CSF) collection was the most common complication (20%). Only 1 patient experienced CSF leak mandating cysto-peritoneal shunting. Conclusıon: Eyebrow supraorbital keyhole microsurgical fenestration for temporal arachnoid cysts can be performed with a fairly low risk of complications and yields a favorable improvement in clinical and neuroimaging outcomes.
Suprasellar arachnoid cyst after subdural haemorrhage in an infant. A case based update.
Sonnet, M-H; Joud, A; Marchal, J-C; Klein, O
2014-01-01
Brain arachnoid cysts (AC) are congenital or acquired malformations. Their prevalence in children ranges between 0.2 and 2.3% of the studied populations. Few reported studies exist where AC appears after a subdural haemorrhage. We present one case of a symptomatic suprasellar AC after post-traumatic subdural haemorrhage in an infant. After endoscopic ventriculocystostomy, the child quickly improved and the cyst reduced in size. The child was monitored for 22 months and his neurocognitive development remained normal. Our case led us to the hypothesis that the inflammatory process due to subdural haemorrhage may locally result in arachnoiditis, and thus to the creation of a neomembrane, and eventually to cyst formation. This is also the case with the development of post-traumatic spinal AC. Copyright © 2014 Elsevier Masson SAS. All rights reserved.
A patient with myasthenia gravis and a large arachnoid cyst - report of a case.
Bucuk, Mira; Gasparovic, Iva; Sonnenschein, Ivan; Perkovic, Olivio
2017-05-01
Myasthenia gravis is a chronic autoimmune disease characterized by weakening of voluntary muscles during the day and a marked restitution of function during the night and after rest. The symptoms may worsen over days or weeks, sometimes even in a few hours, and are usually well controlled by appropriate therapy. Arachnoid cysts are congenital or acquired deformities of the arachnoid membrane and are usually too small to cause distinct clinical symptomatology. We describe a case of a 76-year-old myasthenia gravis patient with an arachnoid cyst. To the best of our knowledge this is the first reported case of these two comorbidities together.
[Management of arachnoid cysts of the middle cranial fossa accompanied by subdural effusions].
Abderrahmen, K; Saadaoui, K; Bouhoula, A; Boubaker, A; Jemel, H
2012-10-01
Subdural effusions are uncommon but known complications of arachnoid cysts of the middle cranial fossa. They mainly occur after minor head traumas in young patients. Here, we report eight cases of arachnoid cyst of the middle cranial fossa associated with subdural hematoma in five cases and hygroma in three cases. Major symptoms are signs of raised intracranial pressure. CT scan and MRI showed the cyst and the subdural effusion. An excellent therapeutic result was achieved with evacuation of the subdural fluid via burr holes in the five cases of subdural hematoma while in the two cases of hygroma a subduro-peritoneal shunt was necessary. In the last case, a temporal craniotomy was performed with evacuation of the hygroma and fenestration of the cyst. We suggest treating only the complicating event in the case of a subdural hematoma via burr holes evacuation. Whereas, in the case of hygroma we think that craniotomy with fenestration of the cyst or the use of a subdural shunt are more often needed. Copyright © 2012 Elsevier Masson SAS. All rights reserved.
Brewington, Danielle; Petrov, Dmitriy; Whitmore, Robert; Liu, Grant; Wolf, Ronald; Zager, Eric L
2017-02-01
Intraneural arachnoid cyst is an extremely rare etiology of isolated cranial nerve palsy. Although seldom encountered in clinical practice, this pathology is amenable to surgical intervention. Correct identification and treatment of the cyst are required to prevent permanent nerve damage and potentially reverse the deficits. We describe a rare case of isolated third nerve palsy caused by an intraneural arachnoid cyst. A 49-year-old woman with a recent history of headaches experienced acute onset of painless left-sided third nerve palsy. According to hospital records ptosis, mydriasis, absence of adduction, elevation, and intorsion were noted in the left eye. Computed tomography and magnetic resonance imaging studies showed an extra-axial, 1-cm lesion along the left paraclinoid region, causing mild indentation on the uncus. There was dense fluid layering dependently concerning for hemorrhage, but no evidence of aneurysms. A pterional craniotomy was performed, revealing a completely intraneural arachnoid cyst in the third nerve. The cyst was successfully fenestrated. At 7-month follow-up, the left eye had recovered intact intorsion and some adduction, but the left pupil remained dilated and nonreactive. There was still no elevation and no afferent pupillary defect. Double vision persisted with partial improvement in the ptosis, opening up to more than 75% early in the day. To our knowledge, this is the first report of an intraneural arachnoid cyst causing isolated third nerve palsy. This rare pathology proves to be both a diagnostic and therapeutic challenge. Copyright © 2016 Elsevier Inc. All rights reserved.
SAITO, Atsushi; KON, Hiroyuki; HARYU, Shinya; MINO, Masaki; SASAKI, Tatsuya; NISHIJIMA, Michiharu
2014-01-01
A 20-year-old woman suffered gradual progression of right pulsatile exophthalmos and slight headache. Computed tomography (CT) demonstrated outward and downward displacement of the right globe and an arachnoid cyst in the right middle cranial fossa associated with thinned and anterior protrusion of a bony orbit. Microscopic cystocisternotomy was performed and the cerebrospinal fluid (CSF) inside of the cyst communicated into the carotid cistern and cistern in the posterior cranial fossa. Pulsatile exophthalmos improved immediately after surgery. Arachnoid cyst in the middle cranial fossa presenting with exophthalmos is rare. Microscopic cystocisternotomy might successfully improve CSF flow and relieve exophthalmos. PMID:24305013
Bradley, W. G.; Kalbag, R. M.; Ramani, P. S.; Tomlinson, B. E.
1974-01-01
A 20 year old girl presented with a history of neck and occipital pain for six weeks, which was found to be due to a unicameral bone cyst of the left occipital condylar region. The differential diagnosis of bone cysts in the skull is discussed. Six months after the operation, the patient again presented with backache due to adhesive arachnoiditis. The latter was believed to have arisen as a result of a combination of spinal infective meningitis and intrathecal ethyl iodophenyl undecylate (iophendylate, Myodil, Pantopaque). The nature of meningeal reactions to iophendylate and the part played by intrathecal corticosteroids in relieving the arachnoiditis in the present case are discussed. Images
Shaw, P J; Allcutt, D A; Bates, D; Crawford, P J
1990-01-01
A case of cauda equina syndrome with multiple lumbar arachnoid cysts complicating ankylosing spondylitis (AS) is described. The value of computerised tomography (CT) and magnetic resonance imaging (MRI) as a non-invasive means of establishing the diagnosis is emphasised. In contrast to previously reported cases the patient showed neurological improvement following surgical therapy. Surgery may be indicated in some patients, particularly when there is nerve root compression by the arachnoid cysts and when the patient is seen early before irreversible damage to the cauda equina has occurred. Images PMID:2292702
Adhesive arachnoiditis after percutaneous fibrin glue treatment of a sacral meningeal cyst.
Hayashi, Kazunori; Nagano, Junji; Hattori, Satoshi
2014-06-01
The authors present the case of a 64-year-old woman who was referred for severe sacral pain. She reported that her pain had been longstanding, and had greatly increased after percutaneous fibrin glue placement therapy for a sacral meningeal cyst 2 months earlier at a different hospital. An MRI scan obtained immediately after fibrin glue placement at that hospital suggested that fibrin glue had migrated superiorly into the subarachnoid space from the sacral cyst to the level of L-4. On admission to the authors' institution, physical examination demonstrated no abnormal findings except for perianal hypesthesia. An MRI study obtained at admission demonstrated a cystic lesion in the peridural space from the level of S-2 to S-4. Inhomogeneous intensity was identified in this region on T2-weighted images. Because the cauda equina and nerve roots appeared to be compressed by the lesion, total cyst excision was performed. The cyst cavity was filled with fluid that resembled CSF, plus gelatinous material. Histopathological examination revealed that the cyst wall was composed of hyaline connective tissue with some calcification. No nervous tissue or ganglion cells were found in the tissue. The gelatinous material was acellular, and appeared to be degenerated fibrin glue. Sacral pain persisted to some extent after surgery. The authors presumed that migrated fibrin glue caused the development of adhesive arachnoiditis. The risk of adhesive arachnoiditis should be considered when this therapy is planned. Communication between a cyst and the subarachnoid space should be confirmed to be sufficiently narrow to prevent the migration of injected fibrin glue.
Sports participation with arachnoid cysts.
Strahle, Jennifer; Selzer, Béla J; Geh, Ndi; Srinivasan, Dushyanth; Strahle, MaryKathryn; Martinez-Sosa, Meleine; Muraszko, Karin M; Garton, Hugh J L; Maher, Cormac O
2016-04-01
OBJECT There is currently no consensus on the safety of sports participation for patients with an intracranial arachnoid cyst (AC). The authors' goal was to define the risk of sports participation for children with this imaging finding. METHODS A survey was prospectively administered to 185 patients with ACs during a 46-month period at a single institution. Cyst size and location, treatment, sports participation, and any injuries were recorded. Eighty patients completed at least 1 subsequent survey following their initial entry into the registry, and these patients were included in a prospective registry with a mean prospective follow-up interval of 15.9 ± 8.8 months. RESULTS A total 112 patients with ACs participated in 261 sports for a cumulative duration of 4410 months or 1470 seasons. Of these, 94 patients participated in 190 contact sports for a cumulative duration of 2818 months or 939 seasons. There were no serious or catastrophic neurological injuries. Two patients presented with symptomatic subdural hygromas following minor sports injuries. In the prospective cohort, there were no neurological injuries CONCLUSIONS Permanent or catastrophic neurological injuries are very unusual in AC patients who participate in athletic activities. In most cases, sports participation by these patients is safe.
Ali, Mohsin; Bennardo, Michael; Almenawer, Saleh A; Zagzoog, Nirmeen; Smith, Alston A; Dao, Dyda; Ajani, Olufemi; Farrokhyar, Forough; Singh, Sheila K
2015-09-01
Although intracranial arachnoid cysts are a common incidental finding on pediatric brain imaging, only a subset of patients require surgery for them. For the minority who undergo surgery, the comparative effectiveness of various surgical approaches is debated. The authors explored predictors of surgery and compared operative techniques for pediatric patients with an intracranial arachnoid cyst seen at a tertiary care center. The authors reviewed records of pediatric patients with an intracranial arachnoid cyst. For each patient, data on baseline characteristics, the method of intervention, and surgical outcomes for the initial surgery were extracted, and cyst size at diagnosis was calculated (anteroposterior × craniocaudal × mediolateral). Baseline variables were analyzed as predictors of surgery by using logistic regression modeling, excluding patients whose surgery was not related to cyst size (i.e., those with obstructive hydrocephalus secondary to the cyst compressing a narrow CSF flow pathway or cyst rupture/hemorrhage). Data collected regarding surgical outcomes were analyzed descriptively. Among 83 pediatric patients with an intracranial arachnoid cyst seen over a 25-year period (1989-2013), 27 (33%) underwent surgery; all had at least 1 cyst-attributed symptom/finding. In the multivariate model, age at presentation and cyst size at diagnosis were independent predictors of surgery. Cyst size had greater predictive value; specifically, the area under the curve for the receiver-operating-characteristic curve was 0.89 (95% CI 0.82-0.97), with an ideal cutoff point of ≥ 68 cm(3). This cutoff point had 100% sensitivity (95% CI 79%-100%), 75% specificity (95% CI 61%-85%), a 53% positive predictive value (95% CI 36%-70%), and a 100% negative predictive value (95% CI 91%-100%); the positive likelihood ratio was 4.0 (95% CI 2.5-6.3), and the negative likelihood ratio was 0 (95% CI 0-0.3). Although the multivariate model excluded 7 patients who underwent surgery
[Clinical presentation of a dorsal epidural arachnoid cyst after an epidural anesthesia].
Obil-Chavarría, Claudia Alejandra; García-Ramos, Carla Lisette; Castro-Quiñonez, Sergio Alberto; Huato-Reyes, Raúl; Santillán-Chapa, Concepción Guadalupe; Reyes-Sánchez, Alejandro Antonio
Arachnoid cysts are dural diverticula with liquid content similar to cerebrospinal fluid, with 1% occurring in the spinal cord. They locate mainly in the dorsal region of the thoracic spine, and are unusual causes of spinal cord compression. The case is presented of a previously healthy 15-year-old boy, with a 20-month history of spastic paraparesis that started apparently after epidural block for ankle osteosynthesis. There was decreased sensitivity and strength of the pelvic limbs and gradually presented with anaesthesia from T12 to L4 dermatomes, L5 and S1 bilateral hypoaesthesia and 4+/5 bilateral strength, in the L2 root and 2+/5 in L3, L4, L5, S1, hyperreflexia, Babinski and clonus, but with no alteration in the sacral reflexes. In the magnetic resonance it was diagnosed as an extradural arachnoid cyst from T6 to T9. The patient underwent a T6 to T10 laminotomy, cyst resection, dural defect suture, and laminoplasty. One year after surgery, the patient had recovered sensitivity, improvement of muscle strength up to 4+/5 in L2 to S1, and normal reflexes. After the anaesthetic procedure, increased pressure and volume changes within the cyst could cause compression of the spinal cord, leading to symptoms. Despite being a long-term compression, the patient showed noticeable improvement. Copyright © 2015 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.
McCormick, Paul C
2014-09-01
Dorsal thoracic arachnoid web is a rare but often overlooked cause of progressive myelopathy. Syringomyelia, either above or below the compressive arachnoid band, may also be present. Dorsal arachnoid cyst and ventral spinal cord herniation may be mistaken for this condition. This video demonstrates the microsurgical identification and techniques of resection of a dorsal arachnoid band producing a progressive myelopathy in a 63-year-old man. The video can be found here: http://youtu.be/KDNTqiyW6yo.
Sacral extradural arachnoid cyst in association with split cord malformation.
Habibi, Zohreh; Hanaei, Sara; Nejat, Farideh
2016-09-01
Split cord malformation (SCM) is a congenital disease that can be associated with other spinal anomalies. Few cases of concurrent intradural arachnoid cyst and SCM have been sporadically reported; however, sacral extradural arachnoid cyst (SEAC) with SCM is very rare. The report describes our experience with simultaneous surgery in patients with concurrent SEAC and SCM in an effort to document the treatment of the rare spinal concomitant anomalies. The present study is designed as a case series. This is a continuous series of patients with coexisting SCM and SEAC who were presented to our institution. The lower extremities weakness and deformity, radiological imaging, urodynamic tests, and surgical aspects of the patient population are documented. Cases with concomitant anomalies were consecutively enrolled among 73 patients who were operated on for SCM between 2008 and 2014. Clinical data and surgical findings were prospectively filed and retrospectively evaluated. There were seven patients (2 boys and 5 girls), with age ranging from 18 to 119 months (mean: 56.71±39.49). Type I SCM was detected in six cases, and type II SCM was detected in one case. Tethering of the cord was detected in all seven patients, and six patients (85.7%) had syrinx formation rostral to the level of SCM. All patients had at least one kind of urological dysfunctions manifesting as neurogenic bladder. On surgery, fistulous orifice of the meningeal cyst was found and ligated in six cases, and the other one was repaired via sealing the cyst walls as near as possible to the thecal sac. In patients with symptomatic SCM, the signs of concurrent SEAC may be masqueraded by the former condition. It would be impossible to attribute a given sign, particularly urological signs, to either SCM or SEAC. Whatever the sign and nature, both conditions are better to be managed surgically in one session under a single anesthesia to prevent duplicate complications of further anesthesia and interventions in
Analysis on clinical characteristics of intracranial Arachnoid Cysts in 488 pediatric cases
Huang, Jian-Huang; Mei, Wen-Zhong; Chen, Yao; Chen, Jian-Wu; Lin, Zhi-Xiong
2015-01-01
To summarize the clinical characteristics of intracranial arachnoid cysts (IACs) in pediatric cases. A retrospective analysis was carried out on clinical characteristics of IACs in 488 pediatric cases who were treated at our hospital from January 2003 to September 2013. There were 342 males and 146 females (male-to-female ratio, 2.34:1), aged 5.61±3.25 years on average. 221 cases (45.29%) were diagnosed accidentally, 267 cases had clinical complaints (54.71%), among which relationships between clinical complaints and IACs were identified in 123 (46.07%). Simple IACs occurred in 364 cases (4.59%), and concurrent congenital abnormalities occurred in 124 cases (4.59%). In terms of location, 355 had IACs in middle cranial fossa (72.75%), 82 cases in posterior cranial fossa (16.80%), 20 cases in anterior cranial fossa (4.10%), 12 cases in dorsolateral surface (2.46%), 7 cases in suprasellar cistern (1.43%), 5 cases in cerebral ventricle (1.02%), 5 cases in quadrigeminal cistern (1.02%), and 2 cases in interhemispheric region (0.41%). There were 449 cases with single IAC (92.01%) and 39 cases with multiple IACs (7.99%). On MRI, the cysts produced tension in 127 cases (26.02%), but not in the remaining 361 cases (73.98%). Surgery was performed on 76 of 488 cases (15.57%), while conservative observation was accepted in 412 cases (84.43%). For the former, the symptoms and the cyst volume were improved to varying extent; for the latter, the follow-up lasting for 3-72 months (average 32.43±8.92 months) showed that the cyst volume remained stable in 407 cases (98.78%), enlarged with aggravated symptoms in 3 cases (0.73%), and shrank in 2 cases (0.49%). Clinical complaints of IACs varied in pediatric cases, and the relationships between clinical complaints and IACs were established only partially. Some pediatric cases were combined with other congenital abnormalities. The cyst volume largely remained stable during the disease course, and surgery was required for only a few
A screening method to distinguish syndromic from sporadic spinal extradural arachnoid cyst.
Ogura, Yoji; Yabuki, Shoji; Fujibayashi, Shunsuke; Okada, Eijiro; Iwanami, Akio; Watanabe, Kota; Nakamura, Masaya; Matsumoto, Morio; Ishii, Ken; Ikegawa, Shiro
2018-05-01
Spinal extradural arachnoid cyst (SEDAC) is a cystic lesion that protrudes into the epidural space from a small dural defect. Early diagnosis of SEDAC is important because its expansion causes neurological damage. Two types of SEDAC, syndromic and sporadic, are present. Syndromic SEDAC is inherited as a part of lymphedema-distichiasis syndrome caused by mutations in the FOXC2 gene; however, it is often mistaken as sporadic because of low penetrance. It is not reasonable to conduct a genetic testing for all SEDAC patients and their family members. The aim of this study is to establish an effective screening method to distinguish syndromic SEDAC from sporadic SEDAC. We performed a retrospective review of medical records and imaging studies of 29 subjects who were diagnosed with SEDAC. Clinical features, family history and magnetic resonance imaging (MRI) were analyzed. Mutations in FOXC2 were examined by Sanger-sequencing of the entire coding region of the genes. SEDAC having a mutation in FOXC2 gene was defined with syndromic SEDAC. Eleven subjects had a heterozygous mutation in FOXC2. They were all familial and hence syndromic SEDAC. Only one proband had known family history of SEDAC at diagnosis. MRI findings and physical examinations, especially eye and leg examinations, were quite useful to screen syndromic SEDAC. Physical examination often showed accompanying lymphedema and distichiasis in syndromic SEDAC. Syndromic SEDAC tended to have multiple cysts out of the thoracolumbar area. We established an effective screening method based on physical examinations and MRI findings. Copyright © 2018 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.
Endoscopic Transsphenoidal Cisternostomy for Nonneoplastic Sellar Cysts
Su, Yukai; Ishii, Yudo; Lin, Chien-Min; Tahara, Shigeyuki; Teramoto, Akira; Morita, Akio
2015-01-01
Background and Importance. Sellar arachnoid cysts and Rathke's cleft cysts are benign lesions that produce similar symptoms, including optochiasmatic compression, pituitary dysfunction, and headache. Studies have reported the use of various surgical treatment methods for treating these symptoms, preventing recurrence, and minimizing operative complications. However, the postoperative cerebrospinal fluid (CSF) fistula and recurrence rate remain significant. Clinical Presentation. In this paper, we present 8 consecutive cases involving arachnoid cysts and Rathke's cleft cysts, which were managed by using drainage and cisternostomy, the intentional fenestration of the cyst into the subarachnoid space, and then meticulously closing sellar floor using dural sutures. The postoperative images, CSF fistula rate, and the recurrence rate were favorable. Conclusion. We report this technique and discuss the benefit of this minimally invasive approach. PMID:25685785
Bond, Aaron E; Zada, Gabriel; Bowen, Ira; McComb, J Gordon; Krieger, Mark D
2012-04-01
The goal of this study was to review all cases of pediatric spinal arachnoid cysts (SACs) surgically treated at the authors' institution between 1992 and 2008 and to compare these cases to the published literature for the general population. The charts of all pediatric patients with SACs were reviewed for demographics, medical history, presenting symptoms, imaging findings, operative procedure(s), complications, and outcomes. Following a complete literature review, the pediatric data were compared with data from the general population and unique findings associated with pediatric patients were identified. Thirty-one pediatric patients (median age 6.9 years) underwent operative intervention for SACs between 1992 and 2008 (median duration of follow-up 4.2 years). There were 17 female patients (55%) and 14 male patients (45%). Twenty-one patients (68%) presented with symptoms of radiculopathy or myelopathy. The most common presenting symptoms were pain (42%), lower-extremity weakness (39%), gait instability (32%), spasticity (19%), sensory loss (10%), and bladder dysfunction (7%). In 3 patients (10%) SACs were incidental findings. Intradural SACs were more common (18 patients, 58%) than extradural SACs (11 patients, 36%). One patient (3%) had extradural and intradural components. One patient (3%) had a purely intramedullary cyst, and 1 patient (3%) had both an intradural and intramedullary component. Of the 18 intradural SACs, 9 (50%) were located ventral to the spinal cord and 9 (50%) were dorsally situated. One dorsal intradural SAC had an intramedullary component. All extradural SACs were located dorsal to the spinal cord. Intradural SACs were primarily concentrated in the cervical and thoracic regions (67%), whereas extradural cysts were more evenly distributed between the thoracic, lumbar, and sacral regions. Of the 18 patients with intradural SACs, 13 (72%) had significant previous CNS abnormalities, compared with 3 (27%) of 11 patients with extradural SACs
Carteri, A; Gerosa, M; Gaini, S M; Villani, R
1979-01-01
The Authors report their case material concerning some basic items of the dysraphic pathology of the Posterior Fossa: 22 cases of Dandy Walker syndromes (DWS) and "Arachnoid Cysts" (PFC). The mean clinical findings (predominant involvement of the vestibular structures of the brain stem in the DWS, frequent epileptic seizures and some cases of hypothalamic disturbances in the PFC) are discussed in the light of current embryological theories on Weed's "area membranacea". Finally the results of differential surgical treatments are examined: good or satisfactory results were obtained with shunts, while still debatable seems to be the direct surgical approach.
Lee, Chang-Hyun; Han, In Seok; Lee, Ji Yeoun; Phi, Ji Hoon; Kim, Seung-Ki; Kim, Young-Eun; Wang, Kyu-Chang
2017-01-01
Although arachnoid cysts (ACs) are observed in various locations, only sylvian ACs are mainly regarded to be associated with bleeding. The reason for this selective association of sylvian ACs with bleeding is not understood well. This study is to investigate the effect of the location and shape of ACs on the risk of bleeding. A developed finite element model of the head/brain was modified for models of sylvian, suprasellar, and posterior fossa ACs. A spherical AC was placed at each location to compare the effect of AC location. Bowl-shaped and oval-shaped AC models were developed to compare the effect by shape. The shear force on the spot-weld elements (SFSW) was measured between the dura and the outer wall of the ACs or the comparable arachnoid membrane in the normal model. All AC models revealed higher SFSW than comparable normal models. By location, sylvian AC displayed the highest SFSW for frontal and lateral impacts. By shape, small outer wall AC models showed higher SFSW than large wall models in sylvian area and lower SFSW than large ones in posterior fossa. In regression analysis, the presence of AC was the only independent risk of bleeding. The bleeding mechanism of ACs is very complex, and the risk quantification failed to show a significant role of location and shape of ACs. The presence of AC increases shear force on impact condition and may be a risk factor of bleeding, and sylvian location of AC may not have additive risks of AC bleeding.
Zuckerman, Scott L; Prather, Colin T; Yengo-Kahn, Aaron M; Solomon, Gary S; Sills, Allen K; Bonfield, Christopher M
2016-04-01
OBJECTIVE Arachnoid cysts (ACs) are congenital lesions bordered by an arachnoid membrane. Researchers have postulated that individuals with an AC demonstrate a higher rate of structural brain injury after trauma. Given the potential neurological consequences of a structural brain injury requiring neurosurgical intervention, the authors sought to perform a systematic review of sport-related structural-brain injury associated with ACs with a corresponding quantitative analysis. METHODS Titles and abstracts were searched systematically across the following databases: PubMed, Embase, CINAHL, and PsycINFO. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Peer-reviewed case reports, case series, or observational studies that reported a structural brain injury due to a sport or recreational activity (hereafter referred to as sport-related) with an associated AC were included. Patients were excluded if they did not have an AC, suffered a concussion without structural brain injury, or sustained the injury during a non-sport-related activity (e.g., fall, motor vehicle collision). Descriptive statistical analysis and time to presentation data were summarized. Univariate logistic regression models to assess predictors of neurological deficit, open craniotomy, and cystoperitoneal shunt were completed. RESULTS After an initial search of 994 original articles, 52 studies were found that reported 65 cases of sport-related structural brain injury associated with an AC. The median age at presentation was 16 years (range 4-75 years). Headache was the most common presenting symptom (98%), followed by nausea and vomiting in 49%. Thirteen patients (21%) presented with a neurological deficit, most commonly hemiparesis. Open craniotomy was the most common form of treatment (49%). Bur holes and cyst fenestration were performed in 29 (45%) and 31 (48%) patients, respectively. Seven patients (11%) received
NASA Astrophysics Data System (ADS)
Kostama, V.-P.; Tormanen, T.
The Venusian volcano-tectonic structures have been subject to many classification and characterisation schemes. Several structure-types have been identified (e.g. coronae, novae, arachnoids, calderas, and corona-novae). Of these groups, the relationship of arachnoids and coronae has been complicated, and is a subject to much debate. Some previous works and studies have fused these two categories together, and even promoted the view of non-existence of arachnoids at times. However, based on the recognisable differences in morphology and other characteristics (e.g. size, topography, volcanism), they should be treated as a separate class of structures. In our first global study of the volcano-tectonic features, we found 96 arachnoids [1, 2]. During the reanalysis of the features as a by-product of another study, the arachnoid population was re-evalueted, and more importantly, the identification criteria was rechecked. The revised population increases the arachnoid number to 130 features. The work also produced many examples of features that can be considered as transitional forms between different morphological groups. [1] Kostama, V.-P., M. Aittola, LPSC XXXII, Abstract#1185, 2001a. [2] Kostama, V.-P., M. Aittola, The Catalogue of Venusian Arachnoids, Coronae and Novae, http://cc.oulu.fi/tati/JR/Venus/volcanotectonics/catalogue.html, 2001b.
[Intraparotid first branchial arch cyst: complex diagnostic and therapeutic process].
Gilabert Rodríguez, R; Berenguer, B; González Meli, B; Marín Molina, C; de Tomás Palacios, E; Buitrago Weiland, G; Aguado del Hoyo, A
2013-01-01
First branchial arch cysts are uncommon. Therefore, together with its variable clinical and age presentation they are often misdiagnosed at first. The treatment is surgical, requiring a correct procedure to avoid future recurrences. In this paper we describe a typical case of first branchial arch cyst in which as described in other reports, we first made several misdiagnoses and therefore an inadequate treatment and lastly, with the correct diagnosis, we performed a meticulous complete excision under facial nerve monitoring.
Syringomyelia caused by an arachnoid web in a patient with shunted Dandy-Walker malformation.
Lee, Hee Chang; Choi, Jung Won; Lee, Ji Yeoun; Phi, Ji Hoon; Kim, Seung-Ki; Cho, Byung-Kyu; Wang, Kyu-Chang
2017-04-01
Dandy-Walker malformation (DWM) is a congenital brain anomaly characterized by dysgenesis of the cerebellar vermis and the presence of a posterior fossa cyst. The association of syringomyelia with DWM is extremely rare. A 10-year-old patient who was diagnosed with DWM in infancy presented with progressive scoliosis and fecal incontinence. He had been treated with cystoventriculoperitoneal shunting with a Y-connection during infancy, which was followed by a revision 6 years later. During the revision surgery, intraventricular bleeding occurred and was managed conservatively. Imaging studies for the current visit revealed syringomyelia along the cervicothoracic spinal cord and a membranous structure around the cervicomedullary junction. Phase-contrast cine magnetic resonance imaging (MRI) revealed disturbed cerebrospinal fluid (CSF) flow across the membrane. We excised the arachnoid web that was tethering the brainstem and blocking CSF flow. Postoperatively, the patient experienced symptom relief, and the follow-up imaging study demonstrated a dramatic decrease in the size of the syringomyelia. We suggest that syrinx formation in this patient was possibly caused by disturbed CSF flow and tethering of the brainstem. We experienced an unusual case of DWM with syringomyelia which was caused by an arachnoid web blocking CSF flow and tethering the brainstem. The arachnoid web seems to be formed by previous bleeding which occurred at the time of shunt revision. After excision of the arachnoid web, the patient showed good outcome.
Characteristics of arachnoids from Magellan data
NASA Technical Reports Server (NTRS)
Dawson, C. B.; Crumpler, L. S.
1993-01-01
Current high resolution Magellan data enables more detailed geological study of arachnoids, first identified by Barsukov et al. as features characterized by a combination of radar-bright, concentric rings and radiating lineations, named 'arachnoids' on the basis of their spider and web-like appearance. Identification of arachnoids in Magellan data has been based on SAR images, in keeping with the original definition. However, there is some overlap by other workers in identification of arachnoids, corona (predominantly bright rings), and novae (predominantly radiating lineations), as all of these features share some common characteristics. Features used in this survey were chosen based on their classification as arachnoids in Head et al.'s catalog and on SAR characteristics matching Barsukov et al.'s original definition. The 259 arachnoids have been currently identified on Venus, all of which were considered in this study. Fifteen arachnoids from different regions, chosen for their 'type' characteristics and lack of deformation by other regional processes, were studied in depth, using SAR and altimetric data to map and profile these arachnoids in an attempt to better determine their geologic and altimetric characteristics and possible formation sequences.
Algin, Oktay
2018-05-21
Phase-contrast cine magnetic resonance imaging (PC-MRI) is a widely used technique for determination of possible communication of arachnoid cysts (ACs). Three-dimensional (3D) sampling perfection with application-optimized contrasts using different flip-angle evolutions (3D-SPACE) technique is a relatively new method for 3D isotropic scanning of the entire cranium within a short time. In this research, the usage of the 3D-SPACE technique in differentiation of communicating or noncommunicating type ACs was evaluated. Thirty-five ACs in 34 patients were retrospectively examined. The 3D-SPACE, PC-MRI, and contrast material-enhanced cisternography (if present) images of the patients were analyzed. Each cyst was described according to cyst size/location, third ventricle diameter, Evans index, and presence of hydrocephalus. Communication was defined as absent (score 0), suspected (score 1), or present (score 2) on each sequence. Results of PC-MRI or cisternography (if available) examinations were used as criterion standard techniques to categorize all cysts as communicating or noncommunicating type. The results of 3D-SPACE were compared with criterion standard techniques. The comparisons between groups were performed using Mann-Whitney and Fisher exact tests. For demonstration of communication status of the cysts, criterion standard test results and 3D-SPACE findings were almost in perfect harmony (κ[95% confidence interval: 0.94]; P < 0.001). When evaluating the communicative properties, 3D-SPACE findings correlated with other final results at a rate of 97%. There is a positive correlation with third ventricular diameters and Evans index for all patients (r = 0.77, P < 0.001). For other analyzed variables, there is no significant difference or correlation between the groups. The 3D-SPACE technique is an easy, useful, and noninvasive alternative for the evaluation of morphology, topographical relationships, and communication status of ACs.
Torgersen, Johan; Helland, Christian; Flaatten, Hans; Wester, Knut
2010-11-01
The aim of this study was to evaluate and validate the Cambridge Neuropsychological Test Automated Battery (CANTAB) in a Norwegian group of patients undergoing surgery for middle fossa arachnoid cysts (AC). We also wanted to assess health related quality of life (HRQOL) in these patients to see if it could be improved by decompression of the AC. Adult patients (>18 years) with unilateral middle fossa AC and no previous history of neurological disease, head injury, or a psychiatric disorder were eligible for inclusion. We used four tests from CANTAB to assess the level of neuropsychological performance: paired associate learning (PAL) and delayed matching to sample (DMS) assessed temporal lobe functions, while Stockings of Cambridge (SOC) and intra-extra dimensional (IED) shift focused on frontal lobe functions. Patients with postoperative cerebral complications were reported, but excluded from neuropsychological follow-up. In addition to the CANTAB data, pre- and postoperative clinical and radiological data were collected. HRQOL was assessed using Short Form 36 (SF-36) pre- and postoperatively. We found significant improvement in the two temporal tests assessing memory, but no improvement in the two frontal tests assessing executive function. HRQOL was significantly reduced preoperatively in two of eight SF-36 domains and improved significantly in four domains postoperatively. CANTAB facilitates detection of cognitive improvements after decompression of the cyst in patients with AC in the middle fossa. The improvements were detected on the tests sensitive to temporal lobe problems only, not on the tests more sensitive to frontal lobe affection. This establishes construct validity for CANTAB for the first time in this population.
Arachnoiditis ossificans of the thoracic spine.
Bagley, Jacob H; Owens, T Ryan; Grunch, Betsy H; Moreno, Jessica R; Bagley, Carlos A
2014-03-01
Arachnoiditis ossificans is a rare disorder characterized by the development of calcifications of the arachnoid membrane of the thoracic and lumbar spines. It is an extremely rare cause of spinal canal stenosis and consequent neurological compromise, and its origins and optimal management remain unclear. We review of the literature that illustrates the challenges of diagnosis and treatment of arachnoiditis ossificans. A patient with arachnoiditis ossificans is discussed to illustrate the presentation, treatment, and prognosis of the disease. Copyright © 2013 Elsevier Ltd. All rights reserved.
Vaivre-Douret, L; Boschi, A; Cuny, M L; Clouard, C; Mosser, A; Golse, B; Philippe, A; Bourgeois, M; Boddaert, N; Puget, S
2016-12-01
Left temporal arachnoid cyst and specific learning disorders associated with pervasive developmental disorders - not otherwise specified (PDD-NOS): contributions of an integrative neuro-psychomotor, neuropsychological, psychopathological and neurosurgical approach about a case report in a child (François). With DSM-IV and DSM-IV-TR, the terminology of pervasive developmental disorders (PDD) covers two main categories of infantile disorders: disorders of "strictly" autistic nature and pervasive developmental disorders - not otherwise specified (PDD-NOS). Under the terminology of multiple complex developmental disorder (MCDD), it is proposed to classify children presenting symptoms approaching the psychotic disharmonies and usually diagnosed as PDD-NOS. Such a category of developmental disorders is now included without nosographic distinction in the autistic spectrum in the Diagnostic and Statistical Manual of mental disorders (DSM-V). We are reporting a case report of a 6-year-old boy which shows a PDD-NoS/MCDD complex symptomatology type. This child presents multiple disorders: minor neurological signs (soft signs), neuro-psychomotor disorders, developmental coordination disorder (DCD), communication, thought, and regulation of emotions disorders, attention deficit disorders (ADD); in the presence of a high verbal intellectual potential, which makes it difficult to establish a clear diagnosis. A cerebral magnetic resonance imaging (MRI) was carried out due to the presence of minor neurological signs (soft signs) and of neurodevelopmental multiple disorders. The MRI revealed a voluminous arachnoid temporo-polar left cyst with a marked mass effect on the left temporal lobe. A neurosurgical intervention allowed to observe the gradual disappearance of the specific symptomatology (in particular soft signs, neuro-psychomotor functions and autistic symptoms) secondary to the interference of the cyst's pressure with intracranial areas involving neurological and
Temporal Dermoid Cyst with Unusual Imaging Appearance: Case Report.
Abderrahmen, Khansa; Bouhoula, Asma; Aouidj, Lasaad; Jemel, Hafedh
2016-01-01
Intracranial dermoid cysts are benign, slow growing tumors derived from ectopic inclusions of epithelial cells during closure of neural tube. These lesions, accounting for less than 1% of intracranial tumors, have characteristic computed tomography (CT) and magnetic resonance imaging (MRI) appearances that generally permits preoperative diagnosis. However, the radiologic features are uncommon and the cyst can be easily misdiagnosed with other tumors in rare cases. Herein, we report a case of a left temporoparietal dermoid cyst in a 48-year-old woman that was peroperatively and histopathologically proven but not advocated on CT and MRI. Clinical, radiological and histopathological features of a dermoid cyst are reviewed.
Rare case of diffuse spinal arachnoiditis following a complicated vertebral artery dissection.
Atallah, Elias; Dang, Sophia; Rahm, Sage; Feghali, James; Nohra, Chalouhi; Tjoumakaris, Stavropoula; Rosenwasser, Robert H; Zarzour, Hekmat; Herial, Nabeel; Gooch, Michael Reid; Jabbour, Pascal
2018-06-01
Spinal arachnoiditis (SA) is an extremely rare and delayed complication of subarachnoid hemorrhage (SAH). Little is known about its underlying pathogenesis and subsequent clinical course. A middle-aged patient presented with the worst headache of her life and a grade 3 SAH of the basal-cisterns and posterior fossa was identified on Computed Tomography scans (CT). Angiography revealed a ruptured dissecting aneurysm of the left vertebral artery (VA-V4), as well as an unruptured left Anterior Cerebral Artery (ACA-A1) aneurysm. The VA aneurysm was treated with flow diversion. The patient re-ruptured the stented aneurysm, another telescoping pipeline was placed. The patient developed polymicrobial ventriculitis, and returned several months later complaining of paraparesis and left sided weakness. Magnetic Resonance Imaging (MRI) revealed diffuse thecal dural thickening from the cervicomedullary junction to the sacrum. Loculations, diffuse edema and cord compression were noticed along the inferior surface of the cerebellum, and the cervico-thoracic spine with a T4-T6 syrinx. The patient underwent a posterior (T4-T8) spinal fusion and (T5-T7) decompression with arachnoid-cyst fenestration and placement of a subarachnoid-pleural shunt. On latest follow-up, the patient is weaning off the thoraco-lumbosacral orthosis and ambulating with a cane. SA is often a complicated two-staged disease in which a "free interval phase" separates the initial inflammatory reaction (IIR) from the late adhesive phase. Posterior fossa bleeding, warranting prolonged surveillance, additional bleeding and ventriculitis might augment the risk and the severity of arachnoiditis. Copyright © 2018 Elsevier Ltd. All rights reserved.
Utsunomiya, Hidetsuna; Yamashita, Shinichi; Takano, Koichi; Ueda, Yukiyo; Fujii, Akira
2006-07-01
This article describes a classification and imaging diagnosis of intracranial midline cystic malformations based on neuroembryologic analysis. Midline cystic malformations are classified into two categories from an embryologic point of view. In one category, the cyst represents expansion of the roof plate of the brain vesicle, and in the other the cyst consists of extraaxial structures such as an arachnoid membrane or migrating ependymal cells. Infratentorial cysts, such as the Dandy-Walker cyst or Blake's pouch cyst, and supratentorial cysts, such as a communicating interhemispheric cyst with callosal agenesis or a dorsal cyst with holoprosencephaly, are included in the first category. Infratentorial arachnoid cavities, such as the arachnoid cyst, arachnoid pouch, and mega cisterna magna, are in the second category. Noncommunicating interhemispheric cysts, such as interhemispheric arachnoid cyst or ependymal cyst, with callosal agenesis are also in the second category. A careful review of embryologic development is essential for understanding these midline cysts and for making a more accurate radiologic diagnosis.
Huang, Hsun-Yu; Chen, Yuk-Kwan; Ko, Edward Cheng-Chuan; Chuang, Fu-Hsiung; Chen, Ping-Ho; Chen, Ching-Yi; Wang, Wen-Chen
2017-07-01
We aimed to evaluate nonendodontic periapical lesions clinically misdiagnosed as endodontic periapical pathoses in a population of Taiwanese patients. Cases (2000-2014) of histopathological diagnoses of nonendodontic periapical lesions were retrieved from all cases with a clinical diagnosis of radicular cyst, apical granuloma, or apical periodontitis in the institution. These cases were regarded as misdiagnosed nonendodontic periapical lesions, of which the types and frequencies, in addition to the demographic data, were determined. Four thousand and four specimens were clinically diagnosed as endodontically associated pathoses, of which 118 cases (2.95%) received a histopathological diagnosis of a nonendodontic pathologic entity, the most frequent lesion being keratocystic odontogenic tumor (KCOT, n = 38, 32.20%), followed by fibro-osseous lesion (n = 18, 15.25%), and dentigerous cyst (n = 13, 11.02%). Nine malignant lesions in the periapical area [squamous cell carcinoma (n = 7, 5.93%), adenoid cystic carcinoma (n = 1, 0.85%), and Langerhans cell histiocytosis (n = 1, 0.85%)] were also noted. A wide variety of histopathological diagnoses, including benign odontogenic and non-odontogenic cystic and tumorous lesions and infectious diseases, as well as malignant lesions, was noted in these 118 cases of nonendodontic periapical lesions. Squamous cell carcinoma was the most predominant malignancy of nonendodontic periapical lesions misdiagnosed as apical periodontitis lesions from imaging examination overlooking the clinical findings. The current data form a useful basis for clinicopathological investigation and educational teaching regarding nonendodontic periapical lesions misdiagnosed as endodontic apical periodontitis lesions.
Management of a case with misdiagnosed spinal dural arterio-venous fistula.
Lien, Chia-Yi; Lui, Chun-Chung; Lu, Cheng-Hsien; Chang, Wen-Neng
2014-03-01
Spinal dural arterio-venous fistula (SDAVF) is an uncommon and easily misdiagnosed vascular malformation. We aimed to report the diagnosis and management of a case with SDAVF. A 62-year-old man suffered from acute paraparesis about 15 months before this study. He underwent a neurosurgical procedure for herniated discs of the cervical spine at that time but there was no relief and the symptoms worsened despite the surgery. Neurologically, he had spastic paraparesis and decreased vibration sensation of the lower limbs. Spinal magnetic resonance imaging (MRI) revealed intra-medullary hyper-intensity lesion at T8 to T10 levels and tubular-like signal void structures in the corresponding posterior sub-arachnoid space. Further trans-arterial angiography through right T6 intercostal artery catheterization revealed engorged veins, thereby confirming the diagnosis of SDAVF. The patient was treated via endovascular embolization (18% Onyx, EV3TM MIT, Bonn, Germany) through spinal angiography and the results showed a marked decrease in engorged veins. After a 4-month follow-up, the patient was symptomatic but stable. Follow-up MRI showed a complete disappearance of the hyper-intensity change of the spinal cord. Spinal MR angiography did not reveal any recurrence of SDAVF. This case study demonstrated the easily misdiagnosed state of SDAVF. Serial neuroimage studies including spinal MRI, endovascular embolization through spinal angiography and MR angiography can be useful tools for its diagnostic confirmation, management and follow-up study.
Sharon, Low Y Y; Wai Hoe, N G
2016-01-01
Burr-hole drainage of chronic subdural hematomas are routine operative procedures done by neurosurgical residents. Common postoperative complications include acute epidural and/or subdural bleeding, tension pneumocephalus, intracranial hematomas and ischemic cerebral infarction. We report an interesting post-operative complication of a 'subarachnoid cyst' after burr-hole evacuation of a chronic subdural hematoma. The authors hypothesize that the 'cyst' is likely secondary to the splitting of the adjacent neomembrane within its arachnoid-brain interface by iatrogenic irrigation of the subdural space. Over time, this 'cyst' develops into an area of gliosis which eventually causes long-term scar epilepsy in the patient. As far as we are aware, this is the first complication of such a 'subarachnoid cyst' post burr-hole drainage reported in the literature.
Zhang, Xi-An; Qi, Song-Tao; Fan, Jun; Huang, Guang-Long; Peng, Jun-Xiang
2014-08-01
The aim of this study was to describe the similarity of configuration between the arachnoid complex in the posterior half of the incisural space and the Liliequist membrane. Microsurgical dissection and anatomical observation were performed in 20 formalin-fixed adult cadaver heads. The origin, distribution, and configuration of the arachnoid membranes and their relationships with the vascular structures in the posterior half of the incisural space were examined. The posterior perimesencephalic membrane and the cerebellar precentral membrane have a common origin at the tentorial edge and form an arachnoid complex strikingly resembling an inverted Liliequist membrane. Asymmetry between sides is not uncommon. If the cerebellar precentral membrane is hypoplastic on one side or both, the well-developed quadrigeminal membrane plays a prominent part in partitioning the subarachnoid space in the posterior half of the incisural space. The arachnoid complex in the posterior half of the incisural space can be regarded as an inverted Liliequist membrane. This concept can help neurosurgeons to gain better understanding of the surgical anatomy at the level of the tentorial incisura.
Ruptured pulmonary hydatid cyst: a case report.
Karimi, Maryam; Rostami, Ali; Spotin, Adel; Rouhani, Soheila
2017-09-01
Ruptured pulmonary hydatid cyst (PHC) is an important clinical problem in endemic areas to echinococcal infection. Herein we present a rare case of ruptured PHC in an adolescent boy that was misdiagnosed as pulmonary tuberculosis in local health center. When sputum specimen was stained by acid-fast staining for detection of Mycobacterium tuberculosis, hooklets of Echinococcus granulosus were observed. A simple chest X-ray showed a multilobulated mass in the lower part of the left lung. Computed tomography scan verified existence of thick walled caviar lesion with irregular air-fluid level. The diagnosis was confirmed at the time of surgery. Misdiagnoses of PHC may even lead to irreparable damages. Therefore, accurate diagnosis is necessary to prevent severe complications.
Dandy-Walker syndrome studied by computed tomography and pneumoencephalography
DOE Office of Scientific and Technical Information (OSTI.GOV)
Masdeu, J.C.; Dobben, G.D.; Azar-Kia, B.
1983-04-01
Based on air studies, some authors have disputed the ability of computed tomography (CT) to diagnose posterior fossa cysts. The authors correlated the pneumoencephalographic, CT, and pathological findings in 4 patients with classic Dandy-Walker syndrome. Three cases had been misdiagnosed as retrocerebellar arachnoid cysts because the fourth ventricle was incorrectly considered normal on brow-up or erect air studies, reflecting the inability of such studies to evaluate an agenetic vermis and deficient posterior medullary velum which are characteristic of Dandy-Walker malformation. Careful correlation with autopsy findings showed that even with complete agenesis of the inferior vermis, if the slit between themore » cerebellar hemispheres is narrow, the fourth ventricle could be misinterpreted as normal on pneumoencephalography and sagittal CT. Radionuclide studies, a small amount of air, or metrizamide may be needed to determine whether the cyst communicates with the subarachnoid space.« less
Branchial cleft or cervical lymphoepithelial cysts: etiology and management.
Glosser, Jeffrey W; Pires, Carlos Alberto S; Feinberg, Stephen E
2003-01-01
The cervical lymphoepithelial or branchial cleft cyst is a developmental cyst that has a disputed pathogenesis. The objective of this article is to provide a brief review of the literature and to define diagnostic terms related to this anomaly, as well as to describe its etiology, clinical presentation and treatment. The cervical lymphoepithelial or branchial cleft cyst usually presents as a unilateral, soft-tissue fluctuant swelling that typically appears in the lateral aspect of the neck, anterior to the sternocleidomastoid muscle, and becomes clinically evident late in childhood or in early adulthood. Clinicians can diagnose the cyst with appropriate imaging to assess the extent of the lesion before definitive surgical treatment. The authors describe a patient who underwent excision of a well-encapsulated cystic structure that was diagnosed as a branchial cleft cyst. The cervical lymphoepithelial or branchial cleft cyst can be easily misdiagnosed as a parotid swelling or odontogenic infection. It is imperative that clinicians make an accurate diagnosis so that appropriate treatment (that is, surgical excision) can be performed. If the cysts are treated properly, recurrences are rare.
Idiopathic thoracic transdural intravertebral spinal cord herniation
Turel, Mazda K; Wewel, Joshua T; Kerolus, Mena G; O'Toole, John E
2017-01-01
Idiopathic spinal cord herniation is a rare and often missed cause of thoracic myelopathy. The clinical presentation and radiological appearance is inconsistent and commonly confused with a dorsal arachnoid cyst and often is a misdiagnosed entity. While ventral spinal cord herniation through a dural defect has been previously described, intravertebral herniation is a distinct entity and extremely rare. We present the case of a 70-year old man with idiopathic thoracic transdural intravertebral spinal cord herniation and discuss the clinico-radiological presentation, pathophysiology and operative management along with a review the literature of this unusual entity. PMID:29021685
The effects of blood and blood products on the arachnoid cell.
Hansen, Eric A; Romanova, Liudmila; Janson, Christopher; Lam, Cornelius H
2017-06-01
After traumatic brain injury (TBI), large amounts of red blood cells and hemolytic products are deposited intracranially creating debris in the cerebrospinal fluid (CSF). This debris, which includes heme and bilirubin, is cleared via the arachnoid granulations and lymphatic systems. However, the mechanisms by which erythrocytes and their breakdown products interfere with normal CSF dynamics remain poorly defined. The purpose of this study was to model in vitro how blood breakdown products affect arachnoid cells at the CSF-blood barrier, and the extent to which the resorption of CSF into the venous drainage system is mechanically impaired following TBI. Arachnoid cells were grown to confluency on permeable membranes. Rates of growth and apoptosis were measured in the presence of blood and lysed blood, changes in transepithelial electrical resistance (TEER) was measured in the presence of blood and hemoglobin, and small molecule permeability was determined in the presence of blood, lysed blood, bilirubin, and biliverdin. These results were directly compared with an established rat brain endothelial cell line (RBEC4) co-cultured with rat brain astrocytes. We found that arachnoid cells grown in the presence of whole or lysed erythrocytes had significantly slower growth rates than controls. Bilirubin and biliverdin, despite their low solubilities, altered the paracellular transport of arachnoid cells more than the acute blood breakdown components of whole and lysed blood. Mannitol permeability was up to four times higher in biliverdin treatments than controls, and arachnoid membranes demonstrated significantly decreased small molecule permeabilities in the presence of whole and lysed blood. We conclude that short-term (<24 h) arachnoid cell transport and long-term (>5 days) arachnoid cell viability are affected by blood and blood breakdown products, with important consequences for CSF flow and blood clearance after TBI.
SU-E-I-67: Arachnoid Cysts: The Role of the BLADE Technique
DOE Office of Scientific and Technical Information (OSTI.GOV)
Mavroidis, P; Vlachopoulou, A; Kostopoulos, S
2015-06-15
Purpose: The purpose of this study is first to show the extent by which BLADE sequences can reduce all the image artifacts and second to verify that the usefulness of this technique in certain pathological conditions is significant. Methods: In this study, fourteen consecutive patients (5 females, 9 males), who routinely underwent MRI brain examination, between 2010–2014, were selected. The applied routine protocols for brain MR examination included the following sequences: 1) T2-W FLAIR axial; 2) T2-W TSE axial; 3) T2*-W axial, 4) T1-W TSE sagittal; 5) DWI-W axial; 6) T1-W TSE axial; 7) T1-W TSE axial+contrast. In cases ofmore » cystic tumors, the T2-W FLAIR BLADE sequence was added to the protocol. All the images were evaluated independently at two separate settings with 3 weeks interval by two radiologists. The radiologists also evaluated the presence of image artifacts (motion, flow, chemical shift, Gibbs ringing). To evaluate the size of the cyst, the two radiologists compared the two techniques (conventional and BLADE) by assessing the extent of the divergence in the measurements of the cysts. Results: Regarding the extent of the cyst size, BLADE measurements were found to be more reliable than the conventional ones with the differences being statistically significant (p<0.01). The qualitative measurements indicated that the T2 FLAIR BLADE sequences were superior to the conventional T2 FLAIR with statistically significant differences (p<0.001) in the following characteristics: 1) overall image quality, 2) CSF nulling; 3) contrast at the pathology and its surrounding; 4) limits of the pathology; 5) motion artifacts; 6) flow artifacts; 7) chemical shift artifacts and 8) Gibbs ringing artifacts. Conclusion: BLADE sequence was found to decrease both flow artifacts in the temporal lobes and motion artifacts from the orbits and it is proposed for clinical use.« less
Giant ovarian cyst masquerading as a massive ascites: a case report.
Yeika, Eugene Vernyuy; Efie, Derrick Tembi; Tolefac, Paul Nkemtendong; Fomengia, Joseph Nkeangu
2017-12-19
Giant ovarian cysts are tumours of the ovary presenting with diameters greater than 10 cm. Giant ovarian cysts have become rare in recent days as they are diagnosed and managed early due to the availability of good imaging modalities. The aim of this case report is to show how a huge cystic ovarian mass can mislead the diagnosis of ascites in a postmenopausal woman. Factors associated with late presentation of giant ovarian cysts in sub-Saharan Africa have also been discussed. We present the case of a 65-year-old grand multiparous woman who was referred to our centre with a grossly distended abdomen misdiagnosed as a massive ascites. Abdominopelvic ultrasound scan revealed a right giant multiloculated ovarian cyst. She benefited from a cystectomy with an uneventful postoperative stay. Histopathology revealed mucinous cystadenoma. Large cystic ovarian tumours can present masquerading as massive ascites and misleading diagnosis as in this case report. We report this case to increase the suspicion index of a large ovarian cyst in all women presenting with massive ascites.
Nasopalatine duct cyst mimicking an endodontic periapical lesion: a case report.
Bains, Rhythm; Verma, Promila; Chandra, Anil; Tikku, A P; Singh, Nimisha
2016-01-01
Lesions of nonendodontic origin, such as nasopalatine or globulomaxillary cysts, may mimic periapical radiolucencies associated with pulpal pathosis, and incorrect diagnosis may lead to unnecessary endodontic treatment. Horizontal root fractures most commonly affect the maxillary central and lateral incisors. Prognosis depends largely on the level of fracture; fractures in the apical third have the best prognosis, and those in the cervical third have the worst. This case report discusses surgical and restorative management of a patient who had a nasopalatine cyst that had been misdiagnosed and treated as an endodontic lesion of the maxillary right central incisor as well as a midroot horizontal fracture of the adjacent lateral incisor.
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Thotakura, Amit Kumar; Marabathina, Nageswara R
2017-12-01
Acquired Chiari malformation and associated syringomyelia have been previously described following lumbar puncture/drainage, lumboperitoneal shunts, and spontaneous cerebrospinal fluid leakage. In addition to these etiologies, space-occupying lesions such as meningiomas, epidermoid cysts, medulloblastomas, and arachnoid cysts are rare causes of acquired Chiari malformation and syringomyelia. We report a rare case of colloid cyst with hydrocephalus causing secondary Chiari malformation with syringomyelia. A 58-year-old lady presented with neck pain and difficulty in walking and numbness of all 4 limbs of 1-year duration. Diagnostics with magnetic resonance imaging of the head and the cervical spine were done in the referring hospital. The patients was then referred with the diagnosis of colloid cyst with hydrocephalus and Chiari malformation 1 with cervicodorsal syringomyelia. She underwent colloid cyst excision through the transcallosal approach. Postoperatively the patient showed improvement in her symptomatology. Magnetic resonance imaging of the brain and cervical spine at 6 months' follow-up showed resolved Chiari malformation and resolving syrinx. Colloid cyst with hydrocephalus is a rare cause of secondary Chiari malformation with syringomyelia. Surgical management of the underlying lesion improves acquired Chiari malformation and associated syringomyelia. Copyright © 2017 Elsevier Inc. All rights reserved.
Unicameral bone cyst in the spinous process of a thoracic vertebra.
Tsirikos, Athanasios I; Bowen, J Richard
2002-10-01
Unicameral bone cysts affecting the spine are extremely rare and tend to be misdiagnosed. We report on a 17-year-old female patient who presented with a 2-year history of persistent low back pain. The radiographic evaluation and bone scan failed to reveal a pathologic process. Magnetic resonance of the painful area and subsequent computed tomography scan showed a well-circumscribed osteolytic lesion originating from the spinous process and extending into both laminae of T9 vertebra. Aneurysmal bone cyst or osteoblastoma was considered to be the most probable diagnosis. The patient underwent excisional biopsy of the tumor. The intraoperative findings were suggestive of solitary bone cyst, a diagnosis that was confirmed histologically. Because the tumor had not invaded the articular facets, no posterolateral spine fusion was required. The patient had an unremarkable postoperative clinical course. Her symptoms resolved and she returned to her previous level of physical activities. Unicameral bone cysts, although uncommon, should be included in the differential diagnosis of an osteolytic lesion involving the spine.
Minimally invasive computer-assisted stereotactic fenestration of an aqueductal cyst: case report.
Fonoff, E T; Gentil, A F; Padilha, P M; Teixeira, M J
2010-02-01
Current advances in frame modeling and computer software allow stereotactic procedures to be performed with great accuracy and minimal risk of neural tissue or vascular injury. In this report we associate a previously described minimally invasive stereotactic technique with state-of-the-art 3D computer guidance technology to successfully treat a 55-year-old patient with an arachnoidal cyst obstructing the aqueduct of Sylvius. We provide detailed technical information and discuss how this technique deals with previous limitations for stereotactic manipulation of the aqueductal region. We further discuss current advances in neuroendoscopy for treating obstructive hydrocephalus and make comparisons with our proposed technique. We advocate that this technique is not only capable of treating this pathology but it also has the advantages to enable reestablishment of physiological CSF flow thus preventing future brainstem compression by cyst enlargement. (c) Georg Thieme Verlag KG Stuttgart . New York.
Branchial cysts within the parotid salivary gland
2012-01-01
Cystic lesions within the parotid gland are uncommon and clinically they are frequently misdiagnosed as tumours. Many theories have been proposed as to their embryological origin. A 20-year retrospective review was undertaken of all pathological codes (SNOMED) of all of patients presenting with any parotid lesions requiring surgery. After analysis seven subjects were found to have histopathologically proven parotid branchial cysts in the absence of HIV infection and those patients are the aim of this review. Four of the most common embryological theories are also discussed with regard to these cases, as are their management. PMID:22607735
Aneurysmal Bone Cysts of the Spine: Two Case Reports
Ozdemir, Seymen; Ozden, Ferhat; Kacira, Ozlem Kitiki; Kacira, Tibet
2014-01-01
Aneurysmal bone cysts are rare entities which causes expansile and destructive bone lesions characterized by reactive proliferation of connective tissue. They usually grow rapidly with hypervascularity. In clinical practice they can be easily misdiagnosed due to the rare occurance and having no such typical findings as radiologically. Most cases have uncommon pain symptoms, but rarely, if fractures occur, neurological findings can be seen and the surgical treatment, if needed, could be difficult. We will discuss our evaluations to two cases that we experienced in our clinic in this report. PMID:25620988
Aneurysmal bone cysts of the spine: two case reports.
Ozdemir, Seymen; Yaldiz, Can; Ozden, Ferhat; Kacira, Ozlem Kitiki; Kacira, Tibet
2014-12-01
Aneurysmal bone cysts are rare entities which causes expansile and destructive bone lesions characterized by reactive proliferation of connective tissue. They usually grow rapidly with hypervascularity. In clinical practice they can be easily misdiagnosed due to the rare occurance and having no such typical findings as radiologically. Most cases have uncommon pain symptoms, but rarely, if fractures occur, neurological findings can be seen and the surgical treatment, if needed, could be difficult. We will discuss our evaluations to two cases that we experienced in our clinic in this report.
Ultrastructural characteristics of the cranial dura mater-arachnoid interface layer.
Angelov, D N
1990-01-01
The ultrastructural features of the encephalic dura mater-arachnoid borderline (interface) layer (zone) of rats, rabbits, cats and humans were studied. The rat's interface zone included the electron-lucent epithelium-like arranged fibroblasts of the inner dural layer, the rich in filaments cells of the dural neurothelium, a 20 nm wide intercellular cleft filled with electron-dense material and the dark mitochondria-rich cells of the outer arachnoidal layer; in rabbits and cats, this laminar distinction was less prominent, while in man, it was almost absent.
Minimally Invasive Treatment for a Sacral Tarlov Cyst Through Tubular Retractors.
Del Castillo-Calcáneo, Juan D; Navarro-Ramírez, Rodrigo; Nakhla, Jonathan; Kim, Eliana; Härtl, Roger
2017-12-01
Tarlov cysts (TC) are focal dilations of arachnoid and dura mater of the spinal posterior nerve root sheath that appear as cystic lesions of the nerve roots typically in the lower spine, especially in the sacrum, which can cause radicular symptoms when they increase in size and compress the nerve roots. Different open procedures have been described to treat TCs, but no minimally invasive procedures have been described to effectively address this pathology. A 29-year-old woman presented with right lower extremity pain and weakness. A magnetic resonance imaging scan demonstrated a lumbosacral TC that protruded through the right L5-S1 foramina. Through a small laminotomy, cyst drainage followed by neck ligation using a Scanlan modified technique through tubular retractors was performed. The patient recovered full motor function within the first days postoperatively and showed no signs of relapse at 6-month follow-up. Minimally invasive spine surgery through tubular retractors can be safely performed for successful excision and ligation of TC using a Scanlan modified technique. Copyright © 2017 Elsevier Inc. All rights reserved.
Electron Microscopy of Dural and Arachnoid Disruptions After Subarachnoid Block.
Reina, Miguel Angel; Puigdellívol-Sánchez, Anna; Gatt, Stephen P; De Andrés, José; Prats-Galino, Alberto; van Zundert, André
It has been customary to attribute postdural puncture headache (PDPH) incidence and severity to size and nature of the dural hole produced during major neuraxial blockade or diagnostic dural puncture. Needle orientation in relation to the direction of dural fibers was thought to be of importance because of the propensity for horizontal bevel placement to cause cutting rather than splitting of the dural fibers. In vitro punctures of stringently quality-controlled human dural sac specimens were obtained with 27-gauge (27G) Whitacre needle (n = 33), with 29G Quincke used parallel to the spinal axis (n = 30), and with 29G Quincke in perpendicular approach (n = 40). The samples were studied with a scanning electron microscope, and the perimeter, appearance, and area (%) of the lesion were calculated. When using small 27G to 29G needles, neither needle tip characteristics nor needle orientation had a substantial bearing on the damage to dural fibers in the dural lesion. Of ultimate importance was the characteristic and size of the hole in the arachnoid. Arachnoid layer lesions produced by different types of spinal needles were not markedly different. Accepted theories of the etiology of PDPH need to be revised. This article marks the first time that arachnoid layer damage has been quantified. Dural fibers tend to have sufficient "memory" to close back the hole created by a spinal needle, whereas arachnoid has diminished capacity to do so. The pathogenesis of PDPH and its resolution algorithm are a far more complex process that involves many more "stages" of development than hitherto imagined.
Cranial nerve VI palsy after dural-arachnoid puncture.
Hofer, Jennifer E; Scavone, Barbara M
2015-03-01
In this article, we provide a literature review of cranial nerve (CN) VI injury after dural-arachnoid puncture. CN VI injury is rare and ranges in severity from diplopia to complete lateral rectus palsy with deviated gaze. The proposed mechanism of injury is cerebrospinal fluid leakage causing intracranial hypotension and downward displacement of the brainstem. This results in traction on CN VI leading to stretch and neural demyelination. Symptoms may present 1 day to 3 weeks after dural-arachnoid puncture and typically are associated with a postdural puncture (spinal) headache. Resolution of symptoms may take weeks to months. Use of small-gauge, noncutting spinal needles may decrease the risk of intracranial hypotension and subsequent CN VI injury. When ocular symptoms are present, early administration of an epidural blood patch may decrease morbidity or prevent progression of ocular symptoms.
Hendrix, Philipp; Senger, Sebastian; Griessenauer, Christoph J; Simgen, Andreas; Linsler, Stefan; Oertel, Joachim
2018-01-01
To report a technique for endoscopic cystoventriculostomy guided by preoperative navigated transcranial magnetic stimulation (nTMS) and tractography in a patient with a large speech eloquent arachnoid cyst. A 74-year old woman presented with a seizure and subsequent persistent anomic aphasia from a progressive left-sided parietal arachnoid cyst. An endoscopic cystoventriculostomy and endoscope-assisted ventricle catheter placement were performed. Surgery was guided by preoperative nTMS and tractography to avoid eloquent language, motor, and visual pathways. Preoperative nTMS motor and language mapping were used to guide tractography of motor and language white matter tracts. The ideal locations of entry point and cystoventriculostomy as well as trajectory for stent-placement were determined preoperatively with a pseudo-3-dimensional model visualizing eloquent language, motor, and visual cortical and subcortical information. The early postoperative course was uneventful. At her 3-month follow-up visit, her language impairments had completely recovered. Additionally, magnetic resonance imaging demonstrated complete collapse of the arachnoid cyst. The combination of nTMS and tractography supports the identification of a safe trajectory for cystoventriculostomy in eloquent arachnoid cysts. Copyright © 2017 Elsevier Inc. All rights reserved.
Josephson, A; Greitz, D; Klason, T; Olson, L; Spenger, C
2001-03-01
Spinal cord cysts are a devastating condition that occur secondary to obstructions of the spinal canal, which may be caused by congenital malformations, trauma, spinal canal stenosis, tumors, meningitis, or arachnoiditis. A hypothesis that could explain how spinal cord cysts form in these situations has been presented recently. Therefore, a novel spinal thecal sac constriction model was implemented to test various aspects of this hypothesis. Thecal sac constriction was achieved by subjecting rats to an extradural silk ligature at the T8 spinal cord level. Rats with complete spinal cord transection served as a second model for comparison. The animals underwent high-resolution magnetic resonance imaging and histological analysis. Thecal sac constriction caused edema cranial and caudal to the ligation within 3 weeks, and cysts developed after 8 to 13 weeks. In contrast, cysts in rats with spinal cord transection were located predominantly in the cranial spinal cord. Histological sections of spinal cords confirmed the magnetic resonance imaging results. Magnetic resonance imaging provided the specific advantage of enabling characterization of events as they occurred repeatedly over time in the spinal cords of individual living animals. The spinal thecal sac constriction model proved useful for investigation of features of the cerebrospinal fluid pulse pressure theory. Edema and cyst distributions were in accordance with this theory. We conclude that induced intramedullary pressure gradients originating from the cerebrospinal fluid pulse pressure may underlie cyst formation in the vicinity of spinal canal obstructions and that cysts are preceded by edema.
Pediatric abdominal radiograph use, constipation, and significant misdiagnoses.
Freedman, Stephen B; Thull-Freedman, Jennifer; Manson, David; Rowe, Margot Follett; Rumantir, Maggie; Eltorki, Mohamed; Schuh, Suzanne
2014-01-01
To determine the proportion of children diagnosed with constipation assigned a significant alternative diagnosis within 7 days (misdiagnosis), if there is an association between abdominal radiograph (AXR) performance and misdiagnosis, and features that might identify children with misdiagnoses. We conducted a retrospective cohort study of consecutive children <18 years who presented to a pediatric emergency department in Toronto, between 2008 and 2010. Children assigned an International Statistical Classification of Diseases and Related Health Problems 10th Revision code consistent with constipation were eligible. Misdiagnosis was defined as an alternative diagnosis during the subsequent 7 days that resulted in hospitalization or an outpatient procedure that included a surgical or radiologic intervention. Constipation severity was classified employing text word categorization and the Leech score. 3685 eligible visits were identified. Mean age was 6.6 ± 4.4 years. AXR was performed in 46% (1693/3685). Twenty misdiagnoses (0.5%; 95% CI 0.4, 0.8) were identified (appendicitis [7%], intussusception [2%, bowel obstruction [2%], other [9%]). AXR was performed more frequently in misdiagnosed children (75% vs 46%; P = .01). These children more often had abdominal pain (70% vs 49%; P = .04) and tenderness (60% vs 32%; P =.01). Children in both groups had similar amounts of stool on AXR (P = .38) and mean Leech scores (misdiagnosed = 7.9 ± 3.4; not misdiagnosed = 7.7 ± 2.9; P = .85). Misdiagnoses in children with constipation are more frequent in those in whom an AXR was performed and those with abdominal pain and tenderness. The performance of an AXR may indicate diagnostic uncertainty; in such cases, the presence of stool on AXR does not rule out an alternative diagnosis. Copyright © 2014 Mosby, Inc. All rights reserved.
Gao, Zhen-Hua; Yin, Jun-Qiang; Liu, Da-Wei; Meng, Quan-Fei; Li, Jia-Ping
2013-12-11
To describe the clinical, imaging, and pathologic characteristics and diagnostic methods of telangiectatic osteosarcoma (TOS) for improving the diagnostic level. The authors retrospectively reviewed patient demographics, serum alkaline phosphatase (AKP) levels, preoperative biopsy pathologic reports, pathologic materials, imaging findings, and treatment outcomes from 26 patients with TOS. Patient images from radiography (26 cases) and magnetic resonance (MR) imaging (22 cases) were evaluated by 3 authors in consensus for intrinsic characteristics. There were 15 male and 11 female patients in the study, with an age of 9-32 years (mean age 15.9 years). Eighteen of 26 patients died of lung metastases within 5 years of follow-up. The distal femur was affected more commonly (14 cases, 53.8%). Regarding serum AKP, normal (8 cases) or mildly elevated (18 cases) levels were found before preoperative chemotherapy. Radiographs showed geographic bone lysis without sclerotic margin (26 cases), cortical destruction (26 cases), periosteal new bone formation (24 cases), soft-tissue mass (23 cases), and matrix mineralization (4 cases). The aggressive radiographic features of TOS simulated the appearance of conventional high-grade intramedullary osteosarcoma, though different from aneurysmal bone cyst. MR images demonstrated multiple big (16 cases) or small (6 cases) cystic spaces, fluid-fluid levels (14 cases), soft-tissue mass (22 cases), and thick peripheral and septal enhancement (22 cases). Nine of 26 cases were misdiagnosed as aneurysmal bone cysts by preoperative core-needle biopsy, owing to the absence of viable high-grade sarcomatous cells in the small tissue samples. The aggressive growth pattern with occasional matrix mineralization, and multiple big or small fluid-filled cavities with thick peripheral, septal, and nodular tissue surrounding the fluid-filled cavities are characteristic imaging features of TOS, and these features are helpful in making the correct
Gao, Zhen-Hua; Yin, Jun-Qiang; Liu, Da-Wei; Meng, Quan-Fei
2013-01-01
Abstract Purpose: To describe the clinical, imaging, and pathologic characteristics and diagnostic methods of telangiectatic osteosarcoma (TOS) for improving the diagnostic level. Materials and methods: The authors retrospectively reviewed patient demographics, serum alkaline phosphatase (AKP) levels, preoperative biopsy pathologic reports, pathologic materials, imaging findings, and treatment outcomes from 26 patients with TOS. Patient images from radiography (26 cases) and magnetic resonance (MR) imaging (22 cases) were evaluated by 3 authors in consensus for intrinsic characteristics. There were 15 male and 11 female patients in the study, with an age of 9–32 years (mean age 15.9 years). Results: Eighteen of 26 patients died of lung metastases within 5 years of follow-up. The distal femur was affected more commonly (14 cases, 53.8%). Regarding serum AKP, normal (8 cases) or mildly elevated (18 cases) levels were found before preoperative chemotherapy. Radiographs showed geographic bone lysis without sclerotic margin (26 cases), cortical destruction (26 cases), periosteal new bone formation (24 cases), soft-tissue mass (23 cases), and matrix mineralization (4 cases). The aggressive radiographic features of TOS simulated the appearance of conventional high-grade intramedullary osteosarcoma, though different from aneurysmal bone cyst. MR images demonstrated multiple big (16 cases) or small (6 cases) cystic spaces, fluid-fluid levels (14 cases), soft-tissue mass (22 cases), and thick peripheral and septal enhancement (22 cases). Nine of 26 cases were misdiagnosed as aneurysmal bone cysts by preoperative core-needle biopsy, owing to the absence of viable high-grade sarcomatous cells in the small tissue samples. Conclusion: The aggressive growth pattern with occasional matrix mineralization, and multiple big or small fluid-filled cavities with thick peripheral, septal, and nodular tissue surrounding the fluid-filled cavities are characteristic imaging features of
Branchial cleft cyst at an unusual location: a rare case with a brief review
Panchbhai, A S; Choudhary, M S
2012-01-01
A branchial cleft cyst (BCC) commonly presents as a solitary, painless mass in the neck of a child or young adult. They are most commonly located along the anterior border and the upper third of the sternocleidomastoid muscle in the anterior triangle of the neck. It is very rare for a BCC to manifest in other locations, especially in the posterior triangle of the neck. BCCs are believed to be derived from the branchial apparatus, mostly from the second branchial arch, although many theories have been proposed to explain the aetiology of BCCs. It is possible for BCCs to be easily misdiagnosed as other swellings of oral or paraoral origin owing to their location. Intraoral lymphoepithelial cysts have also been reported in the literature. It is imperative that clinicians make an accurate diagnosis so that appropriate treatment can be performed. If the cysts are excised properly, recurrence is rare. A rare case report of BCC arising in the neck from an unusual location with components in the posterior triangle is presented here. PMID:22116133
Surgical treatment of parapontine epidermoid cysts presenting with trigeminal neuralgia.
Guo, Zhilin; Ouyang, Huoniu; Cheng, Zhihua
2011-03-01
We retrospectively reviewed the management of 49 patients with parapontine epidermoid cyst presenting with trigeminal neuralgia, emphasizing the importance of fully removing the tumor to relieve the trigeminal neuralgia. Clinical symptoms, MRI, the operative approach, and post-operative results were examined. Trigeminal neuralgia was noted in all patients. The mean duration from onset of symptoms to surgery was 18 months. Total removal was achieved in 23 patients, near-total removal in 21, and subtotal removal in five patients. However, all tumor capsule that adhered to the trigeminal nerve was completely removed. After the operation, 33 patients developed facial hypoesthesia, three complained of double vision, and two developed acute hydrocephalus. At six months of follow-up, all patients had recovered and returned to their normal lives. At 2 years of follow-up, one patient experienced pain recurrence and underwent another operation. Parapontine epidermoid cysts either encase cranial nerve (CN) V but with intact arachnoid between the capsule and the nerve, or compress and distort the nerve with tumor capsule adherent or attached to the nerve surface. Resecting the tumor capsule's attachment to CN V is critical in relieving pain, even though this method may damage the nerve. Copyright © 2010 Elsevier Ltd. All rights reserved.
Kim, Juyoung; Park, Daehyun; Han, Won Bo; Jeong, Hyangjin; Park, Youngse
2014-07-01
Torsion of uterine adnexa is an important cause of acute abdominal pain in females. The main organ which can cause torsion is the ovaries, but torsions of the fallopian tube, subserosal myoma, paratubal cyst, and even the uterine body have been reported. The incidence of isolated fallopian tubal torsion is very rare. Even more rarely, it can coil around nearby organs such as the utero-ovarian ligament, showing similar clinical manifestations with those of adnexal torsion. We experienced an extremely rare case of acute abdomen induced by ovarian congestion triggered by the fallopian tube accompanying a paratubal cyst coiling around the utero-ovarian ligament. The right paratubal cyst was misinterpreted as being part of a cystic component of the left ovary on preoperative sonographic examination, and the coiling of the right fallopian tube accompanying the paratubal cyst was misdiagnosed as torsion of the right ovary. We report this rare case with a brief literature review.
Kim, Juyoung; Park, Daehyun; Han, Won Bo; Jeong, Hyangjin
2014-01-01
Torsion of uterine adnexa is an important cause of acute abdominal pain in females. The main organ which can cause torsion is the ovaries, but torsions of the fallopian tube, subserosal myoma, paratubal cyst, and even the uterine body have been reported. The incidence of isolated fallopian tubal torsion is very rare. Even more rarely, it can coil around nearby organs such as the utero-ovarian ligament, showing similar clinical manifestations with those of adnexal torsion. We experienced an extremely rare case of acute abdomen induced by ovarian congestion triggered by the fallopian tube accompanying a paratubal cyst coiling around the utero-ovarian ligament. The right paratubal cyst was misinterpreted as being part of a cystic component of the left ovary on preoperative sonographic examination, and the coiling of the right fallopian tube accompanying the paratubal cyst was misdiagnosed as torsion of the right ovary. We report this rare case with a brief literature review. PMID:25105111
Uçar, Murat; Karagözlü Akgül, Ahsen; Çelik, Fatih; Kılıç, Nizamettin
2016-08-01
Cystic echinococcosis, which is one of the most important helminthic infestations, is a serious life-threatening health problem in developing countries. Hydatid cyst of the kidney is a rare condition in children that can be treated with medical therapy or surgical treatment in some resistant cases. Here, we present a case of renal hydatid cyst that was treated with laparoscopic excision with diode laser. A 15-year-old female patient was admitted with abdominal pain. Abdominal ultrasonography revealed a 32 × 23 × 19-mm solid mass with cystic component at lower pole of right kidney. An indirect hemagglutination (IHA) test for echinococcosis granulosus was positive at a 1:320 titer. Other laboratory tests were within normal limits. The patient received albendazole therapy for 3 months. The follow-up magnetic resonance imaging showed a solitary lesion with exophytic extensions that contained large separations. No contrast enhancement could be detected after gadolinium injection. As no regression could be detected radiologically, surgical treatment was planned. Laparoscopic renal lower pole mass cyst excision with diode laser was performed (Figure). The patient was hospitalized for 1 day without any blood transfusion. Histopathological examination was consistent with hydatid cyst of the kidney. Diagnosis of hydatid cyst of the kidney is generally made incidentally and can be misdiagnosed as a primary kidney tumor. Radiological studies may be insufficient for accurate diagnosis. In our case, laparoscopic excision of cyst and histopathological examination confirmed the diagnosis of cyst hydatid. At the postoperative second month the ultrasonography of kidneys were normal. For patients from endemic areas, hydatid cyst should always be included in the differential diagnosis. Laparoscopic excision of renal hydatid cysts with diode laser is a feasible and safe technique for resistant cases. Copyright © 2016 Journal of Pediatric Urology Company. Published by Elsevier
Shono, Naoyuki; Kin, Taichi; Nomura, Seiji; Miyawaki, Satoru; Saito, Toki; Imai, Hideaki; Nakatomi, Hirofumi; Oyama, Hiroshi; Saito, Nobuhito
2018-05-01
A virtual reality simulator for aneurysmal clipping surgery is an attractive research target for neurosurgeons. Brain deformation is one of the most important functionalities necessary for an accurate clipping simulator and is vastly affected by the status of the supporting tissue, such as the arachnoid membrane. However, no virtual reality simulator implementing the supporting tissue of the brain has yet been developed. To develop a virtual reality clipping simulator possessing interactive brain deforming capability closely dependent on arachnoid dissection and apply it to clinical cases. Three-dimensional computer graphics models of cerebral tissue and surrounding structures were extracted from medical images. We developed a new method for modifiable cerebral tissue complex deformation by incorporating a nonmedical image-derived virtual arachnoid/trabecula in a process called multitissue integrated interactive deformation (MTIID). MTIID made it possible for cerebral tissue complexes to selectively deform at the site of dissection. Simulations for 8 cases of actual clipping surgery were performed before surgery and evaluated for their usefulness in surgical approach planning. Preoperatively, each operative field was precisely reproduced and visualized with the virtual brain retraction defined by users. The clear visualization of the optimal approach to treating the aneurysm via an appropriate arachnoid incision was possible with MTIID. A virtual clipping simulator mainly focusing on supporting tissues and less on physical properties seemed to be useful in the surgical simulation of cerebral aneurysm clipping. To our knowledge, this article is the first to report brain deformation based on supporting tissues.
Spinal extradural cyst: A case report and review of literature.
Lee, Sean Wy; Foo, Aaron; Tan, Char Loo; Tan, Thomas; Lwin, Sein; Yeo, Tseng Tsai; Nga, Vincent Dw
2018-06-02
Spinal extradural cyst (SEDC) accounts for less than 1% of spinal epidural lesions. It is commonly asymptomatic but can give rise to back pain and compressive neurological symptoms. We report the case of a 51-year-old male who presented with gait difficulties over five months associated with occasional urge incontinence. Clinical examination revealed signs suggestive of thoracic myelopathy with bilateral lower limbs spasticity, decreased proprioception and pin prick sensation. MRI showed a Thoracic (T) 7-T9 extradural cystic lesion with an area of flow void on the right side between T8 and T9. A right hemilaminotomy was initially performed, dural defect identified and repaired primarily. Unfortunately, there was a recurrence of the SEDC 2 weeks post-operation and a T7-T9 laminoplasty with complete excision was performed. Computer-tomography (CT) myelography or MRI flow study best visualises the communication between the epidural cyst and sub-arachnoid space. The ideal surgical management for SEDC remains controversial. Our case suggests that there may be higher recurrence associated with fenestration of the SEDC and closure of the dural defect, but perhaps higher complications associated with complete excision. We present a case report and literature review of the terminology, presentation, recommended investigations, management and outcomes of patients with SEDC. Copyright © 2018 Elsevier Inc. All rights reserved.
Takayasu arteritis in childhood: misdiagnoses at disease onset and associated diseases.
Clemente, Gleice; Silva, Clovis A; Sacchetti, Silvana B; Ferriani, Virginia P L; Oliveira, Sheila K; Sztajnbok, Flavio; Bica, Blanca E R G; Cavalcanti, André; Robazzi, Teresa; Bandeira, Marcia; Terreri, Maria Teresa
2018-06-01
Juvenile-Takayasu arteritis (j-TA) is a difficult diagnosis and some patients develop uncommon manifestations and associated diseases that may contribute to the delayed diagnosis. Our aim was to identify the misdiagnoses, the associated diseases and the atypical manifestations observed in a j-TA Brazilian multicentre study. 71 children and adolescents who met the classification criteria for j-TA were included. The misdiagnoses, the associated diseases and the atypical manifestations were evaluated. 19 (26.8%) patients had misdiagnoses. The most common of them was aortic coarctation in six (8.4%) patients, followed by rheumatic fever in five (7.0%) and one patient presented with both former diagnoses. Limb pain (two patients), spondyloarthropathy, juvenile idiopathic arthritis (JIA), spinal arteriovenous malformation, polyarteritis nodosa (PAN) and fever of unknown origin (FUO) were other misdiagnoses. Patients who had misdiagnoses previously to j-TA diagnosis presented a trend to have a longer diagnosis delay. 11 (15.5%) patients had 14 TA-associated diseases, such as pulmonary tuberculosis (5 patients), rheumatic fever (2 patients), spondyloarthropathy, polyarticular JIA, Crohn's disease, Prader-Willi disease, diabetes mellitus, Moyamoya and primary immunodeficiency. 7 (9.9%) patients presented 10 atypical manifestations, such as pyoderma gangrenosum, erythema nodosum, myositis, chorea, enthesitis, episcleritis, uveitis, hepatomegaly, splenomegaly and necrosis of extremities. Our study emphasizes the main misdiagnoses, associated diseases and atypical manifestations that occur in patients with j-TA and warns of the features that may alert paediatricians to this diagnosis, such as constitutional symptoms and elevated inflammatory markers.
Lee, Jae Ho; Jeon, Ikchan; Kim, Sang Woo
2017-01-01
Capillary hemangiomas are common benign vascular tumors on skin and soft tissues, but developing as an intradural and extramedullary (IDEM) tumor in spine is extremely rare. In this report, we present IDEM tumor compressing thoracic cord in T2–3 level with extensive arachnoiditis below the tumor level in a 60-year-old man. The lesion was removed and histological diagnosis was capillary hemangioma. Prompt diagnosis and resection are important to avoid neurological deterioration from acute hemorrhagic condition. Simultaneous arachnoiditis may be originated from old subarachnoid hemorrhage associated tumor before diagnosis, and we suggest it as a helpful diagnostic feature to suspect vascular tumors such as capillary hemangioma. PMID:28704911
Lee, Jae Ho; Jeon, Ikchan; Kim, Sang Woo
2017-06-01
Capillary hemangiomas are common benign vascular tumors on skin and soft tissues, but developing as an intradural and extramedullary (IDEM) tumor in spine is extremely rare. In this report, we present IDEM tumor compressing thoracic cord in T2-3 level with extensive arachnoiditis below the tumor level in a 60-year-old man. The lesion was removed and histological diagnosis was capillary hemangioma. Prompt diagnosis and resection are important to avoid neurological deterioration from acute hemorrhagic condition. Simultaneous arachnoiditis may be originated from old subarachnoid hemorrhage associated tumor before diagnosis, and we suggest it as a helpful diagnostic feature to suspect vascular tumors such as capillary hemangioma.
Primary lacrimal canaliculitis - A clinical entity often misdiagnosed.
Singh, Manpreet; Gautam, Natasha; Agarwal, Aniruddha; Kaur, Manpreet
2018-03-01
Primary lacrimal canaliculitis (PLC) is a unique disorder which often gets misdiagnosed by the general as well as speciality-trained ophthalmologists. Elderly patients with history of chronic or recurrent epiphora with discharge, often get mislead towards chronic dacryocystitis. The aim of our report is to discuss the misleading diseases in our PLC patients and to revisit this hidden disease. The patients of PLC who were previously misdiagnosed were studied. The clinical history, presenting clinical features, misdiagnosis, and final management of the patients is described. There were 5 misdiagnosed female patients. A history of chronic redness, watering, discharge, and medial canthal region edema lead to the misdiagnosis of chronic dacryocystitis in 3 (60%) and medial marginal chalazion in 2 (40%) cases. Slit-lamp examination revealed localized hyperemia (n = 5), classical pouting of lacrimal punctum (n = 3), and expressible purulent discharge (n = 3). Two patients without punctum pouting had an explicit yellowish hue/discoloration of the canalicular region. Our patients had a mean 4 visits before an accurate diagnosis. Three-snip punctoplasty with canalicular curettage was performed in three while two were managed conservatively. At last follow-up, all patients were symptom-free with punctum and canalicular scarring in three, who underwent surgery. PLC is a frequently misdiagnosed clinical entity which delays the initiation of appropriate treatment. A succinct magnified examination of punctum and canalicular region can provide sufficient clues pivotal for accurate diagnosis.
Dura-arachnoid lesions produced by 22 gauge Quincke spinal needles during a lumbar puncture.
Reina, M A; López, A; Badorrey, V; De Andrés, J A; Martín, S
2004-06-01
The dural and arachnoid hole caused by lumbar puncture needles is a determining factor in triggering headaches. The aim of this study is to assess the dimensions and morphological features of the dura mater and arachnoids when they are punctured by a 22 gauge Quincke needle having its bevel either in the parallel or in the transverse position. Fifty punctures were made with 22 gauge Quincke needles in the dural sac of four fresh cadavers using an "in vitro" model especially designed for this purpose. The punctures were performed by needles with bevels parallel or perpendicular to the spinal axis and studied under scanning electron microscopy. Thirty five of the 50 punctures done by Quincke needles (19 in the external surface and 16 in the internal) were used for evaluation. When the needle was inserted with its bevel parallel to the axis of the dural sac (17 of 35), the size of the dura-arachnoid lesion was 0.032 mm(2) in the epidural surface and 0.037 mm(2) in the subarachnoid surface of the dural sac. When the needle's bevel was perpendicular to the axis (18 of 35) the measurement of the lesion size was 0.042 mm(2) for the external surface and 0.033 mm(2) for the internal. There were no statistical significant differences between these results. It is believed that the reported lower frequency of postdural puncture headache when the needle is inserted parallel to the cord axis should be explained by some other factors besides the size of the dura-arachnoid injury.
Minimizing Retraction by Pia-Arachnoidal 10-0 Sutures in Intrasulcal Dissection.
Uluc, Kutluay; Cikla, Ulas; Morkan, Deniz B; Sirin, Alperen; Ahmed, Azam S; Swanson, Kyle; Baskaya, Mustafa K
2018-07-01
In contemporary microneurosurgery reducing retraction-induced injury to the brain is essential. Self-retaining retractor systems are commonly used to improve visualization and decrease the repetitive microtrauma, but sometimes self-retaining retractor systems can be cumbersome and the force applied can cause focal ischemia or contusions. This may increase the morbidity and mortality. Here, we describe a technique of retraction using 10-0 sutures in the arachnoid. To evaluate the imaging and clinical results in patients where 10-0 suture retraction was used to aid the surgical procedure. Adjacent cortex was retracted by placing 10-0 nylon suture in the arachnoid of the bank or banks of the sulcus. The suture was secured to the adjacent dural edge by using aneurysm clips, allowing for easy adjustability of the amount of retraction. We retrospectively analyzed the neurological outcome, signal changes in postoperative imaging, and ease of performing surgery in 31 patients with various intracranial lesions including intracranial aneurysms, intra- and extra-axial tumors, and cerebral ischemia requiring arterial bypass. Clinically, there were no injuries, vascular events, or neurological deficits referable to the relevant cortex. Postoperative imaging did not show changes consistent with ischemia or contusion due to the retraction. This technique improved the visualization and illumination of the surgical field in all cases. Retraction of the arachnoid can be used safely in cases where trans-sulcal dissection is required. This technique may improve initial visualization and decrease the need for dynamic or static retraction.
Proliferating Myositis: An Inflammatory Lesion often Misdiagnosed as A Malignant Tumor.
Binesh, Fariba; Sobhanardekani, Mohammad; Zabihi, Somayeh; Behniafard, Nasim
2016-12-01
Proliferative myositis (PM) is a rare inflammatory disease. Most commonly, the lesion occurs in the extremities. Regarding its fast growth and bizarre shape of the cellular components this entity commonly misdiagnosed and the patients undergo improper therapeutic approaches. In other words, it is often misdiagnosed as sarcoma. The diagnosis can only be made by the microscopic examination, so biopsy is mandatory. Here the authors report a patient with PM who was initially misdiagnosed as pleomorphic sarcoma of the lower extremity and explain this rare entity. Proliferative myositis should be taken into account if a fast growing, intramuscular mass occurs in the extremities.
Dura-arachnoid lesions produced by 22 gauge Quincke spinal needles during a lumbar puncture
Reina, M; Lopez, A; Badorrey, V; De Andres, J A; Martin, S
2004-01-01
Aims: The dural and arachnoid hole caused by lumbar puncture needles is a determining factor in triggering headaches. The aim of this study is to assess the dimensions and morphological features of the dura mater and arachnoids when they are punctured by a 22 gauge Quincke needle having its bevel either in the parallel or in the transverse position. Methods: Fifty punctures were made with 22 gauge Quincke needles in the dural sac of four fresh cadavers using an "in vitro" model especially designed for this purpose. The punctures were performed by needles with bevels parallel or perpendicular to the spinal axis and studied under scanning electron microscopy. Results: Thirty five of the 50 punctures done by Quincke needles (19 in the external surface and 16 in the internal) were used for evaluation. When the needle was inserted with its bevel parallel to the axis of the dural sac (17 of 35), the size of the dura-arachnoid lesion was 0.032 mm2 in the epidural surface and 0.037 mm2 in the subarachnoid surface of the dural sac. When the needle's bevel was perpendicular to the axis (18 of 35) the measurement of the lesion size was 0.042 mm2 for the external surface and 0.033 mm2 for the internal. There were no statistical significant differences between these results. Conclusions: It is believed that the reported lower frequency of postdural puncture headache when the needle is inserted parallel to the cord axis should be explained by some other factors besides the size of the dura-arachnoid injury. PMID:15146008
Tohma, Y; Yamashima, T; Yamashita, J
1992-04-01
Cadherins are a family of intercellular glycoproteins responsible for calcium-dependent cell adhesion and are currently divided into four types: epithelial (E), neuronal (N), placental (P), and vascular (V). Since cadherins are known to be indispensable for not only morphogenesis in the embryo but also maintenance of tumor cell nest, we examined the expression of E-cadherin in 31 meningiomas (11 syncytial, 12 transitional, 8 fibroblastic) and 3 arachnoid villi by immunoblot and immunohistochemical analyses. In the immunoblot analysis, E-cadherin was detected at the main band of Mr 124,000 in all of the arachnoid villi, as well as syncytial and transitional types of meningiomas, but not in the fibroblastic type. The immunohistochemical examination showed that E-cadherin was expressed at the cell borders of syncytial and transitional types, but the expression was absent in the fibroblastic type. Immunoelectron microscopy showed that E-cadherin was localized at the intermediate junctions in arachnoid villi, while it was detected diffusely at the cell surface in meningiomas. It is suggested from these data that the expression of E-cadherin might be closely related to the differentiation and organogenesis of meningioma cells.
Gudu, Wondimu
2014-01-06
Despite global eradication efforts, female genital cutting is still deep routed practice in some parts of Asia and East Africa. The crude and unscientific natures of the practice lead to many complications. Epidermoid inclusion cysts of the vulva are one of the late complications of female genital cutting and typically present as painless cystic swellings. But clinical presentation as 'stone' containing, hard vulvar mass is reported only once in the literature and presentation with acute vulvar pain has never been documented. A 21 yrs old, Ethiopian, unmarried, lady presented with sever acute vulvar pain, discharge, and a stony hard vulvar swelling 13 years after type-III female genital cutting (infibulation). Surgical excision of the cyst, which contained two 'stones' inside it, and defibulation were done. Histopathology confirmed calcified, keratinizing epidermoid inclusion cyst of the vulva. Clinicians, in areas where female genital cutting is prevalent, should be aware of such unusual late vulvar complication of the practice which might be misdiagnosed for other solid vulvar swellings and be familiar with the appropriate management.
Prolonged delirium misdiagnosed as a mood disorder.
Cao, Fei; Salem, Haitham; Nagpal, Caesa; Teixeira, Antonio L
2017-01-01
Delirium can be conceptualized as an acute decline in cognitive function that typically lasts from hours to a few days. Prolonged delirium can also affect patients with multiple predisposing and/or precipitating factors. In clinical practice, prolonged delirium is often unrecognized, and can be misdiagnosed as other psychiatric disorders. We describe a case of a 59-year-old male presenting with behavioral and cognitive symptoms that was first misdiagnosed as a mood disorder in a general hospital setting. After prolonged delirium due to multiple factors was confirmed, the patient was treated accordingly with symptomatic management. He evolved with progressive improvement of his clinical status. Early diagnosis and management of prolonged delirium are important to improve patient prognosis and avoid iatrogenic measures.
Turner, Michael S; Nguyen, Ha Son; Payner, Troy D; Cohen-Gadol, Aaron A
2011-07-01
Posterior fossa cysts are usually divided into Dandy-Walker malformations, arachnoid cysts, and isolated and/or trapped fourth ventricles. Shunt placement is a mainstay treatment for decompression of these fluid collections when their expansion becomes symptomatic. Although several techniques to drain symptomatic posterior fossa cysts have been described, each method carries its own advantages and disadvantages. This article describes an alternative technique. In 10 patients, the authors used an alternative technique involving stereotactic and endoscopic methods to place a catheter in symptomatic posterior fossa cysts across the tentorium. Discussion of these cases is included, along with a review of various approaches to shunt placement in this region and recommendations regarding the proposed technique. No patient suffered intracranial hemorrhage related to the procedure and catheter implantation. All 3 patients who underwent placement of a new transtentorial cystoperitoneal shunt and a new ventriculoperitoneal shunt did not suffer any postoperative complication; a decrease in the size of their posterior fossa cysts was evident on CT scans obtained during the 1st postoperative day. Follow-up CT scans demonstrated either stable findings or further interval decrease in the size of their cysts. In 1 patient, the postoperative head CT demonstrated that the transtentorial catheter terminated posterior to the right parietal occipital region without entering the retrocerebellar cyst. This patient underwent a repeat operation for proximal shunt revision, resulting in an acceptable catheter implantation. The patient in Case 8 suffered from a shunt infection and subsequently underwent hardware removal and aqueductoplasty with stent placement. The patient in Case 9 demonstrated a slight increase in fourth ventricle size and was returned to the operating room. Exploration revealed a kink in the tubing connecting the distal limb of the Y connector to the valve. The Y
Karaaslan, Burak; Ülkü, Göktuğ; Ucar, Murat; Demirdağ, Tuğba Bedir; İnan, Arda; Börcek, Alp Özgün
2016-11-01
Dermoid cysts are benign lesions which contain epidermal and dermal elements. Dermoid cysts usually contain a dermal sinus tract but this is not mandatory. Dermoid cysts can manifest by spinal cord infection without a dermal sinus tract. An infected spinal dermoid cyst associated with a holocord spinal abscess poses diagnostic and surgical challenges. Although radical surgical drainage is considered as the main treatment modality for spinal abscess, less extensive surgery for microbiological sampling and appropriate antibiotic treatment can be another alternative modality. A 1-year-old boy patient was admitted to our hospital with progressive paraplegia, bladder dysfunction, and neck rigidity. Medical history of the patient included recurrent urinary tract infection and cephalosporin treatments several times. Initial neurological examination revealed confusion, fever, neck rigidity, paraplegia (also, the motor power of the right upper extremity was three fifths that of the upper extremities). He had urinary and gastrointestinal retention. Conservative surgery was performed to take pathological and microbiological samples. With appropriate antibiotic regimen, the nuchal rigidity and fever improved dramatically. Infectious parameters in blood biochemistry significantly decreased after the antibiotic regimen. Holocord spinal abscesses are a rare entity. The source of the disease can be hemopoietic spread or contagious spread. The dermal sinus tract is major risk factor for contagious spread. The major hemopoietic sources are urogenital infection, endocarditis, and infective lung diseases. The hemopoietic spread is a more common source for pediatric patients. The thoracolumbar region is the most common site of involvement. Spinal infection has a tendency to extend longitudinally throughout spinal fibers. The pathogenesis of the holocord edema or syrinx is uncertain. The underlying etiology may be inflammation, infection, and associated venous congestion within the
Ciappetta, Pasqualino; Pescatori, Lorenzo
2017-12-01
The anatomy of the arachnoid membranes and cisternal spaces around the pituitary stalk has not been yet exhaustively described and understood. In this study, we performed a detailed anatomic study on fresh, non-formalin-fixed cadavers of the arachnoid membranes encircling the pituitary stalk and correlate our anatomic findings with magnetic resonance imaging (MRI). Ten fresh, non-formalin-fixed, non-silicon-injected adult cadaveric heads were analyzed in this study. The membrane and cisterns that were studied for our study were as follows: 1) the diaphragma sellae and its dural components; 2) the basal arachnoid membrane; 3) the Liliequist membrane with its diencephalic and mesencephalic portion; 4) the medial carotid membrane; 5) the chiasmatic cistern; and 6) the pituitary stalk. MRI examinations of the sellar region were performed in 15 healthy volunteers (9 men, mean age 40 years; and 6 women mean age, 37 years) to visualize the arachnoid membrane encircling the pituitary stalk. MRI examinations were performed with a 3-T unit. A 3-dimensional constructive interference in steady state pulse magnetic resonance sequence was used. All the membranes examined were visualized clearly in all the dissections performed. Their 3-dimensional organization around the pituitary stalk was clarified and confirmed by MRI. Our study gives a detailed description of the pituitary stalk arachnoid sheets on fresh, non-formalin-fixed cadavers. This technique allowed us to clearly identify a funnel-shaped arachnoid collar encircling the pituitary stalk and delimiting a distinct cisternal space belonging to the stalk itself. Copyright © 2017 Elsevier Inc. All rights reserved.
Imaging characteristics of cervical spine extra-arachnoid fluid collections managed conservatively.
Lawrence, David A; Trotta, Brian; Shen, Francis H; Druzgal, Jason T; Fox, Michael G
2016-09-01
Determine the MRI characteristics of large post-traumatic cervical spine extra-arachnoid collections managed conservatively in clinically stable patients and whether evidence of clinical or imaging deterioration materialized. Following IRB approval, we conducted a retrospective search for all patients (>16 years old) over a 17-months period who had an extra-arachnoid fluid collection reported on a post-traumatic cervical spine MRI. Patients were excluded if they had surgery for an unstable fracture (n = 21), emergent decompression (n = 1) or lacked a follow-up MRI within 15 days (n = 1). Two MSK radiologists recorded the size, morphology and MRI signal characteristics of the collections. Eight patients (5 male, 3 female) met the inclusion criteria (mean age 40 years; range 19-78 years). Seven of the eight patients had fluid collections that demonstrated thin, tapered margins, extended >7 vertebral bodies and involved >180 degrees of the spinal canal. The signal characteristics of these collections varied: hyper-T1/iso-T2 (n = 1), iso-T1/T2 (n = 3), hyper-T1/hypo-T2 (n = 3) and mixed-T1/T2 (n = 1). Six of seven collections were ventral. Follow-up MRI demonstrated resolution/significant decrease in size (n = 4 between 1 and 12 days) or no change/slight decrease in size (n = 3; between 2 and 11 days). None of the seven fluid collections enlarged, no patient had abnormal cord signal, and no patient's neurologic symptoms worsened. One of eight patients had a dorsal "mass-like" collection that was slightly smaller 9 days later. In stable patients with large, tapered post-traumatic cervical spine extra-arachnoid collections managed non-surgically, none developed (1) clinical worsening, (2) abnormal cord signal or (3) collection enlargement, regardless of the collection's signal characteristics.
Pyoderma Vegetans Misdiagnosed as Verrucous Carcinoma.
Aksu Çerman, Aslı; Aktaş, Ezgi; Kıvanç Altunay, İlknur; Demirkesen, Cuyan
2016-02-01
Pyoderma vegetans, a rare disorder of the skin, is considered a highly specific marker for inflammatory bowel disease, especially ulcerative colitis. It is clinically characterized by large verrucous plaques with elevated borders and multiple pustules. Here, the authors report the case of a 33-year-old man who was misdiagnosed as having verrucous carcinoma for 4 years.
Oral lymphoepithelial cyst: A clinicopathological study of 26 cases and review of the literature.
Sykara, Maria; Ntovas, Panagiotis; Kalogirou, Eleni-Marina; Tosios, Konstantinos I; Sklavounou, Alexandra
2017-08-01
Τo describe the clinicopathological features of 26 oral lymphoepithelial cysts (LECs) and review the literature. Twenty-six cases of oral LECs diagnosed during a 37-year period were retrospectively collected. The patients' gender and age, as well as the main clinical features of the cysts were retrieved from the requisition forms. The main microscopic features were recorded after reevaluation of all cases. Pubmed and Google Scholar electronic databases were searched with the key word "oral LEC". Inclusion criteria were the microscopic confirmation of LEC diagnosis and the report at least two of three main clinical features (gender, age and cyst's location). The 26 oral LECs represented 0.08% of 31,564 biopsies accessioned during the study period. They affected 25 patients, 14 females and 11 males with a mean age of 33.04±9.81 years. They appeared as smooth (92%) nodules, with soft (24%) or firm (76%) consistency and normal (28%), yellow to normal (20%), yellow (32%) or white (20%) hue, in the tongue (69.23%) or the floor of mouth (30.77%). They were covered by parakeratinized squamous (92.31%) or non-keratinized (7.69%) epithelium and contained desquamated epithelial cells, amorphous eosinophilic material and/or inflammatory cells (100%). The lymphoid tissue surrounded the cystic cavity partially (34.62%) or completely (65.38%), often in a follicular pattern with prominent germinal centers (53.85%). Literature review yielded 316 cases of oral LECs derived from 25 case reports, 3 case studies/retrospective studies with detailed information for each case and 7 studies with summarized data. Oral LEC is a pathologic entity with discrete clinical presentation that is, however, commonly misdiagnosed in clinical practice as other, mostly benign, entities. Its pathogenesis remains obscure, as its clinicopathologic features are consistent with both theories suggested up to date. Key words: Oral lymphoepithelial cyst; developmental cyst; non odontogenic cyst; lymphoid
Orthokeratinised odontogenic cyst mimicking periapical cyst
Rajalakshmi, R; Sreeja, C; Vijayalakshmi, D; Leelarani, V
2013-01-01
Orthokeratinised odontogenic cyst (OOC) denotes the odontogenic cyst that microscopically has an orthokeratinised epithelial lining. OOC is characterised by a less-aggressive behaviour and a low rate of recurrence. This report describes a case of OOC involving posterior part of the mandible that mimicked periapical cyst in a 14-year-old boy. The initial clinical diagnosis was given as periapical cyst based on the clinical and radiographical features. Enucleation of the cyst was performed and the specimen was sent for histopathological examination. A definite diagnosis of OOC was made by histopathological examination of the biopsy specimen. This case emphases on including OOC in the differential diagnosis of radiolucencies occurring in the periapical region of non-vital tooth. PMID:24099763
Orthokeratinised odontogenic cyst mimicking periapical cyst.
Rajalakshmi, R; Sreeja, C; Vijayalakshmi, D; Leelarani, V
2013-10-07
Orthokeratinised odontogenic cyst (OOC) denotes the odontogenic cyst that microscopically has an orthokeratinised epithelial lining. OOC is characterised by a less-aggressive behaviour and a low rate of recurrence. This report describes a case of OOC involving posterior part of the mandible that mimicked periapical cyst in a 14-year-old boy. The initial clinical diagnosis was given as periapical cyst based on the clinical and radiographical features. Enucleation of the cyst was performed and the specimen was sent for histopathological examination. A definite diagnosis of OOC was made by histopathological examination of the biopsy specimen. This case emphases on including OOC in the differential diagnosis of radiolucencies occurring in the periapical region of non-vital tooth.
Simple bone cyst of mandible mimicking periapical cyst.
Hs, Charan Babu; Rai, Bhagawan Das; Nair, Manju A; Astekar, Madhusudan S
2012-05-29
Simple bone cysts (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 bone cyst mimicking a periapical cyst of a mandibular molar in a 37-year-old patient.
Simple bone cyst of mandible mimicking periapical cyst
HS, Charan Babu; Rai, Bhagawan Das; Nair, Manju A.; Astekar, Madhusudan S.
2012-01-01
Simple bone cysts (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 bone cyst mimicking a periapical cyst of a mandibular molar in a 37-year-old patient. PMID:24765458
Cho, Jung-Hae; Jung, Won-Sang; Sun, Dong-Il
2014-03-01
Lingual thyroglossal duct cysts (LTGDCs) are very rare and liable to be misdiagnosed as simple vallecular or mucus retention cysts. We recognized the importance of complete resection by means of the Sistrunk operation and applied the revised surgical technique to the treatment of LTGDCs. The aim of this study was to evaluate the results of surgical management of LTGDCs from the author's series and analyze its utility. Twelve patients, 10 male and 2 female, who were diagnosed with LTGDCs between January 2007 and December 2012, underwent endoscopic radical resection with microdissection electrodes. All cases were evaluated by enhanced CT and flexible laryngoscope before surgery. We reviewed the collected data including presentation, CT findings, surgical techniques, postoperative complication, and recurrence. Most adult LTGDCs presented with foreign body sensation, while one infant presented acute upper airway obstruction. All cysts abutted on the hyoid bone and were located at the midline of the posterior tongue. Endoscopic radical resection with microdissection electrodes was possible by dissecting hyoid periosteum without significant morbidity. All patients excluding 1 infant were not intubated electively overnight and went home the following morning. All patients showed no evidence of recurrence during follow-up. We found that the diagnosis of LTGDCs must be based on the anatomic relationship with the hyoid bone by enhanced sagittal neck CT. Endoscopic radical resection with microdissection electrodes can be recommended for reducing recurrence and morbidity by dissecting the hyoid perichondrium in the treatment of LTGDCs.
Neuroimaging findings in pediatric sports-related concussion.
Ellis, Michael J; Leiter, Jeff; Hall, Thomas; McDonald, Patrick J; Sawyer, Scott; Silver, Norm; Bunge, Martin; Essig, Marco
2015-09-01
The goal in this review was to summarize the results of clinical neuroimaging studies performed in patients with sports-related concussion (SRC) who were referred to a multidisciplinar ypediatric concussion program. The authors conducted a retrospective review of medical records and neuroimaging findings for all patients referred to a multidisciplinary pediatric concussion program between September 2013 and July 2014. Inclusion criteria were as follows: 1) age ≤ 19 years; and 2) physician-diagnosed SRC. All patients underwent evaluation and follow-up by the same neurosurgeon. The 2 outcomes examined in this review were the frequency of neuroimaging studies performed in this population (including CT and MRI) and the findings of those studies. Clinical indications for neuroimaging and the impact of neuroimaging findings on clinical decision making were summarized where available. This investigation was approved by the local institutional ethics review board. A total of 151 patients (mean age 14 years, 59% female) were included this study. Overall, 36 patients (24%) underwent neuroimaging studies, the results of which were normal in 78% of cases. Sixteen percent of patients underwent CT imaging; results were normal in 79% of cases. Abnormal CT findings included the following: arachnoid cyst (1 patient), skull fracture (2 patients), suspected intracranial hemorrhage (1 patient), and suspected hemorrhage into an arachnoid cyst (1 patient). Eleven percent of patients underwent MRI; results were normal in 75% of cases. Abnormal MRI findings included the following: intraparenchymal hemorrhage and sylvian fissure arachnoid cyst (1 patient); nonhemorrhagic contusion (1 patient); demyelinating disease (1 patient); and posterior fossa arachnoid cyst, cerebellar volume loss, and nonspecific white matter changes (1 patient). Results of clinical neuroimaging studies are normal in the majority of pediatric patients with SRC. However, in selected cases neuroimaging can provide
Nabeel, Alnaghmoosh; Lach, Boleslaw; Al-Shail, Essam; Patay, Zoltan
2005-11-01
We describe the clinical, radiological and pathological findings of concurrent, congenital leptomeningeal arteriovenous malformation with hemangioma diagnosed in a newborn by prenatal and immediately postnatal magnetic resonance imaging. Vascular abnormalities were accompanied by massive arachnoidal cell hyperplasia reminiscent of meningioma. To the best of our knowledge, this is the first case of such a lesion reported in the literature.
Oral lymphoepithelial cyst: A clinicopathological study of 26 cases and review of the literature
Sykara, Maria; Ntovas, Panagiotis; Tosios, Konstantinos I.; Sklavounou, Alexandra
2017-01-01
Introduction Τo describe the clinicopathological features of 26 oral lymphoepithelial cysts (LECs) and review the literature. Material and Methods Twenty-six cases of oral LECs diagnosed during a 37-year period were retrospectively collected. The patients’ gender and age, as well as the main clinical features of the cysts were retrieved from the requisition forms. The main microscopic features were recorded after reevaluation of all cases. Pubmed and Google Scholar electronic databases were searched with the key word “oral LEC”. Inclusion criteria were the microscopic confirmation of LEC diagnosis and the report at least two of three main clinical features (gender, age and cyst’s location). Results The 26 oral LECs represented 0.08% of 31,564 biopsies accessioned during the study period. They affected 25 patients, 14 females and 11 males with a mean age of 33.04±9.81 years. They appeared as smooth (92%) nodules, with soft (24%) or firm (76%) consistency and normal (28%), yellow to normal (20%), yellow (32%) or white (20%) hue, in the tongue (69.23%) or the floor of mouth (30.77%). They were covered by parakeratinized squamous (92.31%) or non-keratinized (7.69%) epithelium and contained desquamated epithelial cells, amorphous eosinophilic material and/or inflammatory cells (100%). The lymphoid tissue surrounded the cystic cavity partially (34.62%) or completely (65.38%), often in a follicular pattern with prominent germinal centers (53.85%). Literature review yielded 316 cases of oral LECs derived from 25 case reports, 3 case studies/retrospective studies with detailed information for each case and 7 studies with summarized data. Conclusions Oral LEC is a pathologic entity with discrete clinical presentation that is, however, commonly misdiagnosed in clinical practice as other, mostly benign, entities. Its pathogenesis remains obscure, as its clinicopathologic features are consistent with both theories suggested up to date. Key words:Oral lymphoepithelial
Macrophage polarization differs between apical granulomas, radicular cysts, and dentigerous cysts.
Weber, Manuel; Schlittenbauer, Tilo; Moebius, Patrick; Büttner-Herold, Maike; Ries, Jutta; Preidl, Raimund; Geppert, Carol-Immanuel; Neukam, Friedrich W; Wehrhan, Falk
2018-01-01
Apical periodontitis can appear clinically as apical granulomas or radicular cysts. There is evidence that immunologic factors are involved in the pathogenesis of both pathologies. In contrast to radicular cysts, the dentigerous cysts have a developmental origin. Macrophage polarization (M1 vs M2) is a main regulator of tissue homeostasis and differentiation. There are no studies comparing macrophage polarization in apical granulomas, radicular cysts, and dentigerous cysts. Forty-one apical granulomas, 23 radicular cysts, and 23 dentigerous cysts were analyzed in this study. A tissue microarray (TMA) of the 87 consecutive specimens was created, and CD68-, CD11c-, CD163-, and MRC1-positive macrophages were detected by immunohistochemical methods. TMAs were digitized, and the expression of macrophage markers was quantitatively assessed. Radicular cysts are characterized by M1 polarization of macrophages while apical granulomas show a significantly higher degree of M2 polarization. Dentigerous cysts have a significantly lower M1 polarization than both analyzed periapical lesions (apical granulomas and radicular cysts) and accordingly, a significantly higher M2 polarization than radicular cysts. Macrophage cell density in dentigerous cysts is significantly lower than in the periapical lesions. The development of apical periodontitis towards apical granulomas or radicular cysts might be directed by macrophage polarization. Radicular cyst formation is associated with an increased M1 polarization of infiltrating macrophages. In contrast to radicular cysts, dentigerous cysts are characterized by a low macrophage infiltration and a high degree of M2 polarization, possibly reflecting their developmental rather than inflammatory origin. As M1 polarization of macrophages is triggered by bacterial antigens, these results underline the need for sufficient bacterial clearance during endodontic treatment to prevent a possible M1 macrophage-derived stimulus for radicular cyst
Congenital hernia of cord: an often misdiagnosed entity
Raju, Rubin; Satti, Mohamed; Lee, Quoc; Vettraino, Ivana
2015-01-01
Congenital hernia of the cord, also known as umbilical cord hernia, is an often misdiagnosed and under-reported entity, easily confused with a small omphalocele. It is different from postnatally diagnosed umbilical hernias and is believed to arise from persistent physiological mid-gut herniation. Its incidence is estimated to be 1 in 5000. Unlike an omphalocele, it is considered benign and is not linked with chromosomal anomalies. It has been loosely associated with intestinal anomalies, suggesting the need for a complete fetal anatomical ultrasound evaluation. We present a case of a fetal umbilical cord hernia diagnosed in a 28-year-old woman at 21 weeks gestation. The antenatal and intrapartum courses were uncomplicated. It was misdiagnosed postnatally as a small omphalocele, causing unwarranted anxiety in the parents. Increased awareness and knowledge of such an entity among health professionals is important to prevent unwarranted anxiety from misdiagnosis, and inadvertent bowel injury during cord clamping at delivery. PMID:25899514
... mature in the ovaries, are released in monthly cycles during the childbearing years. Many women have ovarian ... cysts develop as a result of your menstrual cycle (functional cysts). Other types of cysts are much ...
Beware! A simple renal cyst could be a hydatid cyst.
Sehgal, Nidhi; Priyadarshi, Vinod
2017-01-01
Kidney is one of the most common sites for the cyst formation in the body, and the management of simple cysts is required entirely for its symptoms and complications. Surgical decortication is an established treatment for a large and symptomatic simple renal cyst. On the other hand, hydatid cysts of the kidney are usually multiloculated complex or calcified cysts and are quite rare. Their surgical treatment also differs and requires complete excision with pericystectomy or partial/complete nephrectomy depending upon residual functional parenchyma, using extreme caution to avoid spillage, recurrence or development of severe anaphylactic shock. A simple cyst harboring a hydatid cyst is highly uncommon and quite dangerous; as if not diagnosed preoperatively, it can create huge trouble for both the patient and the operating surgeon which happened in the present case.
Follicular hybrid cyst: a combination of bullous pilomatricoma and epidermoid cyst.
Sanusi, Tutyana; Qu, Xiaoying; Li, Yanqiu; Zhang, Jing; Wang, Ming; Zhao, Yun; Yang, Zhen; An, Xiangjie; Qian, Yue; Wang, Chunsen; Chen, Hongxiang; Chen, Siyuan; Huang, Changzheng
2013-01-01
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.
Follicular hybrid cyst: a combination of bullous pilomatricoma and epidermoid cyst
Sanusi, Tutyana; Qu, Xiaoying; Li, Yanqiu; Zhang, Jing; Wang, Ming; Zhao, Yun; Yang, Zhen; An, Xiangjie; Qian, Yue; Wang, Chunsen; Chen, Hongxiang; Chen, Siyuan; Huang, Changzheng
2013-01-01
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. PMID:24294394
Tauro, Anna; Jovanovik, Jelena; Driver, Colin John; Rusbridge, Clare
2018-02-01
Abnormalities within the spinal arachnoid space are often treated surgically, but they can be challenging to detect with conventional magnetic resonance imaging (MRI) sequences. 3D-CISS sequences are considered superior in evaluating structures surrounded by cerebrospinal fluid (CSF) due to the high signal-to-noise ratio, high contrast-to-noise ratio and intrinsic insensitivity to motion with minimal signal loss due to CSF pulsations. Our objective was to describe findings and advantages in adding 3D-CISS sequences to routine MRI in patients affected by spinal arachnoid diverticula (SAD) or arachnoid adhesions. This article is a retrospective review of medical records of 19 dogs admitted at Fitzpatrick Referrals between 2013 and 2017 that were diagnosed with SAD and confirmed surgically. Inclusion criterions were the presence of clinical signs compatible with compressive myelopathy and an MRI diagnosis, which included the 3D-CISS sequence. Our database was searched for additional 19 dogs diagnosed with other spinal lesions other than SAD that had the same MR sequences. All MR images were anonymized and evaluated by two assessors. 3D-CISS sequence appears to improve confidence in diagnosing and surgical planning (Mann-Whitney U -test: p < 0.0005), delineating SAD from other changes associated with abnormal CSF hydrodynamics and providing more anatomical details than conventional MRI sequences. The clinical data in combination with imaging findings would limit over interpretation, when concurrent pathology within the arachnoid space is present. Schattauer GmbH Stuttgart.
Foveal retinoschisis misdiagnosed as bilateral amblyopia.
Kyung, Sungeun E; Lee, Minsoo
2012-12-01
Juvenile foveal retinoschisis is one of the most common causes of bilateral macular degeneration in young boys. School age with accommodative esotropia may develop amblyopia due to late correction of hyperopia. Retinoschisis is hard to diagnose in patient with subtle macula change and hyperopic amblyopia. We report a case of bilateral foveal retinoschisis before and after treatment with topical dorzolamide, which was misdiagnosed as bilateral hyperopic amblyopia. Optical coherence tomography should be considered in diagnostic procedures of children with hyperopic amblyopia.
Familial cleidocranial dysplasia misdiagnosed as rickets over three generations.
Franceschi, Roberto; Maines, Evelina; Fedrizzi, Michela; Piemontese, Maria Rosaria; De Bonis, Patrizia; Agarwal, Nivedita; Bellizzi, Maria; Di Palma, Annunziata
2015-10-01
Cleidocranial dysplasia (CCD) is a rare autosomal dominant skeletal dysplasia characterized by hypoplastic clavicles, late closure of the fontanels, dental problems and other skeletal features. CCD is caused by mutations, deletions or duplications in runt-related transcription factor 2 (RUNX2), which encodes for a protein essential for osteoblast differentiation and chondrocyte maturation. We describe three familial cases of CCD, misdiagnosed as rickets over three generations. No mutations were detected on standard DNA sequencing of RUNX2, but a novel deletion was identified on quantitative polymerase chain reaction (qPCR) and multiple ligation-dependent probe amplification (MLPA). The present cases indicate that CCD could be misdiagnosed as rickets, leading to inappropriate treatment, and confirm that mutations in RUNX2 are not able to be identified on standard DNA sequencing in all CCD patients, but can be identified on qPCR and MLPA. © 2015 Japan Pediatric Society.
Rare Nonneoplastic Cysts of Pancreas
Cho, Jae Hee
2015-01-01
Pancreatic cysts represent a small proportion of pancreatic diseases, but their incidence has been recently increasing. Most pancreatic cysts are identified incidentally, causing a dilemma for both clinicians and patients. In contrast to ductal adenocarcinoma, neoplastic pancreatic cysts may be cured by resection. In general, pancreatic cysts are classified as neoplastic or non-neoplastic cysts. The predominant types of neoplastic cysts include intraductal papillary mucinous neoplasms, mucinous cystic neoplasms, serous cystic neoplasms, and solid pseudopapillary neoplasms. With the exception of serous type, neoplastic cysts, have malignant potential, and in most cases requires resection. Non-neoplastic cysts include pseudocyst, retention cyst, benign epithelial cysts, lymphoepithelial cysts, squamous lined cysts (dermoid cyst and epidermal cyst in intrapancreatic accessory spleen), mucinous nonneoplastic cysts, and lymphangiomas. The incidence of nonneoplastic, noninflammatory cysts is about 6.3% of all pancreatic cysts. Despite the use of high-resolution imaging technologies and cytologic tissue acquisition with endosonography, distinguishing nonneoplastic from neoplastic cysts remains difficult with most differentiations made postoperatively. Nonetheless, the definitive distinction between non-neoplastic and neoplastic cysts is crucial as unnecessary surgery could be avoided with proper diagnosis. Therefore, consideration of these rare disease entities should be entertained before deciding on surgery. PMID:25674524
Odontogenic Cysts and Neoplasms.
Bilodeau, Elizabeth Ann; Collins, Bobby M
2017-03-01
This article reviews a myriad of common and uncommon odontogenic cysts and tumors. The clinical presentation, gross and microscopic features, differential diagnosis, prognosis, and diagnostic pitfalls are addressed for inflammatory cysts (periapical cyst, mandibular infected buccal cyst/paradental cyst), developmental cysts (dentigerous, lateral periodontal, glandular odontogenic, orthokeratinized odontogenic cyst), benign tumors (keratocystic odontogenic tumor, ameloblastoma, adenomatoid odontogenic tumor, calcifying epithelial odontogenic tumor, ameloblastic fibroma and fibroodontoma, odontoma, squamous odontogenic tumor, calcifying cystic odontogenic tumor, primordial odontogenic tumor, central odontogenic fibroma, and odontogenic myxomas), and malignant tumors (clear cell odontogenic carcinoma, ameloblastic carcinoma, ameloblastic fibrosarcoma). Copyright © 2016 Elsevier Inc. All rights reserved.
Ringel, Steven P.; Bailey, Orville T.
1972-01-01
A 29 year old female with a chiasmal syndrome secondary to a Rathke's cleft cyst is described. The histology and pathogenesis of these rare cysts are discussed, contrasting them with other hypophysial cysts. Images PMID:4538890
Bacteria associated with cysts of the soybean cyst nematode (Heterodera glycines).
Nour, Sarah M; Lawrence, John R; Zhu, Hong; Swerhone, George D W; Welsh, Martha; Welacky, Tom W; Topp, Edward
2003-01-01
The soybean cyst nematode (SCN), Heterodera glycines, causes economically significant damage to soybeans (Glycine max) in many parts of the world. The cysts of this nematode can remain quiescent in soils for many years as a reservoir of infection for future crops. To investigate bacterial communities associated with SCN cysts, cysts were obtained from eight SCN-infested farms in southern Ontario, Canada, and analyzed by culture-dependent and -independent means. Confocal laser scanning microscopy observations of cyst contents revealed a microbial flora located on the cyst exterior, within a polymer plug region and within the cyst. Microscopic counts using 5-(4,6-dichlorotriazine-2-yl)aminofluorescein staining and in situ hybridization (EUB 338) indicated that the cysts contained (2.6 +/- 0.5) x 10(5) bacteria (mean +/- standard deviation) with various cellular morphologies. Filamentous fungi were also observed. Live-dead staining indicated that the majority of cyst bacteria were viable. The probe Nile red also bound to the interior polymer, indicating that it is lipid rich in nature. Bacterial community profiles determined by denaturing gradient gel electrophoresis analysis were simple in composition. Bands shared by all eight samples included the actinobacterium genera Actinomadura and STREPTOMYCES: A collection of 290 bacteria were obtained by plating macerated surface-sterilized cysts onto nutrient broth yeast extract agar or on actinomycete medium. These were clustered into groups of siblings by repetitive extragenic palindromic PCR fingerprinting, and representative isolates were tentatively identified on the basis of 16S rRNA gene sequence. Thirty phylotypes were detected, with the collection dominated by Lysobacter and Variovorax spp. This study has revealed the cysts of this important plant pathogen to be rich in a variety of bacteria, some of which could presumably play a role in the ecology of SCN or have potential as biocontrol agents.
Bacteria Associated with Cysts of the Soybean Cyst Nematode (Heterodera glycines)
Nour, Sarah M.; Lawrence, John R.; Zhu, Hong; Swerhone, George D. W.; Welsh, Martha; Welacky, Tom W.; Topp, Edward
2003-01-01
The soybean cyst nematode (SCN), Heterodera glycines, causes economically significant damage to soybeans (Glycine max) in many parts of the world. The cysts of this nematode can remain quiescent in soils for many years as a reservoir of infection for future crops. To investigate bacterial communities associated with SCN cysts, cysts were obtained from eight SCN-infested farms in southern Ontario, Canada, and analyzed by culture-dependent and -independent means. Confocal laser scanning microscopy observations of cyst contents revealed a microbial flora located on the cyst exterior, within a polymer plug region and within the cyst. Microscopic counts using 5-(4,6-dichlorotriazine-2-yl)aminofluorescein staining and in situ hybridization (EUB 338) indicated that the cysts contained (2.6 ± 0.5) × 105 bacteria (mean ± standard deviation) with various cellular morphologies. Filamentous fungi were also observed. Live-dead staining indicated that the majority of cyst bacteria were viable. The probe Nile red also bound to the interior polymer, indicating that it is lipid rich in nature. Bacterial community profiles determined by denaturing gradient gel electrophoresis analysis were simple in composition. Bands shared by all eight samples included the actinobacterium genera Actinomadura and Streptomyces. A collection of 290 bacteria were obtained by plating macerated surface-sterilized cysts onto nutrient broth yeast extract agar or on actinomycete medium. These were clustered into groups of siblings by repetitive extragenic palindromic PCR fingerprinting, and representative isolates were tentatively identified on the basis of 16S rRNA gene sequence. Thirty phylotypes were detected, with the collection dominated by Lysobacter and Variovorax spp. This study has revealed the cysts of this important plant pathogen to be rich in a variety of bacteria, some of which could presumably play a role in the ecology of SCN or have potential as biocontrol agents. PMID:12514048
Modi, Tapan G; Chalishazar, Monali; Kumar, Malay
2018-01-01
Odontogenic cysts are the most common cysts of the jaws and are formed from the remnants of the odontogenic apparatus. Among these odontogenic cysts, radicular cysts (RCs) (about 60% of all diagnosed jaw cysts), dentigerous cysts (DCs) (16.6% of all jaw cysts) and odontogenic keratocysts (OKCs) (11.2% of all developmental odontogenic cysts) are the most common. The behavior of any lesion is generally reflected by its growth potential. Growth potential is determined by measuring the cell proliferative activity. The cell proliferative activity is measured by various methods among which immunohistochemistry (IHC) is the commonly used technique. Most of the IHC studies on cell proliferation have been based on antibodies such as Ki-67 and proliferating cell nuclear antigen. In the present study, the total sample size comprised of 45 cases of odontogenic cysts, with 15 cases each of OKC, RC and DC. Here, an attempt is made to study immunohistochemical (streptavidin-biotin detection system HRP-DAB) method to assess the expression of Ki-67 in different layers of the epithelial lining of OKCs, RCs and DCs. Ki-67 positive cells were highest in epithelium of OKC as compared to DC and RC. The increased Ki-67 labeling index and its expression in suprabasal cell layers of epithelial lining in OKC and its correlation with suprabasal cell layers of epithelial lining in DC and RC could contribute toward its clinically aggressive behavior. OKC is of more significance to the oral pathologist and oral surgeon because of its specific histopathological features, high recurrence rate and aggressive behavior.
... Solitary Kidney Your Kidneys & How They Work Simple Kidney Cysts What are simple kidney cysts? Simple kidney cysts are abnormal, fluid-filled ... that form in the kidneys. What are the kidneys and what do they do? The kidneys are ...
Modi, Tapan G; Chalishazar, Monali; Kumar, Malay
2018-01-01
Introduction and Objectives: Odontogenic cysts are the most common cysts of the jaws and are formed from the remnants of the odontogenic apparatus. Among these odontogenic cysts, radicular cysts (RCs) (about 60% of all diagnosed jaw cysts), dentigerous cysts (DCs) (16.6% of all jaw cysts) and odontogenic keratocysts (OKCs) (11.2% of all developmental odontogenic cysts) are the most common. The behavior of any lesion is generally reflected by its growth potential. Growth potential is determined by measuring the cell proliferative activity. The cell proliferative activity is measured by various methods among which immunohistochemistry (IHC) is the commonly used technique. Most of the IHC studies on cell proliferation have been based on antibodies such as Ki-67 and proliferating cell nuclear antigen. Materials and Method: In the present study, the total sample size comprised of 45 cases of odontogenic cysts, with 15 cases each of OKC, RC and DC. Here, an attempt is made to study immunohistochemical (streptavidin-biotin detection system HRP-DAB) method to assess the expression of Ki-67 in different layers of the epithelial lining of OKCs, RCs and DCs. Observations and Results: Ki-67 positive cells were highest in epithelium of OKC as compared to DC and RC. Conclusion: The increased Ki-67 labeling index and its expression in suprabasal cell layers of epithelial lining in OKC and its correlation with suprabasal cell layers of epithelial lining in DC and RC could contribute toward its clinically aggressive behavior. OKC is of more significance to the oral pathologist and oral surgeon because of its specific histopathological features, high recurrence rate and aggressive behavior. PMID:29731577
Rao, G Mallikarjuna; Haricharan, P; Ramanujacharyulu, S; Reddy, K Lakshmi
2002-01-01
The tail gut is a blind extension of the hindgut into the tail fold just distal to the cloacal membrane. Remnants of this structure may form tail gut cyst. We report a 14-year-old girl with tail gut cyst that presented as acute abdomen. The patient recovered after cyst excision.
... Ganglion Cysts Find a hand surgeon near you. Videos Ganglion Cysts Close Popup Figures Figure 1 - Ganglion ... or "in." Also, avoid using media types like "video," "article," and "picture." Tip 4: Your results can ...
Odontogenic cysts in three dogs: one odontogenic keratocyst and two dentigerous cysts.
Watanabe, Kazuhiro; Kadosawa, Tsuyoshi; Ishiguro, Taketo; Takagi, Satoshi; Ochiai, Kenji; Kimura, Takashi; Okumura, Masahiro; Fujinaga, Toru
2004-09-01
Odontogenic cysts, which showed cystic radiolucency in the jaw bone by radiographic examination and computed tomography, were enucleated by operation in 3 dogs. One dog had a odontogenic keratocyst in the incisive bone of the right maxilla and another 2 cases revealed dentigerous cysts in the mandible. These cyst walls were enucleated or transpired by semiconductor laser. Afterwards, osteogenesis was confirmed at the defective part of jaw bone by extirpation of the cyst in all cases, and no recurrence has been noted in any cases. Odontogenic cyst is a disease which should be treated by surgical extirpation or transpiration.
Spinal Arachnoid Diverticula: Outcome in 96 Medically or Surgically Treated Dogs.
Mauler, D A; De Decker, S; De Risio, L; Volk, H A; Dennis, R; Gielen, I; Van der Vekens, E; Goethals, K; Van Ham, L
2017-05-01
Little is reported about the role of medical management in the treatment of spinal arachnoid diverticula (SAD) in dogs. To describe the outcome of 96 dogs treated medically or surgically for SAD. Ninety-six dogs with SAD. Retrospective case series. Medical records were searched for spinal arachnoid diverticula and all dogs with information on treatment were included. Outcome was assessed with a standardized questionnaire. Fifty dogs were managed medically and 46 dogs were treated surgically. Dogs that underwent surgery were significantly younger than dogs that received medical management. No other variables, related to clinical presentation, were significantly different between both groups of dogs. The median follow-up time was 16 months (1-90 months) in the medically treated and 23 months (1-94 months) in the surgically treated group. Of the 38 dogs treated surgically with available long-term follow-up, 82% (n = 31) improved, 3% (n = 1) remained stable and 16% (n = 6) deteriorated after surgery. Of the 37 dogs treated medically with available long-term follow-up, 30% (n = 11) improved, 30% (n = 11) remained stable, and 40% (n = 15) deteriorated. Surgical treatment was more often associated with clinical improvement compared to medical management (P = .0002). The results of this study suggest that surgical treatment might be superior to medical treatment in the management of SAD in dogs. Further studies with standardized patient care are warranted. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.
Popliteal cyst; Bulge-knee ... Baker cyst is caused by swelling in the knee. The swelling is due to an increase in the fluid that lubricates the knee joint (synovial fluid). When pressure builds up, fluid ...
Lin, Louis M; Ricucci, Domenico; Lin, Jarshen; Rosenberg, Paul A
2009-05-01
It is a general belief that large cyst-like periapical lesions and apical true cysts caused by root canal infection are less likely to heal after nonsurgical root canal therapy. Nevertheless, there is no direct evidence to support this assumption. A large cyst-like periapical lesion or an apical true cyst is formed within an area of apical periodontitis and cannot form by itself. Therefore, both large cyst-like periapical lesions and apical true cysts are of inflammatory and not of neoplastic origin. Apical periodontitis lesions, regardless of whether they are granulomas, abscesses, or cysts, fail to heal after nonsurgical root canal therapy for the same reason, intraradicular and/or extraradicular infection. If the microbial etiology of large cyst-like periapical lesions and inflammatory apical true cysts in the root canal is removed by nonsurgical root canal therapy, the lesions might regress by the mechanism of apoptosis in a manner similar to the resolution of inflammatory apical pocket cysts. To achieve satisfactory periapical wound healing, surgical removal of an apical true cyst must include elimination of root canal infection.
Sivasankar, Vaishnavi; Ranganathan, Kannan; Praveen, B
2014-01-01
Keratinizing dentigerous cyst is a rare entity. This article reports a case of keratinizing dentigerous cyst associated with an impacted mandibular canine. Clinical and radiological features, cone-beam computed tomography findings and histological features of the case are reported along with a discussion on keratinizing odontogenic cysts and the need for follow-up. PMID:24808713
Proteomic Study of Entamoeba histolytica Trophozoites, Cysts, and Cyst-Like Structures
Luna-Nácar, Milka; Navarrete-Perea, José; Moguel, Bárbara; Bobes, Raúl J.; Laclette, Juan P.; Carrero, Julio C.
2016-01-01
The cyst stage of Entamoeba histolytica is a promising therapeutic target against human amoebiasis. Our research team previously reported the production in vitro of Cyst-Like Structures (CLS) sharing structural features with cysts, including rounded shape, size reduction, multinucleation, and the formation of a chitin wall coupled to the overexpression of glucosamine 6-phosphate isomerase, the rate-limiting enzyme of the chitin synthesis pathway. A proteomic study of E. histolytica trophozoites, cysts, and in vitro-produced CLS is reported herein to determine the nature of CLS, widen our knowledge on the cyst stage, and identify possible proteins and pathways involved in the encystment process. Total protein extracts were obtained from E. histolytica trophozoites, CLS, and partially purified cysts recovered from the feces of amoebic human patients; extracts were trypsin-digested and analyzed by LC-MS/MS. In total, 1029 proteins were identified in trophozoites, 550 in CLS, and 411 in cysts, with 539, 299, and 84 proteins unique to each sample, respectively, and only 74 proteins shared by all three stages. About 70% of CLS proteins were shared with trophozoites, even though differences were observed in the relative protein abundance. While trophozoites showed a greater abundance of proteins associated to a metabolically active cell, CLS showed higher expression of proteins related to proteolysis, redox homeostasis, and stress response. In addition, the expression of genes encoding for the cyst wall proteins Jessie and Jacob was detected by RT-PCR and the Jacob protein identified by Western blotting and immunofluorescence in CLS. However, the proteomic profile of cysts as determined by LC-MS/MS was very dissimilar to that of trophozoites and CLS, with almost 40% of hypothetical proteins. Our global results suggest that CLS are more alike to trophozoites than to cysts, and they could be generated as a rapid survival response of trophozoites to a stressful condition
Submental epidermoid cysts in children.
Zielinski, Rafal; Zakrzewska, Anna
2015-01-01
Epidermoid cysts are lesions, which form as a result of implantation of the epidermis in the layers of the dermis or the mucous membrane. The lesions are rare in adults with 7% occurring in the head and neck area and most often located in the submental region. In children population submental epidermoid cysts are extremely rare. The differential diagnosis of the lesions is necessary as it affects the choice of treatment methods. Among the pathological conditions occurring in that region, salivary retention cyst (ranula), thyroglossal duct cyst, vascular lymphatic malformation (cystic hygroma), median neck cyst, lymphadenopathy, thyroid gland tumor, laryngeal cyst, epidermoid and dermoid cysts, submental abscess, sialolithiasis and salivary gland inflammation should be considered. The authors of the present report demonstrate two cases of submental epidermoid cysts in children. Differential diagnosis in case of suspected submental epidermoid cyst in a child with proposed clinical practice and literature review is provided.
... inside the renal cysts. Your doctor may use ultrasound imaging to monitor renal cysts for any changes over ... Related Articles and Media Ultrasound - Abdomen Children's (Pediatric) Ultrasound - Abdomen Magnetic Resonance Imaging (MRI) - Body Ultrasound - Pelvis Children's (Pediatric) Nuclear Medicine ...
... essential to determine what type of cyst or mass you may have. A mass or bulge of the vaginal wall may be ... to rule out vaginal cancer, especially if the mass appears to be solid. If the cyst is ...
A type II first branchial cleft cyst masquerading as an infected parotid Warthin's tumor.
Chen, Meng-Feng; Ueng, Shir-Hwa; Jung, Shih-Ming; Chen, Yao-Liang; Chang, Kai-Ping
2006-01-01
The diagnosis of a parotid mass usually depends on thorough history taking and physical examination. Diagnostic modalities, including ultrasonographic examinations, computed tomography and magnetic resonance images, may also provide substantial information but their accuracy for diagnosis is sometimes questionable, especially in differentiating some rare neoplasms. First branchial cleft cysts (FBCCs) are rare causes of parotid swelling and comprise less than 1% of all branchial anomalies. They are frequently misdiagnosed due to their rarity and unfamiliar clinical signs and symptoms. We present a case of type II FBCC masquerading as an infected parotid Warthin's tumor. We also review the clinical signs and symptoms of FBCCs in order to remind clinicians that this rare branchial anomaly can mimic an infected Warthin's tumor and may be seated in the deep lobe of the parotid gland. By making an accurate pre-operative diagnosis of type II FBCC, we can minimize surgical morbidity and avoid incomplete resection and possible recurrence.
Submental epidermoid cysts in children
Zakrzewska, Anna
2015-01-01
Epidermoid cysts are lesions, which form as a result of implantation of the epidermis in the layers of the dermis or the mucous membrane. The lesions are rare in adults with 7% occurring in the head and neck area and most often located in the submental region. In children population submental epidermoid cysts are extremely rare. The differential diagnosis of the lesions is necessary as it affects the choice of treatment methods. Among the pathological conditions occurring in that region, salivary retention cyst (ranula), thyroglossal duct cyst, vascular lymphatic malformation (cystic hygroma), median neck cyst, lymphadenopathy, thyroid gland tumor, laryngeal cyst, epidermoid and dermoid cysts, submental abscess, sialolithiasis and salivary gland inflammation should be considered. The authors of the present report demonstrate two cases of submental epidermoid cysts in children. Differential diagnosis in case of suspected submental epidermoid cyst in a child with proposed clinical practice and literature review is provided. PMID:28352681
Pilonidal abscess; Pilonidal dimple; Pilonidal disease; Pilonidal cyst; Pilonidal sinus ... An infected pilonidal cyst or abscess requires surgical drainage. It will not heal with antibiotic medicines. If you continue to have infections, the pilonidal cyst can be ...
Splenic abscess due to chronic melioidosis in a patient previously misdiagnosed as tuberculosis
Kunnathuparambil, Sojan George; Sathar, Shanid Abdul; Tank, Devang Chandrakanth; Sreesh, Srijaya; Mukunda, Madhav; Narayanan, Premaletha; Vinayakumar, Kattoor Ramakrishnan
2013-01-01
Melioidosis is endemic in Southeast Asia and Northern Australia. Sporadic cases have been reported from many parts of the world where it has an epidemic potential with high-rate fatality cases. In non-endemic areas, melioidosis may be misdiagnosed with common diseases and this may prove fatal. Sporadic cases of melioidosis are mistaken for tuberculosis in India. We report a case of splenic abscess due to chronic melioidosis who was earlier misdiagnosed as tuberculosis and underwent anti-tuberculosis therapy. Following treatment of melioidosis his symptoms subsided. This case is reported because of the rarity of the disease and to highlight the importance of looking for melioidosis in patients with splenic abscess even in non-endemic areas. PMID:24714690
Neurenteric Cyst or Neuroendodermal Cyst? Immunohistochemical Study and Pathogenesis.
Chen, Chun-Ting; Lai, Hung-Yi; Jung, Shih-Ming; Lee, Ching-Yi; Wu, Chieh-Tsai; Lee, Shih-Tseng
2016-12-01
Neurenteric cysts are rare central nervous system lesions derived from an endodermal origin. There is no consensus concerning pathogenesis because of the paucity of occurrences. We report an immunohistochemical study of 10 cases with neurenteric cysts and postulate its pathogenesis. Ten patients underwent surgical treatment for neurenteric cysts from 1995 to 2015. We retrospectively reviewed clinical, radiologic, operative, and pathologic findings for these patients. Immunohistochemical stains were completed in all cases to distinguish cell type and origin. Three cell types were identified: pseudostratified-ciliated, goblet-columnar, and simple cuboidal cells. All cases were positive for cytokeratin 7, and negative for cytokeratin 20, caudal-type homeobox 2, mucin 2, thyroid transcription factor 1, human chorionic gonadotropin, placental alkaline phosphatase, and cluster of differentiation 31. Four of them had positive staining for mucin 5AC, with expression only in goblet-columnar cells. According to the immunohistochemical results, the cells resembled the respiratory tract (pseudostratified-ciliated), stomach (goblet-columnar), and respiratory bronchioles (simple cuboidal). Seventy-five percent of cases with recurrence had a goblet-columnar component, emphasizing the importance of total resection of the cyst and complete pathologic examination. We postulate that the cystic tumor was derived from multipotent endodermal cells that migrated and traveled along the neuroectoderm, with incomplete differentiation into various cell types as a result of an unsuitable microenvironment. Because the neurenteric canal was only the channel of migration rather than a component of the cysts, the term neuroendodermal cysts is more precise in presenting the embryopathogenesis. Copyright © 2016 The Author(s). Published by Elsevier Inc. All rights reserved.
[Surgical treatment of perinatal ovarian cysts].
Armas Alvarez, A L; Taboada Santomil, P; Pradillos Serna, J M; Rivera Chavez, L L; Méndez Gallart, R; Estévez Martínez, E; Rodríguez Barca, P; Bautista Casasnovas, A; Varela Cives, R
2010-10-01
Actually, the perinatal ovarian cysts are increasingly being diagnosed by prenatal and neonatal ultrasound. We reported our experience in the surgical management of perinatal ovarian cysts. Patients and methods. We have reviewed the clinical charts of 10 female newborns diagnosed of ovarian cysts who underwent surgical management in our hospital from 1989 to 2009. The ovarian cysts were diagnosed antenatally in 8 cases and period neonatal in 2 cases. The clinical presentation was asymptomatic abdominal mass in 7 cases. Ultrasound confirmed the ovarian mass in 8 patients. CT scan and MRI were necessary for confirm suspected diagnosis in two patients. Ultrasonography showed 7 complex cysts and 3 simple cysts. Surgery of the complicated cysts revealed ovarian torsion in 5 cases and 1 hemorragic cyst. At surgery, 5 patients underwent salpingooophorectomy, 2 patients needed oophorectomy and in 3 cases only cystectomy were necessary. The ovarian torsion is the most common complication and the cause of loss of the ovary. The neonatal ovarian cysts greater than 5 centimetres, symptomatic cysts, complex cysts and cysts persisting for more than 6 months need surgical intervention.
Stiff person case misdiagnosed as conversion disorder: A case report.
Razmeh, Saeed; Habibi, Amir Hasan; Sina, Farzad; Alizadeh, Elham; Eslami, Monireh
2017-01-01
Stiff person syndrome (SPS) is a rare neurological disease resulting in stiffness and spasm of muscles. It initially affects the axial muscles and then spread to limb muscles. Emotional stress exacerbated the symptoms and signs of the disease. The pathophysiology of the disease is caused by the decreased level of the glutamic acid decarboxylase (GAD) activity due to an autoantibody against GAD that decreases the level of gamma-aminobutyric acid (GABA). In this paper, we present a case of atypical presentation of SPS with lower limb stiffness misdiagnosed as conversion disorder. We report a patient with atypical presentation of SPS with lower limb stiffness and gait disorder misdiagnosed as conversion disorder for a year. Her antithyroid peroxidase antibody (anti-TPO Ab) level was 75 IU (normal value: 0-34 IU). Intravenous immunoglobulin (IVIG) was administered (2gr/kg, 5 days) for the patient that showed significant improvement in the follow-up visit. It is essential that in any patient with bizarre gait disorder and suspicious to conversion disorder due to the reversibility of symptoms, SPS and other movement disorder should be considered.
Ocular Manifestations of Oblique Facial Clefts
Ortube, Maria Carolina; Dipple, Katrina; Setoguchi, Yoshio; Kawamoto, Henry K.; Demer, Joseph L.
2014-01-01
Introduction In the Tessier classification, craniofacial clefts are numbered from 0 to 14 and extend along constant axes through the eyebrows, eyelids, maxilla, nostrils, and the lips. We studied a patient with bilateral cleft 10 associated with ocular abnormalities. Method Clinical report with orbital and cranial computed tomography. Results After pregnancy complicated by oligohydramnios, digoxin, and lisinopril exposure, a boy was born with facial and ocular dysmorphism. Examination at age 26 months showed bilateral epibulbar dermoids, covering half the corneal surface, and unilateral morning glory anomaly of the optic nerve. Ductions of the right eye were normal, but the left eye had severely impaired ductions in all directions, left hypotropia, and esotropia. Under anesthesia, the left eye could not be rotated freely in any direction. Bilateral Tessier cleft number 10 was implicated by the presence of colobomata of the middle third of the upper eyelids and eyebrows. As the cleft continued into the hairline, there was marked anterior scalp alopecia. Computed x-ray tomography showed a left middle cranial fossa arachnoid cyst and calcification of the reflected tendon of the superior oblique muscle, trochlea, and underlying sclera, with downward and lateral globe displacement. Discussion Tessier 10 clefts are very rare and usually associated with encephalocele. Bilateral 10 clefts have not been reported previously. In this case, there was coexisting unilateral morning glory anomaly and arachnoid cyst of the left middle cranial fossa but no encephalocele. Conclusions Bilateral Tessier facial cleft 10 may be associated with alopecia, morning glory anomaly, epibulbar dermoids, arachnoid cyst, and restrictive strabismus. PMID:20856062
Tirado, Mariantonieta; Ständer, Sonja; Metze, Dieter
2014-11-01
Goltz-Gorlin syndrome presents with multiple basal cell carcinomas, odontogenic keratocysts, and cutaneous cysts, among other manifestations. The cutaneous cysts have been described as both epidermoid cysts and keratocysts but were not further characterized. Light microscopic examinations were made on 23 cutaneous cysts in 4 patients associated with Goltz-Gorlin syndrome located on extremities, face, trunk, palms, and soles and compared with nonsyndromic vellus hair cysts, steatocystomas, and hybrid cysts. Twenty-one of the syndromic cysts revealed alternating infundibular-like and steatocystoma-like squamous epitheliums in varying proportions. The cysts were lined by both smooth and corrugated squamous epithelium. The horny layer was composed by alternating areas of thin, lamellate, and compact eosinophilic keratin. Only 2 cases showed an exclusive steatocystoma-like type of epithelium very similar to odontogenic keratocysts. Sebaceous glands and follicular structures were absent. There were no differences between palmar and plantar cysts and other anatomic locations. The ultrastructural findings in syndromatic cysts confirmed variable expression of keratohyalin granules. Only 3 of 6 cases of nonsyndromic hybrid cysts showed overlapping features with syndromic cysts. Immunohistochemical profiling of keratin, involucrin, filaggrin, loricrin, and BCL-2 expression in syndromatic cysts showed exclusive positivity of K19 and continuous staining for BCL-2. In summary, 2 types of cutaneous cysts are characteristic of Goltz-Gorlin, irrelevant of their anatomic location, namely steatocystoma-like and more frequently hybrid-like. The diagnosis of syndromic hybrid-like cysts should be considered whenever infundibular and steatocystoma differentiation alternate and overlap. Altogether, these findings in epithelial cysts may raise the suspicion of Goltz-Gorlin as an underlying cause.
Unicameral and aneurysmal bone cysts.
Campanacci, M; Capanna, R; Picci, P
1986-03-01
One hundred and seventy-eight cases of unicameral bone cysts (UBC) treated with curettage and bone grafting were compared to 141 cases treated with cortisone injections. The end results were comparable in the two groups. Local recurrence risk factors in the surgical group were active cyst and previous operations. In the other group they were multilocation of the cyst, active cyst, and size of cyst. A new radiographic classification of aneurysmal bone cyst (ABC) is proposed in a report of 198 cases of ABC. The treatment of choice in ABC is surgical and the type (curettage, curettage plus phenole or cryosurgery, resection or hemiresection) is selected on the basis of the radiographic aspect and the rate of growth of the cyst. Radiotherapy is only indicated in inoperable ABC cases.
Mycotic cysts: report of 21 cases including eight pheomycotic cysts from Saudi Arabia.
Sheikh, Salwa S; Amr, Samir S
2007-04-01
Mycotic cysts are subcutaneous cystic granulomas caused by either dematiaceous (pigmented) fungi (pheomycotic cysts) or eumycotic (nonpigmented fungi) present in soil, wood, and decaying plant material. These fungi gain access to the tissues via a wooden splinter or thorn. No deep tissue involvement or extension to bone is known to occur. We reviewed our surgical pathology files for the last 32 years. All cases with the diagnosis of cysts with fungi, thorns, or splinters and associated granulomatous and acute inflammation were reviewed. Gomori's silver and periodic acid-Schiff stains were performed in all cases. Twenty-one cases of mycotic cyst were found, including eight pheomycotic cysts (one with a recurrent lesion seen 11 months after the initial excision of the cyst). Thirteen cysts had nonpigmented fungal hyphae. There were 14 males and seven females, with an age range of 5-76 years. The dorsum of the foot was the most frequently affected site (12 cases). Four cases involved the fingers, two involved the knee area, two involved the big toe, and one each involved the leg, ankle, and forearm. The cysts measured 0.6-4.5 cm in diameter. Histologically, there was granulomatous inflammation with a variable degree of neutrophilic infiltrate giving central abscess formation. Twelve cases showed a wooden splinter. All cases were positive for fungal organisms, mostly septate hyphae and spores that were highlighted by special stains. Fungal pigment, ranging from yellow-brown to light brown to black, was observed in eight cases. No extension to deep tissues was noted. The clinical impression varied widely including ganglion, sebaceous cyst, giant cell tumor of the tendon sheath, and lipoma. One patient was immunosuppressed following renal transplantation. All patients were treated by simple excision. No antifungal chemotherapy was needed or administered in any of the patients. One patient had a recurrence of his lesion within 1 year as a result of inadequate initial
Introduction: Intradural Spinal Surgery video supplement.
McCormick, Paul C
2014-09-01
This Neurosurgical Focus video supplement contains detailed narrated videos of a broad range of intradural pathology such as neoplasms, including intramedullary, extramedullary, and dumbbell tumors, vascular malformations, functional disorders, and rare conditions that are often overlooked or misdiagnosed such as arachnoid cysts, ventral spinal cord herniation, and dorsal arachnoid web. The intent of this supplement is to provide meaningful educational and instructional content at all levels of training and practice. As such, the selected video submissions each provide a comprehensive detailed narrative description and coordinated video that contains the entire spectrum of relevant information including imaging, operative setup and positioning, and exposure, as well as surgical strategies, techniques, and sequencing toward the safe and effective achievement of the operative objective. This level of detail often necessitated a more lengthy video duration than is typically presented in oral presentations or standard video clips from peer reviewed publications. Unfortunately, space limitations precluded the inclusion of several other excellent video submissions in this supplement. While most videos in this supplement reflect standard operative approaches and techniques there are also submissions that describe innovative exposures and techniques that have expanded surgical options such as ventral approaches, stereotactic guidance, and minimally invasive exposures. There is some redundancy in both the topics and techniques both to underscore fundamental surgical principles as well as to provide complementary perspective from different surgeons. It has been my privilege to serve as guest editor for this video supplement and I would like to extend my appreciation to Mark Bilsky, Bill Krauss, and Sander Connolly for reviewing the large number submitted videos. Most of all, I would like to thank the authors for their skill and effort in the preparation of the outstanding
Lobprise, H B; Wiggs, R B
1992-03-01
An infrequently occurring tumor-like lesion arising from the cellular components of the developing dental follicle is the dentigerous cyst. These odontogenic cysts have classic clinical and radiographic findings. The cysts are locally invasive and aggressive and require prompt surgical management. This case describes the diagnosis and surgical treatment of a dentigerous cyst in the mandible of a dog.
Pancreas and cyst segmentation
NASA Astrophysics Data System (ADS)
Dmitriev, Konstantin; Gutenko, Ievgeniia; Nadeem, Saad; Kaufman, Arie
2016-03-01
Accurate segmentation of abdominal organs from medical images is an essential part of surgical planning and computer-aided disease diagnosis. Many existing algorithms are specialized for the segmentation of healthy organs. Cystic pancreas segmentation is especially challenging due to its low contrast boundaries, variability in shape, location and the stage of the pancreatic cancer. We present a semi-automatic segmentation algorithm for pancreata with cysts. In contrast to existing automatic segmentation approaches for healthy pancreas segmentation which are amenable to atlas/statistical shape approaches, a pancreas with cysts can have even higher variability with respect to the shape of the pancreas due to the size and shape of the cyst(s). Hence, fine results are better attained with semi-automatic steerable approaches. We use a novel combination of random walker and region growing approaches to delineate the boundaries of the pancreas and cysts with respective best Dice coefficients of 85.1% and 86.7%, and respective best volumetric overlap errors of 26.0% and 23.5%. Results show that the proposed algorithm for pancreas and pancreatic cyst segmentation is accurate and stable.
Globulomaxillary cysts--do they really exist?
Dammer, U; Driemel, O; Mohren, W; Giedl, C; Reichert, T E
2014-01-01
The so-called "globulomaxillary cyst", described as a fissural cyst, caused by entrapped epithelium between the nasal and maxillary process, is no longer considered for its own entity. Nevertheless, cystic lesions, which correspond to the previous image of globulomaxillary cysts, do still occur in daily practice. This raises the question to which entities pathological processes in this particular region actually belong to. In a retrospective study, 17 cases (12 men and 5 women, 12-59 years old) of primarily diagnosed globulomaxillary cysts are analysed according to clinical, radiological and histological aspects, catamnestic processed and assigned to a new entity. The results are compared with the international literature and draws conclusions on the diagnostic and therapeutic procedure. Seven lateral periodontal cysts, four radicular cysts, two keratocystic odontogenic tumours, one adenomatoid odontogenic tumour, one periapical granuloma, one residual cyst and one undefined jaw cyst were determined. According to the results of our study and the data from the international literature, the entity globulomaxillary cyst is no longer justified.
Stiff person case misdiagnosed as conversion disorder: A case report
Razmeh, Saeed; Habibi, Amir Hasan; Sina, Farzad; Alizadeh, Elham; Eslami, Monireh
2017-01-01
Background: Stiff person syndrome (SPS) is a rare neurological disease resulting in stiffness and spasm of muscles. It initially affects the axial muscles and then spread to limb muscles. Emotional stress exacerbated the symptoms and signs of the disease. The pathophysiology of the disease is caused by the decreased level of the glutamic acid decarboxylase (GAD) activity due to an autoantibody against GAD that decreases the level of gamma-aminobutyric acid (GABA). In this paper, we present a case of atypical presentation of SPS with lower limb stiffness misdiagnosed as conversion disorder. Case presentation: We report a patient with atypical presentation of SPS with lower limb stiffness and gait disorder misdiagnosed as conversion disorder for a year. Her antithyroid peroxidase antibody (anti-TPO Ab) level was 75 IU (normal value: 0–34 IU). Intravenous immunoglobulin (IVIG) was administered (2gr/kg, 5 days) for the patient that showed significant improvement in the follow-up visit. Conclusion: It is essential that in any patient with bizarre gait disorder and suspicious to conversion disorder due to the reversibility of symptoms, SPS and other movement disorder should be considered. PMID:29201327
Non-infected and Infected Bronchogenic Cyst: The Correlation of Image Findings with Cyst Content
Jeon, Hong Gil; Park, Ju Hwan; Park, Hye Min; Kwon, Woon Jung; Cha, Hee Jeong; Lee, Young Jik; Park, Chang Ryul; Jegal, Yangjin; Ahn, Jong-Joon
2014-01-01
We hereby report a case on bronchogenic cyst which is initially non-infected, then becomes infected after bronchoscopic ultrasound (US)-guided transesophageal fine-needle aspiration (FNA). The non-infected bronchogenic cyst appears to be filled with relatively echogenic materials on US, and the aspirate is a whitish jelly-like fluid. Upon contrast-enhanced MRI of the infected bronchogenic cyst, a T1-weighted image shows low signal intensity and a T2-weighted image shows high signal intensity, with no enhancements of the cyst contents, but enhancements of the thickened cystic wall. The patient then undergo video-assisted thoracic surgery 14 days after the FNA. The cystic mass is known to be completely removed, and the aspirate is yellowish and purulent. To understand the image findings that pertain to the gross appearance of the cyst contents will help to diagnose bronchogenic cysts in the future. PMID:24624219
Nahata, Vaishali
2016-01-01
Branchial cleft cyst, sinuses, and fistulae are among the most commonly encountered congenital anomalies in pediatric otolaryngic practice. They can present difficulty in diagnosis and surgical management. Here, I report a case of 14-year-old boy who presented with asymptomatic, congenital swelling located just below the jawline in the lateral part of the neck. The lesion was excised surgically. Histopathology showed the cyst lined by squamous as well as columnar ciliated epithelium, which was a characteristic finding of branchial cleft cyst. The aim of presenting this case is its rarity. PMID:27904209
Nahata, Vaishali
2016-01-01
Branchial cleft cyst, sinuses, and fistulae are among the most commonly encountered congenital anomalies in pediatric otolaryngic practice. They can present difficulty in diagnosis and surgical management. Here, I report a case of 14-year-old boy who presented with asymptomatic, congenital swelling located just below the jawline in the lateral part of the neck. The lesion was excised surgically. Histopathology showed the cyst lined by squamous as well as columnar ciliated epithelium, which was a characteristic finding of branchial cleft cyst. The aim of presenting this case is its rarity.
Bendella, Habib; Brackmann, Derald E; Goldbrunner, Roland; Angelov, Doychin N
2016-10-01
Little is known about the reasons for occurrence of facial nerve palsy after removal of cerebellopontine angle tumors. Since the intra-arachnoidal portion of the facial nerve is considered to be so vulnerable that even the slightest tension or pinch may result in ruptured axons, we tested whether a graded stretch or controlled crush would affect the postoperative motor performance of the facial (vibrissal) muscle in rats. Thirty Wistar rats, divided into five groups (one with intact controls and four with facial nerve lesions), were used. Under inhalation anesthesia, the occipital squama was opened, the cerebellum gently retracted to the left, and the intra-arachnoidal segment of the right facial nerve exposed. A mechanical displacement of the brainstem with 1 or 3 mm toward the midline or an electromagnet-controlled crush of the facial nerve with a tweezers at a closure velocity of 50 and 100 mm/s was applied. On the next day, whisking motor performance was determined by video-based motion analysis. Even the larger (with 3 mm) mechanical displacement of the brainstem had no harmful effect: The amplitude of the vibrissal whisks was in the normal range of 50°-60°. On the other hand, even the light nerve crush (50 mm/s) injured the facial nerve and resulted in paralyzed vibrissal muscles (amplitude of 10°-15°). We conclude that, contrary to the generally acknowledged assumptions, it is the nerve crush but not the displacement-induced stretching of the intra-arachnoidal facial trunk that promotes facial palsy after cerebellopontine angle surgery in rats.
... develop normally. The birth defect may appear as open spaces called cleft sinuses, which may develop on one or both sides of the neck. A branchial cleft cyst may form from fluid drained from a sinus. The cyst or sinus can become infected.
A Case Series of Anal Carcinoma Misdiagnosed as Idiopathic Chronic Anal Fissure.
Barbeiro, Sandra; Atalaia-Martins, Catarina; Marcos, Pedro; Gonçalves, Cláudia; Cotrim, Isabel; Vasconcelos, Helena
2017-09-01
Chronic anal fissure is a linear ulcer in the anal canal that has not cicatrized for more than 8-12 weeks of treatment. Most anal fissures are idiopathic and are located in the posterior midline. Squamous cell carcinoma of the anus commonly presents as bleeding and anal pain. It may also present as a mass, nonhealing ulcer, itching, discharge, fecal incontinence and fistulae. Not uncommonly, small and early cancers are misdiagnosed as benign anorectal disorders like anal fissures or hemorrhoids. The clinical suspicion of squamous cell carcinoma of the anus is of paramount importance in patients with nonhealing anal fissures, fissures in atypical positions or with indurated or ulcerated anal tags and in patients with risk factors for the development of anal squamous intraepithelial lesions that are precursors of invasive anal squamous cell carcinoma. The authors present 3 cases of squamous cell carcinoma of the anus initially misdiagnosed as benign chronic anal fissure.
Yin, Fu-Fen; Wang, Ning; Wang, You-Lin; Bi, Xiao-Ning; Xu, Xiao-Hui; Wang, Yan-Kui
2015-01-01
Bladder leiomyoma is a rare benign tumor and it could be easily misdiagnosed with many other pelvic diseases, especially obstetrical and gynecological diseases; abdominal, laparoscopic, and transurethral resection of bladder leiomyoma have been reported. Herein, we present a case of bladder leiomyoma misdiagnosed with a vaginal mass preoperatively; the mass was isolated, enucleated from the bladder neck, and removed transvaginally; to the best of our knowledge, this is the first case of intramural leiomyoma of bladder neck that has been enucleated transvaginally only without cystotomy. PMID:26693368
Update on pancreatic cyst fluid analysis
Rockacy, Matthew; Khalid, Asif
2013-01-01
Pancreatic cystic lesions (PCL) may be incidentally detected in up to 13.5% of patients. These represent a wide variety of lesions including mucinous cysts [intraductal papillary mucinous neoplasms (IPMN) and mucinous cystic neoplasms (MCN)] that have malignant potential. The difficulty in identifying the various PCL and their unpredictable potential for malignant degeneration makes their management cumbersome. The current diagnostic evaluation of PCL often includes EUS-guided fine needle aspiration (EUS-FNA) for cyst fluid analysis. Cyst fluid can be analyzed for tumor markers, cytology, mucins, DNA analysis and amylase. Pancreatic cyst CEA level is considered the most accurate tumor marker for diagnosing mucinous cysts. Approximately 0.2 to 1.0 mL of cyst fluid is required to run the test and a cut-off of 192 ng/ mL can be expected to capture ~75% of mucinous cysts. The presence of a KRAS mutation is very specific for a mucinous cyst but lacks sensitivity. Cytology is especially helpful in diagnosing malignancy typically in the presence of a solid component in the cyst. Newer markers to improve diagnostic accuracy are on the horizon, but clinical studies are awaited. PMID:24714589
Cyclin d1 expression in odontogenic cysts.
Taghavi, Nasim; Modabbernia, Shirin; Akbarzadeh, Alireza; Sajjadi, Samad
2013-01-01
In the present study expression of cyclin D1 in the epithelial lining of odontogenic keratocyst, radicular cyst, dentigerous cyst and glandular odontogenic cyst was investigated to compare proliferative activity in these lesions. Immunohistochemical staining of cyclin D1 on formalin-fixed, paraffin-embedded tissue sections of odontogenic keratocysts (n=23), dentigerous cysts (n=20), radicular cysts (n=20) and glandular odontogenic cysts (n=5) was performed by standard EnVision method. Then, slides were studied to evaluate the following parameters in epithelial lining of cysts: expression, expression pattern, staining intensity and localization of expression. The data analysis showed statistically significant difference in cyclin D1 expression in studied groups (p < 0.001). Assessment of staining intensity and staining pattern showed more strong intensity and focally pattern in odontogenic keratocysts, but difference was not statistically significant among groups respectively (p=0.204, 0.469). Considering expression localization, cyclin D1 positive cells in odontogenic keratocysts and dentigerous cysts were frequently confined in parabasal layer, different from radicular cysts and glandular odontogenic cysts. The difference was statistically significant (p < 0.01). Findings showed higher expression of cyclin D1 in parabasal layer of odontogenic keratocyst and the entire cystic epithelium of glandular odontogenic cysts comparing to dentigerous cysts and radicular cysts, implying the possible role of G1-S cell cycle phase disturbances in the aggressiveness of odontogenic keratocyst and glandular odontogenic cyst.
Aswath, Nalini; Mastan, Kader; Manikandan, Tirupathi; Samuel, Gigi
2013-01-01
The calcifying odontogenic cyst (COC) is reported to be associated with odontoma in 24% of cases. Separation of the cases of calcifying odontogenic cyst associated with odontoma (COCaO) may lead to a better understanding of the pathogenesis of this lesion. The literature revealed 52 cases of COCaO. The male to female ratio was 1:1.9, with a mean age of 16 years. Most common location was the maxilla (61.5%). The radiographic appearance of most cases (80.5%) was a well-defined, mixed radiolucent-radiopaque lesion. Histologically, the lesions consisted of a single large cyst with tooth-like structures as an integral part, giving the impression of a single lesion. In addition to the unique histologic features, differences in gender and distribution were found between the cases of COCaO and those of simple COC. COCaO may be regarded as a separate entity and classified as a benign, mixed odontogenic tumor. The term odontocalcifying odontogenic cyst is suggested.
Hormia, M; Ylipaavalniemi, P; Nagle, R B; Virtanen, I
1987-08-01
Immunostaining with monoclonal antibodies was used to study and compare the cytokeratin content of odontogenic cysts and normal gingival epithelium. Two monoclonal antibodies, PKK2 and KA1, stained the whole epithelium in all cyst samples. In gingiva, PKK2 gave a suprabasal staining and KA1 reacted with all epithelial cell layers. Antibodies PKK1, KM 4.62 and KS 8.12 gave a heterogeneous staining in follicular and radicular cysts. In keratocysts and in gingiva PKK1 and KM 4.62 reacted mainly with basal cells and KS 8.12 gave a suprabasal staining. Antibodies reacting with the simple epithelial cytokeratin polypeptide No. 18 (PKK3, KS 18.18) recognized in gingiva only solitary cells compatible with Merkel cells. In a case of follicular ameloblastoma a distinct staining of tumor epithelium was revealed with these antibodies. In 2 follicular cysts, but not in other cyst types, a layer of cytokeratin 18-positive cells was revealed. KA5 and KK 8.60 antibodies, reacting exclusively with keratinizing epithelia, including normal gingiva, gave no reaction in radicular cysts, keratocysts and ameloblastoma. Two of the follicular cysts, were negative for PKK3 and KS 18.18, but reacted strongly with KA5 and KK 8.60. The present results show that odontogenic jaw cysts have distinct differences in their cytokeratin content. With the exception of some follicular cysts, they lack signs of keratinizing epithelial differentiation. Only follicular cysts appear to share with some types of ameloblastoma the expression of cytokeratin polypeptide No. 18.
Chrysophyte cysts as potential environmental indicators.
Adam, D.P.; Mahood, A.D.
1981-01-01
Many chrysophyte algae produce morphologically distinctive, siliceous, microscopic cysts during a resting stage of their life cycles; these cysts are often preserved in sediments. Scanning electron microscopy and Nomarski optics permit much more detailed observation of these cysts than was heretofore possible. Many cyst types are found only in specific habitats, such as montane lakes, wet meadows, ephemeral ponds, and Sphagnum bogs. In the samples studied, cysts seem to be most common in fluctuating fresh-water habitats of low to moderate pH and some winter freezing. Chrysophyte cysts have the potential to be a useful tool for modern environmental assessments and paleoecological studies of Cenozoic fresh-water lacustrine deposits. -from Authors
Chrysophyte cysts as potential environmental indicators
Adam, David P.; Mahood, Albert D.
1981-01-01
Many Chrysophyte algae produce morphologically distinctive, siliceous, microscopic cysts during a resting stage of their life cycles; these cysts are often preserved in sediments. Scanning electron microscopy and Nomarski optics permit much more detailed observation of these cysts than was heretofore possible. We have used an ecologic and biogeographic approach to study the distribution of cyst forms in sediments and have established that many cyst types are found only in specific habitats, such as montane lakes, wet meadows, ephemeral ponds, and Sphagnum bogs. In the samples we have studied, cysts seem to be most common in fluctuating fresh-water habitats of low to moderate pH and some winter freezing. Numerous taxonomic problems have yet to be resolved. We believe that chrysophyte cysts have the potential to become a useful tool for both modern environmental assessments and paleoecological studies of Cenozoic fresh-water lacustrine deposits.
Intrathoracic extrapulmonary hydatid cysts.
Atoini, Fouad; Ouarssani, Aziz; Hachimi, Moulay Ahmed; Aitlhou, Fatima; Rguibi, Mustapha Idrissi; Hommadi, Abdelaziz
2012-01-01
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.
Management strategy for unicameral bone cyst.
Chuo, Chin-Yi; Fu, Yin-Chih; Chien, Song-Hsiung; Lin, Gau-Tyan; Wang, Gwo-Jaw
2003-06-01
The management of a unicameral bone cyst varies from percutaneous needle biopsy, aspiration, and local injection of steroid, autogenous bone marrow, or demineralized bone matrix to the more invasive surgical procedures of conventional curettage and grafting (with autogenous or allogenous bone) or subtotal resection with bone grafting. The best treatment for a unicameral bone cyst is yet to be identified. Better understanding of the pathology will change the concept of management. The aim of treatment is to prevent pathologic fracture, to promote cyst healing, and to avoid cyst recurrence and re-fracture. We retrospectively reviewed 17 cases of unicameral bone cysts (12 in the humerus, 3 in the femur, 2 in the fibula) managed by conservative observation, curettage and bone grafting with open reduction and internal fixation, or continuous decompression and drainage with a cannulated screw. We suggest percutaneous cannulated screw insertion to promote cyst healing and prevent pathologic fracture. We devised a protocol for the management of unicameral bone cysts.
Infected orbital cyst following exenteration.
Barak, A; Hirsh, A; Rosner, M; Rosen, N
1996-09-01
An orbital cyst is a rare complication of orbital trauma and exenteration. Infections of such cysts have not been described, and are potentially dangerous unless treated immediately. The authors describe a case of delayed treatment of such an infected cyst, which resolved following surgical drainage. The potentially hazardous outcome makes knowledge of such cases important.
Change in head posture and character of nystagmus in a patient with neurological upbeat nystagmus.
Gonzalez, Caleb; Seth, Rajeev K; Ramos-Esteban, Jerome C
2007-01-01
To report a case of a patient with chin-up head posture and presumed congenital toxoplasmosis chorioretinal scars, who had a change in the character of the nystagmus and therefore the head posture following treatment for a neurological upbeat nystagmus. A 5 month old female presented with a chin up head posture and upbeat nystagmus. Magnetic resonance imaging of the brain revealed an arachnoid cyst in the area of the pineal gland. Nine months after cyst-peritoneal shunt surgery, the upbeat nystagmus was dampened but change in character to a rotary nystagmus worse on the left gaze. The patient had assumed a left face turn, shifting the null point from the vertical to the horizontal plane. The left face turn was successfully corrected at age eight years with a Kestenbaum procedure. This case emphasizes the possibility of having two distinct types of nystagmus associated with two etiologies. In this case, an acquired upbeat nystagmus secondary to an arachnoid cyst, and a congenital left rotary nystagmus from the chorioretinal scars. Furthermore, there can be a change in head position and character of nystagmus after treating the cause of the central motility disorder, thereby affecting the choice and timing of surgical intervention to correct the head positioning.
Vo, Quoc Duy; Monnard, Etienne; Hoogewoud, Henri Marcel
2013-01-01
We report the case of a patient with a palpable mass and abdominal pain in the left upper quadrant. A physical examination revealed tenderness in this region. An ultrasound performed initially showed a large cystic structure. A CT examination revealed a large cyst originating in the spleen with loculations in its upper part and focal calcification in the wall. On MRI, the cystic mass showed high signal on T1-weighted and T2-weighted images. The carbohydrate antigen 19-9 (CA 19-9) was measured at 88 U/ml (standard <37.1 mUI/l). According to the imaging examinations and laboratory tests performed, it was impossible to determine if the splenic cyst was parasitic or non-parasitic. Given the most important risks of complications encountered in parasitic cysts, it was decided to treat this splenic cyst as a parasitic cyst. For this reason, an elective laparoscopic splenectomy with preoperative embolisation of the splenic artery was performed. The histological diagnosis was a primary epidermoid splenic cyst with inner lining epithelial cells. PMID:23667225
Lichenoid keratosis is frequently misdiagnosed as basal cell carcinoma.
Maor, D; Ondhia, C; Yu, L L; Chan, J J
2017-08-01
Lichenoid keratosis (LK), also known as benign lichenoid keratosis or lichen planus-like keratosis, is a solitary, pink to red-brown scaly plaque representing a host immunological response to a variety of precursor lesions. LK is often misdiagnosed as a dermatological malignancy owing to its clinical resemblance to basal cell carcinoma (BCC) or Bowen disease. We performed a retrospective analysis of the pathology records of a series of LK lesions with reference to the demographic features and accuracy of clinical diagnosis. The pathology records from 2008 to 2009 of 263 consecutive patients with a histological diagnosis of LK from a specialized skin laboratory were retrieved. Data relating to clinical diagnosis, age, sex, anatomical location, time of year of presentation and any coexistent pathological lesions adjacent to the LK were recorded. Mean age at presentation was 64 years (range 34-96), and 58% of patients were female. The most common anatomical site was the chest/anterior torso, followed by the back and legs. The most common coexisting lesion was solar keratosis at 14%, followed by seborrhoeic keratosis (SK) at 7.8%. The correct clinical diagnosis of LK was made in 29.5% of cases. The most common clinical diagnosis was BCC (47%), while SK was the preferred diagnosis in 18%. A clinical diagnosis was not given in 5.5% of cases. In conclusion, it appears that LK is frequently misdiagnosed, with misdiagnosis occurring in > 70% of cases in this study. © 2017 British Association of Dermatologists.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Tomita, Tadakimi; Bzik, David J.; Ma, Yan Fen
2013-12-26
Toxoplasma gondii infects up to one third of the world’s population. A key to the success of T.gondii is its ability to persist for the life of its host as bradyzoites within tissue cysts. The glycosylated cyst wall is the key structural feature that facilitates persistence and oral transmission of this parasite. We have identified CST1 (TGME49_064660) as a 250 kDa SRS (SAG1 related sequence) domain protein with a large mucin-like domain. CST1 is responsible for the Dolichos biflorus Agglutinin (DBA) lectin binding characteristic of T. gondii cysts. Deletion of CST1 results in a fragile brain cyst phenotype revealed bymore » a thinning and disruption of the underlying region of the cyst wall. These defects are reversed by complementation of CST1. Additional complementation experiments demonstrate that the CST1-mucin domain is necessary for the formation of a normal cyst wall structure, the ability of the cyst to resist mechanical stress and binding of DBA to the cyst wall. RNA-seq transcriptome analysis demonstrated dysregulation of bradyzoite genes within the various cst1 mutants. These results indicate that CST1 functions as a key structural component that reinforces the cyst wall structure and confers essential sturdiness to the T. gondii tissue cyst.« less
[Study of 103 cases of odontogenic cysts].
Moctezuma-Bravo, Gustavo Sergio; Magallanes-González, Eduardo
2009-01-01
To describe characteristics of odontogenic cysts in a Mexican population. A retrospective study of 103 odontogenic cysts in 86 patients was done. The data were obtained from files of the Pathology Department of a General Hospital. We observed a frequency of the 8.13 % of odontogenic cysts (103) in 1266 pathological studies. The dentigerous cyst 56 % and odontogenic keratocyst 33 % were the most common odontogenic cysts. Sixty one percent of the cysts appeared in the second and third decades of life. In 71 cysts, 42 % appeared in the posterior region jaw, 29 % in the anterior region of the maxilla and 21 % in the posterior region of the maxilla. A 6.7 % developed a recurrence after treatment and a case of keratocyst of posterior region of the maxilla was associated with epidermoid carcinoma. The study included three women with the syndrome of carcinoma of the basal cell nevus, who presented multiple keratocysts. The dentigerous cysts and odontogenic keratocysts were the most frequent odontogenic cysts. They appeared mainly in the second and third decades of life.
Extraoral sinus tract misdiagnosed as an endodontic lesion.
Cohenca, Nestor; Karni, Sunil; Rotstein, Ilan
2003-12-01
The extraoral sinus tract may occur as a result of an inflammatory process associated with a necrotic pulp. However, several non-odontogenic disorders may also produce an extraoral sinus tract. Thus, the differential diagnosis of this clinical finding is of paramount importance in providing appropriate clinical care because misdiagnosis of this condition may result in healing failure or unnecessary treatment. This case report of a 19-yr-old male patient describes an extraoral cutaneous sinus tract misdiagnosed as an endodontic lesion. Consequently, the patient underwent unnecessary exploratory procedures and antibiotic therapy. Identification of the inflammatory source of the lesion and removal of the affected tissue led to tissue healing.
Managing Incidental Pancreatic Cysts.
Phan, Jennifer; Raman Muthusamy, V
2018-06-09
The goal of this review is to critically analyze the current literature regarding the management of incidental pancreatic cysts. Given their increased rates of detection due to the frequent use of cross-sectional imaging, correctly identifying the subset of high risk lesions that are appropriate for surgical resection is critical. However, the existing consensus and societal guidelines discussed in this review lack high quality data to create evidence-based recommendations, making achieving this important aim challenging. Several recent studies have focused on the natural history of pancreatic cysts and defining the role of endoscopic ultrasound, which remains unclear. EUS-guided diagnostic tools include molecular analysis of obtained fluid; EUS-guided FNA, FNB, and intracystic forceps biopsy of the cyst wall; and confocal endomicroscopy. While their precise role in diagnosing pancreatic cystic neoplasms remains to be defined, they represent promising innovations that may play a future role in cyst assessment and management. Large, long-term, prospective studies of incidentally identified pancreatic cysts are essential to fully understand their natural history and potential for neoplastic progression. Given the absence of such data at present, an individualized patient approach is recommended.
Fatemeh, Mashhadiabbas; Sepideh, Arab; Sara, Bagheri Seyedeh; Nazanin, Mahdavi
2017-01-01
Objectives An odontogenic keratocyst (OKC) is a developmental odontogenic cyst with aggressive clinical behavior. This cyst shows a different growth mechanism from the more common dentigerous cyst and now has been renamed as a keratocystic odontogenic tumor (KCOT). Inflammation can assist tumor growth via different mechanisms including dysregulation of the p53 gene. This study aims to assess and compare the expression of tumor suppressor gene p53 in inflamed and non-inflamed types of OKC and dentigerous cyst. Methods Immunohistochemical expression of p53 was assessed in 14 cases of dental follicle, 34 cases of OKC (including 18 inflamed OKCs), and 31 cases of dentigerous cyst (including 16 inflamed cysts). Results The mean percentage of p53 positive cells was 0.7% in dental follicles, 5.4% in non-inflamed OKCs, 17.3% in inflamed OKCs, 1.2% in non-inflamed dentigerous cysts, and 2.2% in inflamed dentigerous cysts. The differences between the groups were statistically significant (p < 0.050) except for the difference between inflamed and non-inflamed dentigerous cysts, and between dental follicle and non-inflamed dentigerous cyst. Conclusions The difference in p53 expression in OKC and dentigerous cyst can explain their different growth mechanism and clinical behavior. Inflammation is responsible for the change in behavior of neoplastic epithelium of OKC via p53 overexpression. PMID:28584604
Fatemeh, Mashhadiabbas; Sepideh, Arab; Sara, Bagheri Seyedeh; Nazanin, Mahdavi
2017-05-01
An odontogenic keratocyst (OKC) is a developmental odontogenic cyst with aggressive clinical behavior. This cyst shows a different growth mechanism from the more common dentigerous cyst and now has been renamed as a keratocystic odontogenic tumor (KCOT). Inflammation can assist tumor growth via different mechanisms including dysregulation of the p53 gene. This study aims to assess and compare the expression of tumor suppressor gene p53 in inflamed and non-inflamed types of OKC and dentigerous cyst. Immunohistochemical expression of p53 was assessed in 14 cases of dental follicle, 34 cases of OKC (including 18 inflamed OKCs), and 31 cases of dentigerous cyst (including 16 inflamed cysts). The mean percentage of p53 positive cells was 0.7% in dental follicles, 5.4% in non-inflamed OKCs, 17.3% in inflamed OKCs, 1.2% in non-inflamed dentigerous cysts, and 2.2% in inflamed dentigerous cysts. The differences between the groups were statistically significant ( p < 0.050) except for the difference between inflamed and non-inflamed dentigerous cysts, and between dental follicle and non-inflamed dentigerous cyst. The difference in p53 expression in OKC and dentigerous cyst can explain their different growth mechanism and clinical behavior. Inflammation is responsible for the change in behavior of neoplastic epithelium of OKC via p53 overexpression.
Cases of pediatric narcolepsy after misdiagnoses.
Kauta, Shilpa R; Marcus, Carole L
2012-11-01
Narcolepsy is characterized by recurrent brief attacks of irresistible sleepiness. Signs can begin during childhood. However, diagnoses are frequently delayed by 10-15 years because of unfamiliarity with pediatric narcolepsy and variable presentations of its associated features (cataplexy, hypnagogic/hypnopompic hallucinations, and sleep paralysis). Therefore, patients may remain untreated during their formative years. Three children with narcolepsy who were initially misdiagnosed are described. Each child's signs were initially related to depression, hypothyroidism, jaw dysfunction, or conversion disorder. However, after a multiple sleep latency test, the diagnosis of narcolepsy was established. All three patients were treated appropriately with stimulant medications, selective serotonin reuptake inhibitors, or sodium oxybate, and demonstrated positive responses. Although no definitive cure exists for narcolepsy, early recognition and appropriate symptomatic treatment with medications can allow affected children to improve quality of life and achieve normality, both academically and socially. Copyright © 2012 Elsevier Inc. All rights reserved.
Parathyroid cysts: the Latin-American experience.
Román-González, Alejandro; Aristizábal, Natalia; Aguilar, Carolina; Palacios, Karen; Pérez, Juan Camilo; Vélez-Hoyos, Alejandro; Duque, Carlos Simon; Sanabria, Alvaro
2016-12-01
Parathyroid cyst is an infrequent and unsuspected disease. There are more than 300 hundred cases reported in the world literature, a few of them are from Latin America. The experience of our centers and a review of the cases are presented. Case report of a series of patients with parathyroid cyst from our institutions according to the CARE guidelines (Case Reports). A search of Medline, Embase, BIREME ( Biblioteca Regional de Medicina ) LILACS ( Literatura Latinoamericana y del Caribe en Ciencias de la Salud ), Google Scholar and Scielo ( Scientific Electronic Library on Line ) databases and telephonic or email communications with other experts from Latin-America was performed . Six patients with parathyroid cyst were found in our centers in Colombia. Most of them were managed with aspiration of the cyst. Two of them required surgery. Only one case was functional. Twelve reports from Latin America were found for a total of 18 cases in our region adding ours. Parathyroid cysts are uncommonly reported in Latin America. Most of them are diagnosed postoperatively. Suspicion for parathyroid cyst should be raised when a crystal clear fluid is aspirated from a cyst. The confirmation of the diagnosis may be easily done if parathyroid hormone (PTH) level is measured in the cyst fluid.
Parathyroid cysts: the Latin-American experience
Aristizábal, Natalia; Aguilar, Carolina; Palacios, Karen; Pérez, Juan Camilo; Vélez-Hoyos, Alejandro; Duque, Carlos Simon; Sanabria, Alvaro
2016-01-01
Background Parathyroid cyst is an infrequent and unsuspected disease. There are more than 300 hundred cases reported in the world literature, a few of them are from Latin America. The experience of our centers and a review of the cases are presented. Methods Case report of a series of patients with parathyroid cyst from our institutions according to the CARE guidelines (Case Reports). A search of Medline, Embase, BIREME (Biblioteca Regional de Medicina) LILACS (Literatura Latinoamericana y del Caribe en Ciencias de la Salud), Google Scholar and Scielo (Scientific Electronic Library on Line) databases and telephonic or email communications with other experts from Latin-America was performed . Results Six patients with parathyroid cyst were found in our centers in Colombia. Most of them were managed with aspiration of the cyst. Two of them required surgery. Only one case was functional. Twelve reports from Latin America were found for a total of 18 cases in our region adding ours. Conclusions Parathyroid cysts are uncommonly reported in Latin America. Most of them are diagnosed postoperatively. Suspicion for parathyroid cyst should be raised when a crystal clear fluid is aspirated from a cyst. The confirmation of the diagnosis may be easily done if parathyroid hormone (PTH) level is measured in the cyst fluid. PMID:28149800
Keratinous inclusion cyst of oesophagus: unusual finding
Wan Abdul Rahman, Wan Faiziah; Mutum, Samarendra Singh; Fauzi, Mohd Hashairi
2013-01-01
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
Giant radicular cyst of the maxilla
Deshmukh, Jeevanand; Shrivastava, Ratika; Bharath, Kashetty Panchakshari; Mallikarjuna, Rachappa
2014-01-01
Radicular cysts are inflammatory odontogenic cysts of tooth bearing areas of the jaws. Most of these lesions involve the apex of offending tooth and appear as well-defined radiolucencies. Owing to its clinical characteristics similar to other more commonly occurring lesions in the oral cavity, differential diagnosis should include dentigerous cyst, ameloblastoma, odontogenic keratocyst, periapical cementoma and Pindborg tumour. The present case report documents a massive radicular cyst crossing the midline of the palate. Based on clinical, radiographical and histopathological findings, the present case was diagnosed as an infected radicular cyst. The clinical characteristics of this cyst could be considered as an interesting and unusual due to its giant nature. The lesion was surgically enucleated along with the extraction of the associated tooth; preservation of all other teeth and vital structures, without any postoperative complications and satisfactory healing, was achieved. PMID:24792022
[CT diagnosis of hemorrhagic renal cysts].
Wu, Y Z; Li, D T; Luo, J G
2001-06-28
CT signs of nineteen cases of hemorrhagic renal cysts that surgically and pathologically proved were analyzed. 8 of the 19 cases revealed as high density hemorrhagic lesion. CT signs in those 8 patients include low density rim sign, cyst immerging sign, and perirenal fascia thickening. The other 11 of 19 cases revealed as low density lesion. CT signs include thickened cyst wall and inhomogeneous density of the cystic content. The hounsfield unit of the lesion is correlated with the duration of disease. It is suggested that CT is valuable in diagnosis of high density hemorrhagic renal cysts, and it gives a clue to the diagnosis of low density hemorrhagic renal cysts.
Molecular aspects of cyst nematodes.
Lilley, Catherine J; Atkinson, Howard J; Urwin, Peter E
2005-11-01
SUMMARY Taxonomy: Superkingdom Eukaryota; kingdom Metazoa; phylum Nematoda; class Chromadorea; order Tylenchida; suborder Tylenchina; superfamily Tylenchoidea; family Heteroderidae; subfamily Heteroderinae; main genera Heterodera and Globodera. Cyst nematodes comprise approximately 100 known species in six genera. They are pathogens of temperate, subtropical and tropical plant species and the host range of many species is narrow. The most economically important species are within the Globodera and Heterodera genera. Globodera pallida and G. rostochiensis are important pathogens of potato crops. There are many economic species in the Heterodera genus, including Heterodera glycines (soybean cyst nematode), H. avenae (cereal cyst nematode) and H. schachtii (sugar beet cyst nematode), the last of which attacks a range of Chenopodiaceae and Cruciferae, including Arabidopsis thaliana. Disease symptoms: Field symptoms of severe cyst nematode infection are often stunting, wilting and chlorosis, but considerable yield loss can occur without obvious symptoms. The only unique indicator of cyst nematode infection is the presence of adult female nematodes attached to host roots after several weeks of parasitism. Disease control: This is usually achieved by using integrated pest management involving cultural practices such as crop rotation, resistant cultivars if available and chemical control when economically justified.
Yodoya, Mitsuko; Hiraki, Takao; Iguchi, Toshihiro; Fujiwara, Hiroyasu; Matsui, Yusuke; Masaoka, Yoshihisa; Sakurai, Jun; Mitsuhashi, Toshiharu; Gobara, Hideo; Kanazawa, Susumu
2017-06-01
To retrospectively evaluate the effect of cryoablation of renal-cell carcinoma on nearby renal cysts with the goal to investigate the potential for an alternative therapy to treat symptomatic renal cysts. The study population comprised 46 cysts (mean size, 12 mm; range, 5-43 mm) that were within or near the ice ball during cryoablation in 22 patients. Size change of each cyst was evaluated via enhanced CT or MR imaging before and 1, 3, 6, and 12 months after cryoablation. Forty-one cysts were also followed after 12 months. Variables including positional relationship between the cyst and the ice ball were evaluated via linear regression analysis using generalized estimating equation models to determine which factors affected cyst shrinkage rate at 12 months. Fifteen, 12, and 19 cysts were completely included in, partially included in, or excluded from the ice ball, respectively. The overall shrinkage rate was 62%, and 57% of cysts (26 of 46) had disappeared at 12 months. Only the relationship between the cyst and the ice ball was significantly (P < .001) associated with cyst shrinkage rate. Cyst disappearance rates at 12 months were 100% (15 of 15), 67% (8 of 12), and 16% (3 of 19) for cysts completely included, partially included, and excluded from the ice ball, respectively. Among the 22 cysts that disappeared at 12 months and continued to be followed, none recurred after 12 months. All renal cysts that were completely included in the ice ball disappeared after cryoablation, demonstrating the potential utility of cryoablation as an alternative therapy for symptomatic renal cysts. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.
Mammary and femoral hydatid cysts.
Shamim, Muhammad
2010-08-01
Hydatid cyst disease most commonly affects liver and lungs, but it can affect all viscera and soft tissues of the body. Simultaneous mammary and femoral hydatid cysts, without any other visceral involvement, are extremely rare. This is a case report of 25-years-old female, presenting with lump in left breast mimicking fibroadenoma and lump in right thigh mimicking fibroma. Both turned out to be hydatid cysts.
A new classification system for congenital laryngeal cysts.
Forte, Vito; Fuoco, Gabriel; James, Adrian
2004-06-01
A new classification system for congenital laryngeal cysts based on the extent of the cyst and on the embryologic tissue of origin is proposed. Retrospective chart review. The charts of 20 patients with either congenital or acquired laryngeal cysts that were treated surgically between 1987 and 2002 at the Hospital for Sick Children, Toronto were retrospectively reviewed. Clinical presentation, radiologic findings, surgical management, histopathology, and outcome were recorded. A new classification system is proposed to better appreciate the origin of these cysts and to guide in their successful surgical management. Fourteen of the supraglottic and subglottic simple mucous retention cysts posed no diagnostic or therapeutic challenge and were treated successfully by a single endoscopic excision or marsupialization. The remaining six patients with congenital cysts in the study were deemed more complex, and all required open surgical procedures for cure. On the basis of the analysis of the data of these patients, a new classification of congenital laryngeal cysts is proposed. Type I cysts are confined to the larynx, the cyst wall composed of endodermal elements only, and can be managed endoscopically. Type II cysts extend beyond the confines of the larynx and require an external approach. The Type II cysts are further subclassified histologically on the basis of the embryologic tissue of origin: IIa, composed of endoderm only and IIb, containing endodermal and mesodermal elements (epithelium and cartilage) in the wall of the cyst. A new classification system for congenital laryngeal cysts is proposed on the basis of the extent of the cyst and the embryologic tissue of origin. This classification can help guide the surgeon with initial management and help us better understand the origin of these cysts.
Multiple Colloid Cysts: Case Report and Literature Review.
Rizk, Ahmed R; Bettag, Martin
2018-06-14
Colloid cysts usually occur in the anterior third ventricle at the level of the foramina of Monro. Colloid cysts may extend from the third toward the lateral ventricle. We present a rare case of multiple intraventricular colloid cysts, two of which were in the third ventricle and one in the lateral ventricle. A 40-year-old female patient presented with three intraventricular cystic lesions: one cyst in the typical localization in the anterior rostral third ventricle, another cyst behind it in the same (third) ventricle, and a larger bulging cyst in the right lateral ventricle. A bilateral ventriculoperitoneal shunt had been inserted 26 years before to treat hydrocephalus. All three cysts had different magnetic resonance imaging (MRI) signal characteristics. We removed the cysts through an endoscopically assisted right transcortical transventricular microsurgical approach, using the right ventricular catheter as a guide to the lateral ventricle. After removal of the lateral ventricular cyst, we observed that the foramen of Monro was greatly enlarged (most likely as a result of the large cyst), which allowed us to remove the cysts in the third ventricle. During surgery, the cysts were found to have different consistencies. MRI 2 years following surgery showed complete removal and no hydrocephalus. The patient had no symptoms, and the clinical examinations were normal. Colloid cysts may become large and extend to the lateral ventricle, especially in patients treated with ventriculoperitoneal shunts. Studying the relevant pathoanatomy of these cysts is very important for preoperative planning including the choice of surgical approach. Georg Thieme Verlag KG Stuttgart · New York.
Reinke Edema: Watch For Vocal Fold Cysts.
Tüzüner, Arzu; Demirci, Sule; Yavanoglu, Ahmet; Kurkcuoglu, Melih; Arslan, Necmi
2015-06-01
Reinke edema is one of the common cause of dysphonia middle-aged population, and severe thickening of vocal folds require surgical treatment. Smoking plays a major role on etiology. Vocal fold cysts are also benign lesions and vocal trauma blamed for acquired cysts. We would like to present 3 cases with vocal fold cyst related with Reinke edema. First case had a subepidermal epidermoid cyst with Reinke edema, which could be easily observed before surgery during laryngostroboscopy. Second case had a mucous retention cyst into the edematous Reinke tissue, which was detected during surgical intervention, and third case had a epidermoid cyst that occurred 2 months after before microlaryngeal operation regarding Reinke edema reduction. These 3 cases revealed that surgical management of Reinke edema needs a careful dissection and close follow-up after surgery for presence of vocal fold cysts.
Anatomic variants in Dandy-Walker complex.
Jurcă, Maria Claudia; Kozma, Kinga; Petcheşi, CodruŢa Diana; Bembea, Marius; Pop, Ovidiu Laurean; MuŢiu, Gabriela; Coroi, Mihaela Cristiana; Jurcă, Alexandru Daniel; Dobjanschi, Luciana
2017-01-01
Dandy-Walker complex (DWC) is a malformative association of the central nervous system. DWC includes four different types: Dandy-Walker malformation (vermis agenesis or hypoplasia, cystic dilatation of the fourth ventricle and a large posterior fossa); Dandy-Walker variant (vermis hypoplasia, cystic dilatation of the fourth ventricle, normal posterior fossa); mega cysterna magna (large posterior fossa, normal vermis and fourth ventricle) and posterior fossa arachnoid cyst. We present and discuss four cases with different morphological and clinical forms of the Dandy-Walker complex. In all four cases, diagnosis was reached by incorporation of clinical (macrocephaly, seizures) and imaging [X-ray, computed tomography (CT), magnetic resonance imaging (MRI)] data. Two patients were diagnosed with Dandy-Walker complex, one patient was diagnosed with Dandy-Walker variant in a rare association with neurofibromatosis and one patient was diagnosed with a posterior fossa arachnoid cyst associated with left-sided Claude Bernard-Horner syndrome, congenital heart disease (coarctation of the aorta, mitral stenosis) and gastroesophageal reflux. In all forms of DWC, the clinical, radiological and functional manifestations are variable and require adequate diagnostic and therapeutic measures.
Surgical management of calcaneal unicameral bone cysts.
Glaser, D L; Dormans, J P; Stanton, R P; Davidson, R S
1999-03-01
Unicameral bone cysts are not seen commonly in the calcaneus. Little is known about the etiology and natural history of these lesions. Calcaneal cysts often are symptomatic, although some of these lesions are detected as incidental findings. Treatment has been advocated based on the fear of pathologic fracture and collapse. Several published series have been divided in their favor for either open treatment or injection management. These series are small, and the optimal treatment is still in question. The current study compared the efficacy of methylprednisolone acetate injection treatment with curettage and bone grafting in the treatment of unicameral bone cysts of the calcaneus. All patients treated for unicameral bone cysts of the calcaneus during the past 7 years at two institutions were reviewed. Eleven patients met inclusion criteria. All diagnoses were confirmed radiographically or histologically. Demographic information, presenting complaints, diagnostic imaging, treatment modalities, and outcome were analyzed. Long term radiographic and subjective followup was obtained. Eighteen surgical procedures were performed on 11 patients with 12 cysts. Nine injections performed on six patients failed to show healing of the cyst. Nine cysts treated with curettage and bone grafting showed cyst healing. At mean followup of 28 months (range, 12-77 months), all 11 patients had no symptoms; there were no recurrences of the cyst in the nine patients who underwent bone grafting and persistence of the cyst in the two patients who underwent injection therapy. This review reports one of the largest series of cysts in this location. The results indicate that steroid injection treatment, although useful in other locations, may not be the best option for the management of unicameral bone cysts in the calcaneus. Curettage and bone grafting yielded uniformly good results.
Subconjunctival epidermoid cysts in Gorlin-Goltz syndrome.
De Craene, S; Batteauw, A; Van Lint, M; Claerhout, I; Decock, C
2014-08-01
Epidermoid cysts are common benign cysts which occur particularly on the skin of the face, neck and upper trunk. Subconjunctival location of these cysts is very rare and, until today, only seen in patients with Gorlin-Goltz syndrome. Histopathological examination of these cysts show similarities with odontogenic keratocysts, a typical clinical manifestation of Gorlin-Goltz syndrome.
de Noronha Santos Netto, Juliana; Pires, Fábio Ramôa; da Fonseca, Eliene Carvalho; Silva, Licínio Esmeraldo; de Queiroz Chaves Lourenço, Simone
2012-09-01
Several cell types are associated with the development of cystic and tumoral odontogenic lesions. Among inflammatory cells, mast cells can be associated with their pathogenesis. The aim of this study was to analyze mast cells in periapical cysts, dentigerous cysts, and keratocystic odontogenic tumors. Tissue sections were submitted to toluidine blue staining and immunohistochemistry with antibody anti-tryptase (clone G3). Mast cells were quantitated using Image-Pro Plus software to obtain the mean number of mast cells in three regions: epithelial, superficial portion of the fibrous wall and deep portion of the fibrous wall from 20 periapical cysts, 20 dentigerous cysts (six non-inflamed and 14 inflamed) and 20 keratocystic odontogenic tumors (four non-inflamed and 16 inflamed). The mean number of mast cells detected per lesion by immunohistochemistry (4.1) was higher than by histochemistry (1.5) (P<0.0001). Inflamed dentigerous cysts and keratocystic odontogenic tumors showed a higher mean number of mast cells than non-inflamed lesions in all regions. The deep region from all cysts showed the highest mean number of degranulated mast cells, except for non-inflamed keratocystic odontogenic tumors analyzed by immunohistochemistry. Immunohistochemical staining detected higher number of mast cells than histochemistry. The higher number of mast cells observed in inflamed lesions could indicate the participation of these cells in the inflammatory response in odontogenic lesions. The prevalence of degranulated mast cells in the deep region suggests intense activity of these cells, possibly related to growth of cystic lesions. © 2012 John Wiley & Sons A/S.
Epidermoid Cyst of Mandible Ramus: Case Report.
Loxha, Mergime Prekazi; Salihu, Sami; Kryeziu, Kaltrina; Loxha, Sadushe; Agani, Zana; Hamiti, Vjosa; Rexhepi, Aida
2016-06-01
An epidermoid cyst is a benign cyst usually found on the skin. Bone cysts are very rare and if they appear in bone they usually appear in the distal phalanges of the fingers. Epidermoid cysts of the jaws are uncommon. We present a case, of a 41 year-old female patient admitted to our department because of pain and swelling in the parotid and masseteric region-left side. There was no trismus, pathological findings in skin, high body temperature level, infra-alveolar nerves anesthesia or lymphadenopathy present. The orthopantomography revealed a cystic lesion and a unilocular lesion that included mandibular ramus on the left side with 3 cm in diameter. Under total anesthesia, a cyst had been reached and was enucleated. Histopathologic findings showed that the pathologic lesion was an epidermoid cyst. Epidermoid and dermoid cysts are rare, benign lesions found throughout the body. Only a few cases in literature describe an intraossesus epidermoid cyst. Our case is an epidermoid cyst with a rare location in the region of the mandibular ramus. It is not associated with any trauma in this region except medical history reveals there was an operative removal of a wisdom tooth 12 years ago in the same side. These cysts are interesting from the etiological point of view. They should be considered in the differential diagnosis of other radiolucent lesions of the jaws. Surgically they have a very good prognosis, and are non-aggressive lesions.
Epidermoid Cyst of Mandible Ramus: Case Report
Loxha, Mergime Prekazi; Salihu, Sami; Kryeziu, Kaltrina; Loxha, Sadushe; Agani, Zana; Hamiti, Vjosa; Rexhepi, Aida
2016-01-01
Introduction: An epidermoid cyst is a benign cyst usually found on the skin. Bone cysts are very rare and if they appear in bone they usually appear in the distal phalanges of the fingers. Epidermoid cysts of the jaws are uncommon. Case presentation: We present a case, of a 41 year-old female patient admitted to our department because of pain and swelling in the parotid and masseteric region–left side. There was no trismus, pathological findings in skin, high body temperature level, infra-alveolar nerves anesthesia or lymphadenopathy present. The orthopantomography revealed a cystic lesion and a unilocular lesion that included mandibular ramus on the left side with 3 cm in diameter. Under total anesthesia, a cyst had been reached and was enucleated. Histopathologic findings showed that the pathologic lesion was an epidermoid cyst. Discussion: Epidermoid and dermoid cysts are rare, benign lesions found throughout the body. Only a few cases in literature describe an intraossesus epidermoid cyst. Conclusion: Our case is an epidermoid cyst with a rare location in the region of the mandibular ramus. It is not associated with any trauma in this region except medical history reveals there was an operative removal of a wisdom tooth 12 years ago in the same side. These cysts are interesting from the etiological point of view. They should be considered in the differential diagnosis of other radiolucent lesions of the jaws. Surgically they have a very good prognosis, and are non-aggressive lesions. PMID:27594757
Laparoscopic Excision of a Ciliated Hepatic Foregut Cyst
Mak, Grace Z.; Reynolds, Jordan P.; Tevar, Amit D.; Pritts, Timothy A.
2009-01-01
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. PMID:19366552
Tharmalingam, J; Prabhakar, A T; Gangadaran, P; Dorny, P; Vercruysse, J; Geldhof, P; Rajshekhar, V; Alexander, M; Oommen, A
2016-10-01
Neurocysticercosis (NCC), Taenia solium larval infection of the brain, is an important cause of acquired seizures in endemic countries, which relate to number, location and degenerating cysts in the brain. Multicyst infections are common in endemic countries although single-cyst infection prevails in India. Single-cyst infections in an endemic country suggest a role for host immunity limiting the infection. This study examined ex vivo CD4(+) T cells and in vitro Th1 and Th2 cytokine responses to T. solium cyst antigens of peripheral blood mononuclear cells of healthy subjects from endemic and nonendemic regions and of single- and multicyst-infected patients for association with cyst burden of NCC. T. solium cyst antigens elicited a Th1 cytokine response in healthy subjects of T. solium-endemic and T. solium-non-endemic regions and those with single-cyst infections and a Th2 cytokine response from subjects with multicyst neurocysticercosis. Multicyst neurocysticercosis subjects also exhibited low levels of effector memory CD4(+) T cells. Th1 cytokine response of T. solium exposure and low infectious loads may aid in limiting cyst number. Th2 cytokines and low effector T cells may enable multiple-cyst infections to establish and persist. © 2016 John Wiley & Sons Ltd.
Li, Nannan; Gao, Xing; Xu, Ziyuan; Chen, Zhuo; Zhu, Laikuan; Wang, Jinrui; Liu, Wei
2014-11-01
To investigate the incidence and prevalence of developmental odontogenic cysts in children and adolescents and compare the features of the two most common types, dentigerous cyst and keratocystic odontogenic tumor (KCOT). A retrospective review in a series of 369 patients with all histological diagnoses of developmental odontogenic cysts in children (≤12 years) and adolescents (13-18 years) was conducted. Among these, 361 (97.8%) patients were diagnosed as dentigerous cyst (n = 281) and KCOT (n = 80), with the male-to-female ratios of dentigerous cyst and KCOT both being 2:1. The average age of the patients with KCOT was older than that of those with dentigerous cyst (14.7 years vs 11.8 years, p < 0.001). Dentigerous cyst (59.1%) was more common in children, but KCOT (78.8%) was more common in adolescents (p < 0.001). Dentigerous cyst (57.6%) predominantly located on the maxilla, but KCOT (60.3%) predominantly located on the mandible (p = 0.010). Adolescent patients with lesions located on the mandible would favor KCOT over dentigerous cyst. This study aids in better knowledge of the prevalence of developmental odontogenic cysts in a large pediatric population, and shows that a well-supported early diagnosis is indispensable for a more adequate treatment.
Moura da Silva, Luis Fernando; Buffon, Viviane Aline; Coelho Neto, Maurício; Ramina, Ricardo
2015-10-01
Vestibular schwannomas (VS) are the most common lesions of cerebellopontine angle (CPA) corresponding to 76-91 % of the cases. Usually, these lesions present typical CT and MRI findings. Non-schwannomatous tumors restricted to the internal auditory meatus (IAM) are rare and their preoperative radiological diagnosis may be difficult. This article describes nine surgically treated intrameatal non-schwannomatous lesions (NSL) and reviews the literature. In the last 16 years, a total of 471 patients with diagnosis of VS were operated on in our department. Preoperatively, 42 patients had diagnosis of intrameatal schwannomas, but surgery revealed in nine cases NSL (3 meningiomas, 3 arachnoiditis/neuritis, 1 cavernoma, 1 vascular loop, and 1 arachnoid cyst). Most frequent symptoms presented by patients with NSL were hearing loss 89 % (8/9) of patients, tinnitus 78 % (7/9), and vertigo 33 % (3/9). Almost all lesions (8/9) presented MRI findings of isointense signal in T1W with contrast enhancement. The only exception was the arachnoid cyst with intracystic bleeding, which was hyperintense in T1W that is not enhanced with contrast. This series shows an occurrence of 21.4 % of non-schwannomatous tumors in 42 cases of lesions restricted to the IAM. Whenever a solely intrameatal enhanced tumor is detected, it is necessary to think about other diagnostic possibilities rather than VS. Therapeutic management may be changed, specially if radiosurgical treatment is considered.
Seifert, G
1996-12-01
Concerning the hypothesis that distinct types of salivary gland cysts may be the starting point of a salivary gland tumour, a histological examination of 1,661 salivary gland cysts was performed in order to analyse the cell types and their proliferative activity. Epithelial alterations were found especially in salivary duct cysts of parotid gland and in mucous retention cysts of minor salivary glands. Characteristic cellular changes were epithelial metaplasias (goblet cells, clear cells, squamous cells) and focal epithelial proliferations with plump or papillary plaques projecting into the cyst lumen. Only in one case had a mucoepidermoid carcinoma developed in the wall of a parotid duct cyst. The epithelial metaplasia and focal proliferative activity in salivary duct cysts is comparable to similar alterations in odontogenic cysts as possible early manifestation of a tumour, especially of an ameloblastoma or mucoepidermoid carcinoma. The differential diagnosis of salivary duct cysts must take primarily cystadenomas and cystic mucoepidermoid carcinomas of well-differentiated type into account.
Videothoracoscopy in the treatment of mediastinal cysts
Brzeziński, Daniel; Kozak, Józef
2014-01-01
Introduction Progress in the development of surgical techniques has led to the growing use of video-assisted thoracoscopic surgery (VATS) techniques in mediastinal cyst treatment. Aim To present our experience of treating mediastinal cysts with the minimally invasive technique. Material and methods Fifty patients with mediastinal cysts were treated from 2001 to 2011. There were 32 women and 18 men. The age of the patients ranged from 17 to 72, the mean age being 42 years. All patients underwent basic preoperative diagnostic tests of the chest: X-ray, computed tomography (CT), bronchoscopy and spirometry; 4 patients underwent endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and 3 fine needle aspiration biopsy (FNAB) of the described lesions. Results The VATS was performed in each case. Conversion was carried out due to superior mediastinal location in 10 cases and pleural adhesions in 3 cases. The partial resection of a cyst was performed in 3 patients. One patient was treated conservatively due to heart failure. In that patient the transthoracic needle aspiration of a cyst under ultrasound guidance using alcoholisation with 76% ethanol with a good effect was performed twice. Cyst recurrence was observed in 1 case. Conclusions The surgical access depends on the location of a cyst. The VATS resection of a superior mediastinal cyst is not always feasible. Surgery of mediastinal cysts is both diagnostic and curative. PMID:25337163
[Traumatic rupture of hepatic hydatid cyst].
Martino, A; Rampone, B; Schiavone, B; Viviano, C; Cuomo, O; Iovine, L; Sacco, M; Maharajan, G; Confuorto, G
2010-01-01
Hydatid disease is endemic in some areas of the world. It is located mostly in the liver. The cysts rupture is possible after a trauma, or spontaneously by the increase of intracystic pressure. Rupture of the hydatid cyst requires urgent surgical intervention. We report our experience in treatment of traumatic rupture of hepatic hydatid cyst.
Sclerotherapy for hydrocoele and epididymal cysts.
Nash, J R
1979-04-01
A prospective study was carried out on the efficacy of sclerotherapy for the treatment of hydrocoeles and epididymal cysts. Thirty-six hydrocoeles and 13 epididymal cysts were treated and followed up for between 1 and 2 years. Thirty-four hydrocoeles were cured, 1 failed to respond to treatment and 1 recurred after treatment. All 13 epididymal cysts were cured.
... and location. Sometimes, a cyst looks like a skin cancer and may need to be removed to be ... and pits. In: Patterson JW, ed. Weedon's Skin Pathology . 4th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2016: ...
An unusual encounter of an epidermoid cyst
Sritharan, Kaji; Ghani, Yaser; Thompson, Hilary
2014-01-01
Epidermoid cysts are extremely common and can occur in any hair-containing area. We present the case of a 20-year-old man with an epidermoid cyst in the perianal region. Epidermal cysts have been described in this area previously after haemorrhoidectomy, but cysts of the size seen in this case are rare in the absence of previous anal trauma. The diagnosis was confirmed by excision biopsy. PMID:24825558
Minimally invasive management of hepatic cysts: indications and complications.
Vardakostas, D; Damaskos, C; Garmpis, N; Antoniou, E A; Kontzoglou, K; Kouraklis, G; Dimitroulis, D
2018-03-01
Liver cysts are divided into congenital and acquired. Congenital cystic lesions include polycystic liver disease, simple cysts, duct related and ciliated hepatic foregut cysts. Acquired cystic lesions are divided into infectious and non-infectious. The infectious cysts are the hydatid cyst, the amoebic abscess, and the pyogenic abscess, whereas the non-infectious cysts are neoplastic cysts and false cysts. While modern medicine provides a lot of minimally invasive therapeutic modalities, there has emerged a pressing need for understanding the various types of liver cysts, the possible minimal therapeutic options along with their indications and complications. We aim is to clarify the role of minimally invasive techniques in the management of hepatic cysts. A literature review was performed using the MEDLINE database. The search terms were: liver cyst, minimally invasive, laparoscopic, percutaneous, drainage and fenestration. We reviewed 82 English language publications articles, published until October 2017. Minimally invasive management of liver LC is an emerging field including many therapeutic modalities ranging from the percutaneous aspiration of pyogenic abscesses to laparoscopic hepatectomy for hepatic cystadenomas. The most used techniques are percutaneous drainage, laparoscopic fenestration, and laparoscopic hepatectomy. The application of the various minimally invasive approaches, as well as their indication and complications, depend on the type of the cystic lesion, its size and its position in the liver. Percutaneous drainage is mostly used in simple cysts, hydatid cysts, pyogenic abscesses and bilomas. Laparoscopic fenestration is mostly used in simple cysts and polycystic liver disease. Finally, laparoscopic hepatectomy is mostly used in polycystic liver disease, hydatid cysts, and cystadenomas.
Hazard and outcome of retreated choledochal cyst patients.
Chijiiwa, K
1993-01-01
Thirty-nine patients initially treated for choledochal cyst (25: cyst-enterostomy for 15 type I and 10 type IV A, 13: cyst excision for 8 type I and 5 type IV A, 1: sphincterotomy for type III) have been completely followed up for a mean period of 17 years to examine the effect of surgical management on their lives. Eighteen of 25 cases with cyst-enterostomy (72%) needed retreatment due to the complications but one could not be retreated because of the presence of advanced bile duct carcinoma. Fourteen of 17 cases were retreated with cyst excision, of whom 12 showed an excellent outcome but other two were suffering from cholangitis and hepatolithiasis. The remaining 3 patients retreated with PTCS or cyst-enterostomy showed a poor outcome. Of 13 patients who had undergone cyst excision with hepatico-jejunostomy as the first choice, 12 showed a good outcome but one needed retreatment due to the anastomotic stenosis and hepatolithiasis. Thus, excision of cyst should be the surgical management for choledochal cyst. However, it should be noted that three of 27 patients treated initially or secondarily with cyst excision showed unsatisfactory results mainly due to the anastomotic stenosis. The results demonstrate that hepaticojejunostomy with a wide opening stoma is necessary to prevent postoperative morbidity.
Retrospective clinicopathological study of 418 odontogenic cysts.
Nuñez-Urrutia, Sergio; Figueiredo, Rui; Gay-Escoda, Cosme
2010-09-01
To determine the relative incidence of odontogenic cysts and to identify the main clinicopathological features among patients treated in the Oral Surgery Department of the Dental Clinic of the University of Barcelona (Spain). A retrospective observational study was made of 418 odontogenic cysts diagnosed in 380 patients included in the database of 1235 histopathological diagnoses. The subjects were treated in the Master degree program of Oral Surgery and Implantology of the University of Barcelona in the period 1997-2006. The following variables were recorded: gender, age, clinical characteristics of the lesions (size and location), radiological features, duration, treatment, complications and relapses. A descriptive analysis was made of the study variables, using the SPSS version 15.0. The incidence of odontogenic cysts was 33.8%. The mean patient age at appearance of the lesion was 42 years (range 7-83). The cysts were slightly more prevalent in males (58.4%). The lesion size ranged from 2-60 mm, with a mean size of 18.4 mm. The most frequent diagnosis was radicular cyst (50.2%). The most common location of the odontogenic cysts was in the mandible (61.5%), particularly the lower third molar region (36.8%). The most frequently diagnosed lesion was the radicular cyst. Odontogenic cysts were seen to be slightly more prevalent in males, and showed a high mandibular incidence. Knowledge of the biological and histological behavior of odontogenic cysts and their frequency are key aspects for ensuring early detection and adequate treatment.
Towards an Ecological Understanding of Dinoflagellate Cyst Functions
Bravo, Isabel; Figueroa, Rosa Isabel
2014-01-01
The life cycle of many dinoflagellates includes at least one nonflagellated benthic stage (cyst). In the literature, the different types of dinoflagellate cysts are mainly defined based on morphological (number and type of layers in the cell wall) and functional (long- or short-term endurance) differences. These characteristics were initially thought to clearly distinguish pellicle (thin-walled) cysts from resting (double-walled) dinoflagellate cysts. The former were considered short-term (temporal) and the latter long-term (resting) cysts. However, during the last two decades further knowledge has highlighted the great intricacy of dinoflagellate life histories, the ecological significance of cyst stages, and the need to clarify the functional and morphological complexities of the different cyst types. Here we review and, when necessary, redefine the concepts of resting and pellicle cysts, examining both their structural and their functional characteristics in the context of the life cycle strategies of several dinoflagellate species. PMID:27694774
Odontogenic cysts: analysis of 680 cases in Brazil.
Prockt, Anderson P; Schebela, Clarissa R; Maito, Fábio D M; Sant'Ana-Filho, Manoel; Rados, Pantelis V
2008-09-01
The purpose of this study was to evaluate the prevalence of 680 odontogenic cysts diagnosed in Porto Alegre, RS, Brazil, and to compare results with findings in the literature. Data of odontogenic cysts diagnosed from 1985 to 2005 were collected from the files of the Oral Pathology Laboratory of Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil, and entered in a standardized form for later comparisons. The most prevalent odontogenic cysts were radicular (72.50%), dentigerous (22.20%) and residual (4.26%) cysts. The mandible of white patients was the anatomic site and ethnic group most frequently affected by this disease. Four of the six types of cysts were more frequent in the second and fourth decades of life, and no significant differences were found between sexes in the diagnosis of odontogenic cysts. In conclusion, the prevalence of odontogenic cysts was similar to that reported in the literature, which shows that inflammatory cysts are the most frequent.
Branchial cleft cyst encircling the hypoglossal nerve
Long, Kristin L.; Spears, Carol; Kenady, Daniel E.
2013-01-01
Branchial cleft anomalies are a common cause of lateral neck masses and may present with infection, cyst enlargement or fistulas. They may affect any of the nearby neck structures, causing compressive symptoms or vessel thrombosis. We present a case of a branchial cleft cyst in a 10-year-old boy who had been present for 1year. At the time of operation, the cyst was found to completely envelop the hypoglossal nerve. While reports of hypoglossal nerve palsies due to external compression from cysts are known, we believe this to be the first report of direct nerve involvement by a branchial cleft cyst. PMID:24963902
Naegleria fowleri: enolase is expressed during cyst differentiation.
Chávez-Munguía, Bibiana; Segovia-Gamboa, Norma; Salazar-Villatoro, Lizbeth; Omaña-Molina, Maritza; Espinosa-Cantellano, Martha; Martínez-Palomo, Adolfo
2011-01-01
Cysts of Naegleria fowleri present an external single-layered cyst wall. To date, little information exists on the biochemical components of this cyst wall. Knowledge of the cyst wall composition is important to understand its resistance capacity under adverse environmental conditions. We have used of a monoclonal antibody (B4F2 mAb) that specifically recognizes enolase in the cyst wall of Entamoeba invadens. By Western blot assays this antibody recognized in soluble extracts of N. fowleri cysts a 48-kDa protein with similar molecular weight to the enolase reported in E. invadens cysts. Immunofluorescence with the B4F2 mAb revealed positive cytoplasmic vesicles in encysting amebas, as well as a positive reaction at the cell wall of mature cysts. Immunoelectron microscopy using the same monoclonal antibody confirmed the presence of enolase in the cell wall of N. fowleri cysts and in cytoplasmic vesicular structures. In addition, the B4F2 mAb had a clear inhibitory effect on encystation of N. fowleri. © 2011 The Author(s). Journal of Eukaryotic Microbiology © 2011 International Society of Protistologists.
Cervical bronchogenic cysts in head and neck region.
Ustundag, Emre; Iseri, Mete; Keskin, Gurkan; Yayla, Berna; Muezzinoglu, Bahar
2005-06-01
Congenital cysts of the neck are not uncommon. Most of these are thyroglossal, branchial cleft and thymic cysts. Bronchogenic cysts are uncommon developmental anomalies of the tracheobronchial tree and rarely occur in the neck. More than 70 cases of bronchogenic cysts in the head and neck region have been reported in the literature. We report three cases presenting with neck swelling in the hyoid region that were diagnosed as bronchogenic cysts based on clinical and histopathological findings.
Kouhsoltani, Maryam; Moradzadeh Khiavi, Monir; Jamali, Golshan; Farnia, Samira
2015-12-01
The aim of this study was to verify the density of mast cells (MCs) and microvessels in odontogenic cysts. Furthermore, the correlation between MCs and microvessels was evaluated to assess the contribution of MCs to angiogenesis and growth of odontogenic cysts. This approach may be a basis for the development of future pharmaceuticals addressed to MCs performance to manage odontogenic cysts. To our knowledge, no study investigating the correlation between MCs and microvessels has been performed to date. 60 cases of odontogenic cysts consisting of 20 radicular cysts (RCs), 20 odontogenic keratocysts (OKCs) and 20 dentigerous cysts (DCs) were included in this study. Five high power fields in superficial connective tissue and five high power fields in deep connective tissue were counted for each sample. Moreover, a total mean of ten fields was calculated. RC showed the highest mean numbers of MCs and microvessels (p<0.05). The subepithelial zones of all cysts contained more MCs and microvessels compared to the deeper zones. A statistically significant correlation between the numbers of MCs and microvessels was not observed (r=0.00, p=0.49). Although the number of MCs was not significantly associated with microvessels, these cells may be related to the growth of odontogenic lesions, particularly RCs. Further studies on the in vivo functions of MCs will make the concept more clear.
Kouhsoltani, Maryam; Moradzadeh Khiavi, Monir; Jamali, Golshan; Farnia, Samira
2015-01-01
Purpose: The aim of this study was to verify the density of mast cells (MCs) and microvessels in odontogenic cysts. Furthermore, the correlation between MCs and microvessels was evaluated to assess the contribution of MCs to angiogenesis and growth of odontogenic cysts. This approach may be a basis for the development of future pharmaceuticals addressed to MCs performance to manage odontogenic cysts. To our knowledge, no study investigating the correlation between MCs and microvessels has been performed to date. Methods: 60 cases of odontogenic cysts consisting of 20 radicular cysts (RCs), 20 odontogenic keratocysts (OKCs) and 20 dentigerous cysts (DCs) were included in this study. Five high power fields in superficial connective tissue and five high power fields in deep connective tissue were counted for each sample. Moreover, a total mean of ten fields was calculated. Results: RC showed the highest mean numbers of MCs and microvessels (p<0.05). The subepithelial zones of all cysts contained more MCs and microvessels compared to the deeper zones. A statistically significant correlation between the numbers of MCs and microvessels was not observed (r=0.00, p=0.49). Conclusion: Although the number of MCs was not significantly associated with microvessels, these cells may be related to the growth of odontogenic lesions, particularly RCs. Further studies on the in vivo functions of MCs will make the concept more clear. PMID:26793609
Oral foregut cyst in a neonate.
Rosa, Ana Cláudia Garcia; Hiramatsu, Daniel Martins; de Moraes, Fábio Roberto Ruiz; Passador-Santos, Fabrício; de Araújo, Vera Cavalcanti; Soares, Andresa Borges
2013-11-01
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.
CD56 Expression in Odontogenic Cysts and Tumors.
Jaafari-Ashkavandi, Zohreh; Dehghani-Nazhvani, Ali; Razmjouyi, Faranak
2014-01-01
Background and aims. Odontogenic cysts and tumors have a wide spectrum of clinical characteristics that lead to the different management strategies. Since definite diagnosis is difficult in some cases, it has been suggested that CD56 may be a candidate marker for definitive diagnosis of some odontogenic tumors. The present study was designed to examine CD56 expression in lesions with histopathological similarities. Materials and methods. In this cross-sectional, analytical study the subjects were 22 ameloblastomas, 13 dentigerous cysts, 10 keratocystic odontogenic tumors (KCOT), 4 adenomatoid odontogenic tumors (AOT), 3 orthokeratinized odonto-genic cysts, 3 calcifying odontogenic cysts (COC) and one glandular odontogenic cyst (GOC). All the samples were examined for CD56 immunoreactivity. Data were analyzed using chi-square test. Results. Twenty cases (91%) of ameloblastomas, 3 (75%) AOT, 4 (40%) KCOT and one case of GOC were positive for CD56. None of the dentigerous cysts, COC and orthokeratinized odontogenic cysts was CD56-positive. There was a significant difference in the CD56 expression between ameloblastoma and dentigerous cyst, as well as COC. Also, KCOT showed significantly higher expression than orthokeratinized odontogenic cyst. Conclusion. In this study CD56 expression was limited to the odontogenic tumors and more aggressive cystic lesions. This marker can be a useful aid for distinguishing cysts and tumors from similar lesions.
Expression of extracellular matrix metalloproteinase inducer in odontogenic cysts.
Ali, Mohammad Abdulhadi Abbas
2008-08-01
Extracellular matrix metalloproteinase inducer (EMMPRIN) is known to induce matrix metalloproteinase (MMP) production. The expression of EMMPRIN in odontogenic cysts has not been previously studied. This study was done to determine the presence and the variability of EMMPRIN expression in various types of odontogenic cysts. An immunohistochemical study using a polyclonal anti-EMMPRIN antibody was done using 48 odontogenic cyst cases: 13 odontogenic keratocysts (OKCs), 18 dentigerous cysts (DCs), and 17 periapical cysts (PAs). Twelve cases of normal dental follicles (DFs) were also included in this study for comparison. EMMPRIN immunoreactivity was detected in all of the cysts and DFs studied. In odontogenic cysts, EMMPRIN immunoreactivity was generally higher in basal cells than in suprabasal cells. The overall EMMPRIN expression in the epithelial lining of the 3 different types of odontogenic cyst was significantly higher than in the DFs. Overall EMMPRIN expression was also found to be significantly higher in the epithelial lining of OKCs than in the other types of cysts. This study confirmed that EMMPRIN is present in odontogenic cysts and DFs. The higher EMMPRIN expression in OKCs suggests that it may be involved in the aggressive behavior of this type of cyst.
Neonatal ovarian cysts: ultrasound assessment and differential diagnosis.
Llorens Salvador, R; Sangüesa Nebot, C; Pacheco Usmayo, A; Picó Aliaga, S; Garcés Iñigo, E
Ovarian cysts are the most common abdominal cysts in female fetuses and newborn girls. Ultrasonography is the imaging technique of choice for diagnosing ovarian cysts because it makes it possible to differentiate them from other cystic lesions. Although most neonatal ovarian cysts regress in the first few months after birth, complications can occur during gestation or after birth. The manifestations of ovarian cysts on ultrasonography will depend on the complications. The management is controversial, although the current trend favors watchful waiting. We describe the different presentations of neonatal ovarian cysts with their complications and their patterns of findings on ultrasonography. We also discuss the differential diagnosis with other cystic abdominal lesions, and finally we discuss the therapeutic management of neonatal ovarian cysts. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.
Arthroscopic Decompression for a Giant Meniscal Cyst.
Ohishi, Tsuyoshi; Suzuki, Daisuke; Matsuyama, Yukihiro
2016-01-01
The authors report the case of a giant medial meniscal cyst in an osteoarthritic knee of an 82-year-old woman that was successfully treated with only arthroscopic cyst decompression. The patient noticed a painful mass on the medial side of the right knee that had been gradually growing for 5 years. Magnetic resonance imaging showed an encapsulated large medial cystic mass measuring 80×65×40 mm that was adjacent to the medial meniscus. An accompanying horizontal tear was also detected in the middle and posterior segments of the meniscus. The medial meniscus was resected up to the capsular attachment to create bidirectional flow between the joint and the cyst with arthroscopic surgery. Magnetic resonance imaging performed 14 months postoperatively showed that the cyst had completely disappeared, and no recurrence was observed during a 2-year follow-up period. An excellent result could be obtained by performing limited meniscectomy to create a channel leading to the meniscal cyst, even though the cyst was large. Among previously reported cases of meniscal cysts, this case is the largest to be treated arthroscopically without open excision. Copyright 2016, SLACK Incorporated.
Ossifying fibroma misdiagnosed as chronic apical periodontitis.
de Moraes Ramos-Perez, Flávia Maria; Soares, Ulysses Nicida; Silva-Sousa, Yara Teresinha Corrêa; da Cruz Perez, Danyel Elias
2010-03-01
Ossifying fibroma mimicking chronic apical periodontitis is extremely rare. This report describes a case of ossifying fibroma located in the periapical region of the mandibular right canine that was misdiagnosed as chronic apical periodontitis. A 40-year-old woman complained of slight pain in the right anterior mandibular region without mucosal abnormalities or swelling. Radiographically, a well-circumscribed, unilocular, radiolucent lesion was observed that was located in the periapical region of the mandibular right canine, which presented an endodontically treated root canal. Under local anesthesia, the lesion was fully excised. Microscopically, there was fibrocellular connective tissue associated with a mineralized component, which consisted of lamellar or trabecular and woven bone, compatible with the diagnosis of ossifying fibroma. Although it is very rare, ossifying fibroma should be considered in the differential diagnosis of unusual or persistent apical radiolucencies. Copyright (c) 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
Clinical approach to incidental pancreatic cysts
Chiang, Austin L; Lee, Linda S
2016-01-01
The approach to incidentally noted pancreatic cysts is constantly evolving. While surgical resection is indicated for malignant or higher risk cysts, correctly identifying these highest risk pancreatic cystic lesions remains difficult. Using parameters including cyst size, presence of solid components, and pancreatic duct involvement, the 2012 International Association of Pancreatology (IAP) and the 2015 American Gastroenterological Association (AGA) guidelines have sought to identify the higher risk patients who would benefit from further evaluation using endoscopic ultrasound (EUS). Not only can EUS help further assess the presence of solid component and nodules, but also fine needle aspiration of cyst fluid aids in diagnosis by obtaining cellular, molecular, and genetic data. The impact of new endoscopic innovations with novel methods of direct visualization including confocal endomicroscopy require further validation. This review also highlights the differences between the 2012 IAP and 2015 AGA guidelines, which include the thresholds for sending patients for EUS and surgery and methods, interval, and duration of surveillance for unresected cysts. PMID:26811661
Primary hydatid cyst of the neck.
Mujtaba, Syeddah Shafaq; Faridi, Naveen; Haroon, Saroona
2013-11-01
Hydatid cysts in the neck are relatively exceptional, even in areas where Echinococcus granulosis is endemic, such as Asia. Although liver and lung are frequent sites of involvement, it can involve all tissues, with neck remaining one of the most rare sites. It should come in the differential diagnosis of cystic lesion of neck, as the treatment options differ widely from common neck cysts. The role of radiological investigation is important and, in these cases, the involvement of other organs should be investigated. Serological tests may be helpful. The major treatment modality is surgical and the cyst should be excised as a whole, without being ruptured, to prevent any treatment complications, as the cyst fluid can initiate an anaphylactic reaction. Postoperative albendazole therapy is recommended particularly when there is intra-operative spillover. We report a case of an isolated hydatid cyst localized in the anterior triangle of the neck without any pulmonary or hepatic involvement.
Bilateral nasolabial cysts associated with recurrent dacryocystitis.
Kyrmizakis, Dionysios E; Lachanas, Vassilios A; Benakis, Antonios A; Velegrakis, George A; Aslanides, Ioannis M
2005-05-01
Nasolabial cysts are rare, nonodontogenic, soft-tissue, developmental cysts occurring inferior to the nasal alar region. They are thought to arise from remnants of the nasolacrimal ducts and they are frequently asymptomatic. We report a rare case of bilateral nasolabial cysts accompanied by bilateral chronic dacryocystitis. A 48-year-old woman suffering from bilateral chronic dacryocystitis was referred to our department for endonasal dacryocystorhinostomy. She had undergone external dacryocystorhinostomy on the left side a few years earlier. Physical examination and computed tomography scan revealed nasolabial cysts bilaterally inferior to the nasal alar region. The cysts were removed via a sublabial approach and endoscopic dacryocystorhinostomy was performed on the right side. Ten months after surgery, the patient was asymptomatic. There may be a correlation, due to embryological reasons, between the presence of nasolabial cysts and the presence of chronic dacryocystitis. Both can be corrected surgically, under the same anaesthesia, without visible scar formation.
Diagnosing aneurysmal and unicameral bone cysts with magnetic resonance imaging.
Sullivan, R J; Meyer, J S; Dormans, J P; Davidson, R S
1999-09-01
The differential between aneurysmal bone cysts and unicameral bone cysts usually is clear clinically and radiographically. Occasionally there are cases in which the diagnosis is not clear. Because natural history and treatment are different, the ability to distinguish between these two entities before surgery is important. The authors reviewed, in a blinded fashion, the preoperative magnetic resonance images to investigate criteria that could be used to differentiate between the two lesions. All patients had operative or pathologic confirmation of an aneurysmal bone cyst or unicameral bone cyst. The authors analyzed the preoperative magnetic resonance images of 14 patients with diagnostically difficult bone cysts (eight children with unicameral bone cysts and six children with aneurysmal bone cysts) and correlated these findings with diagnosis after biopsy or cyst aspiration and contrast injection. The presence of a double density fluid level within the lesion strongly indicated that the lesion was an aneurysmal bone cyst, rather than a unicameral bone cyst. Other criteria that suggested the lesion was an aneurysmal bone cyst were the presence of septations within the lesion and signal characteristics of low intensity on T1 images and high intensity on T2 images. The authors identified a way of helping to differentiate between aneurysmal bone cysts and unicameral bone cysts on magnetic resonance images. Double density fluid level, septation, and low signal on T1 images and high signal on T2 images strongly suggest the bone cyst in question is an aneurysmal bone cyst, rather than a unicameral bone cyst. This may be helpful before surgery for the child who has a cystic lesion for which radiographic features do not allow a clear differentiation of unicameral bone cyst from aneurysmal bone cyst.
A giant ovarian cyst in a neonate.
Soccorso, Giampiero; Walker, Jenny
2009-06-01
Antenatally diagnosed abdominal cysts are common, and frequently are ovarian in origin, which usually regress spontaneously. Surgery is indicated in the infantile period in case of very large, persisting or symptomatic cysts. Many surgeons feel that watchful waiting can be justified in newborns with simple and complex cysts. We present a neonate with an ovarian cyst diagnosed antenatally by ultrasound (US) and showing persistent enlargement within 3 months after birth when reached a diameter of 13 cm. Assessment and treatment is described. The extremely large, non-resolving ovarian cysts in neonates present a major challenge for clinicians and should be treated by surgery to avoid complications. We advocate laparotomy and cystectomy when possible to avoid unnecessary loss of functional ovarian tissue.
Follow-up of pineal cysts in children: is it necessary?
Jussila, Miro-Pekka; Olsén, Päivi; Salokorpi, Niina; Suo-Palosaari, Maria
2017-12-01
Pineal cysts are common incidental findings in children undergoing magnetic resonance imaging (MRI). Several studies have suggested MRI follow-up if the cyst is larger than 10 mm. However, cysts do not usually change during follow-up. Prevalence, growth, and structure of the pineal cysts were analyzed to decide if follow-up MRI is necessary. A retrospective review between 2010 and 2015 was performed using 3851 MRI examinations of children aged 0-16 years to detect pineal cysts having a maximum diameter ≥ 10 mm. Eighty-one children with pineal cysts were identified and 79 of them had been controlled by MRI. Cysts were analyzed for the size, growth, and structure. A total of 1.8% of the children had a pineal cyst with a diameter ≥ 10 mm. Cysts were present in 48 girls (59.3%) and 33 boys (40.7%). Most pineal cysts (70/79) did not significantly grow during the follow-up (median 10 months, range 3-145 months). A total of 11.4% (9/79) of the cysts grew with the biggest change measured from the outer cyst wall sagittal anteroposterior dimension (mean 3.4 mm ± 1.7 mm). Only one cyst grew more than 5 mm. We found no factors correlating with the cyst growth among 9 cysts that grew > 2 mm. A majority of pineal cysts remained unchanged during the MRI follow-up. Results of this study suggest that routine MRI follow-up of pineal cysts is not necessary in the absence of unusual radiological characteristics or related clinical symptoms.
Khamaysi, Iyad; Abu Ammar, Aiman; Vasilyev, Gleb; Arinstein, Arkadii; Chowers, Yehuda; Zussman, Eyal
2017-01-01
Differentiation between mucinous and non-mucinous pancreatic cysts is exceedingly important and challenging, particularly as the former bears malignant transformation potential. Pancreatic cyst fluid (PCF)-based diagnostics, including analyses of biochemical markers, as well as cytology, has shown inadequate accuracy. Herein, a preliminary single-center study of 22 PCF samples, collected by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA), assessed the rheological behavior of PCF and its correlation with lesion type. The dependence of PCF shear viscosity on shear rate was found to follow a power law and could be fitted using Ostwald–de Waele model. Three types of flow curves were identified, where two types correlated with non-mucinous cysts, differing by their power law exponent, and the third type corresponding to mucinous cysts. Viscosity measured at a high shear rate was shown to serve as an accurate and independent marker distinguishing between mucinous and non-mucinous cysts, with an optimal cutoff value of ηc = 1.3 cP The accuracy of this novel technique proved superior to string-sign, cytology, carcinoembryonic antigen, and amylase assessments. Moreover, the combined predictive value of ηc and patient age provided for sensitivity and specificity of 100% and 95.5%, respectively. This simple and rapid diagnostic tool can be immediately implemented after EUS-FNA sampling. PMID:28358122
Caveolin-1 expression in odontogenic cysts and ameloblastomas.
Jaafari-Ashkavandi, Zohreh; Pardis, Soheil; Asadzadeh, Maryam; Andisheh-Tadbir, Azadeh; Dehghani-Nazhvani, Ali
2014-01-01
The aim of this study is to evaluate the caveolin-1 expression in a group of odontogenic cysts and tumors. In this cross-sectional study, the expression of caveolin-1 was evaluated immunohistochemically in 75 samples including 18 cases of dentigerous cyst, 18 odontogenic keratocysts, 3 orthokeratinized odontogenic cysts, 2 calcifying odontogenic cysts and 34 ameloblastomas (solid and unicystic). Positive immunohistochemical reaction was found in 100% of odontogenic cysts and this was significantly more than both unicystic (65%) and solid (55%) ameloblastomas. The present study showed the expression of caveolin-1 in all odontogenic cysts and more than ameloblastomas. The results suggested that absence of caveolin-1 might enhance aggressiveness of odontogenic lesions and could be a useful marker for distinguishing ameloblastomas from other odontogenic lesions.
Başgül, A; Kavak, Z N; Gökaslan, H; Küllü, S
2002-01-01
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. PMID:12530482
Orbital dermoid and epidermoid cysts: case study.
Veselinović, Dragan; Krasić, Dragan; Stefanović, Ivan; Veselinović, Aleksandar; Radovanović, Zoran; Kostić, Aleksandar; Cvetanović, Marija
2010-01-01
Dermoid and epidermoid cysts of the orbit belong to choristomas, tumours that originate from the aberrant primordial tissue. Clinically, they manifest as cystic movable formations mostly localized in the upper temporal quadrant of the orbit. They are described as both superficial and deep formations with most frequently slow intermittent growth. Apart from aesthetic effects, during their growth, dermoid and epidermoid cysts can cause disturbances in the eye motility, and in rare cases, also an optical nerve compression syndrome. In this paper, we described a child with a congenital orbital dermoid cyst localized in the upper-nasal quadrant that was showing signs of a gradual enlargement and progression. The computerized tomography revealed a cyst of 1.5-2.0 cm in size. At the Maxillofacial Surgery Hospital in Nis, the dermoid cyst was extirpated in toto after orbitotomy performed by superciliary approach. Postoperative course was uneventful, without inflammation signs, and after two weeks excellent functional and aesthetic effects were achieved. Before the decision to treat the dermoid and epidermoid cysts operatively, a detailed diagnostic procedure was necessary to be done in order to locate the cyst precisely and determine its size and possible propagation into the surrounding periorbital structures. Apart from cosmetic indications, operative procedures are recommended in the case of cysts with constant progressions, which cause the pressure to the eye lobe, lead to motility disturbances and indirectly compress the optical nerve and branches of the cranial nerves III, IV and VI.
Cysts of the oro-facial region: A Nigerian experience
Lawal, AO; Adisa, AO; Sigbeku, OF
2012-01-01
Aim: Though many studies have examined cysts of the jaws, most of them focused on a group of cysts and only few have examined cysts based on a particular classification. The aim of this study is to review cysts of the oro-facial region seen at a tertiary health centre in Ibadan and to categorize these cases based on Lucas, Killey and Kay and WHO classifications. Materials and Methods: All histologically diagnosed oro-facial cysts were retrieved from the oral pathology archives. Information concerning cyst type, topography, age at time of diagnosis and gender of patients was gathered. Data obtained was analyzed with the SPSS 18.0.1 version software. Results: A total of 92 histologically diagnosed oro-facial cysts comprising 60 (65.2%) males and 32 (34.8%) females were seen. The age range was 4 to 73 years with a mean age of 27.99 ± 15.26 years. The peak incidence was in the third decade. The mandible/ maxilla ratio was 1.5:1. Apical periodontal was the most common type of cyst accounting for 50% (n = 46) of total cysts observed. Using the WHO classification, cysts of the soft tissues of head, face and neck were overwhelmingly more common in males than females with a ratio of 14:3, while non-epithelial cysts occurred at a 3:1 male/female ratio. Conclusion: This study showed similar findings in regard to type, site and age incidence of oro-facial cysts compared to previous studies and also showed that the WHO classification protocol was the most comprehensive classification method for oro-facial cysts. PMID:22923885
Water relations during desiccation of cysts of the potato-cyst nematode Globodera rostochiensis.
Wharton, D A; Worland, M R
2001-03-01
The loss during desiccation of osmotically active water (OAW), which freezes during cooling to -45 degrees C, and osmotically inactive water (OIW), which remains unfrozen, from the cysts of the potato cyst nematode, Globodera rostochiensis, was determined using differential scanning calorimetry. Exotherms and endotherms associated with non-egg compartments were not detected after 5 min desiccation at 50% relative humidity and 20 degrees C. The pattern of water loss from the cysts indicates that water is lost from compartments outside the eggs first, that nearly all the non-egg water is OAW and that the OIW content of the cyst is contained within the eggs. Water is lost from the eggs only after the OAW content outside the eggs falls below that within the eggs. Both OAW and OIW are lost from the eggs during desiccation but the eggs retain a small amount of OIW. Other animals which survive some desiccation but which are not anhydrobiotic will tolerate the loss of OAW but not the loss of their OIW. Anhydrobiotic animals can survive the loss of both their OAW and a substantial proportion of their OIW.
The predominant bacteria isolated from radicular cysts
2013-01-01
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. PMID:24011184
Metastases of Hepatocellular Carcinoma Misdiagnosed as Isolated Hypertrophic Cardiomyopathy.
Greco, Assunta; De Masi, Roberto; Orlando, Stefania; Metrangolo, Antonio; Zecca, Vittorio; Morciano, Giancarlo; De Donno, Antonella; Bagordo, Francesco; Piccinni, Giancarlo
At present, cardiac metastasis of hepatocellular carcinoma is rarely mentioned in the literature. We report a hepatocellular carcinoma patient with cardiac metastasis misdiagnosed as hypertrophic cardiomyopathy in 2011. Two years later, on presentation of syncope, an abnormal ventricular septal size was recorded by ultrasound scan, and was subsequently shown by magnetic resonance imaging to be a tumour lesion. A myocardial biopsy confirmed infiltration of hepatocellular carcinoma. This observation underlines the risk of hepatocellular carcinoma cardiac metastasis, manifested in its infiltrative form as hypertrophic cardiomyopathy. In conclusion, we suggest that the ultrasound appearance of hypertrophic cardiomyopathy in hepatocellular carcinoma patients should be seen as a "red flag" and recommend the introduction of magnetic resonance imaging assessment of transplant candidates.
Migrating lumbar facet joint cysts.
Palmieri, Francesco; Cassar-Pullicino, Victor N; Lalam, Radhesh K; Tins, Bernhard J; Tyrrell, Prudencia N M; McCall, Iain W
2006-04-01
The majority of lumbar facet joint cysts (LFJCs) are located in the spinal canal, on the medial aspect of the facet joint with characteristic diagnostic features. When they migrate away from the joint of origin, they cause diagnostic problems. In a 7-year period we examined by computed tomography (CT) and magnetic resonance (MR) imaging five unusual cases of facet joint cysts which migrated from the facet joint of origin. Three LFJCs were identified in the right S1 foramen, one in the right L5-S1 neural foramen and one in the left erector spinae and multifidus muscles between the levels of L2-L4 spinous process. Awareness that spinal lesions identified at MRI and CT could be due to migrating facet joint cyst requires a high level of suspicion. The identification of the appositional contact of the cyst and the facet joint needs to be actively sought in the presence of degenerative facet joints.
Automated classification of four types of developmental odontogenic cysts.
Frydenlund, A; Eramian, M; Daley, T
2014-04-01
Odontogenic cysts originate from remnants of the tooth forming epithelium in the jaws and gingiva. There are various kinds of such cysts with different biological behaviours that carry different patient risks and require different treatment plans. Types of odontogenic cysts can be distinguished by the properties of their epithelial layers in H&E stained samples. Herein we detail a set of image features for automatically distinguishing between four types of odontogenic cyst in digital micrographs and evaluate their effectiveness using two statistical classifiers - a support vector machine (SVM) and bagging with logistic regression as the base learner (BLR). Cyst type was correctly predicted from among four classes of odontogenic cysts between 83.8% and 92.3% of the time with an SVM and between 90 ± 0.92% and 95.4 ± 1.94% with a BLR. One particular cyst type was associated with the majority of misclassifications. Omission of this cyst type from the data set improved the classification rate for the remaining three cyst types to 96.2% for both SVM and BLR. Copyright © 2013 Elsevier Ltd. All rights reserved.
Epidermoid cyst of the breast: Mammography, ultrasound, MRI.
Wynne, Elisabeth; Louie, Adeline
2011-01-01
Epidermal cysts are common cysts located cutaneously or subcutaneously in the head, neck, and trunk. However, deep epidermal cysts of the breast are very rare, and are frequently associated with traumatic implantation. We present the case of a 62-year-old woman with a palpable mass in the right breast. The patient was evaluated using mammography, ultrasound, and MRI, which uniquely characterized the mass and revealed a second mass. Histological analysis revealed fragments of an epidermoid cyst. The origin of the cysts and location deep within the breast tissue likely were due to a previous bilateral-reduction mammoplasty.
Recurrent intramedullary epidermoid cyst of conus medullaris
Fleming, Christina; Kaliaperumal, Chandrasekaran; O’Sullivan, Michael
2011-01-01
Spinal intramedullary epidermoid cyst is a rare condition. Recurrent epidermoid cyst in the spine cord is known to occur. The authors describe a case of recurrent conus medullaris epidermoid cyst in a 24-year-old female. She initially presented at 7 years of age with bladder disturbance in the form of diurnal enuresis and recurrent urinary tract infection. MRI lumbar spine revealed a 4 cm conus medullaris epidermoid cyst. Since the initial presentation, the cyst had recurred seven times in the same location and she underwent surgical intervention in the form of exploration and debulking. This benign condition, owing to its anatomical location, has posed a surgical and overall management challenge. This occurrence is better managed in a tertiary-care centre requiring multi-disciplinary treatment approach. PMID:22669964
Bone cysts: unicameral and aneurysmal bone cyst.
Mascard, E; Gomez-Brouchet, A; Lambot, K
2015-02-01
Simple and aneurysmal bone cysts are benign lytic bone lesions, usually encountered in children and adolescents. Simple bone cyst is a cystic, fluid-filled lesion, which may be unicameral (UBC) or partially separated. UBC can involve all bones, but usually the long bone metaphysis and otherwise primarily the proximal humerus and proximal femur. The classic aneurysmal bone cyst (ABC) is an expansive and hemorrhagic tumor, usually showing characteristic translocation. About 30% of ABCs are secondary, without translocation; they occur in reaction to another, usually benign, bone lesion. ABCs are metaphyseal, excentric, bulging, fluid-filled and multicameral, and may develop in all bones of the skeleton. On MRI, the fluid level is evocative. It is mandatory to distinguish ABC from UBC, as prognosis and treatment are different. UBCs resolve spontaneously between adolescence and adulthood; the main concern is the risk of pathologic fracture. Treatment in non-threatening forms consists in intracystic injection of methylprednisolone. When there is a risk of fracture, especially of the femoral neck, surgery with curettage, filling with bone substitute or graft and osteosynthesis may be required. ABCs are potentially more aggressive, with a risk of bone destruction. Diagnosis must systematically be confirmed by biopsy, identifying soft-tissue parts, as telangiectatic sarcoma can mimic ABC. Intra-lesional sclerotherapy with alcohol is an effective treatment. In spinal ABC and in aggressive lesions with a risk of fracture, surgical treatment should be preferred, possibly after preoperative embolization. The risk of malignant transformation is very low, except in case of radiation therapy. Copyright © 2014 Elsevier Masson SAS. All rights reserved.
[Epidermal cyst and osteolysis of the cranial vault].
Guillaud, V; Rémond, J; Balme, B; Moulin, G
1992-01-01
In a 40-year old man undergoing, under local anaesthesia, excision of an epidermal cyst located in the frontal region, at the border of the scalp, the operator had difficulties in removing the deep part of the cyst and perceived an underlying bone depression. The depression was caused by a 2 x 1.3 cm wide lacuna in the calvarium, which was subsequently treated by neurosurgeons. Histology showed only fragments of a simple epidermal cyst wall and no evidence of dermoid cyst. The causes of osteolysis associated with congenital or acquired skin lesions are reviewed. In this case, the old age and volume of the cyst may explain the osteolysis by mechanical compression. This case is exceptional since we were unable to find other examples in the literature, apart from dermoid and trichilemmal cysts.
Surgical management of anterior chamber epithelial cysts.
Haller, Julia A; Stark, Walter J; Azab, Amr; Thomsen, Robert W; Gottsch, John D
2003-03-01
To review management strategies for treatment of anterior chamber epithelial cysts. Retrospective review of consecutive interventional case series. Charts of patients treated for epithelial ingrowth over a 10-year period by a single surgeon were reviewed. Cases of anterior chamber epithelial cysts were identified and recorded, including details of ocular history, preoperative and postoperative acuity, intraocular pressure (IOP), and ocular examination, type of surgical intervention, and details of further procedures performed. Seven eyes with epithelial cysts were identified. Patient age ranged from 1.5 to 53 years at presentation. Four patients were children. In four eyes, cysts were secondary to trauma, one case was presumably congenital, one case developed after corneal perforation in an eye with Terrien's marginal degeneration, and one case developed after penetrating keratoplasty (PK). Three eyes were treated with vitrectomy, en bloc resection of the cyst and associated tissue, fluid-air exchange and cryotherapy. The last four eyes were treated with a new conservative strategy of cyst aspiration (three cases) or local excision (one keratin "pearl" cyst), and endolaser photocoagulation of the collapsed cyst wall/base. All epithelial tissue was successfully eradicated by clinical criteria; one case required repeat excision (follow-up, 9 to 78 months, mean 45). Two eyes required later surgery for elevated IOP, two for cataract extraction and one for repeat PK. Final visual acuity ranged from 20/20 to hand motions, depending on associated ocular damage. Best-corrected visual results were obtained in the more conservatively managed eyes. Anterior chamber epithelial cysts can be managed conservatively in selected cases with good results. This strategy may be particularly useful in children's eyes, where preservation of the lens, iris, and other structures may facilitate amblyopia management. Copyright 2003 by Elsevier Science Inc.
Vocal cysts: clinical, endoscopic, and surgical aspects.
Martins, Regina Helena Garcia; Santana, Marcela Ferreira; Tavares, Elaine Lara Mendes
2011-01-01
Vocal cysts are benign laryngeal lesions, which affect children and adults. They can be classified as epidermic or mucous-retention cyst. The objective was to study the clinical, endoscopic, and surgical aspects of vocal cysts. We reviewed the medical charts of 72 patients with vocal cysts, considering age, gender, occupation, time of vocal symptoms, nasosinusal and gastroesophageal symptoms, vocal abuse, tabagism, alcoholism, associated lesions, treatment, and histological details. Of the 72 cases, 46 were adults (36 females and 10 male) and 26 were children (eight girls and 18 boys). As far as occupation is concerned, there was a higher incidence of students and teachers. All the patients had symptoms of chronic hoarseness. Nasosinusal (27.77%) and gastroesophageal (32%) symptoms were not relevant. Vocal abuse was reported by 45.83%, smoking by 18%, and alcoholism by 8.4% of the patients. Unilateral cysts were seen in 93% of the cases, 22 patients had associated lesions, such as bridge, sulcus vocalis, and microweb. Surgical treatment was performed in 46 cases. Histological analysis of the epidermic cysts revealed a cavity with caseous content, covered by stratified squamous epithelium, often keratinized. Mucous cysts presented mucous content, and the walls were coated by a cylindrical ciliated epithelium. Vocal cysts are benign vocal fold lesions that affect children and adults, being often associated with vocal overuse, which frequently affects people who use their voices professionally. Vocal symptoms are chronic in course, often times since childhood, and the treatment of choice is surgical removal. A careful examination of the vocal folds is necessary during surgery, because other laryngeal lesions may be associated with vocal cysts. Copyright © 2011 The Voice Foundation. Published by Mosby, Inc. All rights reserved.
Traumatic bone cyst resembling apical periodontitis.
Rosen, D J; Ardekian, L; Machtei, E E; Peled, M; Manor, R; Laufer, D
1997-10-01
Among the pseudocysts of the jaws, the traumatic bone cyst is known as an asymptomatic lesion often noted unintentionally during routine radiographic examinations. The lesion neither devitalizes the teeth within its borders, nor does it cause resorption of their roots. The well-demarcated traumatic bone cyst often projects into the intraradicular septa and hence has been described as having scalloped borders. The following presentation is of a traumatic bone cyst that resembled periodontal pathology in its appearance.
Species of Heterodera cysts in cereal fields in Flanders.
Yilmaz, Zeliha Colak; Deeren, Anne-Marie; De Sutter, Nancy; Viaene, Nicole
2009-01-01
Heterodera is a genus of cyst-forming nematodes, including the cereal cysts which can provoke yield reductions in grain crops. As little is known about the occurrence of these cysts in Belgian grain fields, a survey was organized, starting in Flanders. Soil samples were taken from 50 fields where cereals are grown in rotation with mainly beet, potato and vegetables. Cysts were extracted from the 112 samples and 10 individuals per sample were identified up to species level by morphometrical and morphological observations. The beet cyst nematode, Heterodera schachtii, was found in 34 fields (56%) at infestation levels varying from 0.6 to 1322 cysts/kg soil. Other Heterodera species (e.g. H. trifolii, H. mani) were found in low numbers and sometimes in mixtures with H. schachtii, but no cereal cysts were detected. This survey confirms that beet cyst nematodes are a problem in Flanders. The few cereal cysts that might be present were perhaps not detected due to the few individuals that were identified. For this reason, molecular identification tools which allow fast and accurate identification of Heterodera species would be very useful. It could be interesting to find out why cereal cysts are suppressed in our regions and to expand the survey to the Walloon region where more cereals are grown.
Surgical treatment for hypopharyngeal cysts with a side-opened direct laryngoscope.
Kawaida, M; Fukuda, H; Shiotani, A; Kohno, N
1994-01-01
Two cases of hypopharyngeal cyst are reported. Both cysts occurred in the piriform sinus of the hypopharynx. Histopathological examination indicated that both were retention cysts. These cysts were removed by laryngomicrosurgical technique using a side-opened direct laryngoscope. In the cyst with a distinct base, a laryngomicrosurgical snare was used for removal. In the wide-based cyst, the mucous membrane around the cyst was incised with an electrosurgical instrument and then detached to facilitate removal. In this paper, we describe our surgical procedure for removing hypopharyngeal cysts and discuss the causes of such cysts.
... with aspiration and injection therapy, there are nevertheless cases in which the ganglion cyst returns. Find an ACFAS Physician Search Search Tools Find an ACFAS Physician: Search by Mail Address ...
Extraforaminal Discal Cyst as Cause of Radiculopathy.
Mathon, Bertrand; Bienvenot, Peggy; Leclercq, Delphine
2018-01-01
We report the first extraforaminal location of a lumbar discal cyst. The patient was treated by hemilaminectomy, arthrectomy, cyst resection, and unilateral arthrodesis, achieving complete release of the nerve root. Extraforaminal lumbar discal cyst may represent an unexpected cause of sciatic pain with favorable outcome after surgical resection. Copyright © 2017 Elsevier Inc. All rights reserved.
Ultrasound biomicroscopic analysis of iris cysts.
Pedro-Aguilar, L; Fuentes-Cataño, C; Pedroza-Seres, M
2016-02-01
To describe the ultrasound biomicroscopic (UBM) features and complications associated with iris cysts. A retrospective case series. Thirteen patients with iris cysts were identified in a 10 year period study at a ophthalmologic reference Center in Mexico City. The variables included demographic data, ocular and medical history, clinical course, and complications. All patients were examined by UBM, and type, number, location, and acoustic characteristics of cysts were evaluated. Descriptive statistics were performed. Thirteen patients were included (8 men and 5 women). The mean age was 44.5 ± 15.5 years (range 6-70 years). The origin most prevalent was neuroepithelial (92.3%), and 7.7% had stromal cysts. Regarding to location 76.9% were found in the periphery, and 69.2% between meridians II and VI. All cysts showed a moderate to high reflectivity in the wall. Complications were present in 38.5% of cases (15.4% partial angle closure, 15.4% secondary angle closure glaucoma and 7.7% dyscoria). Most cysts are derived from iris pigmented epithelium, with a benign course and a minor rate of complications. The UBM is an indispensable tool that allows us to plan more specific and conservative treatments, with less damage to ocular structures and, therefore, better visual prognosis. Copyright © 2015 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.
Supratentorial endodermal cysts: review of literature and case report.
Caruso, Riccardo; Artico, Marco; Colonnese, Claudio; Marrocco, Luigi; Wierzbicki, Venceslao
2013-11-01
Supratentorial endodermal cysts are very rare pathological entities. Their pathoembryology is largely unknown and they can represent a diagnostic challenge. A research performed on the PubMed database in December 2010, to screen for supratentorial endodermal cyst studies, demonstrated that since 1960 only 31 supratentorial endodermal cysts have been described in the literature, including our case: a 42-year-old woman with a parasellar endodermal cyst. These lesions are usually benign. As with other types of brain cysts, the signs and symptoms caused by supratentorial endodermal cysts are mainly linked to the compression or irritation of surrounding neural structures. Upon neuroimaging examination, they typically appear as a round or lobulated mass. The signal intensity may vary depending on the protein content of the cyst. The majority of reported supratentorial endodermal cysts were completely excised with good or excellent results. Incomplete excision can result in an increased risk of recurrence, infection, and dissemination. Georg Thieme Verlag KG Stuttgart · New York.
[Giant intradiploic infratentorial epidermoid cyst].
Alberione, F; Caire, F; Fischer-Lokou, D; Gueye, M; Moreau, J J
2007-10-01
Epidermoid cysts are benign, uncommon lesions (1% of all intracranial tumors). Their localization is intradiploic in 25% of cases, and exceptionally subtentorial. We report here a rare case of giant intradiploic infratentorial epidermoid cyst. A 74-year old patient presented with recent diplopia and sindrome cerebellar. CT scan and MR imaging revealed a giant osteolytic extradural lesion of the posterior fossa (5.2 cm x 3.8 cm) with a small area of peripheral enhancement after contrast injection. Retrosigmoid suboccipital craniectomy allowed a satisfactory removal of the tumor, followed by an acrylic cranioplasty. The outcome was good. Neuropathological examination confirmed an epidermoid cyst. We review the literature and discuss our case.
Percutaneous drainage without sclerotherapy for benign ovarian cysts.
Zerem, Enver; Imamović, Goran; Omerović, Safet
2009-07-01
To evaluate percutaneous short-term catheter drainage in the management of benign ovarian cysts in patients at increased surgical risk. Thirty-eight patients with simple ovarian cysts were treated with drainage of fluid content by catheters until output stopped. All patients were poor candidates for surgery. All procedures were performed under ultrasonographic (US) control and local anesthesia. Cytologic examination was performed in all cases. The patients were followed up monthly with color Doppler US for 12 months. Outcome measure was the recurrence of a cyst. During the 12-month follow-up period, 10 of 38 cysts recurred. Seven of the 10 cysts required further intervention, and three were followed up without intervention. Four of the seven patients who required further intervention underwent repeat transabdominal aspiration and three declined repeat aspiration and subsequently underwent surgery. After repeated aspirations, two of four cysts disappeared, one necessitated follow-up only, and one necessitated surgical intervention. Cyst volume (P = .009) and diameter (P = .001) were significantly larger in the cysts that recurred. No evidence of malignancy was reported in the cytologic examination in any patient. No patients developed malignancy during follow-up. No major complications were observed. The hospital stay was 1 day for all patients. The median duration of drainage in the groups with resolved and recurrent cysts was 1 day (interquartile range, 1-1) and 2 days (interquartile range, 1-3), respectively (P = .04). In patients considered poor candidates for open surgery or laparoscopy, percutaneous treatment of ovarian cysts with short-term catheter drainage without sclerotherapy appears to be a safe and effective alternative, with low recurrence rates.
Laryngeal Cysts in Adults: Simplifying Classification and Management.
Heyes, Richard; Lott, David G
2017-12-01
Objective Laryngeal cysts may occur at any mucosa-lined location within the larynx and account for 5% to 10% of nonmalignant laryngeal lesions. A number of proposed classifications for laryngeal cysts exist; however, no previously published classification aims to guide management. This review analyzes contemporary laryngeal cyst management and proposes a framework for the terminology and management of cystic lesions in the larynx. Data Sources PubMed/Medline. Review Methods A primary literature search of the entire Medline database was performed for all titles of publications pertaining to laryngeal cysts and reviewed for relevance. Full manuscripts were reviewed per the relevance of their titles and abstracts, and selection into this review was according to their clinical and scientific relevance. Conclusion Laryngeal cysts have been associated with rapid-onset epiglottitis, dyspnea, stridor, and death; therefore, they should not be considered of little significance. Symptoms are varied and nonspecific. Laryngoscopy is the primary initial diagnostic tool. Cross-sectional imaging may be required, and future use of endolaryngeal ultrasound and optical coherence tomography may revolutionize practice. Where possible, cysts should be completely excised, and there is growing evidence that a transoral approach is superior to transcervical excision for nearly all cysts. Histology provides definitive diagnosis, and oncocytic cysts require close follow-up. Implications for Practice A new classification system is proposed that increases clarity in terminology, with the aim of better preparing surgeons and authors for future advances in the understanding and management of laryngeal cysts.
Management of non-neoplastic ovarian cysts with sclerotherapy.
Kafali, H; Yurtseven, S; Atmaca, F; Ozardali, I
2003-04-01
To evaluate sclerotherapy with alcohol and erythromycin in the management of simple ovarian cysts. Twenty-four simple ovarian cysts were subjected to sclerotherapy with alcohol and erythromycin. All procedures were performed under local anesthesia and in an outpatient setting. Cytological examination was carried out in all cases and two patients were excluded from the study because of suspicious cytological results. The patients were followed up monthly with color Doppler sonography for more than 12 months. Cyst fluid was serous in 17 cases and dark-chocolate colored in seven cases. The volume of aspirated fluid ranged from 100 to 220 ml. The size of ovarian masses and cyst-wall thickness ranged from 5.5 to 8.5 cm and 1.5 to 5 mm, respectively. Cytological analysis of 15 cysts revealed acellular sediment, seven cysts were compatible with endometrioma, and two were reported as suspicious. During the 12-month follow-up, seven cyst recurrences were detected. Aspiration and sclerotherapy with alcohol and erythromycin are followed by a relatively high recurrence rate when the aspirate is bloody. However, patients with a simple cyst that is painful or liable to torsion could benefit from sclerotherapy. Such patients, who are at low risk for malignancy, are relieved with sclerotherapy while avoiding surgery.
Spontaneous haemorrhage and rupture of third ventricular colloid cyst
Ogbodo, Elisha; Kaliaperumal, Chandrasekaran; Bermingham, Niamh; O'Sullivan, Michael
2012-01-01
Acute bleeding within a colloid cyst of the third ventricle represents a rare event causing sudden increase in the cyst volume that may lead to acute hydrocephalus and rapid neurological deterioration. We report a case of spontaneous rupture of haemorrhagic third ventricular colloid cyst and its management. A 77-year-old ex-smoker presented with unsteady gait, incontinence and gradually worsening confusion over a 3-week period. Brain CT scan findings were highly suggestive of a third ventricular colloid cyst with intraventricular rupture. He underwent cyst excision and histopathology, which confirmed the radiological diagnosis with evidence of haemorrhage within the cyst. A ventriculo peritoneal shunt was performed for delayed hydrocephalus. Surgical management of these patients must include emergency ventriculostomy followed by prompt surgical removal of the haemorrhagic cyst. PMID:22949002
Primary iris stromal cyst with rapid growth.
Xiao, Yang; Wang, Yu-Hong; Niu, Gai-Ling; Gao, Min
2009-11-01
To describe the clinical features and the surgical management of primary iris stromal cyst with rapid growth. A 14-year-old Chinese-Mongolian girl was referred to us with a 1-month history of obstructed vision and photophobia. On an examination, a semitransparent cyst with a densely pigmented posterior wall was revealed in the anterior chamber of the left eye. The information regarding the location and extent of the cyst was further analyzed by anterior segment optical coherence tomography and ultrasound biomicroscopy. It arose within the iris stroma, measuring 7.52 x 3.60 mm. Blood vessels on the surface of the lesion were revealed by iris angiography. There was no history of amniocentesis, birth trauma, antecedent ocular injury, or maternal illness during gestation. The diagnosis of primary iris stromal cyst was made. A combination of needle aspiration, piecemeal resection of cyst wall, cryotherapy, and argon laser photocoagulation with overlapped spots was used. Histopathology of the cyst wall revealed nonkeratinized, multilayered, stratified squamous epithelium with clusters of goblet cells. Complete resolution of the cyst was successfully achieved. The visual acuity improved to 20/25 from counting fingers. At 6 months of follow-up, there was no recurrence. Complete eradication and devitalization of any remaining epithelial cells are the key factors for preventing recurrence and diffuse epithelialization of the anterior chamber.
A retrospective study of oral cysts in Nigerian children.
Salako, N O; Taiwo, E O
1995-01-01
A retrospective analysis of oral cysts that were seen over an 11-year period in children at a dental institution in Nigeria was carried out. In general, oral cysts accounted for only 2.6% of the total biopsied lesions during the period under review. The most common oral cysts were the mucous retention cysts, the gingival cysts of infants and the dentigerous cyst. The commonest sites were the maxilla, the mandible and the floor of the mouth respectively and there was no significant difference in sex preference. Most of the cases were seen in the age group 11-16 years while the least was in the group aged 6-10 years.
Sclerotherapy for 'scrotal cysts' using tetracycline instillation.
Courtney, S P; Wightman, J A
1991-04-01
Aspiration and tetracycline (Achromycin) instillation has been used to sclerose 'scrotal cysts'. Thirteen hydroceles and epididymal cysts were treated. Of the cysts treated, four failed to sclerose, and moderate to severe pain occurred in eight patients. In three patients the pain was severe, necessitating admission to the hospital. We would not recommend this treatment either in terms of efficacy or for patient comfort.
Suspended Alexandrium spp. hypnozygote cysts in the Gulf of Maine
NASA Astrophysics Data System (ADS)
Kirn, Sarah L.; Townsend, David W.; Pettigrew, Neal R.
2005-09-01
The life cycle of dinoflagellates of the genus Alexandrium includes sexual reproduction followed by the formation of a dormant hypnozygote cyst, which serves as a resting stage. Negatively buoyant cysts purportedly fall to the benthos where they undergo a mandatory period of quiescence. Previous reports of cysts in the surficial sediments of the Gulf of Maine, where Alexandrium blooms are well documented, show a broad distribution of cysts, with highest concentrations generally in sediments below 100 m depth. We report here an exploration of cysts suspended in the water column, where they would be better positioned to inoculate springtime Alexandrium populations. During cruises in February, April, and June of 2000, water samples were collected at depths just off the bottom (within 5 m), at the top of the bottom nepheloid layer, and near the surface (1 m) and examined for cyst concentrations. Suspended cysts were found throughout the Gulf of Maine and westernmost Bay of Fundy. Planktonic cyst densities were generally greater in near-bottom and top of the bottom nepheloid layer samples than in near-surface water samples; densities were of the order of 10 2 cysts m -3 in surface waters, and 10 2-10 3 cysts m -3 at near-bottom depths. Temporally, they were most abundant in February and least abundant in April. Reports by earlier workers of cysts in the underlying sediments were on the order of 10 3 cysts cm -3. We present calculations that demonstrate the likelihood of cyst resuspension from bottom sediments forced by swell and tidal currents, and propose that such resuspended cysts are important in inoculating the seasonal bloom. We estimate that suspended cysts may contribute significantly to the annual vegetative cell population in the Gulf of Maine.
... trying to get pregnant and you often get functional cysts, you can prevent them by taking hormone drugs (such as birth control pills). These medicines prevent follicles from growing. Alternative Names Physiologic ovarian ...
Developmental odontogenic cysts of jaws: a clinical study of 245 cases.
Yazdani, Javad; Kahnamouii, Shiva Solahaye
2009-01-01
The aim of this study was to investigate the relative frequency of developmental odontogenic cysts in an Iranian population. In this study 245 cysts from both jaws, treated in the Faculty of Dentistry at Tabriz University of Medical Sciences during a 10-year period from 1998 to 2008, were analyzed in order to evaluate the incidence of such cysts. We had permission from all the patients. Case histories of 65% of male and 35% of female patients were analyzed. The age of the patients varied from 14 to 64 years, with an average of 33.21 ± 10.89. In this 10-year study of odontogenic cysts, 97 cases were developmental odontogenic cysts with the following inci-dence: dentigerous cyst, 44%; odontogenic keratocyst, 36%; primordial cyst, 9%; Gorlin cyst, 2%; lateral periodontal cyst, 3%; eruption cyst, 3%; and gingival cyst, 3% (adults 2%, infants 1%). A total of 60% of the cysts were found in the mandible and 40% in the maxilla. Regarding the mandible, the molar region was involved in 47% of the cases, premolar region in 33% and anterior region in 20% (total = 100%). Regarding the maxilla, the canine-to-canine region was involved in 52% of the cases, premolar region in 20% and molar region in 28% (total = 100%). An important finding in this study was the fact that 39% of the jaw cysts were developmental odontogenic cysts and the most common developmental odontogenic cysts were dentigerous cyst and OKC (odontogenic keratocyst).
Vanishing large ovarian cyst with thyroxine therapy.
Dharmshaktu, Pramila; Kutiyal, Aditya; Dhanwal, Dinesh
2013-01-01
A 21-year-old female patient recently diagnosed with severe hypothyroidism was found to have a large ovarian cyst. In view of the large ovarian cyst, she was advised to undergo elective laparotomy in the gynaecology department. She was further evaluated in our medical out-patient department (OPD), and elective surgery was withheld. She was started on thyroxine replacement therapy, and within a period of 4 months, the size of the cyst regressed significantly, thereby improving the condition of the patient significantly. This case report highlights the rare and often missed association between hypothyroidism and ovarian cysts. Although very rare, profound hypothyroidism that can cause ovarian cysts in an adult should always be kept in the differential diagnosis to avoid unnecessary ovarian surgery. Hypothyroidism should be considered in the differential diagnosis of adult females presenting with multicystic ovarian tumours.Adequate thyroid hormone replacement therapy can prevent these patients from undergoing unnecessary and catastrophic ovarian resection.Surgical excision should be considered only when adequate thyroid replacement therapy fails to resolve ovarian enlargement.In younger women with ovarian cysts, it is also desirable to avoid unnecessary surgery so as to not compromise fertility in the future.
Vanishing large ovarian cyst with thyroxine therapy
Dharmshaktu, Pramila; Kutiyal, Aditya; Dhanwal, Dinesh
2013-01-01
Summary A 21-year-old female patient recently diagnosed with severe hypothyroidism was found to have a large ovarian cyst. In view of the large ovarian cyst, she was advised to undergo elective laparotomy in the gynaecology department. She was further evaluated in our medical out-patient department (OPD), and elective surgery was withheld. She was started on thyroxine replacement therapy, and within a period of 4 months, the size of the cyst regressed significantly, thereby improving the condition of the patient significantly. This case report highlights the rare and often missed association between hypothyroidism and ovarian cysts. Although very rare, profound hypothyroidism that can cause ovarian cysts in an adult should always be kept in the differential diagnosis to avoid unnecessary ovarian surgery. Learning points Hypothyroidism should be considered in the differential diagnosis of adult females presenting with multicystic ovarian tumours.Adequate thyroid hormone replacement therapy can prevent these patients from undergoing unnecessary and catastrophic ovarian resection.Surgical excision should be considered only when adequate thyroid replacement therapy fails to resolve ovarian enlargement.In younger women with ovarian cysts, it is also desirable to avoid unnecessary surgery so as to not compromise fertility in the future. PMID:24683475
Incidental pineal cysts in children who undergo 3-T MRI.
Whitehead, Matthew T; Oh, Christopher C; Choudhri, Asim F
2013-12-01
Pineal cysts, both simple and complex, are commonly encountered in children. More cysts are being detected with MR technology; however, nearly all pineal cysts are benign and require no follow-up. To discover the prevalence of pineal cysts in children at our institution who have undergone high-resolution 3-T MRI. We retrospectively reviewed 100 consecutive 3-T brain MRIs in children ages 1 month to 17 years (mean 6.8 ± 5.1 years). We evaluated 3-D volumetric T1-W imaging, axial T2-W imaging, axial T2-W FLAIR (fluid attenuated inversion recovery) and coronal STIR (short tau inversion recovery) sequences. Pineal parenchymal and cyst volumes were measured in three planes. Cysts were analyzed for the presence and degree of complexity. Pineal cysts were present in 57% of children, with a mean maximum linear dimension of 4.2 mm (range 1.5-16 mm). Of these cysts, 24.6% showed thin septations or fluid levels reflecting complexity. None of the cysts demonstrated complete T2/FLAIR signal suppression. No cyst wall thickening or nodularity was present. There was no significant difference between the ages of children with and without cysts. Cysts were more commonly encountered in girls than boys (67% vs. 52%; P = 0.043). There was a slight trend toward increasing pineal gland volume with age. Pineal cysts are often present in children and can be incidentally detected by 3-T MRI. Characteristic-appearing pineal cysts in children are benign, incidental findings, for which follow-up is not required if there are no referable symptoms or excessive size.
[MR cholangiopancreatography in choledochal cysts].
Frampas, E; Moussaly, F; Léauté, F; Heloury, Y; Le Neel, J C; Dupas, B
1999-12-01
To assess the value of MR cholangiopancreatography (MRCP) in the diagnosis and preoperative evaluation of choledochal cysts. Five patients (aged between 6 days and 28 years) were investigated by MRCP, referred for ultrasonographic detection of a bile duct dilatation or a cystic structure, of antenatal diagnosis (1 case), for jaundice or abdominal pain (3 cases) or in late follow-up of a choledochal cyst surgery. Two endoscopic-ultrasonographic studies were performed. The five patients underwent surgery without preoperative biliary cholangiography. MRCP was performed using a HASTE sequence in frontal, oblique, axial planes (1,5 Tesla MR unit). MRCP allowed to confirm choledochal cyst, helps to specify the anatomical type (2 type I, 3 type II), detects choledocholithiasis (3 cases). Anatomic correlation was perfect. MRCP allowed to exclude gastrointestinal duplication. Anomalous junction of the pancreaticobiliary duct was found in one case. MRCP diagnoses choledochal cysts, specifies type, helps surgery and can avoid endoscopic retrograde cholangiography or endoscopic sonographic examinations especially for children. It may find an anomalous junction of the pancreaticobiliary duct.
Endoscopic modified medial maxillectomy for odontogenic cysts and tumours.
Nakayama, Tsugihama; Otori, Nobuyoshi; Asaka, Daiya; Okushi, Tetsushi; Haruna, Shin-ichi
2014-12-01
Odontogenic maxillary cysts and tumours originate from the tooth root and have traditionally been treated through an intraoral approach. Here, we report the efficacy and utility of endoscopic modified medial maxillectomy (EMMM) for the treatment of odontogenic maxillary cysts and a tumour. We undertook EMMM under general anaesthesia in six patients: four had radicular cysts, one had a dentigerous cyst, and one had a keratocystic odontogenic tumour. The cysts and tumours were completely excised and the inferior turbinate and nasolacrimal duct were preserved in all patients. There were no peri- or postoperative complications, and no incidences of recurrence. Endoscopic modified medial maxillectomy appears to be an effective and safe technique for treating odontogenic cysts and tumours.
Rare, simultaneous, multiple, and recurrent mandibular bone cysts.
Mupparapu, Muralidhar; Milles, Maano; Singer, Steven R; Rinaggio, Joseph
2008-04-01
Simple bone cysts, also referred to as traumatic bone cysts, are benign connective tissue-lined cavities occurring most commonly in young people. Most of the time, they occur as solitary radiolucencies. In the jaws, they also have been reported to occur concurrently with benign fibro-osseous lesions. The radiographic appearance of simple bone cysts could be confused with other jaw cysts and benign tumors. This case report presents a patient who had 3 separate lesions simultaneously within the mandible. The right mandibular lesion presented as a multilocular radiolucency. The 2 left mandibular lesions were periapical, with mixed radiodensities and radiographically mimicked lesions of focal or periapical cemento-osseous dysplasia. More aggressive benign lesions of the jaw were initially included in the differential diagnosis, as well. A biopsy revealed the diagnosis of simple bone cysts in all 3 locations. Minimal surgical management resulted in complete recovery of these osseous defects only to recur in 2 years on the mandibular left premolar-molar region. A new biopsy confirmed that the lesion was a recurrent simple bone cyst. Simultaneous presence of benign cemento-osseous dysplasia was also considered, as it is known to coexist with the simple bone cysts.
Unicameral (simple) bone cysts.
Baig, Rafath; Eady, John L
2006-09-01
Since their original description by Virchow, simple bone cysts have been studied repeatedly. Although these defects are not true neoplasms, simple bone cysts may create major structural defects of the humerus, femur, and os calcis. They are commonly discovered incidentally when x-rays are taken for other reasons or on presentation due to a pathologic fracture. Various treatment strategies have been employed, but the only reliable predictor of success of any treatment strategy is the age of the patient; those being older than 10 years of age heal their cysts at a higher rate than those under age 10. The goal of management is the formation of a bone that can withstand the stresses of use by the patient without evidence of continued bone destruction as determined by serial radiographic follow-up. The goal is not a normal-appearing x-ray, but a functionally stable bone.
Epidermal cyst mimicking incision line metastasis.
Gündoğdu, Ramazan; Ayhan, Erhan; Çolak, Tahsin
2017-01-01
Epidermal cysts are cystic tumors lined with keratinized squamous layer and filled with keratin debris. Epidermal cysts may develop by implantation of surface epidermal layer into the dermis or subcutaneous tissue after trauma or surgical procedures. Cervix cancer spreads either directly or via the vascular and lymphatic systems. Distant skin metastasis of endometrium or cervix cancer is very rare. In this case report, a patient who had a history of cervix cancer operation 11 years ago and presented with a mass that mimicked incision line metastasis and was histopathologically diagnosed with epidermal cyst is presented.
Developmental Odontogenic Cysts of Jaws: A Clinical Study of 245 Cases
Yazdani, Javad; Kahnamouii, Shiva Solahaye
2009-01-01
Background and aims The aim of this study was to investigate the relative frequency of developmental odontogenic cysts in an Iranian population. Materials and methods In this study 245 cysts from both jaws, treated in the Faculty of Dentistry at Tabriz University of Medical Sciences during a 10-year period from 1998 to 2008, were analyzed in order to evaluate the incidence of such cysts. We had permission from all the patients. Case histories of 65% of male and 35% of female patients were analyzed. The age of the patients varied from 14 to 64 years, with an average of 33.21 ± 10.89. Results In this 10-year study of odontogenic cysts, 97 cases were developmental odontogenic cysts with the following inci-dence: dentigerous cyst, 44%; odontogenic keratocyst, 36%; primordial cyst, 9%; Gorlin cyst, 2%; lateral periodontal cyst, 3%; eruption cyst, 3%; and gingival cyst, 3% (adults 2%, infants 1%). A total of 60% of the cysts were found in the mandible and 40% in the maxilla. Regarding the mandible, the molar region was involved in 47% of the cases, premolar region in 33% and anterior region in 20% (total = 100%). Regarding the maxilla, the canine-to-canine region was involved in 52% of the cases, premolar region in 20% and molar region in 28% (total = 100%). Conclusion An important finding in this study was the fact that 39% of the jaw cysts were developmental odontogenic cysts and the most common developmental odontogenic cysts were dentigerous cyst and OKC (odontogenic keratocyst). PMID:23230485
Two Cases of Giant Epidermal Cyst Occurring in the Neck
Kang, Sang-Gue; Kim, Chul-Han; Cho, Hong-Ki; Park, Mi-Youn; Lee, Yoon-Jin
2011-01-01
Epidermal cysts are the most common cysts of the skin. Aconventional epidermal cyst rarely reaches a size of more than 5 cm in diameter. We report on two cases of giant epidermal cyst occurring in the neck. One patient had a cyst measuring 12×9×9 cm and the other patient had a non-pulsatile, dome-shaped lesion in the neck, which measured 6×5×3 cm. The lesions were totally excised. Histopathologically, both were confirmed as giant epidermal cysts. PMID:22028561
Bilateral Radicular Cyst in Mandible: An Unusual Case Report
Bava, Fareed Ahmed; Umar, Dilshad; Bahseer, Bahija; Baroudi, Kusai
2015-01-01
A radicular cyst is one of the furthermost everyday odontogenic cysts of the anterior maxilla, not regularly comprehended in youth. They are found mostly at the apices of the tooth (periapical cyst), lateral surface of the roots (lateral radicular cyst) and remains in the jaw after removal of the offending tooth (residual cyst). The radicular cyst has been catalogued as an inflammatory cyst, as an outcome to pulpal necrosis succeeding caries, with a linked periapical inflammatory reaction. They advance sluggishly and asymptomatic lest infected. Because of this they can extent to big dimensions. Many times it is perplexing to segregate radicular cysts from the obligatory pre-existing chronic periapical periodontitis lesions radiographically. Here, we present a rare case with bilateral radicular cyst in relation to first molar of the mandible in a 19-year-old. Orthopantomograph showed a large unilocular radiolucency with a well-defined border in the periapical region of the first molar on the left side extending from the root of the second premolar to the mesial root of the second molar. Correspondingly another well-defined unilocular radiolucency with a well-defined border was seen on the right side of the mandible. Several treatment possibilities are presented for a radicular cyst such as surgical endodontic treatment, extraction of the transgressing tooth, enucleation with primary closure, and marsupialization trailed by enucleation. The patient management comprised surgical enucleation of cystic sac followed by rehabilitation of the same area. PMID:25859111
Bilateral radicular cyst in mandible: an unusual case report.
Bava, Fareed Ahmed; Umar, Dilshad; Bahseer, Bahija; Baroudi, Kusai
2015-02-01
A radicular cyst is one of the furthermost everyday odontogenic cysts of the anterior maxilla, not regularly comprehended in youth. They are found mostly at the apices of the tooth (periapical cyst), lateral surface of the roots (lateral radicular cyst) and remains in the jaw after removal of the offending tooth (residual cyst). The radicular cyst has been catalogued as an inflammatory cyst, as an outcome to pulpal necrosis succeeding caries, with a linked periapical inflammatory reaction. They advance sluggishly and asymptomatic lest infected. Because of this they can extent to big dimensions. Many times it is perplexing to segregate radicular cysts from the obligatory pre-existing chronic periapical periodontitis lesions radiographically. Here, we present a rare case with bilateral radicular cyst in relation to first molar of the mandible in a 19-year-old. Orthopantomograph showed a large unilocular radiolucency with a well-defined border in the periapical region of the first molar on the left side extending from the root of the second premolar to the mesial root of the second molar. Correspondingly another well-defined unilocular radiolucency with a well-defined border was seen on the right side of the mandible. Several treatment possibilities are presented for a radicular cyst such as surgical endodontic treatment, extraction of the transgressing tooth, enucleation with primary closure, and marsupialization trailed by enucleation. The patient management comprised surgical enucleation of cystic sac followed by rehabilitation of the same area.
Acute pancreatitis complicating choledochal cysts in children.
Muthucumaru, Mathievathaniy; Ljuhar, Damir; Panabokke, Gayathri; Paul, Eldho; Nataraja, Ramesh; Ferguson, Peter; Dagia, Charuta; Clarnette, Tom; King, Sebastian
2017-03-01
To analyse the characteristics of patients with choledochal cysts presenting with acute pancreatitis. Multicenter retrospective review of all paediatric patients (<18 years) with choledochal cysts managed over a 14-year period (2001-2014) at two tertiary paediatric surgical centres. Patient data were analysed for demographics, presentation, radiological classification of cyst type (Todani), operative interventions, complications and long-term follow-up. A total of 49 patients with choledochal cysts were identified with 15 (31%) being Type I fusiform, 18 (37%) Type I cystic and 16 (32%) Type IV-A. Seventeen (35%) patients presented with acute pancreatitis, one having had an ante-natally diagnosed choledochal cyst. Patients presenting with pancreatitis were older when compared to the non-pancreatitis group (5.1 vs. 1.2 years, P = 0.005). Nine out of 16 (53%) patients with Type IV-A cysts presented with pancreatitis compared to five (33%) of Type I fusiform and three (17%) of Type I cystic. There was however no statistically significant association between Todani types and the development of pancreatitis (Type I fusiform, P = 1.0; Type I cystic, P = 0.063; Type IV-A, P = 0.053). The rate of complications was similar in both groups. Pancreatitis was a common presentation in children with a choledochal cyst, however, there was no clear statistically significant association with Todani types and pancreatitis. © 2016 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).
Toxoplasma gondii tissue cyst purification using Percoll gradients
Watts, Elizabeth A.; Dhara, Animesh; Sinai, Anthony P.
2017-01-01
The protozoan parasite Toxoplasma gondii is capable of infecting all warm blooded animals and humans. Infectious, transmissible forms of the parasite include oocysts produced by the sexual cycle within the definitive feline host and tissue cysts that form Toxoplasma in the CNS and muscle during the asexual cycle within all chronically infected warm-blooded hosts. These tissue cysts are populated with slow growing bradyzoites which have been until recently thought to be dormant entities in the context of immune sufficiency. Reactivation to active growth during immune suppression is of critical clinical importance. Yet we know little about tissue cysts or the bradyzoites they house as the diversity of tissue cysts cannot be replicated in cell culture systems. Our optimization of tissue cyst purification from the brains of infected mice using Percoll gradients provides an efficient means to recover in vivo derived tissue cysts that can be applied to imaging, cell-biologic, biochemical, transcriptomic and proteomic analyses. PMID:28510363
Multiplex real-time PCR assays for the identification of the potato cyst and tobacco cyst nematodes
USDA-ARS?s Scientific Manuscript database
TaqMan primer-probe sets were developed for the detection and identification of potato cyst nematodes (PCN) Globodera pallida and G. rostochiensis using two-tube, multiplex real-time PCR. One tube contained a primer-probe set specific for G. pallida (pale cyst nematode) multiplexed with another prim...
Mycobiome of Cysts of the Soybean Cyst Nematode Under Long Term Crop Rotation
Hu, Weiming; Strom, Noah; Haarith, Deepak; Chen, Senyu; Bushley, Kathryn E.
2018-01-01
The soybean cyst nematode (SCN), Heterodera glycines Ichinohe (Phylum Nematoda), is a major pathogen of soybean. It causes substantial yield losses worldwide and is difficult to control because the cyst protects the eggs which can remain viable for nearly a decade. Crop rotation with non-host crops and use of biocontrol organisms such as fungi and bacteria offer promising approaches, but remain hampered by lack of knowledge of the biology of nematode parasitic organisms. We used a high-throughput metabarcoding approach to characterize fungal communities associated with the SCN cyst, a microenvironment in soil that may harbor both nematode parasites and plant pathogens. SCN cysts were collected from a long-term crop rotation experiment in Southeastern Minnesota at three time points over two growing seasons to characterize diversity of fungi inhabiting cysts and to examine how crop rotation and seasonal variation affects fungal communities. A majority of fungi in cysts belonged to Ascomycota and Basidiomycota, but the presence of several early diverging fungal subphyla thought to be primarily plant and litter associated, including Mortierellomycotina and Glomeromycotina (e.g., arbuscular mycorrhizal fungi), suggests a possible role as nematode egg parasites. Species richness varied by both crop rotation and season and was higher in early years of crop rotation and in fall at the end of the growing season. Crop rotation and season also impacted fungal community composition and identified several classes of fungi, including Eurotiomycetes, Sordariomycetes, and Orbiliomycetes (e.g., nematode trapping fungi), with higher relative abundance in early soybean rotations. The relative abundance of several genera was correlated with increasing years of soybean. Fungal communities also varied by season and were most divergent at midseason. The percentage of OTUs assigned to Mortierellomycotina_cls_Incertae_sedis and Sordariomycetes increased at midseason, while Orbiliomycetes
Mycobiome of Cysts of the Soybean Cyst Nematode Under Long Term Crop Rotation.
Hu, Weiming; Strom, Noah; Haarith, Deepak; Chen, Senyu; Bushley, Kathryn E
2018-01-01
The soybean cyst nematode (SCN), Heterodera glycines Ichinohe (Phylum Nematoda), is a major pathogen of soybean. It causes substantial yield losses worldwide and is difficult to control because the cyst protects the eggs which can remain viable for nearly a decade. Crop rotation with non-host crops and use of biocontrol organisms such as fungi and bacteria offer promising approaches, but remain hampered by lack of knowledge of the biology of nematode parasitic organisms. We used a high-throughput metabarcoding approach to characterize fungal communities associated with the SCN cyst, a microenvironment in soil that may harbor both nematode parasites and plant pathogens. SCN cysts were collected from a long-term crop rotation experiment in Southeastern Minnesota at three time points over two growing seasons to characterize diversity of fungi inhabiting cysts and to examine how crop rotation and seasonal variation affects fungal communities. A majority of fungi in cysts belonged to Ascomycota and Basidiomycota, but the presence of several early diverging fungal subphyla thought to be primarily plant and litter associated, including Mortierellomycotina and Glomeromycotina (e.g., arbuscular mycorrhizal fungi), suggests a possible role as nematode egg parasites. Species richness varied by both crop rotation and season and was higher in early years of crop rotation and in fall at the end of the growing season. Crop rotation and season also impacted fungal community composition and identified several classes of fungi, including Eurotiomycetes, Sordariomycetes, and Orbiliomycetes (e.g., nematode trapping fungi), with higher relative abundance in early soybean rotations. The relative abundance of several genera was correlated with increasing years of soybean. Fungal communities also varied by season and were most divergent at midseason. The percentage of OTUs assigned to Mortierellomycotina_cls_Incertae_sedis and Sordariomycetes increased at midseason, while Orbiliomycetes
Vital, Domenic; Huber, Gerhard F.; Pézier, Thomas F.; Rössle, Matthias; Probst, Rudolf; Widmer, Gian-Marco
2014-01-01
We report the case of a 66-year-old man with a cervical neck mass located behind the left sternocleidomastoid muscle. To exclude malignancy, a full workup, including clinical, radiological, and cytological examination, was performed but failed to provide a definitive diagnosis. Histological analysis following excisional biopsy revealed a benign epithelial cyst, consistent with an atypically located branchial cyst. We describe an approach to the management of these neck masses and discuss several theories of the etiology of branchial cysts and how they may come to be abnormally located. PMID:24523976
Lin, Louis M; Huang, George T-J; Rosenberg, Paul A
2007-08-01
There is continuing controversy regarding the potential for inflammatory apical cysts to heal after nonsurgical endodontic therapy. Molecular cell biology may provide answers to a series of related questions. How are the epithelial cell rests of Malassez stimulated to proliferate? How are the apical cysts formed? How does the lining epithelium of apical cysts regress after endodontic therapy? Epithelial cell rests are induced to divide and proliferate by inflammatory mediators, proinflammatory cytokines, and growth factors released from host cells during periradicular inflammation. Quiescent epithelial cell rests can behave like restricted-potential stem cells if stimulated to proliferate. Formation of apical cysts is most likely caused by the merging of proliferating epithelial strands from all directions to form a three-dimensional ball mass. After endodontic therapy, epithelial cells in epithelial strands of periapical granulomas and the lining epithelium of apical cysts may stop proliferating because of a reduction in inflammatory mediators, proinflammatory cytokines, and growth factors. Epithelial cells will also regress because of activation of apoptosis or programmed cell death through deprivation of survival factors or by receiving death signals during periapical wound healing.
Frequency of odontogenic cysts and tumors: a systematic review.
Johnson, Nigel R; Gannon, Orla M; Savage, Neil W; Batstone, Martin D
2014-02-01
A systematic review of the literature from 1993 to 2011 was undertaken examining frequency data of the most common odontogenic cysts and tumors. Seven inclusion criteria were met for the paper to be incorporated. In the preliminary search 5231 papers were identified, of these 26 papers met the inclusion criteria. There were 18 297 odontogenic cysts reported. Of these there were 9982 (54.6%) radicular cysts, 3772 (20.6%) dentigerous cysts and 2145 (11.7%) keratocystic odontogenic tumors. With the reclassification of keratocystic odontogenic tumor in 2005 as an odontogenic tumor, there were 8129 odontogenic tumors reported with 3001 (36.9%) ameloblastomas, 1163 (14.3%) keratocystic odontogenic tumors, 533 (6.5%) odontogenic myxomas, 337 (4.1%) adenomatoid odontogenic tumors and 127 (1.6%) ameloblastic fibromas. This systematic review found that odontogenic cysts are 2.25 times more frequent than odontogenic tumors. The most frequent odontogenic cyst and tumor were the radicular cyst and ameloblastoma respectively. © 2013 Wiley Publishing Asia Pty Ltd.
Pericardial Cyst: Cause of Sudden Cardiac Death?
Ley, Marie Brix; Larsen, Maiken Kudahl
2018-05-21
Cardiovascular disease is the leading cause of sudden death in the world. The etiology of sudden cardiac death involves a wide range of diseases, but seldom pericardial cysts. A pericardial cyst is an uncommon cyst usually located in the middle mediastinum and rarely in the posterior part. They are usually harmless and asymptomatic. Here, we present a case of a 63-year-old woman who presented with dyspnea and hoarseness, but died suddenly after a CT scan was attempted. The detailed forensic pathologic and histologic examination revealed a pericardial cyst located in the posterior mediastinum. Toxicology and biochemistry tests, including tryptase, found no competing cause of death. © 2018 American Academy of Forensic Sciences.
Sclerotherapy of cervical cysts with Picibanil (OK-432).
Knipping, Stephan; Goetze, Gerrit; Neumann, Kerstin; Bloching, Marc
2007-04-01
The effectiveness of intralesional sclerotherapy of lymphangiomas and ranulas with OK-432 (Picibanil) has been proved in several clinical studies. The aim of our study was to review the effectiveness of sclerotherapy of benign cervical cysts with Picibanil as an alternative method to surgical excision. Between March 2002 and March 2006, a prospective observational study was carried out to assess the effects of Picibanil on cervical cysts. Between 2002 and 2006 we treated 14 patients having cervical cysts through intralesional application of Picibanil with a dose of 0.01 mg/ml. So far we used Picibanil with 13 patients achieving a high success rate. In eight cases we observed, both clinically and ultrasonographically, a nearly complete regression, and a complete regression of the cysts in three cases. In two cases the cysts atrophied. In these cases only residual findings could be observed. In one case we extirpated the remaining cyst. If there is no clear reaction of the cyst to the treatment, an excision is indicated 6 weeks after the injections to gain meaningful histological examination. No significant complication after sclerotherapy with Picibanil was observed. According to our results the application of OK-432 (Picibanil) is a safe and effective primary method for sclerotherapy of benign cervical cysts which can replace surgical extirpation in special cases. However, the risk of malign diseases has to be excluded before the commencement of the Picibanil treatment.
Asymptomatic vallecular cyst: case report.
Yuce, Yucel; Uzun, Sennur; Aypar, Ulku
2013-01-01
A 56-year-old man presented himself for an intracranial glioblastoma multiforme excision. After being routinely monitored, he was preoxygenated. We induced anesthesia and paralysis with 200 mg propofol, 50 μg fentanyl and 9 mg vecuronium. Direct laryngoscopy with a Macintosh 3 blade revealed a 2x2 cm cyst, pedunculated, arising from the right side of the vallecula preventing the endotracheal intubation. While the patient remained anesthetized, we urgently consulted an otolaryngologist and aspirated the cyst with a 22-gauge needle and syringe under direct laryngoscopy. We aspirated 10 cc of liquid content. This was followed by an uneventful tracheal intubation with a 9.0 enforced spiral cuffed tube. An alternative to fiberoptic intubation may be careful cyst aspiration to facilitate the intubation.
Endosonography in the diagnosis and management of pancreatic cysts
Kadiyala, Vivek; Lee, Linda S
2015-01-01
Rapid advances in radiologic technology and increased cross-sectional imaging have led to a sharp rise in incidental discoveries of pancreatic cystic lesions. These cystic lesions include non-neoplastic cysts with no risk of malignancy, neoplastic non-mucinous serous cystadenomas with little or no risk of malignancy, as well as neoplastic mucinous cysts and solid pseudopapillary neoplasms both with varying risk of malignancy. Accurate diagnosis is imperative as management is guided by symptoms and risk of malignancy. Endoscopic ultrasound (EUS) allows high resolution evaluation of cyst morphology and precise guidance for fine needle aspiration (FNA) of cyst fluid for cytological, chemical and molecular analysis. Initially, clinical evaluation and radiologic imaging, preferably with magnetic resonance imaging of the pancreas and magnetic resonance cholangiopancreatography, are performed. In asymptomatic patients where diagnosis is unclear and malignant risk is indeterminate, EUS-FNA should be used to confirm the presence or absence of high-risk features, differentiate mucinous from non-mucinous lesions, and diagnose malignancy. After analyzing the cyst fluid for viscosity, cyst fluid carcinoembryonic antigen, amylase, and cyst wall cytology should be obtained. DNA analysis may add useful information in diagnosing mucinous cysts when the previous studies are indeterminate. New molecular biomarkers are being investigated to improve diagnostic capabilities and management decisions in these challenging cystic lesions. Current guidelines recommend surgical pancreatic resection as the standard of care for symptomatic cysts and those with high-risk features associated with malignancy. EUS-guided cyst ablation is a promising minimally invasive, relatively low-risk alternative to both surgery and surveillance. PMID:25789091
Surgical management of complicated hydatid cysts of the liver
Malik, Ajaz A; Bari, Shams UL; Amin, Ruquia; Jan, Masooda
2010-01-01
AIM: To review the clinical presentation and surgical management of complicated hydatid cysts of the liver and to assess whether conservative surgery is adequate in the management of complicated hydatid cysts of liver. METHODS: The study was carried out at Sher-i-Kashmir Institute of Medical Science, Srinagar, Kashmir, India. Sixty nine patients with hydatid disease of the liver were surgically managed from April 2004 to October 2005 with a follow up period of three years. It included 27 men and 42 women with a median age of 35 years. An abdominal ultrasound, computed tomography and serology established diagnosis. Patients with jaundice and high suspicion of intrabiliary rupture were subjected to preoperative endoscopic retrograde cholangiography. Cysts with infection, rupture into the biliary tract and peritoneal cavity were categorized as complicated cysts. Eighteen patients (26%) had complicated cysts and formed the basis for this study. RESULTS: Common complications were infection (14%), intrabiliary rupture (9%) and intraperitoneal rupture (3%). All the patients with infected cysts presented with pain and fever. All the patients with intrabiliary rupture had jaundice, while only four with intrabiliary rupture had pain and only two had fever. Surgical procedures performed in complicated cysts were: infection-omentoplasty in three and external drainage in seven; intrabiliary rupture-omentoplasty in two and internal drainage in four patients. Two patients with intraperitoneal rupture underwent external drainage. There was no mortality. The postoperative morbidity was 50% in complicated cysts and 16% in uncomplicated cysts. CONCLUSION: Complicated hydatid cyst of the liver can be successfully managed surgically with good long term results. PMID:21160854
A case of peribiliary cysts accompanying bile duct carcinoma
Miura, Fumihiko; Takada, Tadahiro; Amano, Hodaka; Yoshida, Masahiro; Isaka, Takahiro; Toyota, Naoyuki; Wada, Keita; Takagi, Kenji; Kato, Kenichiro
2006-01-01
A rare case of peribiliary cysts accompanying bile duct carcinoma is presented. A 54-year-old man was diagnosed as having lower bile duct carcinoma and peribiliary cysts by diagnostic imaging. He underwent pylorus preserving pancreatoduodenectomy. As for the peribiliary cysts, a course of observation was taken. Over surgery due to misdiagnosis of patients with biliary malignancy accompanied by peribiliary cysts should be avoided. PMID:16874882
Multiple mucous retention cysts of the oral mucosa.
Tal, H; Altini, M; Lemmer, J
1984-12-01
While mucoceles of the oral mucosa are relatively common, multiple mucous retention cysts have not previously been reported. In this article two such cases, in which numerous minor salivary gland ducts had dilated to the point of cyst formation, are described. The number of individual cysts exceeded 100 in each case. Since it is clear that these cysts formed as a result of dilatation of salivary ducts, it would seem that either the ducts were blocked by altered secretion or there was an acquired or congenital weakness in their structure.
Application of three-dimensional rendering in joint-related ganglion cysts.
Spinner, Robert J; Edwards, Phillip K; Amrami, Kimberly K
2006-05-01
The origin of para-articular cysts is poorly understood and controversial. The relatively common, simple (extraneural) cysts are presumed to be derived from joints, although joint connections are not always established. Rarer complex cysts are thought by many to form de novo within nerves (intraneural ganglion cysts) or within vessels (adventitial cysts) (degenerative theory). We believe that these simple and complex ganglion cysts are joint-related (articular theory). Joint connections are often not readily appreciated with routine imaging or at surgery. Not identifying and/or treating joint connections frequently leads to cyst recurrence. More sophisticated imaging may enhance visualization of these joint connections. We created a 3D rendering technique to assess potential joint connections of simple and complex cysts localized to the knee and superior tibiofibular joints in patients with fibular (peroneal) neuropathy. Two- and three-dimensional data sets from MRI examinations were segmented semiautomatically by signal intensity with further refinement based on interaction with the user to identify specific anatomic structures, such as small nerves and vessels on serial images. The bone, cysts, nerves, and vessels were each assigned different color representations, and 3D renderings were created in ANALYZE using the data sets closest to isotropic (voxel with equal length in all dimensions) resolution as the primary background rendering. We selected four cases to illustrate the spectrum of pathology. In all of these cases, we demonstrated joint connections and correlated imaging and operative findings. Surgery addressing the cyst and the joint connection resulted in excellent outcomes; postoperative MRIs done more than 6 months later confirmed that there was no recurrence. In addition to highlighting the important relationship of these cysts to neighboring anatomic structures, this 3D technique allows visualization of "occult" connections not readily appreciated
Diagnostic problems with parasitic and non-parasitic splenic cysts.
Adas, Gokhan; Karatepe, Oguzhan; Altiok, Merih; Battal, Muharrem; Bender, Omer; Ozcan, Deniz; Karahan, Servet
2009-05-29
The splenic cysts constitute a very rare clinical entity. They may occur secondary to trauma or even being more seldom due to parasitic infestations, mainly caused by ecchinocccus granulosus. Literature lacks a defined concencus including the treatment plans and follow up strategies, nor long term results of the patients. In the current study, we aimed to evaluate the diagnosis, management of patients with parasitic and non-parasitic splenic cysts together with their long term follow up progresses. Twenty-four patients with splenic cysts have undergone surgery in our department over the last 9 years. Data from eighteen of the twenty-four patients were collected prospectively, while data from six were retrospectively collected. All patients were assessed in terms of age, gender, hospital stay, preoperative diagnosis, additional disease, serology, ultrasonography, computed tomography (CT), cyst recurrences and treatment. In this study, the majority of patients presented with abdominal discomfort and palpable swelling in the left hypochondrium. All patients were operated on electively. The patients included 14 female and 10 male patients, with a mean age of 44.77 years (range 20-62). Splenic hydatid cysts were present in 16 patients, one of whom also had liver hydatid cysts (6.25%). Four other patients were operated on for a simple cyst (16%) two patients for an epithelial cyst, and the last two for splenic lymphangioma. Of the 16 patients diagnosed as having splenic hydatit cysts, 11 (68.7%) were correctly diagnosed. Only two of these patients were administered benzimidazole therapy pre-operatively because of the risk of multicystic disease The mean follow-up period was 64 months (6-108). There were no recurrences of splenic cysts. Surgeons should keep in mind the possibility of a parasitic cyst when no definitive alternative diagnosis can be made. In the treatment of splenic hydatidosis, benzimidazole therapy is not necessary, although it is crucial to perform
Odontogenic cysts: a clinicopathological study of 507 cases.
Avelar, Rafael L; Antunes, Antonio A; Carvalho, Ricardo W F; Bezerra, Paulo G C F; Oliveira Neto, Patrício J; Andrade, Emanuel S S
2009-12-01
The purpose of this study was to determine the prevalence of odontogenic cysts at the Pernambuco School of Dentistry - Universidade de Pernambuco (Brazil) and compare this prevalence with other international studies. Data for the study were obtained from reports of patients diagnosed with odontogenic cysts between 1992 and 2007. Case records of patients who fit the Histological Classification of the World Health Organization (2005) were included. The following variables were analyzed: gender, age group, anatomical location, histological type and ethnic background. Odontogenic cysts accounted for 9.94% of all lesions biopsied throughout the study period. Mean patient age was 28.9 years and 57.6% of the patients were males (P > 0.05). Radicular cyst was the most prevalent histological type (52.2%), followed by dentigerous cyst (30.7%). Regarding ethnic background, 41.8 % of the patients were of African descent, followed by Caucasians and other ethnic groups (P > 0.05). The mandible was the most prevalent site of the lesions (56%). Odontogenic cysts appear to have a distinct predilection for the male gender, the second and third decades of life (P < 0.05) and are more frequent in the mandible. The removal of odontogenic keratocysts from the new WHO classification has not altered the order of the most prevalent cysts in the maxillofacial complex.
Diagnosis and Management of Parathyroid Cysts: Description with Two Cases.
Aydoğdu, Koray; Şahin, Furkan; İncekara, Funda; Fındık, Göktürk; Kaya, Sadi; Ağaçkıran, Yetkin
2015-10-01
Parathyroid cysts are unilocular, thin-walled cysts, and they are seen very rarely. Their formation mechanisms are not clear. They are usually localized in the cervical region, and mediastinal settlements are rare. They are usually asymptomatic, but cysts that have settled in the neck may be symptomatic, such as tracheal pressure symptoms. There are two types-namely, functional cysts and non-functional cysts-depending on their hormonal characteristics. There are still difficulties in the diagnosis, and they can be mistaken by thyroid pathology. Treatment is surgery. We discussed two cases of parathyroid cysts that we surgically excised.
Pediatric Odontogenic Cysts of the Jaws.
Arce, Kevin; Streff, Christopher S; Ettinger, Kyle S
2016-02-01
Odontogenic cysts represent a common form of pathology of the jaws, and the natural history, clinicopathologic findings, and appropriate management strategies are important to the oral and maxillofacial surgeon. Odontogenic cysts in the pediatric populations are important pathologic entities given their potential impact on the growth and development of the maxillofacial complex. Inappropriate management strategies can severely affect the form and function of the growing child. Categorizing pediatric odontogenic cysts into inflammatory or developmental causes provides a convenient way of conceptualizing these various entities and helps facilitate the appropriate diagnosis and the subsequent management. Copyright © 2016 Elsevier Inc. All rights reserved.
Epidermal cyst mimicking incision line metastasis
Gündoğdu, Ramazan; Ayhan, Erhan; Çolak, Tahsin
2017-01-01
Epidermal cysts are cystic tumors lined with keratinized squamous layer and filled with keratin debris. Epidermal cysts may develop by implantation of surface epidermal layer into the dermis or subcutaneous tissue after trauma or surgical procedures. Cervix cancer spreads either directly or via the vascular and lymphatic systems. Distant skin metastasis of endometrium or cervix cancer is very rare. In this case report, a patient who had a history of cervix cancer operation 11 years ago and presented with a mass that mimicked incision line metastasis and was histopathologically diagnosed with epidermal cyst is presented. PMID:28740968
Alexandrium minutum resting cyst distribution dynamics in a confined site
NASA Astrophysics Data System (ADS)
Anglès, Sílvia; Jordi, Antoni; Garcés, Esther; Basterretxea, Gotzon; Palanques, Albert
2010-02-01
The life cycle of the toxic dinoflagellate Alexandrium minutum consists of an asexual stage, characterized by motile vegetative cells, and a sexual stage, a resting cyst that once formed remains dormant in the sediment. Insight into the factors that determine the distribution and abundance of resting cysts is essential to understanding the dynamics of the vegetative phase. In investigations carried out between January 2005 and January 2008 in Arenys de Mar harbor (northwestern Mediterranean Sea), the spatial and temporal distribution patterns of A. minutum resting cysts and of the sediments were studied during different bloom stages of the vegetative population. Maximum cyst abundance was recorded mainly in the innermost part of the harbor while the lowest abundance always occurred near the harbor entrance, consistent with the distribution of silt-clay sediment fractions. The tendency of cysts in sediments to increase after bloom periods was clearly associated with new cyst formation, while cyst abundance decreased during non-bloom periods. Exceptions to this trend were observed in stations dominated by the deposition of coarse sediments. High correlation between the presence of cysts and clays during non-bloom periods indicates that cysts behave as passive sediment particles and are influenced by the same hydrodynamic processes as clays. In Arenys de Mar, the main physical forcing affecting sediment resuspension is the seiche, which was studied using in situ measurements and numerical models to interpret the observed distribution patterns. During non-bloom periods, cyst losses were smaller when the seiche was more active and at the station where the seiche-induced current was larger. Thus, seiche-forced resuspension appears to reduce cyst losses by reallocating cysts back to the sediment surface such that their burial in the sediment is avoided. The observed vertical profiles of the cysts were consistent with this process.
Edema is a precursor to central nervous system peritumoral cyst formation.
Lonser, Russell R; Vortmeyer, Alexander O; Butman, John A; Glasker, Sven; Finn, Michael A; Ammerman, Joshua M; Merrill, Marsha J; Edwards, Nancy A; Zhuang, Zhengping; Oldfield, Edward H
2005-09-01
Despite the common occurrence and frequent clinical effects of peritumoral cysts in the central nervous system (CNS), the mechanism underlying their development and evolution is not understood. Because they commonly produce peritumoral cysts and because serial magnetic resonance imaging (MRI) is obtained in von Hippel-Lindau disease patients, hemangioblastomas provide an opportunity to examine the pathophysiology of CNS peritumoral cyst formation. Serial MRI was correlated with the clinical findings in 16 von Hippel-Lindau disease patients with 22 CNS hemangioblastomas (11 spinal cord; 11 cerebellar) that were associated with the appearance and evolution of peritumoral cysts. Hemangioblastoma-associated cyst wall histomorphological analysis was performed on postmortem tissues from three von Hippel-Lindau disease patients (not in the clinical series). Comparative proteomic profiling was performed on peritumoral cyst fluid and serum. Vascular endothelial growth factor levels were determined in peritumoral cysts. MRI clearly showed peritumoral edema that developed and slowly and progressively evolved into enlarging hemangioblastoma-associated cysts in all tumors (mean follow-up, 130 +/- 38 months; mean +/- standard deviation). Postcontrast MRI demonstrated convective leakage of gadolinium into cysts. Mean time required for edema to evolve into a cyst was 36 +/- 23 months (range, 8-72 months). Thirteen (59%) hemangioblastoma-cysts became symptomatic (mean time to symptom formation after cyst development, 35 +/- 32 months; range, 3-102 months) and required resection. Protein profiles of cyst fluid and serum were similar. Mean cyst fluid vascular endothelial growth factor concentration was 1.5 ng/ml (range, 0-5.4 ng/ml). Histology of the cyst walls was consistent with reactive gliosis. CNS peritumoral cyst formation is initiated by increased tumor vascular permeability, increased interstitial pressure in the tumor, and plasma extravasation with convective distribution
[Endoscopic surgery in the treatment of patients with extensive odontogenic cysts].
Sysolyatin, P G; Sysolyatin, S P; Baydik, O D
The aim of the study was the assessment of effectiveness of endoscopic techniques in the treatment of extensive odontogenic cysts. Endosurgery for diagnostic and therapeutic purposes was used in 67 patients with odontogenic cysts of the jaws: 23 follicular cysts, 19 radicular cysts, 6 residual cysts, and 19 keratokists. The results prove that the developed methods of endovideosurgery of odontogenic cysts have low invasiveness, provide an optimal healing of bone tissue and reduce postoperative complications.
... Rarely, a Baker's cyst bursts and synovial fluid leaks into the calf region, causing: Sharp pain in your knee Swelling in the calf Sometimes, redness of your calf or a feeling of water running down your calf These signs and symptoms ...
Comparison of Mast Cells Count in Odontogenic Cysts Using Histochemical Staining.
Rajabi-Moghaddam, Mahdieh; Abbaszadeh-Bidokhty, Hamid; Bijani, Ali
2015-01-01
Odontogenic cysts are among the most frequent destructive lesions of jaws which their pathogenesis and growth mechanism are not cleared. With respect to different roles of mast cells, they may play a role in the pathogenesis and growth of odontogenic cysts. The aim of present study was to evaluate mast cells in the most common odontogenic cyst. Thirty paraffin-embedded tissue blocks including 10 radicular cysts, 10 dentigerous cysts and 10 odontogenic keratocysts were used and 5 micron sections stained with toluidine blue and observed by light microscope under ×400 magnification to evaluate mast cells within these cysts. For each case, 5 high-power field areas, selected from hot-spot areas, were considered and each area divided into 3 zones: intra-epithelial zone, sub-epithelial zone and deep zone. Most of the studied cyst showed presence of mast cells. There was not any significant difference in mast cell count between studied cysts ( P -values > 0.05).With respect to intra-epithelial, sub-epithelial and deep zones, there was not any significant difference between three studied cysts. There was not any significant difference between sub-epithelial zone and deep zone within each of these cysts. There was only significant difference between intra-epithelial zone and sub-epithelial zone within dentigerous cysts and odontogenic keratocysts ( P -value < 0.05). Prevalence of mast cells in fibrous wall of odontogenic cysts suggests their activity in these cysts. Mast cells may not be directly involved in the pathogenesis of odontogenic keratocysts.
Ovarian dermoid cyst leakage--a cautionary tale.
Edwards, A G; Lawrence, A; Tsaltas, J
1998-08-01
This case illustrates that when a dermoid cyst is punctured, an immediate operative laparoscopy or laparotomy should be performed, along with lavage, to avoid the problems associated with dermoid cyst contents spillage.
[Retention cysts of the vocal cords (author's transl)].
Grundmann, E W
1979-05-01
Present day knowledge in laryngology maintains that the free edge of the true cord mucosa is devoid of glands so that retention cysts should not occur in this tissue. When such cysts do occur, it is difficult to define their pathogenesis. Reference is made to the author's earlier study which found a regular occurrence of mucous glands in the squamous epithelial region of the vocal cords. A retention cyst in the true cord is described histologically in the present report. The glands responsible for these cysts are believed to function by moistening the mucous membrane of the vocal cords.
Epidermoid Cyst of the Sole - A Case Report
Rajput, Santosh Singh; Gopinathan, Nayar Sajeeth
2016-01-01
Epidermoid cysts are common benign subcutaneous lesion also termed as epidermal cysts. Epidermoid cyst are commonly seen in hairy regions of body like scalp, face and scrotum, can be single or multiple, but rarely can occur in glabrous skin of palm and sole. They are known to result from progressive cystic ectasia of the infundibular portion of hair follicle but the pathogenesis in palmo-plantar epidermoid cyst differs that is traumatic sequestration of epidermal elements into dermis. Here, we report a case of 30-year-old female presented with complaints of swelling in her left sole. On examination a palpable firm swelling was noted just below the 2nd web space left foot plantar region, on X-ray foot no osseous lesion or foreign body was detected. Swelling was excised and sent for histopathological examination which confirmed it as epidermoid cyst. PMID:28050432
An Unusual Right-sided Suprarenal Accessory Spleen Misdiagnosed as an Atypical Pheochromocytoma.
Xia, Zenan; Zhou, Zhien; Shang, Zhiyuan; Ji, Zhigang; Yan, Weigang
2017-12-01
Compared with left suprarenal splenosis, a right suprarenal accessory spleen is more likely to be misdiagnosed as an adrenal tumor because of its extreme rarity. Especially when splenosis mimics an atypical pheochromocytoma, preoperative diagnosis may become more difficult and elusive. Herein we report the case of a female patient with a right suprarenal mass, which was suspected to be an atypical pheochromocytoma based on a history of the classic triad and positive somatostatin receptor scintigraphy, but histopathology suggested a final diagnosis of right suprarenal splenosis. Copyright © 2017 Elsevier Inc. All rights reserved.
Hepatic cyst penetration of cefazolin in patients receiving aspiration sclerotherapy.
Lantinga, M A; Wijnands, T F M; Te Morsche, R H M; de Sévaux, R G L; Kuipers, S; Allegaert, K; Burger, D; Drenth, J P H
2016-09-01
Hepatic cyst infection is a potentially severe complication in cystic disease. Treatment demands effective antibiotic concentrations within the infected cyst. The aim of this study was to use elective hepatic cyst drainage as a unique pharmacokinetic model to investigate whether cefazolin, a first-generation cephalosporin, is able to penetrate hepatic cysts. Patients scheduled to undergo percutaneous aspiration sclerotherapy of a symptomatic non-infected, non-neoplastic hepatic cyst were eligible for this study. All participants received a single perioperative prophylactic dose of cefazolin (1000 mg, intravenously). We collected blood and cyst fluid samples to determine total and unbound cefazolin concentrations using HPLC. The primary outcome was hepatic cyst penetration, expressed as the ratio (%) of unbound concentration of cefazolin in cyst fluid to plasma (both in mg/L). We included eight patients [male = 25%, median age = 60 years (IQR 54-75), median estimated glomerular filtration rate = 97 mL/min/1.73 m(2) (IQR 67-102) and median serum albumin = 40 g/L (IQR 37-40)]. We detected low concentrations of unbound cefazolin in cyst fluid (≤1.0 mg/L). The median plasma unbound cefazolin peak level (immediately after cefazolin administration) was 36.6 mg/L (IQR 23.7-54.1) and the level at the time of cyst fluid aspiration was 16.1 mg/L (IQR 13.0-20.1). In total, the hepatic cyst penetration of free cefazolin was only 2.2% (IQR 0.7-5.2). We developed a study model to investigate the penetration of antibiotics into hepatic cysts. Cefazolin did not reach adequate intracystic concentrations. Future studies should explore alternatives. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.
Bosniak Classification for Complex Renal Cysts Reevaluated: A Systematic Review.
Schoots, Ivo G; Zaccai, Keren; Hunink, Myriam G; Verhagen, Paul C M S
2017-07-01
We systematically evaluated the Bosniak classification system with malignancy rates of each Bosniak category, and assessed the effectiveness related to surgical treatment and oncologic outcome based on recurrence and/or metastasis. In a systematic review according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement and the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies) criteria, we selected 39 publications for inclusion in this analysis and categorized them into 1) surgical cohorts-all cysts treated surgically and 2) radiological cohorts-cysts with surgical treatment or radiological followup. A total of 3,036 complex renal cysts were categorized into Bosniak II, IIF, III and IV. In surgical and radiological cohorts pooled estimates showed a malignancy prevalence of 0.51 (0.44, 0.58) in Bosniak III and 0.89 (0.83, 0.92) in Bosniak IV cysts, respectively. Stable Bosniak IIF cysts showed a malignancy rate of less than 1% during radiological followup (surveillance). Bosniak IIF cysts, which showed reclassification to the Bosniak III/IV category during radiological followup (12%), showed malignancy in 85%, comparable to Bosniak IV cysts. The estimated surgical number needed to treat to avoid metastatic disease of Bosniak III and IV cysts was 140 and 40, respectively. The effectiveness of the Bosniak classification system for complex renal cysts was high in categories II, IIF and IV, but low in category III, and 49% of Bosniak III cysts was overtreated because of a benign outcome. This surgical overtreatment combined with the excellent outcome for Bosniak III cysts may suggest that surveillance is a rational alternative to surgery. This will require further study to assess whether surveillance of Bosniak III cysts will prove safe. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Recurrent neck abscess due to a bronchogenic cyst in an adult.
Hazenberg, A J C; Pullmann, L M; Henke, R-P; Hoppe, F
2010-12-01
Neck abscesses can originate from congenital cervical cysts. Cervical cysts of bronchogenic origin are rare and often asymptomatic. Common symptoms of bronchogenic cysts are stridor, dyspnoea and dysphagia. The reported patient represents the second published case of a bronchogenic cyst causing a neck abscess in an adult. We report a case of a cervical bronchogenic cyst presenting as a recurrent supraclavicular abscess in a middle-aged woman. During extirpation, a fistula was demonstrated to the right upper lobe of the lung, suspected because the cyst inflated synchronously with respiration. The symptoms of bronchogenic cysts are due to the effects of compression or fistulas. In the majority of these cysts, a thorough investigation involving history, examination and radiological imaging does not clearly demonstrate a fistula. Therefore, extirpation is both diagnostic and therapeutic. A bronchogenic cyst is a very rare cause of a recurrent deep neck abscess. Total extirpation is the treatment of choice.
Clinico-radiographic study of odontogenic cysts at a tertiary care centre.
Ali, Kamran; Munir, Faisal; Rehman, Abdur; Abbas, Iram; Ahmad, Nofil; Akhtar, Muhammad Usman
2014-01-01
Cysts of the jaws constitute an important pathology in the oral and maxillofacial region and are broadly classified as odontogenic and non-odontogenic. Objective of this study was to document the clinical and radiographic presentation of odontogenic cysts at a tertiary care centre. In this descriptive case-series, patients presenting with features of suspected cystic lesions of the jaws were investigated using radiographs and incisional biopsy. Subjects showing clinico- radiographic features of odontogenic cyst(s) with subsequent confirmation on histopathological examination were included. A total of 112 subjects were investigated for suspected jaw cysts and cystic diagnosis of odontogenic cysts was confirmed in 100 patients with 53 males (53%) and 47 females (47%). The age range of patients was from 12-55 years. Radicular cyst was the most commonly diagnosed odontogenic cyst (63%) followed by dentigerous cyst (22%) and odontogenickeratocyst (14%). Anterior maxilla was the most affected site (44%) followed by posterior mandible (30%). Odontogenic cysts constitute an established pathology affecting the jaws with varying frequency. This study augments the data cited from Western countries and re-emphasizes the need for early diagnosis and prompt management. It also highlights the differences in the presentation of odontogenic cysts as observed in the current series.
Prevalence and distribution of odontogenic and nonodontogenic cysts in a Turkish Population
Uzun-Bulut, Emel; Özden, Bora; Gündüz, Kaan
2012-01-01
Objective: To determine the relative frequency and distribution of odontogenic and nonodontogenic cysts in a large Turkish population. Study Design A retrospective survey of jaw cysts was undertaken at the Oral Diagnosis and Radiology and Oral and Maxillofacial Surgery Department, Ondokuz Mayıs University Dental School, Samsun, Turkey. Data were retrieved from clinical files, imaging, and histopathology reports from 2000 to 2008; a total of 12,350 patients were included. In each case, we analyzed age, gender, type and number of cysts, and cyst location. Imaging patterns and pathologies associated with cystic lesions were also determined. Results: The prevalence of odontogenic and nonodontogenic cysts was 3.51%; males were affected more frequently than females. There were 452 odontogenic cysts (98.5%) and seven nonodontogenic cysts (1.5%). The most frequent odontogenic cyst was radicular (54.7%), followed by dentigerous (26.6%), residual (13.7%), odontogenic keratocyst (3.3%), and lateral periodontal cyst (0.2%). Nasopalatine duct cyst (1.5%) was the only nonodontogenic cyst. By age, cysts peaked in the third decade (24.2%). Concerning location, no statistically significant difference was found between the maxilla and mandible (p>0.05). The most frequent radiological feature of these lesions was unilocular cyst (93.7%). Pathologies associated with cystic lesions occurred in 14.7%. Conclusion: The prevalence of both odontogenic and nonodontogenic cysts were lower than that reported in many other studies. In our study population, cysts were mainly inflammatory in origin. Key words: Prevalence, odontogenic, nonodontogenic, cysts. PMID:21743428
Treatment of a large radicular cyst-enucleation or decompression?
Matijević, Stevo; Jovivić, Bojan; Bubalo, Marija; Dukić, Smiljka; Cutović, Tatjana
2015-04-01
Radicular cysts treatment involves surgical approach, more or less aggressive. However, treatment of large cystic lesions, including radicular cysts, causes some of dilemmas concerning the choice of the surgical method, especially the degree of radicalism. We presented a 65-year-old male patient with large radicular cyst in the mandible. A large elliptical multilocular radiolucency, located in the left side of the mandible, being in close vicinity to the mandibular canal, was registered at the orthopantomographic radiography. There was a risk of pathological fracture of the mandible. However, the cyst was completely removed by enucleation without intraoperative and postoperative complications. The presented case support the opinion that careful enucleation of large mandibular cysts may be done without complications, such as damages of surrounding anatomical structures or mandibular fracture. The authors indicate reasons for strong support of the undertaken surgical approach of treating large radicular cysts in the mandible.
Comparison of Mast Cells Count in Odontogenic Cysts Using Histochemical Staining
Rajabi-Moghaddam, Mahdieh; Abbaszadeh-Bidokhty, Hamid; Bijani, Ali
2015-01-01
Background & Objectives: Odontogenic cysts are among the most frequent destructive lesions of jaws which their pathogenesis and growth mechanism are not cleared. With respect to different roles of mast cells, they may play a role in the pathogenesis and growth of odontogenic cysts. The aim of present study was to evaluate mast cells in the most common odontogenic cyst. Methods: Thirty paraffin-embedded tissue blocks including 10 radicular cysts, 10 dentigerous cysts and 10 odontogenic keratocysts were used and 5 micron sections stained with toluidine blue and observed by light microscope under ×400 magnification to evaluate mast cells within these cysts. For each case, 5 high-power field areas, selected from hot-spot areas, were considered and each area divided into 3 zones: intra-epithelial zone, sub-epithelial zone and deep zone. Results: Most of the studied cyst showed presence of mast cells. There was not any significant difference in mast cell count between studied cysts ( P -values > 0.05).With respect to intra-epithelial, sub-epithelial and deep zones, there was not any significant difference between three studied cysts. There was not any significant difference between sub-epithelial zone and deep zone within each of these cysts. There was only significant difference between intra-epithelial zone and sub-epithelial zone within dentigerous cysts and odontogenic keratocysts ( P -value < 0.05). Conclusions: Prevalence of mast cells in fibrous wall of odontogenic cysts suggests their activity in these cysts. Mast cells may not be directly involved in the pathogenesis of odontogenic keratocysts. PMID:26351470
Airway management in an infant with a giant vallecular cyst.
Reiersen, David A; Gungor, Anil A
2014-01-01
Review vallecular cysts and report the surgical management of a vallecular cyst of unusual size with near-complete obliteration of the airway. This case report describes an unusually large mucus retention cyst in an 8-week-old infant that was diagnosed during induction of general anesthesia and prevented visualization of airway. Intubation was performed after rapid aspiration of the cyst contents. Vallecular cysts can present as a life-threatening obstruction in infants and complicate the establishment of an airway after induction of anesthesia. In our case, rapid thinking and aspiration of the cyst contents helped establish the airway for definitive CO2 laser excision. Copyright © 2014 Elsevier Inc. All rights reserved.
Mucous retention cyst of the maxillary sinus.
Ruprecht, A; Batniji, S; el-Neweihi, E
1986-12-01
The mucous retention cyst is not a rare phenomenon. The incidence of dental patients was determined. Of 1685 patient radiographs reviewed, 44 (2.6%) had one or more mucous retention cysts in the maxillary sinuses.
Misdiagnosed bipolar disorder in adolescents in a special educational school and treatment program.
Isaac, G
1992-04-01
Twelve adolescents found to be the most problematic, crisis prone, and treatment resistant were comprehensively reevaluated in the special educational day school and treatment program they were attending. This reevaluation took place over a 6-month period and was done to arrive upon a more comprehensive diagnostic understanding so that more relevant and effective treatment measures could be instituted. The author conducted semistructured interviews with the adolescents on multiple occasions as the clinical situations warranted. All information available, recorded or otherwise, was comprehensively reviewed and reevaluated. The children were observed informally in and out of their classrooms throughout the period. All parents available were interviewed to clarify the children's present and past symptomatology and to assess the nature of psychiatric disorders, if any, in first- and second-degree family members. The reevaluation showed that 8 of the 12 youngsters clearly satisfied DSM-III-R criteria for bipolar disorder, which had been misdiagnosed mainly as attention-deficit hyperactivity disorder (ADHD) and conduct disorder. Three other youngsters showed significant bipolar features though not fully satisfying the criteria for this disorder. Bipolar disorder may be very common among highly problematic adolescents in special educational and outpatient treatment facilities for emotionally disturbed youngsters but may still be misdiagnosed very often as ADHD and conduct disorder, with all the negative consequences of such misdiagnosis.
Ultrasound diagnostic of mesonephric paraovarian cyst - case report
Bohîlțea, RE; Cîrstoiu, MM; Turcan, N; Ionescu, CA
2016-01-01
Paraovarian cysts are a rare pathology, constituting 10-20% of the adnexal masses. The origin can be represented by paramesonephric ducts (Hydatid cysts of Morgagni), vestiges of mesonephric ducts also represented by mesothelium, or neoplastic (cystadenomas or cystadenofibromas) that are mostly benign. Borderline or malignant paraovarian tumors are encountered less often. This article presents a case of paraovarian cyst in a 37-year-old patient, with a history of 2 pregnancies, completed by cesarean. The patient sought medical attention for an asymptomatic voluminous ovarian cyst, detected in a routine ultrasound scan. Laboratory tests and tumor markers were within normal limits. Transvaginal ultrasound and color Doppler revealed a cystic adnexal mass with 10 cm transonic, smooth, homogeneous content, avascular walls with no internal papillary projections, with a “hyperechoic line” sign of delimitation from the ovarian capsule, mostly visible when the adnexa was mobilized. The diagnostic and curative laparoscopic surgery was successful, followed by a quick recovery. The histopathological exam confirmed the benignity and the origin of the paraovarian cyst. The case was discussed in the context of the literature review concerning this pathology, drawing attention to the real possibility of differentiating ovarian from paraovarian cysts by ultrasound. PMID:27974934
Giant Vulvar Epidermoid Cyst in an Adolescent Girl
Karaman, Erbil; Çim, Numan; Akdemir, Zülküf; Elçi, Erkan; Akdeniz, Hüseyin
2015-01-01
Introduction. Vulvar cyst in adolescent girls is very uncommon. Epidermoid cyst can be seen in many sites including face, trunk, and extremities but its occurrence in vulva is uncommon. This is the first case of epidermoid cyst of vulva reported in an adolescent girl. Case. A 17-year-old, adolescent girl admitted to our gynecology outpatient clinic with a complaint of painful and palpable mass in her vulva. On examination, a giant mass located in left vulva and labia majora with 11 cm in diameter was seen. The magnetic resonance imaging (MRI) showed a well-defined cystic mass without contrast enhancement. The surgery was advised to the patient and the pathologic examination of mass revealed vulvar epidermoid cyst. Discussion. Vulvar cysts generally grow slowly and the main etiologies are vulvar trauma and surgical interventions including episiotomy and female circumcision in some culture. The exact treatment is total surgical excision and pathologic examination. MRI is an important imaging modality for detection of extension to deep perineal tissue and localization of mass in vulva especially in giant ones. Conclusion. Although vulvar mass in adolescents is rare, the epidermoid cyst with benign origin should be kept in mind. PMID:25949839
Prevalence of incidental pancreatic cyst on upper endoscopic ultrasound
Martínez, Belén; Martínez, Juan F.; Aparicio, José R.
2018-01-01
Background: This study aimed to determine the prevalence of incidental pancreatic cysts in patients undergoing upper endoscopic ultrasound without a known pancreatic abnormality. Methods: This prospective study was conducted in two hospitals in Spain and enrolled consecutive patients referred for upper endoscopic ultrasound for a condition unrelated to the pancreas. Patients with a previous pancreatic anomaly, history of acute or chronic pancreatitis, evidence of acute pancreatitis, previous upper gastrointestinal surgery, or chronic abdominal pain suggestive of pancreatic origin were excluded. Univariate logistic regression was performed to evaluate individual covariates and the incidental pancreatic cyst risk. Results: A total of 298 patients were included, of whom 64 had pancreatic cysts (21.5%; 16.9-26.6%). The mean size of the cysts was 6.3±3.7 (range 3-25) mm. Six cysts (2%) were >10 mm and 16 (5.4%) were compatible with branch duct intraductal papillary mucinous neoplasm. The pancreatic cyst prevalence was similar in the two hospitals and increased significantly with age. Conclusion: The prevalence of incidental pancreatic cysts during endoscopic ultrasound was very high in our study population. PMID:29333072
[The so-called "chocolate cyst"--frequently misinterpreted as ovarian endometriosis?].
Christensen, B; Schindler, A E
1996-09-01
Limitation of morphological diagnostic and possible misinterpretations are shown in a patient with anamnestic ovarian endometriosis. In cases of "chocolate cysts" it is necessary to differentiate between ovarian endometriosis and functional cysts. Hints for the existence of a functional cyst are an atypical past history or perioperative findings. Biochemical analysis of the cyst fluid may lead to a correct diagnosis.
Unicameral bone cyst of the calcaneum.
Hazmy, C H Wan
2004-12-01
The calcaneus is not a common site for a unicameral solitary bone cyst. Little is known about the etiology and natural history of these lesions. The author reports an adult man with a solitary bone cyst of the os calcis which was confirmed radiologically and histologically and successfully treated with curretage and bone grafting.
Unicameral Bone Cysts of the Pelvis
Hammoud, Sommer; Weber, Kristy; McCarthy, Edward F
2005-01-01
Unicameral bone cysts 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 bone cysts 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 bone cysts 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 bone cysts 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). PMID:16089077
Xu, Chao; Zhang, Xinxian; Dong, Lina; Zhu, Bin; Xin, Tao
2017-06-01
We verified the advantages of using magnetic resonance imaging (MRI) for improving the diagnostic quality of growth hormone deficiency (GHD) in children with short stature caused by pituitary lesions. Clinical data obtained from 577 GHD patients with short stature caused by pituitary lesions were retrospectively analyzed. There were 354 cases (61.3%) with anterior pituitary dysplasia; 45 cases (7.8%) of pituitary stalk interruption syndrome (PSIS); 15 cases (2.6%) of pituitary hyperplasia due to primary hypothyroidism; 38 cases (6.6%) of Rathke cleft cyst; 68 cases (11.8%) of empty sella syndrome; 16 cases (2.8%) of pituitary invasion from Langerhans cell histiocytosis; 2 cases (0.3%) of sellar regional arachnoid cyst and 39 cases (6.8%) of craniopharyngioma. MRI results showed that the height of anterior pituitary in patients was less than normal. Location, size and signals of posterior pituitary and pituitary stalk were normal in anterior pituitary dysplasia. In all cases pituitary hyperplasia was caused by hypothyroidism. MRI results showed that anterior pituitary was enlarged, and we detected upward apophysis and obvious homogeneous enhancement. There were no pituitary stalk interruption and abnormal signal. We also observed that after hormone replacement therapy the size of pituitary gland was reduced. Anterior pituitary atrophy was observed in Rathke cleft cyst, empty sella syndrome, sellar regional arachnoid cyst and craniopharyngioma. The microstructure of hypophysis and sellar region was studied with MRI. We detected pituitary lesions, and the characteristics of various pituitary diseases of GHD in children with short stature. It was concluded that in children with GHD caused by pituitary lesions, MRI was an excellent method for early diagnosis. This method offers clinical practicability and we believe it can be used for differential diagnosis and to monitor the therapeutic effects.
9 CFR 311.24 - Hogs affected with tapeworm cysts.
Code of Federal Regulations, 2013 CFR
2013-01-01
... 9 Animals and Animal Products 2 2013-01-01 2013-01-01 false Hogs affected with tapeworm cysts. 311.24 Section 311.24 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF... affected with tapeworm cysts. Carcasses of hogs affected with tapeworm cysts (Cysticercus cellulosae) may...
9 CFR 311.24 - Hogs affected with tapeworm cysts.
Code of Federal Regulations, 2011 CFR
2011-01-01
... 9 Animals and Animal Products 2 2011-01-01 2011-01-01 false Hogs affected with tapeworm cysts. 311.24 Section 311.24 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF... affected with tapeworm cysts. Carcasses of hogs affected with tapeworm cysts (Cysticercus cellulosae) may...
9 CFR 311.24 - Hogs affected with tapeworm cysts.
Code of Federal Regulations, 2012 CFR
2012-01-01
... 9 Animals and Animal Products 2 2012-01-01 2012-01-01 false Hogs affected with tapeworm cysts. 311.24 Section 311.24 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF... affected with tapeworm cysts. Carcasses of hogs affected with tapeworm cysts (Cysticercus cellulosae) may...
9 CFR 311.24 - Hogs affected with tapeworm cysts.
Code of Federal Regulations, 2014 CFR
2014-01-01
... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false Hogs affected with tapeworm cysts. 311.24 Section 311.24 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF... affected with tapeworm cysts. Carcasses of hogs affected with tapeworm cysts (Cysticercus cellulosae) may...
Aneurysmal bone cyst: a hereditary disease?
Leithner, Andreas; Machacek, Felix; Haas, Oskar A; Lang, Susanna; Ritschl, Peter; Radl, Roman; Windhager, Reinhard
2004-05-01
Recent genetic and immunohistochemical studies propose that the primary aneurysmal bone cyst is a tumour and not a reactive tumour-simulating lesion. Based on a familial case of aneurysmal bone cyst the authors contacted 135 patients with this disease. Sixty-eight females and 67 males (median age 14 years; range 2-73 years) were asked if other family members had bone lesions. One hundred and seven patients (79%) denied having other family members with lesions, 23 patients (17%) did not answer, and five patients (4%) gave evidence of other bone lesions in the family. These data indicate that a predisposing genetic defect could be part of a multifactorial pathogenesis in the development of some aneurysmal bone cysts.
Liesegang rings in renal cyst fluid.
Katz, L B; Ehya, H
1990-01-01
Peculiar ring-like structures identified as Liesegang rings (LRs) were found in renal cyst fluid from three patients with benign renal cysts. They ranged in size from 5 to 820 mu. Most had a double-layer outer wall with equally spaced radial cross-striations and an amorphous central nidus. Special stains were performed in one case, and the results are discussed. Reports of LRs in cystic or inflamed tissues have recently appeared in the literature. Some LRs have been mistaken for eggs or mature components of the giant kidney worm, Dioctophyma renale. We propose that cytologic assessment of renal cyst fluid in conjunction with histologic examination decreases the likelihood of misdiagnosis of LRs.
Maxillary bone epithelial cyst in an adult miniature schnauzer.
Lin, Chung-Tien; Tasi, Wen-Chih; Hu, Chun-Kun; Lin, Nien-Ting; Huang, Pei-Yun; Yeh, Lih-Seng
2008-09-01
Maxillary bone epithelial cyst is rare in dogs. A 5-year-old, spayed female miniature schnauzer developed a swelling below the nasal canthus of left eye. Plain radiograph demonstrated a 1.5 cm diameter of radiolucent lesion on the maxillary bone anteroventral to the eye, and contrast dacryocystorhinography confirmed an obstructed nasolarcrimal duct. The swelling showed poor response to antibiotic treatment but responded well to oral prednisolone. Exploratory surgery revealed a cyst-like structure filled with brown serous fluid. Histopathological examination of the removed cyst revealed a double cuboidal epithelial cyst. The dog recovered rapidly after surgery, and the swelling had not recurred for a 36-month follow-up. It is the first case of periorbital bone epithelial cyst reported in an adult miniature schnauzer.
Immunohistochemical analysis of P53 protein in odontogenic cysts
Gaballah, Essam Taher M.A.; Tawfik, Mohamed A.
2010-01-01
The p53 is a well-known tumor suppressor gene, the mutations of which are closely related to the decreased differentiation of cells. Findings of studies on immunohistochemical P53 expression in odontogenic cysts are controversial. The present study was carried-out to investigate the immunohistochemical expression of P53 protein in odontogenic cysts. Thirty paraffin blocks of diagnosed odontogenic cysts were processed to determine the immunohistochemical expression of P53 protein. Nine of the 11 odontogenic keratocysts (81.8%) expressed P53, one of three dentigerous cyst cases expressed P53, while none of the 16 radicular cysts expressed P53 protein. The findings of the present work supported the reclassification of OKC as keratocystic odontogenic tumor. PMID:23960493
Limited remyelination of CNS axons by Schwann cells transplanted into the sub-arachnoid space.
Blakemore, W F
1984-06-01
Areas of primary demyelination which did not subsequently remyelinate spontaneously were prepared in the cat spinal cord by injecting small volumes of ethidium bromide into tissue which had previously been exposed to 40 Grays of X-irradiation. Autologous peripheral nerve tissue was placed in the sub-arachnoid space over such lesions, either at the time of injecting ethidium bromide, or at 14 days or 28 days after injecting ethidium bromide. The extent of Schwann cell remyelination was assessed 28 days after transplantation. In no case were all the demyelinated axons remyelinated; rather, remyelination was limited to axons near to blood vessels. It was concluded that Schwann cells migrated from the transplanted tissue into the lesion via the perivascular space and that they failed to remyelinate the bulk of demyelinated axons because of an absence within the CNS of suitable extracellular matrix.
Morphometric evaluation of AgNORs in odontogenic cysts.
Sreeshyla, Huchanahalli S; Shashidara, Raju; Sudheendra, Udyavara Sridhara
2013-10-01
To evaluate the morphometry of AgNORs in odontogenic cysts and to compare their biologic behavior to determine whether AgNOR morphometry is helpful in predicting the behavior. Ten cases each of odontogenic keratocyst (OKC), dentigerous cyst (DC) and radicular cyst (RC) were stained with silver nitrate. Morphometric analysis of 100 selected epithelial and connective tissue cells was done to record their nuclear volume, nuclear perimeter, contour index of the nucleus, AgNOR count, AgNOR proportion and single AgNOR volume. The results were statistically analyzed using ANOVA. AgNOR count, nuclear volume and nuclear perimeter were greatest in the OKC followed by DC and RC, suggesting that these parameters differentiate between the aggressive and less aggressive odontogenic cysts. Single AgNOR volume and AgNOR proportion were greatest in the RC followed by OKC and DC, respectively. Results of our study taken in isolation point to AgNOR count as the most reliable factor in differentiating between aggressive and nonaggressive odontogenic cysts.
Aquatic biomonitoring of Giardia cysts and Cryptosporidium oocysts in peninsular Malaysia.
Lee, Soo Ching; Ngui, Romano; Tan, Tiong Kai; Roslan, Muhammad Aidil; Ithoi, Init; Lim, Yvonne A L
2014-01-01
An aquatic biomonitoring of Giardia cysts and Cryptosporidium oocysts in river water corresponding to five villages situated in three states in peninsular Malaysia was determined. There were 51.3% (20/39) and 23.1% (9/39) samples positive for Giardia and Cryptosporidium (oo)cysts, respectively. Overall mean concentration between villages for Giardia cysts ranged from 0.10 to 25.80 cysts/l whilst Cryptosporidium oocysts ranged from 0.10 to 0.90 oocysts/l. Detailed results of the river samples from five villages indicated that Kuala Pangsun 100% (9/9), Kemensah 77.8% (7/9), Pos Piah 33.3% (3/9) and Paya Lebar 33.3% (1/3) were contaminated with Giardia cysts whilst Cryptosporidium (oo)cysts were only detected in Kemensah (100 %; 9/9) and Kuala Pangsun (66.6%; 6/9). However, the water samples from Bentong were all negative for these waterborne parasites. Samples were collected from lower point, midpoint and upper point. Midpoint refers to the section of the river where the studied communities are highly populated. Meanwhile, the position of the lower point is at least 2 km southward of the midpoint and upper point is at least 2 km northward of the midpoint. The highest mean concentration for (oo)cysts was found at the lower points [3.15 ± 6.09 (oo)cysts/l], followed by midpoints [0.66 ± 1.10 (oo)cysts/l] and upper points [0.66 ± 0.92 (oo)cysts/l]. The mean concentration of Giardia cysts was highest at Kuala Pangsun (i.e. 5.97 ± 7.0 cysts/l), followed by Kemensah (0.83 ± 0.81 cysts/l), Pos Piah (0.20 ± 0.35 cysts/l) and Paya Lebar (0.10 ± 0.19 cysts/l). On the other hand, the mean concentration of Cryptosporidium oocysts was higher at Kemensah (0.31 ± 0.19 cysts/l) compared to Kuala Pangsun (0.03 ± 0.03cysts/l). All the physical and chemical parameters did not show significant correlation with both protozoa. In future, viability status and molecular characterisation of Giardia and Cryptosporidium should be applied to identify
First record of cysts in the tidal tardigrade Echiniscoides sigismundi
NASA Astrophysics Data System (ADS)
Clausen, Lykke K. B.; Andersen, Kasper N.; Hygum, Thomas L.; Jørgensen, Aslak; Møbjerg, Nadja
2014-12-01
Tardigrades are microscopic metazoans that withstand environmental extremes by entering dormant states, such as cryptobiosis (latent life). In addition, they may also form cysts. Here, we present the first report of cyst formation in a marine heterotardigrade, i.e., Echiniscoides sigismundi, which constitutes a cryptic species complex present worldwide in tidal zones. The cysts were initially discovered during experimental series constructed to investigate osmotic stress tolerance. The animals, which eventually formed cysts, showed signs of an imminent molt at the beginning of experimentation. We use the term "cyst" for stages, where a total of three or more cuticles have been synthesized. Our observations show that encystment in E. sigismundi involves synthesizing of at least two new cuticle layers. Legs with discharged claws are present in connection with the first outer cuticle, as well as the second cuticular layer. In the most developed cyst, a third cuticle lacking claws seems to surround the animal, which is delineated by a fourth cuticle. Many features are shared with the well-studied cysts of eutardigrades. The cysts of E. sigismundi, however, lack pigmentation and have an extra set of claws, and the animal inside retains buccopharyngeal sclerified parts, until discharging the third cuticle. The finding of cysts in a marine heterotardigrade is novel and confirms that encystment also occurs within this major evolutionary lineage.
Misdiagnosed crusted scabies in an AIDS patient leads to hyperinfestation.
Yari, Niloofar; Malone, C Helen; Rivas, Antonio
2017-03-01
Crusted scabies is a severe, highly contagious form of classic scabies caused by the mite Sarcoptes scabiei var hominis . Crusted scabies is more common in immunosuppressed populations and overcrowded environments. In this condition, the host's immune system is overwhelmed and unable to defend against the mites on the skin, resulting in hyperinfestation of the host. Diagnosis can be challenging because the condition resembles other common skin conditions, such as plaque psoriasis. Furthermore, delayed diagnosis and inappropriate treatment can lead to worsening of the condition. We report a case of crusted scabies that was initially misdiagnosed in a 34-year-old incarcerated man with multidrug-resistant human immunodeficiency virus/AIDS. The patient had a complicated but complete recovery after treatment with permethrin and ivermectin was instituted.
Sonographic Spectrum of Tunica Albuginea Cyst
Alvarez, Daniel M.; Bhatt, Shweta; Dogra, Vikram S.
2011-01-01
Tunica albuginea (TA) cyst is the most common extratesticular benign mass, which is usually palpable. Ultrasound examination is the imaging modality of choice to characterize palpable testicular lesions. This pictorial essay presents the spectrum of sonographic features of TA cysts in order to assist radiologists in making the correct diagnosis and avoid unnecessary surgeries. PMID:21915386
An Approach towards Ultrasound Kidney Cysts Detection using Vector Graphic Image Analysis
NASA Astrophysics Data System (ADS)
Mahmud, Wan Mahani Hafizah Wan; Supriyanto, Eko
2017-08-01
This study develops new approach towards detection of kidney ultrasound image for both with single cyst as well as multiple cysts. 50 single cyst images and 25 multiple cysts images were used to test the developed algorithm. Steps involved in developing this algorithm were vector graphic image formation and analysis, thresholding, binarization, filtering as well as roundness test. Performance evaluation to 50 single cyst images gave accuracy of 92%, while for multiple cysts images, the accuracy was about 86.89% when tested to 25 multiple cysts images. This developed algorithm may be used in developing a computerized system such as computer aided diagnosis system to help medical experts in diagnosis of kidney cysts.
Diagnosing cysts with correlation coefficient images from 2-dimensional freehand elastography.
Booi, Rebecca C; Carson, Paul L; O'Donnell, Matthew; Richards, Michael S; Rubin, Jonathan M
2007-09-01
We compared the diagnostic potential of using correlation coefficient images versus elastograms from 2-dimensional (2D) freehand elastography to characterize breast cysts. In this preliminary study, which was approved by the Institutional Review Board and compliant with the Health Insurance Portability and Accountability Act, we imaged 4 consecutive human subjects (4 cysts, 1 biopsy-verified benign breast parenchyma) with freehand 2D elastography. Data were processed offline with conventional 2D phase-sensitive speckle-tracking algorithms. The correlation coefficient in the cyst and surrounding tissue was calculated, and appearances of the cysts in the correlation coefficient images and elastograms were compared. The correlation coefficient in the cysts was considerably lower (14%-37%) than in the surrounding tissue because of the lack of sufficient speckle in the cysts, as well as the prominence of random noise, reverberations, and clutter, which decorrelated quickly. Thus, the cysts were visible in all correlation coefficient images. In contrast, the elastograms associated with these cysts each had different elastographic patterns. The solid mass in this study did not have the same high decorrelation rate as the cysts, having a correlation coefficient only 2.1% lower than that of surrounding tissue. Correlation coefficient images may produce a more direct, reliable, and consistent method for characterizing cysts than elastograms.
Endoscopic colloid cyst excision: surgical techniques and nuances.
Azab, Waleed Abdelfattah; Najibullah, Mustafa; Yosef, Waleed
2017-06-01
Endoscopic excision of colloid cysts is currently well established as a minimally invasive and highly effective technique that is associated with less morbidity in comparison to microsurgical resection. Operative charts and videos of patients undergoing endoscopic colloid cyst excision were retrieved from the senior author's database of endoscopic procedures and reviewed. This revealed nine trans-foraminal and three trans-septal procedures. Description of the surgical techniques was then formulated. Variation of the technique is based on the specific patho-anatomical features of the colloid cyst being resected. For the trans-foraminal approach, we think that the rotational technique is associated with a more complete removal of the cyst wall and consequently lower recurrence rate.
Frontal horn thin walled cysts in preterm neonates are benign
Pal, B; Preston, P; Morgan, M; Rushton, D; Durbin, G
2001-01-01
BACKGROUND—Screening cranial ultrasound led to the discovery of isolated frontal horn cysts quite distinct from periventricular leucomalacia cysts. AIM—To clarify their significance, incidence, characteristics, causal factors or aetiology, and effect on long term outcome. DESIGN—A retrospective observational study of all first cranial ultrasound scans (total of 2914) performed during the period 1984-1994 inclusive found 21 neonates with smooth thin walled frontal horn cysts: 18 of 2629 scanned were of birth weight < 1500 g or gestation < 33 weeks, and three of 285 were > 33 weeks gestation. Sequential ultrasound, maternal records, and neonatal events were retrospectively assessed. In survivors, routine neurodevelopmental evaluations were obtained. Postmortem studies of one cyst were performed to determine the nature and origin of these lesions. RESULTS—Of the 21 subjects, 15 had isolated frontal horn cysts and six had additional ultrasound scan abnormalities, including four with subependymal haemorrhage. The sonographic features of frontal horn cysts were of distinctive morphology (elliptical, smooth, thin walled, ranging in size from 3 to 20 mm) and position (adjacent to the tip of the anterior horns). The cysts enlarged and then regressed by a median corrected age of 2 months. Subjects of < 33 weeks gestation (n = 18) had a median birth weight of 1465g (range 720-1990) and median gestation of 30 weeks (range 24-32). There was no consistent perinatal course. The neurodevelopmental outcome in 10 of the 11 survivors with isolated frontal horn cysts was normal. Five subjects died from causes unrelated to brain pathology in the neonatal period, and one subject died after infancy. Histological examination of a cyst at autopsy in one additional subject subsequent to the period of study confirmed the cyst to be lined by neuroblasts and ependymal cells. CONCLUSIONS—The incidence of frontal horn cysts in this low birthweight population was 7 per 1000 (0
Atypical Intracranial Epidermoid Cysts: Rare Anomalies with Unique Radiological Features
Law, Eric K. C.; Lee, Ryan K. L.; Ng, Alex W. H.; Siu, Deyond Y. W.; Ng, Ho-Keung
2015-01-01
Epidermoid cysts are benign slow growing extra-axial tumours that insinuate between brain structures, while their occurrences in intra-axial or intradiploic locations are exceptionally rare. We present the clinical, imaging, and pathological findings in two patients with atypical epidermoid cysts. CT and MRI findings for the first case revealed an intraparenchymal epidermoid cyst that demonstrated no restricted diffusion. The second case demonstrated an aggressive epidermoid cyst that invaded into the intradiploic spaces, transverse sinus, and the calvarium. The timing of ectodermal tissue sequestration during fetal development may account for the occurrence of atypical epidermoid cysts. PMID:25667778
Clinico-pathologic study of odontogenic cysts in a Mexican sample population.
Ledesma-Montes, C; Hernández-Guerrero, J C; Garcés-Ortíz, M
2000-01-01
Odontogenic cysts are uncommon lesions that frequently behave agressively and attain a large size. Unfortunately, information on the relative incidence of these cysts from different populations is not abundant. In Mexico, for example, only a few examples have been reported. The aim of this study was to ascertain the frequency of odontogenic cysts in a Mexican sample and to compare these data with previously reported studies from other countries. The files of the Oral and Maxillofacial Pathology Diagnosis Service at the School of Dentistry at the Universidad Nacional Autónoma de México (UNAM) were reviewed and all accessions of odontogenic cysts were listed. Clinical and radiographic data were recorded and microscopic slides evaluated according to the most recent World Health Organization (WHO) classification (1992). Three hundred and four cases of odontogenic cysts (55.9% male predominance) were found. The most frequent odontogenic cysts were the following: periapical cyst (38. 8%); dentigerous cyst (35.5%), and odontogenic keratocyst (18.8%). Periapical cyst was more frequent in females, and maxillary anterior teeth were most commonly involved. Dentigerous cysts appeared in males at a rate of 64.8%, this cyst found more frequently between the 1st and 2nd decades of life and in the molar zone. Odontogenic keratocyst was more frequent in males (59.6%), between the 2nd and 4th decades of life and more common in the molar zone. More than 50% of the sample were aggressive cysts (dentigerous and keratocyst). Our results suggest that Mexican patients develop aggressive odontogenic cysts more commonly than other populations. Our figures point to the need for a precise diagnosis in order to institute the correct surgical procedure, prevent recurrence, and forestall more extensive tissue destruction.
Grall, Maximilien; Azoulay, Elie; Galicier, Lionel; Provôt, François; Wynckel, Alain; Poullin, Pascale; Grange, Steven; Halimi, Jean-Michel; Lautrette, Alexandre; Delmas, Yahsou; Presne, Claire; Hamidou, Mohamed; Girault, Stéphane; Pène, Frédéric; Perez, Pierre; Kanouni, Tarik; Seguin, Amélie; Mousson, Christiane; Chauveau, Dominique; Ojeda-Uribe, Mario; Barbay, Virginie; Veyradier, Agnès; Coppo, Paul; Benhamou, Ygal
2017-04-01
Thrombotic thrombocytopenic purpura (TTP) has a devastating prognosis without adapted management. Sources of misdiagnosis need to be identified to avoid delayed treatment. We studied 84 patients with a final diagnosis of severe (<10%) acquired ADAMTS13 deficiency-associated TTP from our National database that included 423 patients, who had an initial misdiagnosis (20% of all TTP). Main diagnostic errors were attributed to autoimmune thrombocytopenia, associated (51%) or not (37%) with autoimmune hemolytic anemia. At admission, misdiagnosed patients were more frequently females (P = .034) with a history of autoimmune disorder (P = .017) and had organ involvement in 67% of cases; they had more frequently antinuclear antibodies (P = .035), a low/undetectable schistocyte count (P = .001), a less profound anemia (P = .008), and a positive direct antiglobulin test (DAT) (P = .008). In multivariate analysis, female gender (P = .022), hemoglobin level (P = .028), a positive DAT (P = .004), and a low schistocytes count on diagnosis (P < .001) were retained as risk factors of misdiagnosis. Platelet count recovery was significantly longer in the misdiagnosed group (P = .041) without consequence on mortality, exacerbation and relapse. However, patients in the misdiagnosed group had a less severe disease than those in the accurately diagnosed group, as evidenced by less organ involvement at TTP diagnosis (P = .006). TTP is frequently misdiagnosed with autoimmune cytopenias. A low schistocyte count and a positive DAT should not systematically rule out TTP, especially when associated with organ failure. © 2017 Wiley Periodicals, Inc.
Schultz, Randall; Steven, Andrew; Wessell, Aaron; Fischbein, Nancy; Sansur, Charles A; Gandhi, Dheeraj; Ibrahimi, David; Raghavan, Prashant
2017-06-01
OBJECTIVE Dorsal arachnoid webs (DAWs) and spinal cord herniation (SCH) are uncommon abnormalities affecting the thoracic spinal cord that can result in syringomyelia and significant neurological morbidity if left untreated. Differentiating these 2 entities on the basis of clinical presentation and radiological findings remains challenging but is of vital importance in planning a surgical approach. The authors examined the differences between DAWs and idiopathic SCH on MRI and CT myelography to improve diagnostic confidence prior to surgery. METHODS Review of the picture archiving and communication system (PACS) database between 2005 and 2015 identified 6 patients with DAW and 5 with SCH. Clinical data including demographic information, presenting symptoms and neurological signs, and surgical reports were collected from the electronic medical records. Ten of the 11 patients underwent MRI. CT myelography was performed in 3 patients with DAW and in 1 patient with SCH. Imaging studies were analyzed by 2 board-certified neuroradiologists for the following features: 1) location of the deformity; 2) presence or absence of cord signal abnormality or syringomyelia; 3) visible arachnoid web; 4) presence of a dural defect; 5) nature of dorsal cord indentation (abrupt "scalpel sign" vs "C"-shaped); 6) focal ventral cord kink; 7) presence of the nuclear trail sign (endplate irregularity, sclerosis, and/or disc-space calcification that could suggest a migratory path of a herniated disc); and 8) visualization of a complete plane of CSF ventral to the deformity. RESULTS The scalpel sign was positive in all patients with DAW. The dorsal indentation was C-shaped in 5 of 6 patients with SCH. The ventral subarachnoid space was preserved in all patients with DAW and interrupted in cases of SCH. In no patient was a web or a dural defect identified. CONCLUSIONS DAW and SCH can be reliably distinguished on imaging by scrutinizing the nature of the dorsal indentation and the integrity of
Mucus retention cyst of the maxillary sinus: the endoscopic approach.
Hadar, T; Shvero, J; Nageris, B I; Yaniv, E
2000-06-01
To present our experience of endoscopic surgery for symptomatic mucus retention cyst of the maxillary sinus. Retrospective study. Teaching hospital, Israel. 60 patients with 65 symptomatic cysts of the maxillary sinus who were operated on endoscopically. Only patients with large cysts that filled at least 50% of the sinus space were included. A rigid nasal endoscope was used in all cases; most of the cysts were removed through the natural sinus ostium. Cysts recurred in only two patients during the first postoperative year. There were no complications from the procedure. The endoscopic approach to the treatment of maxillary sinus cyst is associated with a low rate of recurrence (3% in this study) and no complications, and we recommend it as the surgical procedure of choice. Copyright 2000 The British Association of Oral and Maxillofacial Surgeons.
Giant Follicular Cyst of Ovary in an Adolescent Girl
Gedam, Jaya; Bhalerao, Minal; Nadar, Ponambalaganpathi A
2014-01-01
Cystic abdominal lesions are extremely common in adolescent girls and are now diagnosed more frequently due to the availability of better imaging modalities. Presentations as huge cysts have become rare as most of them are diagnosed and treated early. Adolescent girls presenting with huge benign abdominal cysts is not uncommon, most of them due to serious cystadenomas of the ovary, but large follicular cysts are rare. We present a 13-year-old girl who presented with a large abdominal mass which was subsequently diagnosed as juvenile follicular cyst of the ovary. PMID:25177606
Acoustic Characteristics in Epiglottic Cyst.
Lee, YeonWoo; Kim, GeunHyo; Wang, SooGeun; Jang, JeonYeob; Cha, Wonjae; Choi, HongSik; Kim, HyangHee
2018-05-03
The purpose of this study was to analyze the acoustic characteristics associated with alternation deformation of the vocal tract due to large epiglottic cyst, and to confirm the relation between the anatomical change and resonant function of the vocal tract. Eight men with epiglottic cyst were enrolled in this study. The jitter, shimmer, noise-to-harmonic ratio, and first two formants were analyzed in vowels /a:/, /e:/, /i:/, /o:/, and /u:/. These values were analyzed before and after laryngeal microsurgery. The F1 value of /a:/ was significantly raised after surgery. Significant differences of formant frequencies in other vowels, jitter, shimmer, and noise-to-harmonic ratio were not presented. The results of this study could be used to analyze changes in the resonance of vocal tracts due to the epiglottic cysts. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
Effect of nutrient pollution on dinoflagellate cyst assemblages ...
We analyzed surface sediments from 23 northeast USA estuaries, from Maine to Delaware, and nine estuaries from Prince Edward Island (PEI, Canada), to determine how dinoflagellate cyst assemblages varied with nutrient loading. Overall the abundance of cysts of heterotrophic dinoflagellates correlates with modeled nitrogen loading, but there were also regional signals. On PEI cysts of Gymnodinium microreticulatum characterized estuaries with high nitrogen loading while the sediments of eutrophic Boston Harbor were characterized by high abundances of Spiniferites spp. In Delaware Bay and the Delaware Inland Bays Polysphaeridium zoharyi correlated with higher temperatures and nutrient loading. This is the first study to document the dinoflagellate cyst eutrophication signal at such a large geographic scale in estuaries, thus confirming their value as indicators of water quality change and anthropogenic impact. Estuarine and coastal waters are important resources for US and Canadian citizens. This paper summarizes the use of biological indicators that provide information on the eutrophication status and impacts for estuaries along the NW Atlantic coast. These relatively new biological indicators, dinoflagellate cysts, have the potential to provide environmental managers information on recent and historical environmental conditions in estuaries. Together with information on drivers and pressures, dinoflagellate cysts can be used to develop driver-pressure-state-imp
Richards, K S; Arme, C; Bridges, J F
1983-06-01
Peritoneal hydatids of Echinococcus granulosus equinus of 9 months standing in BALB/c mice occurred as free cysts or cysts within cyst masses. Both showed wide variation in size and in host tissue response, and all had a well-developed laminated layer separating the host tissue response from the germinal layer. In the smallest cyst-mass cysts the host tissue response was present as remnants of the initial cellular attack involving eosinophils. Slightly larger cyst-mass cysts possessed a primary macrophage invasion which phagocytosed the remnants of the initial attack and also, though to little effect, the laminated layer material. In the largest cyst-mass cysts a second macrophage invasion, of monocyte origin, had commenced and transformation stages of these cells to macrophages were observed. No fibroblasts surrounded individual cyst-mass cysts but they were present around the cyst mass, encapsulating it and possibly preventing further host cell invasion. Thus, the host tissue response around individual cyst-mass cysts remained 'preserved' at an early stage such as existed at the time of encapsulation. Small free cysts showed a primary macrophage invasion and transformation stages of cells of a secondary infiltration of peritoneal origin. Peripheral to the macrophages were fibroblasts demonstrating limited fibrinogenesis, and each cyst was surrounded by a layer of mesothelial cells. Large free cysts, also delimited by a mesothelial layer, possessed peripheral connective tissue, a deep fibrous layer and a monolayer of very compressed macrophages lying adjacent to the laminated layer. It is emphasized that an understanding of the host tissue response in cysts of different sizes and from different locations is an essential pre-requisite for the design of experimental studies.
Viable Blastocystis Cysts in Scottish and Malaysian Sewage Samples
Suresh, K.; Smith, H. V.; Tan, T. C.
2005-01-01
Blastocystis cysts were detected in 38% (47/123) (37 Scottish, 17 Malaysian) of sewage treatment works. Fifty percent of influents (29% Scottish, 76% Malaysian) and 28% of effluents (9% Scottish, 60% Malaysian) contained viable cysts. Viable cysts, discharged in effluent, provide further evidence for the potential for waterborne transmission of Blastocystis. PMID:16151162
[Prevalence of postmenopausal simple ovarian cyst diagnosed by ultrasound].
Luján Irastorza, Jesús E; Hernández Marín, Imelda; Figueroa Preciado, Gudelia; Ayala, Aquiles R
2006-10-01
The high-resolution ultrasound has taken to discover small ovary cysts in postmenopausal asymptomatic women who in another situation would not been detected; these cysts frequently disappear spontaneously and rarely develop cancer; however, they are treated aggressively. To know the prevalence, evolution and treatment of ovary simple cysts in the postmenopausal women in our department, since in our country there are not studies that had analyzed these data. We made a retrospective and descriptive study in the Service of Biology of the Human Reproduction of the Hospital Juarez de Mexico, in a four-year period (2000-2003) that included 1,010 postmenopausal women. The statistical analysis was made using the SPSS software program with which we obtained descriptive measurements in localization, dispersion and by a graphic analysis. We found a simple cysts prevalence of 8.2% (n = 83); the average of age at the diagnosis time was 50.76 years with a standard deviation of 5.55; the cysts diameter was between 0.614 to 12,883 cm with a mean and standard deviation of 2.542 and 1.91 cm respectively; in 27.71% of the cases (n = 23), the cysts disappear spontaneously in the follow up of 3 to 36 month (mean of 14.1). Surgery was indicated in 16.46% (n = 13), by increase in the size of the cyst in 9 patients (11.64%) and by changes in morphology from simple to complex in 4 (4.82%). Tumor like markers were made only to 37 patients (44.57%), which were in normal ranks; no carcinoma was found in this group. The prevalence of ovary simple cysts was similar to the reported in literature. Risk of cancer of these cysts is extremely low when a suitable evaluation is made, a reason why the conservative treatment is suggested when these are simple cysts lesser than 5cm with Ca-125 levels within normal ranks. We recommend a follow up every 3-6 months by Doppler color ultrasound and tumor like markers for five years.
Transvaginal Aspiration of Ovarian Cysts: Long-Term Follow-up
DOE Office of Scientific and Technical Information (OSTI.GOV)
Duke, D.; Colville, J.; Keeling, A.
2006-06-15
Background and purpose. Transvaginal aspiration of ovarian cysts has been advocated as a viable alternative to surgery in patients who are high-risk surgical candidates. We describe a retrospective study evaluating the results of transvaginal aspirations of benign ovarian cysts in patients at increased surgical risk, focusing on long-term follow-up for recurrence of the cyst and/or development of malignancy. Methods. Twenty-four women with ovarian cysts underwent 34 transvaginal drainages between October 1998 and December 2004. All patients were referred following diagnosis of a persistent ovarian cyst with a benign appearance on ultrasound. All patients were unsuitable candidates for surgery (history ofmore » previous pelvic surgery, n = 21; high risk for anesthesia, n = 1; and unsuitable for laparoscopy due to obesity, n = 2). Patients with a history of pregnancy, acute abdominal symptoms, or previous gynecologic malignancy were excluded. A 20G x 20 cm Chiba needle was used for transvaginal aspiration using an endocavity probe (Acuson XP, Mountain View, CA, USA; Siemens Sololine, Erlangen, Germany) and intravenous sedoanalgesia. Cysts were aspirated to dryness. Results. Long-term follow-up of patients was performed and revealed a recurrence rate of 75%. Eighty-three percent of cysts on the left and 42% of those on the right recurred. Nine of 15 (60%) patients with recurrence required further intervention. Two of 9 underwent surgical intervention only, 4 of 9 had repeat transvaginal aspiration(s) performed, and 3 of 9 had a combination of both transvaginal aspiration and surgery. No patient developed ovarian malignancy. Conclusion. Transvaginal cyst aspiration has many advantages including short hospital stay, rapid recovery, excellent patient tolerance, and a low rate of procedure-related complications. Our study demonstrates that ovarian cyst recurrence following transvaginal drainage is a more significant problem than previously documented, especially if the
Congenital choledochal cyst: video-guided laparoscopic treatment.
Farello, G A; Cerofolini, A; Rebonato, M; Bergamaschi, G; Ferrari, C; Chiappetta, A
1995-10-01
We report our first experience with a laparoscopic treatment of congenital choledochal cysts involving the total cyst resection and the reconstruction of the biliary and gastrointestinal tracts through a transmesocolic hepatic-jejunal Roux-en-Y loop anastomosis. The procedure was carried out in a 14-kg 6-year-old girl with a congenital choledochal cyst of the first type, according to the Alonso-Lej classification. The cyst was divided using a Multifire EndoGIA 30 stapler. Hepatic-jejunal and jejunojejunal anastomoses were made with 4.0 chrome catgut interrupted sutures. Intestinal recanalization occurred on the 2nd postoperative day and the postoperative course was uneventful. The laparoscopic approach affords several advantages: excellent intraoperative visualization of tiny structures and, therefore, great surgical accuracy; early resumption of peristalsis; no postoperative pain; no laparocele; prevention of adhesions; excellent esthetics; and quicker resumption of school and sports activities.
Unexplained apnoea and loss of consciousness during sub arachnoid block for caesarean section.
Acharya, S P; Marhatta, M N; Amatya, R
2009-01-01
Sub arachnoid block (SAB) is often perceived safe by many anesthesiologists and other faculties but is also not completely safe choice especially in pregnant females, as the incidence of complications and local anaesthetic agent toxicity is high in these groups of patients. Here we present four such cases out of the seventeen patients over a period of six months, who developed apnea and transient loss of consciousness after spinal anesthesia for lower segment caesarean section. Typically all these patients after spinal anesthesia developed difficulty in breathing, became apnoea and had loss of consciousness for about a minute or two. The apnea was relieved with bag and mask ventilation following which the patient regained consciousness and start breathing normally. The rest of the procedure was uneventful. We presented these cases with aim of sharing similar experiences, and to aware about the possibility of such events as these events do occur frequently but case reports and literatures are unavailable.
Tinea capitis favosa misdiagnosed as tinea amiantacea
Anane, Sonia; Chtourou, Olfa
2012-01-01
Introduction Favus of the scalp or tinea capitis favosa is a chronic dermatophyte infection of the scalp. In almost cases, favus is caused by Trichophyton schoenleinii, anthropophilic dermatophyte. It is characterized by the presence of scutula and severe alopecia. Besides the classic clinical type of tinea capitis favosa, there are many variant of clinical form which may persist undiagnosed for many years. In this work, we report an atypical form of favus to Trichophyton schoenleinii which was misdiagnosed as tinea amiantacea. Case-report An 11-year old girl came to the outpatient department of dermatology (day 0) with history of tinea amiantacea treated unsuccessfully with keratolytic shampoo (day – 730). She presented a diffuse scaling of the scalp with thick scaly patches and without scutula or alopecia. A diagnosis of tinea favosa by T. schoenleinii was made by mycological examination. She was treated with griseofulvin and ketoconazole in the form of foaming gel for twelve weeks. Despite treatment, clinical evolution was marked by appearance of permanent alopecia patches. The follow-up mycological examination was negative. Conclusion Because of ultimate evolution of favus into alopecia, we emphasize the importance of mycological examination in case of diffuse scaling. PMID:24432210
Larocque, R; Nakagaki, K; Lee, P; Abdul-Wahid, A; Faubert, G M
2003-10-01
The process of encystation is a key step in the Giardia duodenalis life cycle that allows this intestinal protozoan to survive between hosts during person-to-person, animal-to-person, waterborne, or food-borne transmission. The release of cysts from infected persons and animals is the main contributing factor to contamination of the environment. Genes coding for cyst wall proteins (CWPs), which could be used for developing a transmission-blocking vaccine, have been cloned. Since the immunogenicity of recombinant Giardia CWP is unknown, we have investigated the immunogenicity of recombinant CWP2 (rCWP2) and its efficacy in interfering with the phenomenon of encystation taking place in the small bowels of BALB/c mice vaccinated with the recombinant protein. Here we report that the immunization of BALB/c mice with rCWP2 stimulated the immune system in a manner comparable to that for a live infection with Giardia muris cysts. Fecal and serum anti-rCWP2 immunoglobulin A (IgA) antibodies were detected in the immunized mice. In addition, anti-rCWP2 IgG1 and IgG2a antibodies were detected in the serum. mRNAs coding for Th1 and Th2 types of cytokines were detected in spleen and Peyer's patch cells from immunized mice. When the vaccinated mice were challenged with live cysts, the animals shed fewer cysts. We conclude that rCWP2 is a possible candidate antigen for the development of a transmission-blocking vaccine.
Antoniades, D; Epivatianos, A; Markopoulos, A; Kolokotronis, A; Zaraboukas, T
2009-01-01
To report 2 cases of coexisting mucous retention cyst and basal cell adenoma arising from the lining epithelium of the cyst. Two cases of painless swellings, well-demarcated, soft to palpation, and located in the submucosa of the upper lip were clinically examined with the provisional diagnosis of mucocele or salivary gland tumor. Histological examination showed the presence of a large unilocular cystic cavity in many parts surrounded by single or bilayered lining epithelium composed of flattened to cuboidal cells, and in other parts surrounded by projections of cells arranged in a trabecular pattern far into the cystic cavity. The trabeculae were composed of basal and low columnar cells that sometimes formed small duct-like structures. Immunohistochemistry showed that the lining epithelium of the cystic cavity and the cells of the projections expressed cytokeratin 7 and high-molecular-weight cytokeratins. The cells of the projections were weakly positive for S-100 protein and negative for vimentin and alpha-smooth muscle actin. Based on the results, a diagnosis of coexisting mucous retention cysts and basal cell adenomas arising from the lining epithelium of cysts was made. The coexistence of mucous retention cysts and basal cell adenomas arising from the lining epithelium of the cyst is reported. Copyright 2009 S. Karger AG, Basel.
Cook, N.; Nichols, R. A. B.; Wilkinson, N.; Paton, C. A.; Barker, K.; Smith, H. V.
2007-01-01
We report a method for detecting Giardia duodenalis cysts on lettuce, which we subsequently use to examine salad products for the presence of Giardia cysts and Cryptosporidium oocysts. The method is based on four basic steps: extraction of cysts from the foodstuffs, concentration of the extract and separation of the cysts from food materials, staining of the cysts to allow their visualization, and identification of cysts by microscopy. The concentration and separation steps are performed by centrifugation, followed by immunomagnetic separation using proprietary kits. Cyst staining is also performed using proprietary reagents. The method recovered 46.0% ± 19.0% (n = 30) of artificially contaminating cysts in 30 g of lettuce. We tested the method on a variety of commercially available natural foods, which we also seeded with a commercially available internal control, immediately prior to concentration of the extract. Recoveries of the Texas Red-stained Giardia cyst and Cryptosporidium oocyst internal controls were 36.5% ± 14.3% and 36.2% ± 19.7% (n = 20), respectively. One natural food sample of organic watercress, spinach, and rocket salad contained one Giardia cyst 50 g−1 of sample as an indigenous surface contaminant. PMID:17890337
Thyroid Cysts in Cats: A Retrospective Study of 40 Cases.
Miller, M L; Peterson, M E; Randolph, J F; Broome, M R; Norsworthy, G D; Rishniw, M
2017-05-01
Thyroid cysts are rare in cats and poorly documented. To report distinguishing clinical features and treatment responses of cats with thyroid cysts. Forty client-owned cats. Retrospective review of medical records for cats with thyroid cysts confirmed by scintigraphy, ultrasound, magnetic resonance imaging, or necropsy at 4 referral centers between 2005 and 2016. Signalment, clinical findings, diagnostic testing, treatment, and outcome were recorded. Cats ranged in age from 8 to 20 years with no apparent breed or sex predilection. 37 of 40 (93%) cats were hyperthyroid (duration, 1-96 months). Clinical findings included palpable neck mass (40/40, 100%), weight loss (15/40, 38%), dysphagia (8/40, 20%), decreased appetite (5/40, 13%), and dyspnea (4/40, 10%). Cysts were classified as small (≤8 cm 3 ) in 16 (40%) and large (>8 cm 3 ) in 24 (60%) cats. Of 25 cats treated with radioiodine, hyperthyroidism resolved in 23 (92%), whereas thyroid cysts resolved in 12 (50%). Radioiodine treatment resolved small cysts in 8 of 13 (62%) cats and large cysts in 4 of 11 (36%) cats. Eight cats, including 2 euthyroid cats, underwent thyroid-cystectomy; 3 with bilateral thyroid involvement were euthanized postoperatively for hypocalcemia. Excised cystic thyroid masses were identified as cystadenoma (4) and carcinoma (4). Thyroid cysts are encountered in hyperthyroid and euthyroid cats with benign and malignant thyroid tumors. Radioiodine treatment alone inconsistently resolved thyroid cysts. Thyroid-cystectomy could be considered in cats with unilateral thyroid disease or when symptomatic cysts persist despite successful radioiodine treatment of hyperthyroidism. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.
[A pediatric case of hydatid cyst in the infratemporal fossa].
Hiroual, A; Elbouihi, M; Fawzi, S; Lahmiti, S; Aimmadeddine, S; Mansouri-Hattab, N
2014-06-01
Hydatid cyst or disease is an anthropozoonosis due to the development of the larval form of the taenia Echinococcus granulosus in humans. It is endemic in Morocco. The location of a hydatid cyst in the infratemporal fossa (ITF) is extremely rare. The authors report a pediatric case. An 11 year old child was admitted to hospital with a history of left latero-facial swelling gradually increasing in volume for 2 months, CT scan of the face revealed a cystic formation of 7 cm diameter sitting at the left ITF, hydatid serology was negative. A transzygomatic approach allowed the excision of the cyst. The histopathological examination of the resected specimen confirmed the diagnosis of hydatid cyst. The location at the infratemporal fossa of an expansive process such as hydatid cyst in children may have a particular impact on adjacent structures and a more meaningful clinical expression. The rate of growth of hydatid cysts is highly variable and ranges from 1 to 5 cm a year. Hydatid serology is often negative. CT examination is the gold-standard radiological examination. Surgical removal of the hydatid cyst is the most effective treatment. The transzygomatic approach allowed a sufficient access to the cyst and a good quality of excision. Copyright © 2014 Elsevier Masson SAS. All rights reserved.
Biogeography of dinoflagellate cysts in northwest Atlantic ...
Few biogeographic studies of dinoflagellate cysts include the near-shore estuarine environment. We determine the effect of estuary type, biogeography, and water quality on the spatial distribution of organic-walled dinoflagellate cysts from the Northeast USA (Maine to Delaware) and Canada (Prince Edward Island). A total of 69 surface sediment samples were collected from 27 estuaries, from sites with surface salinities >20. Dinoflagellate cysts were examined microscopically and compared to environmental parameters using multivariate ordination techniques. The spatial distribution of cyst taxa reflects biogeographic provinces established by other marine organisms, with Cape Cod separating the northern Acadian Province from the southern Virginian Province. Species such as Lingulodinium machaerophorum and Polysphaeridinium zoharyi were found almost exclusively in the Virginian Province, while others such as Dubridinium spp. and Islandinium? cezare were more abundant in the Acadian Province. Tidal range, sea surface temperature (SST), and sea surface salinity (SSS) are statistically significant parameters influencing cyst assemblages. Samples from the same type of estuary cluster together in canonical correspondence analysis when the estuaries are within the same biogeographic province. The large geographic extent of this study, encompassing four main estuary types (riverine, lagoon, coastal embayment, and fjord), allowed us to determine that the type of estuary has
Apoptosis as a possible mechanism of infertility in Echinococcus granulosus hydatid cysts.
Paredes, R; Jiménez, V; Cabrera, G; Iragüen, D; Galanti, N
2007-04-01
Echinococcus granulosus is a parasitic cestode causing hydatidosis in intermediate hosts (human and herbivorous). Most symptoms of the disease occur by the pressure exerted on viscera by cysts that are formed upon ingestion of the parasite eggs excreted by definitive hosts (canines). Protoscoleces, the developmental form of the parasite infective to definitive hosts, are formed in the germinal nucleated layer of fertile hydatid cysts. For unknown reasons, some cysts are unable to produce protoscoleces (infertile hydatid cysts). In this study, analysis of DNA fragmentation using TUNEL and agarose gel electrophoresis showed higher levels of apoptosis in infertile cysts as compared to fertile cysts. Additionally, caspase 3 was detected both in fertile and infertile cysts; the activity of this enzyme was found to be higher in infertile cysts. We conclude that apoptosis may be involved in hydatid cyst infertility. This is the first report on the presence of programmed cell death in E. granulosus. c 2006 Wiley-Liss, Inc.
Dinoflagellate Cyst Contribution to Settling Organic Matter in the Coastal Ocean
NASA Astrophysics Data System (ADS)
Bringue, M.; Thunell, R.; Pospelova, V.; Tappa, E.; Johannessen, S.; Macdonald, R. W.
2016-12-01
The coastal ocean hosts much of the global primary production, with an estimated 40% of carbon sequestration occurring along continental margins alone. This study characterizes the variability in organic-walled dinoflagellate cyst fluxes and assemblage composition during sedimentation through the water column, in the context of bulk organic and inorganic particulate matter export, in three different coastal settings: the Cariaco Basin (off Venezuela), the Santa Barbara Basin (Southern California) and the Strait of Georgia (western Canada). At each site, moorings of 2-5 sediment traps positioned at different depths collected settling particles over intervals of 7-14 days. The contribution of dinoflagellate cysts to particulate matter fluxes, and their fate as they are being exported to the seafloor, is investigated by comparing cyst fluxes and assemblages in samples collected simultaneously from discrete depths at each location. Preliminary results from the 1,400 m deep Cariaco Basin sediment trap time series indicate that dinoflagellate cyst fluxes during the upwelling season are high (average of 117,000 cyst m-2 day-1 in January-February 2006) and highly consistent between depths. The only notable exception is the record from the shallowest trap (Trap Z, 150 m bsl) which shows marked variations in cyst fluxes (from 7,700 to 240,000 cyst m-2 day-1) that are not reflected in the other four trap records. Dinoflagellate cyst assemblages from each interval along the five traps are statistically identical, indicating that cysts produced in the upper water column are rapidly transported to the seafloor, and that no selective degradation/preservation has altered the cyst assemblages within the water column. Excluding the Trap Z record, the ratio of dinoflagellate cyst to organic carbon fluxes shows an 35% increase from the top to bottom traps, suggesting a dinoflagellate cyst "enrichment" relative to other organic particles in settling material.
Actinomyces israelii in radicular cysts: a molecular study.
Gomes, Nathália Rodrigues; Diniz, Marina Gonçalves; Pereira, Thais Dos Santos Fontes; Estrela, Carlos; de Macedo Farias, Luiz; de Andrade, Bruno Augusto Benevenuto; Gomes, Carolina Cavaliéri; Gomez, Ricardo Santiago
2017-05-01
To investigate whether the microscopic filamentous aggregates observed in radicular cysts are associated with the molecular identification of Actinomyces israelii. Moreover, to verify whether this bacterium can be detected in radicular cyst specimens not presenting aggregates. Microscopic colonies suggestive of Actinomyces were found in 8 out of 279 radicular cyst samples (case group). The case and control groups (n = 12; samples without filamentous colonies) were submitted to the semi-nested polymerase chain reaction to test the presence of A israelii. DNA sequencing was performed to validate polymerase chain reaction results. Two and 3 samples in the case and control groups, respectively, did not present a functional genomic DNA template and were excluded from the study. A israelii was identified in all samples of the case group and in 3 out of 9 samples of the control group. Although A israelii is more commonly identified in radicular cysts presenting filamentous aggregates, it also appears to be detected in radicular cysts without this microscopic finding. Copyright © 2017 Elsevier Inc. All rights reserved.
Adenomatoid odontogenic tumor associated with a dentigerous cyst.
Manjunatha, B S; Harsh, Ashutosh; Purohit, Sharad; Naga, Mahita V
2015-01-01
Adenomatoid odontogenic tumor (AOT) is a relatively uncommon benign lesion of odontogenic origin mainly affecting females in second decade of life, having a predilection for the anterior region of the maxilla. Histologically, it is composed of odontogenic epithelium in a variety of histopathological patterns in a mature, fibrous connective tissue stroma and characterized by slow but progressive growth. Very few cases of AOT associated with a dentigerous cyst have been reported in the literature. PubMed and Medline data showed a total of 11 cases of AOT associated with a dentigerous cyst in the literature. We present an additional case of an AOT arising from a dentigerous cyst around the crown of an unerupted upper canine in a 20-year-old female, which was clinically diagnosed as a dentigerous cyst. Histologically, the case showed proliferation of odontogenic epithelium in the form of whorls and islands typical of AOT associated with dentigerous cyst appearing thin reduced enamel like epithelium lining the cystic cavity, described previously. However, it is unclear whether this entity has a more aggressive potential.
[Giant paraovarian cyst in childhood - Case report].
Torres, Janina P; Íñiguez, Rodrigo D
2015-01-01
Paraovarian cysts are very uncommon in children To present a case of giant paraovarian cyst case in a child and its management using a modified laparoscopic-assisted technique A 13-year-old patient with a 15 day-history of intermittent abdominal pain, located in the left hemiabdomen and associated with progressive increase in abdominal volume. Diagnostic imaging was inconclusive, describing a giant cystic formation that filled up the abdomen, but without specifying its origin. Laboratory tests and tumor markers were within normal range. Video-assisted transumbilical cystectomy, a modified laparoscopic procedure with diagnostic and therapeutic intent, was performed with a successful outcome. The histological study reported giant paraovarian cyst. Cytology results were negative for tumor cells. The patient remained asymptomatic during the postoperative follow-up. The video-assisted transumbilical cystectomy is a safe procedure and an excellent diagnostic and therapeutic alternative for the treatment of giant paraovarian cysts. Copyright © 2015. Publicado por Elsevier España, S.L.U.
Ultrasound-guided interventional therapy for recurrent ovarian chocolate cysts.
Wang, Lu-Lu; Dong, Xiao-Qiu; Shao, Xiao-Hui; Wang, Si-Ming
2011-10-01
The aim of this study was to determine the effectiveness of ultrasound-guided interventional therapy in the treatment of postoperative recurrent chocolate cysts. The 198 patients enrolled in this study were divided into three groups. In group 1, the saline washing group, the cavity of the cyst was washed thoroughly with warm saline. In group 2, the ethanol short-time retention group, after washing with saline, the cyst was injected with 95% ethanol with a volume of half of the fluid aspirated from the cyst. Ten minutes later, the rest of the ethanol was aspirated. In group 3, the ethanol retention group, the procedures were the same as with the ethanol short-time retention group, except that 95% of the ethanol was retained in the cyst. An ultrasound examination was performed in the third, sixth and 12th months after therapy. The chocolate cyst cure rate was significantly higher in the ethanol retention group (96%, 66/69) than in the ethanol short-time retention group (82%, 56/68) and no case was cured in the first group (saline washing). We conclude that ultrasound-guided injection and 95% ethanol retention are an effective therapy for the treatment of postoperative recurrent chocolate cysts. Copyright © 2011 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.
Clinical management of pineal cysts: a worldwide online survey.
Májovský, Martin; Netuka, David; Beneš, Vladimír
2016-04-01
A pineal cyst is a benign affection of a pineal gland on the borderline between a pathological lesion and a variant of normality. Clinical management of patients with a pineal cyst remains controversial, especially when patients present with non-specific symptoms. An online questionnaire consisting of 13 questions was completed by 110 neurosurgeons worldwide. Responses were entered into a database and subsequently analysed. Based on data from the questionnaire, the main indication criteria for pineal cyst resection are hydrocephalus (90 % of the respondents), Parinaud's syndrome (80 %) and growth of the cyst (68 %). Only 15 % of the respondents occasionally operate on patients with non-specific symptoms. If surgery is indicated, improvement is expected in 88 % of the patients. The vast majority of the respondents favour a supracerebellar infratentorial approach to the pineal region. Most (78 %) of the respondents regarded the patient registry as a potentially useful instrument. This survey sheds light on the current practice of pineal cyst management across the world. Most of the respondents perform surgery on pineal cysts only if patients are presenting with symptoms attributable to a mass effect. Surgery for patients with non-specific complaints (headache, vertigo) is not widely accepted, although it may prove effective. A prospective patient registry might be useful in the decision-making process in the clinical management of pineal cysts.
Mahesh, B S; P Shastry, Shilpa; S Murthy, Padmashree; Jyotsna, T R
2017-01-01
To report a rare case of large radicular cyst-associated deciduous tooth and to discuss the importance of cone beam computed tomography (CBCT) in diagnosing the condition. Radicular cyst is the most common cyst affecting the permanent teeth, but its occurrence in deciduous teeth is rare. Most of the radicular cysts are asymptomatic and are discovered accidentally when radiographs are taken. Conventional radiographs show two-dimensional images of three-dimensional objects. Cone beam computed tomography provides undistorted three-dimensional information of hard tissues and gives adequate spatial resolution. A 7-year-old child, with a complaint of swelling in the maxillary anterior region, was diagnosed with radicular cyst in relation to primary maxillary right central incisor based on CBCT and histopathological features. Early diagnosis and prompt treatment of radicular cyst in primary dentition is important to prevent damage to permanent tooth. Mahesh BS, Shastry SP, Murthy PS, Jyotsna TR. Role of Cone Beam Computed Tomography in Evaluation of Radicular Cyst mimicking Dentigerous Cyst in a 7-year-old Child: A Case Report and Literature Review. Int J Clin Pediatr Dent 2017;10(2):213-216.
[Dysplastic cysts of the liver: our experience].
Nardello, O; Muggianu, M; Cabras, V; Farina, G P; Cagetti, M
2004-08-01
Systematic surveys with advanced non-invasive imaging techniques have revealed that hepatic cysts are quite common in the general population. Therefore, we retrospectively examined our case series and compared it with the literature. Between January 1990 and December 2000, 228 patients with non-parasitic liver cysts were referred to the outpatients section of the Department of Surgery of the University of Cagliari and 23 were submitted to treatment: 14 patients (60.8%) for solitary cyst and 9 (39.2%) for multiple simple cysts of the liver. One patient (4.5%) had right upper quadrant pain. Eleven (47.8%) patients were asymptomatic: 7 (63.7%) required treatment for other pathologies, 3 (27.3%) for a progressive enlargement of the cyst and 1 (9%) for a suspected hydatid disease. Mean diameter of the treated cysts measured by preoperative CT or US was 8.8 cm (range 7-14). Percutaneous aspiration-injection reaspiration (PAIR) was performed in 5 patients (21.7%), US-guided in 2 cases (40%) and CT-guided in 3 (60%). Twenty patients (86.9%) underwent cysts unroofing, 18 (78.2%) with open surgical fenestration and the latest 2 cases with a laparoscopic approach. Two patients had PAIR as second treatment for recurrence: CT-guided in one and US-guided in the other case. Four (25%) out of 16 patients treated exclusively for cystic liver disease, had fever in 3 cases and nausea and vomiting in 1 case; 8 patients (50%) had an intraperitoneal drainage for a mean of 6-7 days (range 4-11) and of 116 cc of serum-hematic liquid. In our opinion the choice of an adequate treatment must be based on an accurate evaluation of the clinical aspects of the patients and on the characteristics of cystic lesions such as number, size and location. These data let us to choose a surgical treatment rather than a strict US follow-up and to get the best outcome in terms of absence of recurrence, and less biological and economic costs.
LOW PRESSURE ULTRAVEIOLET STUDIES FOR INACTIVATION OF GIARDIA MURIS CYSTS
Cysts of Giardia muris were inactivated using a low pressure ultravolet (UV) light source. Cyst viability was detemined by both in vitro excystation and animal infectivity. Cyst doeses were counted using a flow cytometer for the animal infectivity experiments. Using in vitro excy...
LOW PRESSURE ULTRAVIOLET STUDIES FOR INACTIVATION OF GIARDIA MURIS CYSTS
Cysts of Giardia muris were inactivated using a low pressure ultravolet (UV) light source. Cyst viability was detemined by both in vitro excystation and animal infectivity. Cyst doeses were counted using a flow cytometer for the animal infectivity experiments. Using in vitro excy...
[Acute rupture of hydatid cysts in the peritoneum: 17 cases].
Beyrouti, Mohamed Issam; Beyrouti, Ramez; Abbes, Imed; Kharrat, Madiha; Ben Amar, Mohamed; Frikha, Foued; Elleuch, Slim; Gharbi, Walid; Chaabouni, Mohamed; Ghorbel, Ali
2004-03-27
Specify the clinical and progressive characteristics of acute rupture of hydatid cysts in the peritoneum. We retrospectively studied patients who had undergone surgery for a hydatid cyst (HC) of the abdomen between January 1990 and December 2000 and in whom the exploration had confirmed the diagnosis of acute rupture of a hydatid cyst in the peritoneum. Over this period of 11 Years, 970 patients had undergone surgery for hydatid cysts of the liver and the spleen, 17 of whom had presented an acute rupture of the hydatid cyst in the peritoneum, that is to say 1.75% of the cases. The mean age was 30 Years and sex ratio was 0.41. Rupture was secondary to a trauma in 6 cases and to an intense physical effort in one case. The clinical table was acute peritonitis in 14 cases, acute intestinal occlusion in one case, suggested anaphylactic shock in one case, and a non-complicated hydatid cyst in one case. Ultra-sonographic diagnosis was made in all the cases, but that of rupture in 12 cases only. No scans were performed. Intervention was decided on within a delay of less than 72 hours in 16 cases. Surgical treatment consisted in the treatment of the peritonitis, the ruptured hydatid cyst, the associated hydatid cysts in the liver and the spleen, and the hydatid cyst of the right lung in two cases. Post-operative follow-up was complicated in 4 cases with two deaths through septic shock. Distant follow-up was marked by a secondary peritoneal hydatidosis in a patient whom has not benefited from medical treatment. The latter, based on albendazole, was prescribed in 6 patients with satisfying results and a mean follow-up of 32 months. The therapeutic progress has improved the prognosis of ruptured hydatid cysts in the peritoneum. Secondary peritoneal hydatidosis is fundamentally enhanced by the delay in diagnosis and treatment and the absence of medical treatment. The optimal strategy is to treat the patients at the non-complicated stage of the hydatid cyst and, above all
Intratarsal keratinous eyelid cysts in Gorlin syndrome: A review and reappraisal.
Wolkow, Natalie; Jakobiec, Frederick A; Yoon, Michael K
2017-12-27
A 38-year-old woman presented with multiple bilateral recurrent eyelid cysts. Her medical history was notable for Gorlin (nevoid basal cell carcinoma) syndrome. Histopathologic and immunohistochemical examinations revealed that the lesions were intratarsal keratinous cysts. They were similar in appearance to sporadic intratarsal keratinous cysts and closely resembled odontogenic keratocysts of the jaw. Eyelid cysts occur in up to 40% of patients with Gorlin syndrome; however, their description has been cursory and, for the most part, outside of the ophthalmic literature. Although ophthalmologists are familiar with the periocular basal cell carcinomas that occur in patients with Gorlin syndrome, up to 10% of patients never develop a basal cell carcinoma, but they may manifest other ophthalmic findings. Awareness of these other features may contribute to the earlier diagnosis of the syndrome. We discuss the clinical and histopathologic features of intratarsal keratinous cysts in Gorlin syndrome, comparing them to sporadic intratarsal keratinous cysts, other eyelid cysts, and jaw cysts that also characterize this syndrome. We briefly review the ocular and systemic manifestations of Gorlin syndrome and recent genetic and therapeutic developments so that the eyelid cysts may be appreciated within the appropriate context of Gorlin syndrome as a whole. Copyright © 2017 Elsevier Inc. All rights reserved.
A clinicopathological study of odontogenic cysts and tumors in hamadan, iran.
Baghaei, Fahimeh; Zargaran, Massoumeh; Najmi, Hamidreza; Moghimbeigi, Abbas
2014-12-01
Odontogenic cysts and tumors are the most frequent osseous destructive lesions of the jaws; however, there is little information regarding the relative frequency of these lesions among the Iranian population. The purpose of this study was to determine the distribution of clinically and histologically- diagnosed odontogenic cysts and tumors during a period of 13 years in Hamadan, and also its correlation with age, gender, and the site of the lesion. A descriptive cross-sectional study was performed on 413 oral and maxillofacial specimens during 1996 to 2008.The age and the gender of patients, as well as the site of lesion were recorded. The data were analyzed using SPSS software. Totally, 70 specimens were recorded as odontogenic cysts and 11 specimens were diagnosed as odontogenic tumors. The most frequent odontogenic cysts were dentigerous cysts (27.2%), followed by radicular cysts (18.6%) and odontogenic keratocysts (18.6%). In addition, cysts were more frequent in male than female individuals. Ameloblastoma was the most frequent odontogenic tumor (64%). Odontogenic cysts were in correlation with age, gender and location. These results showed that dentigerous cyst and odontogenic keratocyst were more frequent than other studies. More investigations should be performed to determine the frequency of odontogenic tumors in Iran.
Intracranial, intradural aneurysmal bone cyst.
Afnan, Jalil; Snuderl, Matija; Small, Juan
2015-01-01
Aneurysmal bone cysts (ABCs) are benign, expansile, blood-filled, osteolytic lesions with internal septations that may be intraosseous or extraosseous. The cysts may cause local mass effect, and changes in the regional vascular supply necessitating intervention. A case of an intracranial, intradural ABC in a young male patient with progressively severe headaches is presented. This is only the third recorded intradural case, the majority of these rare lesions being extracranial and only a minute fraction intracranial. Copyright © 2015 Elsevier Inc. All rights reserved.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Parasites not transmissible to man; tapeworm cysts in sheep; hydatid cysts; flukes; gid bladder-worms. 311.25 Section 311.25 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY ORGANIZATION AND TERMINOLOGY; MANDATORY MEAT AND POULTRY PRODUCTS...
Nodular Fasciitis of the Breast Previously Misdiagnosed as Breast Carcinoma
Ozben, Volkan; Aydogan, Fatih; Karaca, Fatih Can; Ilvan, Sennur; Uras, Cihan
2009-01-01
Summary Background Nodular fasciitis of the breast is a rare benign pathology that can mimic breast cancer clinically, radiologically, and histopathologically. Case Report An 18-year-old female patient had first visited a physician in a different center with the complaint of a lump in her left breast. Breast examination had revealed a palpable mass located in the left upper outer quadrant. Ultrasonography had demonstrated a hypoechoic lesion. Excisional biopsy of the lump had been performed and histopathologic examination misdiagnosed this lump as a mesenchymal tumor. The patient was then referred to our clinic for further investigations. Pathologic revision was performed and the diagnosis of nodular fasciitis of the breast was established. Conclusion Awareness of this rare clinical entity, nodular fasciitis, in the breast eliminates the misdiagnosis of breast cancer. PMID:20877676
[Congenital cyst of the common bile duct. Surgical treatment with total excision of the cyst].
Orozco-Sánchez, J; Carreón-Carranza, J J; Benitez-Sánchez, J A; Rosas-Salas, G; Casian-Castellanos, G; Llanes-González, E; Turcio-Cortazar, E
1989-02-01
Congenital choledochal cyst (CChC) has a very low frequency in our population; it is more frequent among females and its pattern of inheritance is multifactorial. The frequency of CChC in our population was 1 per 20,000 to 1 per 30,000 hospitalized patients in the pediatrics department of the Hospital Juarez and Hospital Infantil de Tacubaya, respectively. Four new cases of CChC are reported, two school children and two teenagers. Pre-operative diagnosis was accomplished clinically, which is the most precise non-invasive method. The most effective actual diagnostic methods include ultrasonography, CAT scan, and basic laboratory data, which can corroborate the clinical diagnosis of CChC with 100% certainty. The surgical treatment of CChC is controversial, but the surgical procedures of choice are choledochocystojejunostomy with total cyst removal, Roux's Y, and cholecystectomy. One case was treated with latero-terminal choledochocystojejunostomy and 3 cases with total removal of the cyst. The results were excellent.
Eymann, R; Kiefer, M
2018-05-17
Headache is the most common symptom of colloid cysts, Rathke cysts, and craniopharyngioma due to their location in the midline, being extra-axial and typically presenting in the parasellar region. Although these tumors are generally considered benign, each has its typical characteristics defined by its location and histology. These individual characteristics define whether surgery is necessary at all and if so, the preferred surgical approach and resection's totality. The histopathological findings primarily indicate that embryonic malformations-at the first glance, ectodermal in nature-cause these tumors. Due to the fact that these disturbances occur at the boundary between ectodermal stomodeum and endodermal cephalogaster, however, does leave some doubts.
Need for lung resection in patients with intact or ruptured hydatid cysts.
Vasquez, J C; Montesinos, E; Peralta, J; Rojas, L; DeLaRosa, J; Leon, J J
2009-08-01
Lung hydatid cyst caused by Echinococcus granulosus is endemic in many areas of the world. We aimed to compare the outcome of surgical treatment in intact and ruptured (infected or noninfected) cysts. We reviewed the medical records of 115 patients with lung hydatid disease who were surgically treated between 2001 and 2005 in a tertiary hospital in Lima, Peru. Patients were divided into 3 groups based on cyst characteristics: intact cysts (n = 41), ruptured noninfected cysts (n = 47) and ruptured infected cysts (n = 27). If a patient had more than one type of cyst, the most severe form of disease was recorded. Data related to symptoms, morbidity and mortality were recorded and compared. We also calculated direct patient costs. Mean age of patients was 23.6 +/- 15.1 years old. Ruptured cysts were present in 64 % of patients and giant cysts (> 10 cm diameter) were present in 26 % of patients. Hemoptysis was present in 47.0 % of patients and was more frequent in patients with ruptured infected cysts. Lung resection was performed in 58 % of patients. The most common postoperative complication was infection of the operative wound (6.08 %). Perioperative mortality was zero. Patients with ruptured cysts had a longer hospitalization time and higher total cost (12.28 +/- 0.92 days, US$ 890.34 +/- 303.35) than patients with intact cysts (10.17 +/- 0.79 days, US$ 724.81 +/- 14.38). Surgical treatment of lung hydatid disease is safe, with a good outcome and a low mortality rate. The lung resection rate was higher than most published series and reflects the relatively high proportion of patients with giant and ruptured infected cysts.
Unicameral bone cysts: general characteristics and management controversies.
Pretell-Mazzini, Juan; Murphy, Robert Francis; Kushare, Indranil; Dormans, John P
2014-05-01
Unicameral bone cysts are benign bone lesions that are often asymptomatic and commonly develop in the proximal humerus and femur of skeletally immature patients. The etiology of these lesions remains unknown. Most patients present with a pathologic fracture, but these cysts can be discovered incidentally, as well. Radiographically, a unicameral bone cyst appears as a radiolucent lesion with cortical thinning and is centrally located within the metaphysis. Although diagnosis is frequently straightforward, management remains controversial. Because the results of various management methods are heterogeneous, no single method has emerged as the standard of care. New minimally invasive techniques involve cyst decompression with bone grafting and instrumentation. These techniques have yielded promising results, with low rates of complications and recurrence reported; however, prospective clinical trials are needed to compare these techniques with current evidence-based treatments.
Clinical signs and histologic findings in dogs with odontogenic cysts: 41 cases (1995-2010).
Verstraete, Frank J M; Zin, Bliss P; Kass, Philip H; Cox, Darren P; Jordan, Richard C
2011-12-01
To characterize clinical signs and histologic findings in dogs with odontogenic cysts and determine whether histologic findings were associated with clinical features. Retrospective case series. 41 dogs. Medical records were reviewed to obtain clinical data, including breed, age, sex, and lesion location. Microscopic sections and results of diagnostic imaging were reviewed. Odontogenic cysts were identified in 41 dogs between 1995 and 2010. There were 29 dogs with dentigerous cysts, 1 with a radicular cyst, 1 with a lateral periodontal cyst, and 1 with a gingival inclusion cyst. In addition, 9 dogs with odontogenic cysts that had clinical and histologic features suggestive of, but not diagnostic for, odontogenic keratocysts seen in people were identified. In all 9 dogs, these cysts were located in the maxilla and surrounded the roots of normally erupted teeth. Of the 29 dogs with dentigerous cysts, 23 had a single cyst, 5 had 2 cysts, and 1 had 3 cysts. Six cysts were associated with an unerupted canine tooth, and 30 were associated with an unerupted first premolar tooth (1 cyst was associated both with an unerupted canine tooth and with an unerupted first premolar tooth). Dentigerous cysts were identified in a variety of breeds, but several brachycephalic breeds were overrepresented, compared with the hospital population during the study period. Results suggested that a variety of odontogenic cysts can occur in dogs. In addition, cysts that resembled odontogenic keratocysts reported in people were identified. We propose the term canine odontogenic parakeratinized cyst for this condition.
Treatment of Bartholin gland cyst with CO2 laser
Speck, Neila Maria de Góis; Boechat, Karol Pereira Ruela; dos Santos, Georgia Mouzinho Lima; Ribalta, Julisa Chamorro Lascasas
2016-01-01
ABSTRACT Objective To describe the results of treatment with CO2 laser for Bartholin gland cysts. Methods Thirty-one women with Bartholin gland cysts were treated with CO2 laser at an outpatient´s setting. Skin incision was performed with focused laser beam, the capsule was opened to drain mucoid content, followed by internal vaporization of impaired capsule. Results There were no complications. Five patients had recurrence of the cyst and were submitted to a second and successful session. Conclusion CO2 laser surgery was effective to treat Bartholin gland cysts with minimal or no complications, and can be performed at an outpatient´s setting. PMID:27074230
Posttraumatic epidermal inclusion cyst of the deep infratemporal fossa.
Acarturk, T O; Stofman, G M
2001-01-01
The authors report a case of an epidermal inclusion cyst found in the deep infratemporal fossa 12 years after the patient sustained blunt trauma to that region. Posttraumatic epidermal inclusion cysts are rare and occur mainly in the fingers, palms, and soles. Introduction of the epidermal elements into the dermis during the trauma is thought to be the cause. This case is rare in presentation, with few reports in the English literature that describe an epidermal inclusion cyst in the deep infratemporal fossa. Review of the English literature disclosed no other cases of epidermal inclusion cyst after blunt trauma involving the deep infratemporal region.
Shah, Vandana Sandip; Ghanchi, Mohsin Jiva; Gosavi, Sandesh Sachchidanand; Srivastava, Himanshu Mahesh; Pachore, Nivedita Javahir
2016-01-01
Introduction Odontogenic cysts viz Odontogenic Keratocyst (OKC), Dentigerous Cyst (DC) and Radicular Cyst (RC) occur commonly in the oral and maxillofacial region. Cytokeratin (CK) expression studies have been done to evaluate diagnostic accuracy, role in pathogenesis, elucidate behaviour and role in treatment protocols. However, variations have been reported in the expression of CK patterns in these odontogenic cysts, which could be due to the lack of standardization of laboratory techniques. The present study has tried to shed light on CK 18 and 19 expression in odontogenic cysts and offer the brief review of previous studies on these CK. Aim The aim of the present study was to evaluate the intensity and expression patterns of CK 18 and 19 in OKCs, DCs and RCs. Materials and Methods A total of 60 cases, 20 each of OKC, DC and RC were confirmed histologically and evaluated for immunohistochemical expression pattern and intensity of CK 18 and 19. Results A focal and variable expression of CK 18 was observed in 25% of OKCs, 15% of DCs and 10% of RCs. CK 19 was expressed in 75% of OKCs and 100% in DCs as well as RCs. Conclusion The intensity and expression of Cytokeratin 19 was more in all three cysts compared to Cytokeratin 18. PMID:27630961
Trichilemmal cyst nevus of the scalp.
Serra, David; Pereira, Sara; Robalo-Cordeiro, Margarida; Tellechea, Oscar
2011-04-01
We report the observation of a 24-year-old woman presenting a plaque-like lesion of the occipital scalp with hair rarefaction. This lesion was congenital and consisted of numerous, agminated, very small, trichilemmal cysts. It remained stable since birth, slowly growing in proportion with the patient during childhood. We discuss the nosological status of this intriguing lesion and its relationship with the recently described trichilemmal cyst nevus.
A Clinicopathological Study of Odontogenic Cysts and Tumors in Hamadan, Iran
Baghaei, Fahimeh; Zargaran, Massoumeh; Najmi, Hamidreza; Moghimbeigi, Abbas
2014-01-01
Statement of the Problem: Odontogenic cysts and tumors are the most frequent osseous destructive lesions of the jaws; however, there is little information regarding the relative frequency of these lesions among the Iranian population. Purpose: The purpose of this study was to determine the distribution of clinically and histologically- diagnosed odontogenic cysts and tumors during a period of 13 years in Hamadan, and also its correlation with age, gender, and the site of the lesion. Materials and Method: A descriptive cross-sectional study was performed on 413 oral and maxillofacial specimens during 1996 to 2008.The age and the gender of patients, as well as the site of lesion were recorded. The data were analyzed using SPSS software. Results: Totally, 70 specimens were recorded as odontogenic cysts and 11 specimens were diagnosed as odontogenic tumors. The most frequent odontogenic cysts were dentigerous cysts (27.2%), followed by radicular cysts (18.6%) and odontogenic keratocysts (18.6%). In addition, cysts were more frequent in male than female individuals. Ameloblastoma was the most frequent odontogenic tumor (64%). Conclusion: Odontogenic cysts were in correlation with age, gender and location. These results showed that dentigerous cyst and odontogenic keratocyst were more frequent than other studies. More investigations should be performed to determine the frequency of odontogenic tumors in Iran. PMID:25469355
Percutaneous Treatment of Renal Cysts with OK-432 Sclerosis
Cho, Soung Yong; Cho, Kang Su; Lee, Dong Hoon; Lee, Seung Hwan
2007-01-01
Purpose The aim of this study was to demonstrate OK-432 sclerotherapy efficacy for treatment of simple renal cysts. Materials and Methods Twenty patients with 25 symptomatic or large simple cysts were treated by ultrasonography (US)-guided percutaneous aspiration and injection of OK-432 (8 men and 12 women, mean age 63.6 years, SD 9.5). Six patients presented with flank pain, 14 presented with renal mass; renal cyst location was right, left, or bilateral sided in 9, 8, and 8 kidneys, respectively. Patients were evaluated by clinical assessment, US, or CT scan 3 months following the procedure. Complete and partial success was defined as symptom resolution with either total cyst ablation or greater than 70% reduction, respectively. Failure was defined as 30% of cyst size recurrence and/or persistent symptoms. Results Average reduction was 93.0%. Complete and partial resolution occurred in 11 (44.0%) and 13 (52.0%) cysts, respectively. One case was defined as failure, with a 64.2% size reduction from 10.9cm to 3.9cm (volume reduction rate 95.4%). Renal pain improved in all patients, regardless of complete or partial resolution. Minor complications occurred in 3 patients, 2 developed leukocytosis and 1 had mild fever (< 38.5℃) following aspiration and sclerotherapy. Successful treatment was achieved with conservative measures and NSAID therapy. Conclusion Percutaneous treatment of simple renal cysts with OK-432 sclerotherapy was found to be a safe, effective and minimally invasive procedure. PMID:17461526
Hydatid cyst of the liver-criteria for the selection of appropriate treatment.
Menezes da Silva, A
2003-02-01
The appropriate treatment of hydatid cysts of the liver is determined by several factors, namely the patient, the cyst, the therapeutic resources and the physician. Characteristics of cysts, can be described by ultrasonography (US). Based on US images, we can classify hydatid cysts, according the evolutionary phase of the larval parasite and to choose the most appropriate therapeutic approach. US is also important to evaluate the efficacy of the treatment. Concerning the therapeutic methods, surgery had long been the only treatment available for the hydatid cyst of the liver. Beginning the 1970s benzimidazoles, Mebendazole and Albendazole, have been used for the treatment of the hydatid disease and in the early 1980s, with the development of diagnostic US, the deliberate puncture of abdominal cysts, particularly those in the liver, was evaluated this lead to puncture/aspiration, followed by injection of a scolicide which became a therapeutic method known as puncture, aspiration, injection and re-aspiration (PAIR). So, according to the cyst's characteristics based on US evaluation we can establish a therapeutic strategy: cysts type 1 and 3 may be treated by chemotherapy. Alternative treatment should be PAIR but only if the cysts cannot be treated with benzimidazoles. If there are contraindications for PAIR and chemotherapy the treatment should be surgical. Type 2 hydatid cysts can be treated by PAIR following initial treatment with benzimidazoles. If PAIR is not feasible or there is no evidence of degenerative changes after chemotherapy, surgery is indicated. Type 4 cysts are usually inactive and, in these cases, treatment is not indicated. If there is evidence that the cysts contents are still viable PAIR may be indicate. If PAIR is not possible, surgery is the method of choice. Cysts type 5 do not require treatment.
Prevalence and distribution of odontogenic cysts in a Mexican sample. A 753 cases study.
Villasis-Sarmiento, Luis; Portilla-Robertson, Javier; Melendez-Ocampo, Arcelia; Gaitan-Cepeda, Luis-Alberto; Leyva-Huerta, Elba-Rosa
2017-04-01
Odontogenic cysts (OC) are the most frequent lesions of the jaws and their constant epidemiological update is necessary and indispensable. Therefore the principal objective of this report was To determine prevalence and clinical-demographical characteristics of OC in a Mexican sample. 753 cases of OC coming from the archive of a head and neck histopathological teaching service, from January 2000 to December 2013, were included. OC cases were re-assessed according 2005 WHO classification. Chi square test was used to establish possible associations ( p <0.05IC95%). From 753 OC, 369 were female and 384 male; 52.9% of them were in their 2nd- 4th decade of life. The most common location (41%) was the mandibular posterior area. Radicular cysts were more frequent in maxillary anterior zone of females ( p 0.0002) at their fourth decade of life. Dentigerous cysts were more frequent in the mandibular posterior zone of males ( p 0.0000) in their second decade of life. Six cases of periodontal lateral cyst; 4 cases of paradental cysts; 4 eruption cysts and 4 cases of adult gingival cyst, as well were identified. Radicular cyst and dentigerous cyst are the most prevalent odontogenic cyst in this Mexican sample. Due to their etiology, dental pulpar necrosis and impacted teeth, radicular cyst and dentigerous cyst could be prevenible. Therefore, it is necessary to establish preventive strategies to diminish dental decay and programs of prophylactic extractions of impacted teeth, to in consequence decrease the prevalence of odontogenic cysts. Key words: Cyst, dentigerous cyst, mexican, odontogenic cyst, radicular cyst.
Aparna, Manikkath; Chakravarthy, Arumugam; Acharya, Shashi Rashmi; Radhakrishnan, Raghu
2014-01-01
Endodontic diagnosis is challenging and depends on the organisation of information from the patient history, clinical examination and analysis of the pulp, radiographic and histopathological assessment. A 35-year-old man was endodontically treated for radiolucency in relation to the roots of maxillary central incisors as it was a provisionally diagnosed case of radicular cyst. Since the palatal swelling persisted, the lesion was re-evaluated using relevant diagnostic aids and a diagnosis of nasopalatine duct cyst (NPDC) was made, which was missed during the initial assessment. An erroneous interpretation of cystic radiolucency in relation to maxillary central incisors can often lead to inappropriate treatment planning. This case highlights the relevant aspects in the diagnosis of NPDC when it is mistaken for a radicular cyst and emphasises the need for thorough clinical examination and relevant investigations for periapical radiolucencies of questionable origin before initiating endodontic therapy. PMID:24642171
Microbiology of third and fourth branchial pouch cysts.
Pahlavan, Shane; Haque, Waqar; Pereira, Kevin; Larrier, Deidre; Valdez, Tulio A
2010-03-01
To identify the most common pathogens involved in infections of third and fourth branchial pouch cysts. Third and fourth branchial pouch cyst infections are an uncommon cause of anterior neck abscesses often confused with other entities, such as thyroglossal duct cysts and thyroid abscesses leading to misdiagnosis, recurrence, and increased morbidity related to a delay in diagnosis and appropriate treatment. Retrospective chart and literature review. Retrospective chart review case series of patients presenting to the Bobby R. Alford Department of Otolaryngology at Texas Children's Hospital from July 2004 to July 2008 with third and fourth branchial pouch cysts. A total of 11 patients were identified. All patients had left-sided lesions. Eikenella corrodens was found in 60% of cultures and was the most common organism identified in our patient group. Furthermore, 56% of the organisms isolated were anaerobic. All organisms with the exception of Staphylococcus aureus were identified as oral cavity flora. Third and fourth branchial pouch cysts provide a communication between the neck and the oral cavity through pyriform sinus tracts. The presence of oral cavity flora in a left anterior neck abscess should raise the suspicion of a branchial pouch anomaly, and subsequently alter therapeutic management.
Sedimentation of Free and Attached Cryptosporidium Oocysts and Giardia Cysts in Water
Medema, G. J.; Schets, F. M.; Teunis, P. F. M.; Havelaar, A. H.
1998-01-01
Experimental analysis of the sedimentation velocity of Cryptosporidium parvum oocysts and Giardia lamblia cysts was compared with mathematical description of their sedimentation velocities by using measurements of (oo)cyst size and density and the density and viscosity of the sedimentation medium to determine if the sedimentation kinetics of freely suspended oocysts of C. parvum and cysts of G. lamblia can be described by Stokes’ law. The theoretically calculated sedimentation kinetics showed a good agreement with the experimentally observed kinetics. Both showed a decline in sedimentation velocity over time, caused primarily by variation in (oo)cyst density. The initial apparent sedimentation velocities in Hanks balanced salt solution at 23°C was 0.35 μm · s−1 for oocysts and 1.4 μm · s−1 for cysts. (Oo)cysts that enter the surface water environment by discharges of biologically treated sewage may be attached to sewage particles, and this will affect their sedimentation kinetics. Therefore, (oo)cysts were mixed with settled secondary effluent. (Oo)cysts readily attached to the (biological) particles in effluent; 30% of both cysts and oocysts attached during the first minutes of mixing, and this fraction increased to approximately 75% after 24 h. The sedimentation velocity of (oo)cysts attached to secondary effluent particles increased with particle size and was (already in the smallest size fraction [1 to 40 μm]) determined by the sedimentation kinetics of the effluent particles. The observed sedimentation velocities of freely suspended (oo)cysts are probably too low to cause significant sedimentation in surface water or reservoirs. However, since a significant proportion of both cysts and oocysts attached readily to organic biological particles in secondary effluent, sedimentation of attached (oo)cysts after discharge into surface water will probably be a significant factor in the environmental ecology of C. parvum and G. lamblia. Attachment to
Low pressure ultraviolet studies for inactivation of Giardia muris cysts.
Hayes, S L; Rice, E W; Ware, M W; Schaefer, F W
2003-01-01
The research was initiated to confirm earlier ultraviolet (u.v.) light inactivation studies performed on Giardia cysts using excystation as the viability indicator. Following this, a comparison of in vitro excystation and animal infectivity was performed for assessing cyst viability after exposure to low-pressure u.v. irradiation. Cysts of Giardia muris were inactivated using a low-pressure u.v. light source. Giardia muris was employed as a surrogate for the human pathogen Giardia lamblia. Cyst viability was determined by both in vitro excystation and animal infectivity. Cyst doses were counted using a flow cytometer for the animal infectivity experiments. Using in vitro excystation as the viability indicator, fluences as high as approximately 200 mJ cm(-2) did not prevent some cysts from excysting, thus verifying earlier work. Using animal infectivity, u.v. fluences of 1.4, 1.9 and 2.3 mJ cm(-2) yielded log10 reductions ranging from 0.3 to >or= 4.4. Results indicate that in vitro excystation is not a reliable indicator of G. muris cyst viability after u.v. disinfection. Very low doses of u.v. light rendered G. muris cysts non-infective in the mouse model employed. Data presented represent the only complete u.v. inactivation curve for G. muris. This research provides evidence that u.v. can be an effective barrier against Giardia spp. in the treatment of drinking water supplies.
The incidence of satellite cysts in keratocystic odontogenic tumors.
Pavelić, Boiidar; Katunarić, Marina; Segović, Sanja; Karadole, Maja Cimas; Katanec, Davor; Saban, Aida; Puhar, Ivan
2014-03-01
Renaming of the Odontogenic Keratocyst as the Keratocystic Odontogenic Tumor by the World Health Organization (WHO) is based on the aggressive nature of this lesion. Satellite cysts founded in the walls of the original cysts may give rise to a new lesion formation. The aim of this retrospecitve study was to identify the existence of specific features according incidence of satellite cysts and the pallisading of the basal layer of the epithelium and to establish their mutual correlation. The histopathologic data of Keratocystic Odontogenic Tumor on the basis of new WHO's classification (2005) were analized. Prominent palisade basal cell layer was found in 415 (94.75%) and partially absent palisade basal cell layer in 23 (5.25%) cases. Satellite cysts were presented in prominent palisade basal cell layer in 85 specimens (20.5%) and in cases with partial absent of the palisade basal layer in 3 spicemens (13%). The higher the frequency of pallisading was the higher the frequency of satellite cysts was (p > 0.05).
Müllerian duct cyst: diagnosis with MR imaging.
Thurnher, S; Hricak, H; Tanagho, E A
1988-07-01
The value of magnetic resonance (MR) imaging in diagnosing clinically suspected müllerian duct cysts was assessed in six patients. MR imaging correctly demonstrated the abnormality to be intraprostatic, consistent with the diagnosis of müllerian duct cysts in four patients, and allowed the diagnosis to be excluded in the other two. The demonstration of prostatic zonal anatomy, the ability to obtain direct images in all three orthogonal planes, and a large field of view make MR imaging valuable in the study of suspected müllerian duct cysts.
Active unicameral bone cysts in the upper limb are at greater risk of fracture.
Tey, Inn Kuang; Mahadev, Arjandas; Lim, Kevin Boon Leong; Lee, Eng Hin; Nathan, Saminathan Suresh
2009-08-01
To elucidate the natural history of unicameral bone cyst (UBC) and risk factors for pathological fracture. 14 males and 8 females (mean age, 9 years) diagnosed with UBC were reviewed. Cyst location, symptoms, and whether there was any fracture or surgery were recorded. Cyst parameters were measured on radiographs, and included (1) the cyst index, (2) the ratio of the widest cyst diameter to the growth plate diameter, and (3) the adjusted distance of the cyst border from the growth plate. There were 11 upper- and 11 lower-limb cysts. 13 patients had pathological fractures and 9 did not. 20 patients were treated conservatively with limb immobilisation; 2 underwent curettage and bone grafting (one resolved and one did not). Seven cysts resolved (5 had fractures and 2 did not). The risk of fracture was higher in the upper than lower limbs (100% vs 18%, p<0.001). Fractured cysts were larger than unfractured cysts (mean cyst index, 4.5 vs. 2.2, p=0.07). Active cysts were more likely to fracture. Conservative management had a 30% resolution rate. Surgery should be considered for large active cysts in the upper limbs in order to minimise the fracture risk.
Benthic nepheloid layers in the Gulf of Maine and Alexandrium cyst inventories
Pilskaln, C.H.; Hayashi, K.; Keafer, B.A.; Anderson, D.M.; McGillicuddy, D.J.
2014-01-01
Cysts residing in benthic nepheloid layers (BNLs) documented in the Gulf of Maine have been proposed as a possible source of inoculum for annual blooms of a toxic dinoflagellate in the region. Herein we present a spatially extensive data set of the distribution and thickness of benthic nepheloid layers in the Gulf of Maine and the abundance and inventories of suspended Alexandrium fundyense cysts within these near-bottom layers. BNLs are pervasive throughout the gulf and adjacent Bay of Fundy with maximum layer thicknesses of 50–60 m observed. Mean BNL thickness is 30 m in the eastern gulf and Bay of Fundy, and 20 m in the western gulf. Cyst densities in the near-bottom particle resuspension layers varied by three orders of magnitude across the gulf with maxima of 105 cysts m−3. An important interconnection of elevated BNL cyst densities is observed between the Bay of Fundy, the Maine Coastal Current and the south-central region of the gulf. BNL cyst inventories estimated for the eastern and western gulf are each on the order of 1015 cysts, whereas the BNL inventory in the Bay of Fundy is on the order of 1016 . Although BNL cyst inventories in the eastern and western gulf are 1–2 orders of magnitude smaller than the abundance of cysts in the upper 1 cm of sediment in those regions, BNL and sediment-bound cyst inventories are comparable in the Bay of Fundy. The existence of widespread BNLs containing substantial cyst inventories indicates that these near-bottom layers represent an important source of germinating A. fundyense cysts in the region. PMID:25419055
Benthic nepheloid layers in the Gulf of Maine and Alexandrium cyst inventories.
Pilskaln, C H; Hayashi, K; Keafer, B A; Anderson, D M; McGillicuddy, D J
2014-05-01
Cysts residing in benthic nepheloid layers (BNLs) documented in the Gulf of Maine have been proposed as a possible source of inoculum for annual blooms of a toxic dinoflagellate in the region. Herein we present a spatially extensive data set of the distribution and thickness of benthic nepheloid layers in the Gulf of Maine and the abundance and inventories of suspended Alexandrium fundyense cysts within these near-bottom layers. BNLs are pervasive throughout the gulf and adjacent Bay of Fundy with maximum layer thicknesses of 50-60 m observed. Mean BNL thickness is 30 m in the eastern gulf and Bay of Fundy, and 20 m in the western gulf. Cyst densities in the near-bottom particle resuspension layers varied by three orders of magnitude across the gulf with maxima of 10 5 cysts m -3 . An important interconnection of elevated BNL cyst densities is observed between the Bay of Fundy, the Maine Coastal Current and the south-central region of the gulf. BNL cyst inventories estimated for the eastern and western gulf are each on the order of 10 15 cysts, whereas the BNL inventory in the Bay of Fundy is on the order of 10 16 . Although BNL cyst inventories in the eastern and western gulf are 1-2 orders of magnitude smaller than the abundance of cysts in the upper 1 cm of sediment in those regions, BNL and sediment-bound cyst inventories are comparable in the Bay of Fundy. The existence of widespread BNLs containing substantial cyst inventories indicates that these near-bottom layers represent an important source of germinating A. fundyense cysts in the region.
Prevalence and distribution of odontogenic cysts in a Mexican sample. A 753 cases study
Villasis-Sarmiento, Luis; Melendez-Ocampo, Arcelia; Gaitan-Cepeda, Luis-Alberto; Leyva-Huerta, Elba-Rosa
2017-01-01
Background Odontogenic cysts (OC) are the most frequent lesions of the jaws and their constant epidemiological update is necessary and indispensable. Therefore the principal objective of this report was To determine prevalence and clinical-demographical characteristics of OC in a Mexican sample. Material and Methods 753 cases of OC coming from the archive of a head and neck histopathological teaching service, from January 2000 to December 2013, were included. OC cases were re-assessed according 2005 WHO classification. Chi square test was used to establish possible associations (p<0.05IC95%). Results From 753 OC, 369 were female and 384 male; 52.9% of them were in their 2nd- 4th decade of life. The most common location (41%) was the mandibular posterior area. Radicular cysts were more frequent in maxillary anterior zone of females (p 0.0002) at their fourth decade of life. Dentigerous cysts were more frequent in the mandibular posterior zone of males (p 0.0000) in their second decade of life. Six cases of periodontal lateral cyst; 4 cases of paradental cysts; 4 eruption cysts and 4 cases of adult gingival cyst, as well were identified. Conclusions Radicular cyst and dentigerous cyst are the most prevalent odontogenic cyst in this Mexican sample. Due to their etiology, dental pulpar necrosis and impacted teeth, radicular cyst and dentigerous cyst could be prevenible. Therefore, it is necessary to establish preventive strategies to diminish dental decay and programs of prophylactic extractions of impacted teeth, to in consequence decrease the prevalence of odontogenic cysts. Key words:Cyst, dentigerous cyst, mexican, odontogenic cyst, radicular cyst. PMID:28469818
Spontaneous regression of a pituitary cyst: report of two cases.
Nishio, S; Morioka, T; Suzuki, S; Fukui, M
2001-01-01
Two unusual cases of pituitary cysts are described. Both patients presented with sudden onset of severe headache, and magnetic resonance imaging (MRI) demonstrated pituitary cysts, which regressed over months. Although the precise etiology of the cysts was unproven, the cystic lesions in our patients are thought to have shrunken after "pituitary apoplexy."
Nasolacrimal drainage system cyst in an adult.
Yamasoba, T; Sugimura, H
1996-01-01
A cyst of the nasolacrimal drainage system (NLDS) is rare in an adult. We report a case in a 29-year-old man of a mucous retention cyst of the NLDS, which appeared 2 years after the patient developed dacryocystitis coincident with an aggravation of chronic sinusitis. The lesion was successfully managed by removing the bony wall of the NLDS at the interface with the ethmoid and nasal cavity, as well as the membranous closure of the ostium of the common canaliculus. We speculate that the cyst development might have been initiated by inflammatory change such as mucosal adhesion in the NLDS resulting from the spread of secondary infection from the sinonasal tract.
Polidocanol sclerotherapy for hydroceles and epididymal cysts.
Sigurdsson, T; Johansson, J E; Jahnson, S; Helgesen, F; Andersson, S O
1994-04-01
A total of 87 patients with 63 hydroceles and 29 epididymal cysts underwent injection sclerotherapy with polidocanol on an outpatient basis. In the hydrocele group the cure rate after 1 treatment was 67% and the overall cure rate was 87% after a median followup of 14 months. In the group treated for epididymal cyst the corresponding cure rates were 46% and 64%, respectively, with a median followup of 12 months. A low rate of complications was observed. Of 86 evaluable patients 81 (94%) were satisfied with the procedure and the treatment results. Therefore, we recommend injection sclerotherapy with polidocanol as primary treatment for hydroceles and epididymal cysts in patients older than 40 years.
Biogeography of dinoflagellate cysts in northwest Atlantic estuaries
Few biogeographic studies of dinoflagellate cysts include the near-shore estuarine environment. We determine the effect of estuary type, biogeography, and water quality on the spatial distribution of organic-walled dinoflagellate cysts from the Northeast USA (Maine to Delaware) a...
Malignant changes developing from odontogenic cysts: A systematic review.
Borrás-Ferreres, Jordi; Sánchez-Torres, Alba; Gay-Escoda, Cosme
2016-12-01
The aim of this study was to systematically review scientific literature in orderto describe the characteristics and prognosis of malignant entities developing from odontogenic cysts. A search in Pubmed (MEDLINE) and Cochrane databases was conducted. The inclusion criteria were articles published in English related to the malignisation of odontogenic cysts in humans. The exclusion criteria were articles that do not specify the type of odontogenic cyst, malignisation of parakeratinised keratocysts, the presence of an ameloblastic carcinoma and metastasis from distant primary tumours. The selected articles were classified according to Strength of Recommendation Taxonomy criteria. Statistical analysis of the data was carried out using statistical package software SPSS version 22.0. From the 1,237 articles initially obtained, the authors included 3 case series and 45 case reports in the end. Descriptive analysis showed that men have a disposition for malignisation from odontogenic cysts and they frequently appear at the posterior mandible, with pain and swelling being the most frequent signs and symptoms. Follicular cysts were the entities that underwent the most malignant changes with well differentiated squamous cell carcinomas being the most prevalent type of malignancy. The real prognosis of this malignancy is not known because of the heterogeneity of available studies. Key words: Odontogenic cysts, squamous cell carcinoma, neoplastic cell transformation, oral cancer.
[Hydatid Cyst Cases with Different Localization: Region of Erzurum].
Demirci, Elif; Altun, Eren; Çalık, Muhammet; Durur Subaşı, Irmak; Şipal, Sare; Gündoğdu, Özge Beyza
2015-06-01
In this study it is aimed to contribute in determination of geographic distribution of Hydatid Cysts in Turkey and to emphasize the clinic chaos of Hydatid Cysts cases found in various localizations, by indicating the prevalence of Hydatid Cysts in our region. It is evaluated that the cases diagnosed as Hydatid Cysts in Atatürk University Medical Faculty Pathology Depatment/Erzurum laboratories between 2003-2013; in terms of their age, gender, organ involvement and histopathologic detail. In our study, 459 Hydatid Cysts cases are defined. The most common localizations of cases are determined as liver (n:280, 61%) and lung (n:86, 18,7%). Those are followed by the kidney (n:12, 2,6%), brain (n:12, 2,6%) and spleen (n:9, 2.3%). Multi-organ involvement is observed in 31 cases (6.7%), in 10 (2.2%) cases co-occurence of liver and lung is determined. Unusual organ involvement is observed in 64 cases (13.9%) while the liver and lung is not involved. Hydatid Cysts is an important health issue which is endemically seen in our region. It can be observed in various localizations of human body, other than the liver and lung. Those various localizations lie behind the serious diagnostic problems in endemic regions.
The therapeutic effect of OK-432 (picibanil) sclerotherapy for benign neck cysts.
Kim, Myung Gu; Kim, Sun Gon; Lee, Jun Ho; Eun, Young Gyu; Yeo, Seung Geun
2008-12-01
In general, benign neck cysts are treated by surgical excision. This can present technical difficulties and frequent recurrences, because of insufficient surgery. Sclerosing agents such as OK-432 have been tested for the nonsurgical treatment of these cysts. We have assessed the efficacy of OK-432 sclerotherapy for benign neck cysts. The study group consisted of 75 patients (42 men, 33 women) diagnosed with and treated for benign neck cysts between March 2001 and December 2007 by intralesional injection of OK-432. The liquid content of each cyst was aspirated as much as possible, and the same volume of OK-432 solution was injected. Patients were assessed by ultrasonography or computerized tomography, and therapeutic outcomes and adverse effects were evaluated by patient age, sex, cyst type, and number of injections. Of the 75 treated patients, 31 (41.3%) showed total shrinkage, seven (9.3%) showed near-total shrinkage (>90% of cyst volume), five (6.6%) showed marked shrinkage (>70% of cyst volume), and 17 (22.7%) showed partial shrinkage (<70% of cyst volume). No response was seen in 15 patients (20%). Despite repeated sclerotherapy, eight patients (10.7%) showed recurrences. Minor adverse effects of therapy included fever, localized pain, and odynophagia but these complications spontaneously disappeared within several days. OK-432 sclerotherapy is a safe and effective primary alternative to surgery in patients with benign neck cysts.
Upper digestive stenosis due to a hydatid cyst of the liver.
Jarrar, Mohamed Salah; Ben Hadj Khalifa, Mohamed Habib; Toumi, Radhouane; Ghrissi, Rafik; Elghali, Mohamed Amine; Khenissi, Abdelmajid; Hamila, Fehmi; Letaief, Rached
2015-03-01
The complications of the hydatid cyst of the liver are dominated by infection and rupture. The compression of adjacent organs (mainly the inferior vena cava, the portal vein and the bile ducts) can be seen, when the cyst is located in the dome, in the hilum or within the hepatic parenchyma. Upper digestive stenosis by compression of the duodenum by the hydatid cyst is an exceptional complication. A 63 year-old patient had, for two months, upper digestive stenosis associated with a sensation of weight in the right hypochondrium. Digestive endoscopy showed an extrinsic compression of the second portion of the duodenum. Biopsies were negative. Abdominal CT showed up a hydatid cyst in the segment VI of the liver, adhering to the duodenum, with an exo-vesiculation compressing it. The patient was operated on: There was a hydatid cyst of the right lateral sector compressing the duodenum. A partial intralamellar pericystectomy was performed. Hydatid cyst of the liver, a parasitic disease described as benign, may give mechanical complications related to compression of adjacent organs (especially the bile ducts and veins). Compression of the digestive tract is exceptional. This is due to the proximity of the cyst to the duodenum and the thickness of the cyst wall.
The management of orbital cysts associated with congenital microphthalmos and anophthalmos
McLean, C J; Ragge, N K; Jones, R B; Collin, J R O
2003-01-01
Aims: To study the management of the orbital cysts present in a group of patients with anophthalmos and microphthalmos. Methods: A retrospective study of 34 patients (40 orbits) treated for orbital cyst associated with microphthalmos and anophthalmos. Results: The two largest treatment groups comprised 17 orbits (42.5%) where the cyst was removed surgically and 17 orbits (42.5%) where the cyst was retained and conformers were used. The remaining cases comprised two orbits (5%) where the cyst was aspirated initially; two orbits (5%) with large cysts which will need to be excised after further orbital growth; one orbit (2.5%) in which a silicone expander was used initially, and one orbit (2.5%) in which a mildly microphthalmic eye had some vision and was monitored but required no surgery. Conclusion: In this study 33 out of 34 patients had a good cosmetic result which illustrates that the orbital cyst in microphthalmos or anophthalmos performs a useful role in socket expansion and that the majority of patients with this condition can expect a good cosmetic outcome. PMID:12812886
An unusual presentation of presentation of a branchial cleft cyst.
Vemula, Rahul; Greco, Gregory
2012-05-01
Branchial cleft cysts are congenital anomalies that arise from the aberrant embryological development of the branchial apparatus. The location of a branchial cleft cyst is determined by which branchial cleft failed to obliterate during embryological development, with the second branchial cleft cyst being the most commonly recognized lesion. Although the most common location for branchial cleft cysts is between the external auditory canal and the level of the clavicle, the literature does describe unusual locations. We present a case a 15-year-old boy who had an enlarging lesion on his back that had been present since birth. A presumptive radiologic diagnosis of lymphangioma circumscriptum was made. Upon excision of the lesion and pathologic examination, it was determined to be a branchial cleft cyst. The patient had an uneventful postoperative course, and no recurrence was noted after a 2-year follow-up. Our clinical report demonstrates a lesion on the posterior thorax that proved to be a branchial cleft cyst and should always be part of the differential diagnosis for soft tissue masses of the thorax.
Spontaneous resolution of colloid cyst of the third ventricle: Implications for management
Turel, Mazda Keki; Kucharczyk, Walter; Gentili, Fred
2017-01-01
While there is little controversy regarding the treatment of symptomatic colloid cysts, the optimal management of “incidentally” detected and asymptomatic colloid cyst remains unclear. The age of the patient, duration and significance of symptoms related to the cyst, size and radiological characteristics of the cyst and the presence of hydrocephalus are all factors to be considered before considering surgery. While surgery most often provides good results in the majority of patients, complications do occur. Despite growing literature about the natural history of this condition, to date, only three cases of spontaneous resolution of colloid cyst <10 mm have been reported. We report the case of spontaneous resolution of a colloid cyst larger than 10 mm, initially managed with close observation and serial neuroimaging. This case highlights the possible role for a conservative approach even in larger-sized cysts. PMID:28484531
Odontogenic cysts: demographic profile in a Brazilian population over a 38-year period.
de Souza, Lélia-Batista; Gordón-Núñez, Manuel-Antonio; Nonaka, Cassiano-Francisco-Weege; de Medeiros, Marcell-Costa; Torres, Tabita-Fernandes; Emiliano, Gustavo-Barbalho-Guedes
2010-07-01
To determine the distribution of odontogenic cysts diagnosed histologically over a period of 38 years in a Brazilian population according to age, gender and site affected and to compare these data with previously reported studies from other countries. A total of 1019 cases of odontogenic cysts diagnosed between 1970 and 2007 were studied. Clinical features obtained from the patient records and microscope slides were reviewed according to the 1992 World Health Organization classification. The mean age was 31.0 years, and there was a predominance of females. The most frequent odontogenic cysts were radicular cysts (61.4%), followed by dentigerous cysts (20.1%) and odontogenic keratocysts (6.4%). Radicular cysts were more frequent in females (62.0%), and the maxillary teeth were the site most commonly involved (63.05%). The peak incidence of dentigerous cysts occurred in the second decade of life, with the posterior region of the mandible being the site most affected (46.3%), followed by the anterior region of the maxilla (27.8%). Odontogenic keratocysts showed a peak incidence between the third and fourth decades of life and predominance among females. The posterior region of the mandible was the site most frequently affected (65.6%). The present results showed a similar frequency of odontogenic cysts in this Brazilian population and other populations around the world, with inflammatory cysts being identified as the most frequent odontogenic cyst. Radicular cysts, dentigerous cysts, and odontogenic keratocysts are the most common cystic lesions, accounting for 87.9% of all odontogenic cysts.
Literature Review of Periclitoral Cysts in the Prepubertal Population.
Nelson, Kayla L; McQuillan, Sarah K; Brain, Philippa
2016-12-01
Clitoral cysts in the pediatric population are rare conditions that require careful evaluation. In this review of the literature we discuss the evaluation of clitoral abnormalities in the pediatric population, the development of clitoral cysts, and how to differentiate benign from malignant tumors. In addition, a summary of relevant cases of clitoral tumors in the literature are discussed. Literature review. A MedLine and advanced PubMed search was conducted of all English language articles published using the search terms "clitoris" and "cyst" until February 2015. Reference tracing was completed for all articles for completeness. Literature review of clitoral cysts in the prepubertal population. In total, we found 15 cases of benign, spontaneously forming clitoral cysts reported. Eleven of those cases document symptom onset before puberty. Reports of other benign clitoral lesions in the pediatric population include 1 angiokeratoma, 1 hemangiopericytoma, 1 granular cell tumor, 6 hemangiomas, and approximately 30 neurofibromas. Clitoral malignancies in the pediatric population are even more rare with only 3 cases of clitoral schwannomas, 2 rhabdomyosarcomas, 1 lymphoma, and 1 endodermal sinus tumor documented in the literature. Clitoral cysts must be considered as a possible cause of clitoral enlargement in the prepubertal population. Clitoral tumors are distinguished clinically from hormonal abnormalities and intersex disorders by their hormonal profile, and the presence of an underlying mass. Ultrasound and magnetic resonance imaging might be useful imaging modalities to further characterize the clitoral enlargement. When confirmed as the most likely diagnosis, surgical resection is the mainstay of treatment for clitoral cysts. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.
NASA Astrophysics Data System (ADS)
Bringué, Manuel; Thunell, Robert C.; Pospelova, Vera; Pinckney, James L.; Romero, Oscar E.; Tappa, Eric J.
2018-04-01
We present a 2.5-year-long sediment trap record of dinoflagellate cyst production in the Cariaco Basin, off Venezuela (southern Caribbean Sea). The site lies under the influence of wind-driven, seasonal upwelling which promotes high levels of primary productivity during boreal winter and spring. Changes in dinoflagellate cyst production is documented between November 1996 and May 1999 at ˜ 14-day intervals and interpreted in the context of in situ observations of physico-chemical and biological parameters measured at the mooring site. Dinoflagellate cyst assemblages are diverse (57 taxa) and dominated by cyst taxa of heterotrophic affinity, primarily Brigantedinium spp. (51 % of the total trap assemblage). Average cyst fluxes to the trap are high (17.1 × 103 cysts m-2 day-1) and show great seasonal and interannual variability. On seasonal timescales, dinoflagellate cyst production responds closely to variations in upwelling strength, with increases in cyst fluxes of several protoperidinioid taxa observed during active upwelling intervals, predominantly Brigantedinium spp. Cyst taxa produced by autotrophic dinoflagellates, in particular Bitectatodinium spongium, also respond positively to upwelling. Several spiny brown
cysts contribute substantially to the assemblages, including Echinidinium delicatum (9.7 %) and Echinidinium granulatum (7.3 %), and show a closer affinity to weaker upwelling conditions. The strong El Niño event of 1997/98 appears to have negatively impacted cyst production in the basin with a 1-year lag, and may have contributed to the unusually high fluxes of cysts type Cp
(possibly the cysts of the toxic dinoflagellate Cochlodinium polykrikoides sensu Li et al., 2015), with cyst type Cp fluxes up to 11.8 × 103 cysts m-2 day-1 observed during the weak upwelling event of February-May 1999. Possible trophic interactions between dinoflagellates and other major planktonic groups are also investigated by comparing the timing and
Orbital hydatid cyst of Echinococcus oligarthrus in a human in Venezuela.
Lopera, R D; Meléndez, R D; Fernandez, I; Sirit, J; Perera, M P
1989-06-01
This study reports the first known case of human hydatid disease caused by the larval stage of Echinococcus oligarthrus. The patient, a native Venezuelan female, presented a single cyst localized intraorbitally behind the left eye (retroocular), which was discovered by computed tomography. The cyst was removed by surgery, and after parasitological studies it was identified as an E. oligarthrus hydatid cyst. This is also the first case of intraorbital hydatid cyst in humans in Venezuela.
Infection Assay of Cyst Nematodes on Arabidopsis Roots.
Bohlmann, Holger; Wieczorek, Krzysztof
2015-09-20
Plant parasitic nematodes are devastating pests on many crops. Juveniles (J2) of cyst nematodes invade the roots to induce a syncytium. This feeding site is their only source of nutrients. Male nematodes leave the roots after the fourth molt to mate with females. The females stay attached to their syncytia throughout their life and produce hundreds of eggs, which are contained in their bodies. When the females die their bodies form the cysts, which protect the eggs. Cysts can survive for many years in the soil until favorable conditions induce hatching of the juveniles. The beet cyst nematode Heterodera schachtii ( H. schachtii )is a pathogen of sugar beet ( Beta vulgaris ) but can also complete its life cycle on Arabidopsis roots growing on agar plates under sterile conditions. We present here protocols for a stock culture of H. schachtii and an infection assay on agar plates.
Kim, Joo-Hwan; Kim, Jin Ho; Wang, Pengbin; Park, Bum Soo; Han, Myung-Soo
2016-01-01
The identification and quantification of Heterosigma akashiwo cysts in sediments by light microscopy can be difficult due to the small size and morphology of the cysts, which are often indistinguishable from those of other types of algae. Quantitative real-time PCR (qPCR) based assays represent a potentially efficient method for quantifying the abundance of H. akashiwo cysts, although standard curves must be based on cyst DNA rather than on vegetative cell DNA due to differences in gene copy number and DNA extraction yield between these two cell types. Furthermore, qPCR on sediment samples can be complicated by the presence of extracellular DNA debris. To solve these problems, we constructed a cyst-based standard curve and developed a simple method for removing DNA debris from sediment samples. This cyst-based standard curve was compared with a standard curve based on vegetative cells, as vegetative cells may have twice the gene copy number of cysts. To remove DNA debris from the sediment, we developed a simple method involving dilution with distilled water and heating at 75°C. A total of 18 sediment samples were used to evaluate this method. Cyst abundance determined using the qPCR assay without DNA debris removal yielded results up to 51-fold greater than with direct counting. By contrast, a highly significant correlation was observed between cyst abundance determined by direct counting and the qPCR assay in conjunction with DNA debris removal (r2 = 0.72, slope = 1.07, p < 0.001). Therefore, this improved qPCR method should be a powerful tool for the accurate quantification of H. akashiwo cysts in sediment samples.
Orbito-nasal cyst in a young European short-haired cat.
Zemljič, Tadej; Matheis, Franziska L; Venzin, Claudio; Makara, Mariano; Grest, Paula; Spiess, Bernhard M; Pot, Simon A
2011-09-01
To describe a case of an orbito-nasal cyst in a cat. An 18-month-old male European short-haired cat was presented to the Ophthalmology service of the Vetsuisse Faculty, University of Zurich for a subcutaneous swelling in the medial canthal region of the right eye (OD). Ophthalmologic, ultrasound and CT examinations, and fine needle aspiration were performed. After lesion excision, the removed tissue was submitted for histopathology. CT examination was repeated 5 months after removal of the cyst. Ophthalmologic examination revealed a large fluctuant swelling inferonasal to OD. Despite patent lacrimal puncta, only the first few mm of the lacrimal canaliculi could be cannulated. A normal globe with moderate enophthalmos was present. Ultrasound examination showed a well-defined lobulated cyst-like structure in the right orbit, inferonasal and anterior to the eye. CT examination revealed extension of this lesion through the medial orbital wall into the right nasal cavity. Fine needle aspiration confirmed the cystic nature of the lesion. An orbito-nasal cyst was diagnosed. The orbital part of the cyst was dissected from the surrounding tissue and excised from the periosteum in the medial orbital wall defect. Part of the maxillary bone was removed to allow removal of the cyst from the nasal cavity. Histologically, the cyst wall consisted of a single to multilayered, mostly cuboidal epithelium and surrounding connective tissue. Follow-up revealed a good functional result and no recurrence 7 months after cyst removal. Similar orbito-nasal cystic structures were reported in dogs but not in cats. © 2011 American College of Veterinary Ophthalmologists.
[Complications of a voluminous congenital ciliary body cyst].
Kottler, Ulrike B; Schwenn, Oliver
2002-09-01
Multiple cysts of iris and ciliary body may cause many complications such as acute or chronic angle closure glaucoma. We present a boy with multiple congenital cysts of the iris pigment epithelium and a voluminous cyst of the unpigmented ciliary body epithelium of the right eye. This resulted in lenticular astigmatism, concomitant strabismus divergens and subsequently to anisometropia. The voluminous cyst (8 x 12 mm in diameter) was folded around the lens, reached the optic axis and resulted in displacement of the lens and contact between the iris and the corneal endothelium from 6.30 to 11. After puncture and partial resection of the cyst at the age of 8 months the boy developed a subcapsular multivesicular cataractic clouding of the temporal lens and a progredient myopia (up to - 14.0/- 2.0/0 degrees ); in contrast the left eye was hyperopic (+ 3.5/- 3.75/0 degrees ). The lens was subluxated superonasally due to congenital damage of the zonular fibres. Because development of visual acuity seemed limited by these determinants (20/200 at the right eye), cataract surgery with posterior capsulorhexis, anterior vitrectomy, and implantation of a capsular tension ring and posterior chamber intraocular lens was performed at the age of nearly five. Actually, there is an orthotropia, best corrected visual acuity in the distance of 20/32 in the right and 20/20 in the left eye; binocular vision is somewhat restricted. Usually congenital cysts are clinically not very relevant; occasionally surgical intervention is required to ensure adequate development of visual acuity.
Chondroblastoma of the patella with aneurysmal bone cyst.
Tan, Honglue; Yan, Mengning; Yue, Bing; Zeng, Yiming; Wang, You
2014-01-01
Chondroblastoma of the patella is rare. Aneurysmal bone cysts, which develop from a prior lesion such as a chondroblastoma, are seldom seen in the patella. The authors report a case of a 36-year-old man who presented with 2 years of right knee pain without calor, erythema, pain on palpation, or abnormal range of motion. Radiological studies suggested aneurysmal bone cyst. The lesion was excised with curettage and the residual cavity filled with autogenous bone graft. Histopathology revealed chondroblastoma associated with a secondary aneurysmal bone cyst. In the follow-up period, the patient demonstrated normal joint activities with no pain. Normal configuration of the patella and bone union were shown on plain radiographs. The authors present a review of the literature of all cases of patellar chondroblastoma with aneurysmal bone cyst. This case is the 14th report of aneurysmal bone cyst arising in a chondroblastoma of the patella. According to the literature, computed tomography and magnetic resonance imaging are useful in the study of these lesions. The pathologic diagnosis is based on the presence of chondroblastoma and aneurysmal bone cyst. Treatment of this lesion includes patellectomy, curettage alone, and curettage with bone grafting. Despite the risk of recurrence of this lesion in the patella, the authors first recommend curettage followed by filling the cavity with bone graft. To protect the anterior tension of the patella intraoperatively, the bone window should be made at the medial edge of the patella to perform the curettage and bone grafting.
Neonatal intestinal obstruction secondary to a small bowel duplication cyst
Puralingegowda, Anil Kumar; Mohanty, Pankaj Kumar; Razak, Abdul; Nagesh N, Karthik; Chandrayya, Ramachandra
2014-01-01
A 3-week-old neonate developed abdominal distension and vomiting which subsided after conservative management. However, there was a recurrence of symptoms for which a lower gastrointestinal tract contrast study was performed. The infant had a filling defect in the area of the transverse colon. A CT scan was performed, showing a duplication cyst arising from the small bowel and indenting the transverse colon. Resection of the duplication cyst and end-to-end anastomosis of the bowel was performed. The duplication cyst was of tubular type, and a sealed perforation was noted in the cyst wall. PMID:25006055
Mandibular aneurysmal bone cyst in an elderly patient: Case report.
Rațiu, Cristian; Ilea, Aranka; Gal, Florin A; Ruxanda, Flavia; Boşca, Bianca A; Miclăuș, Viorel
2018-06-01
The article aims to highlight the challenge of establishing the presumptive aetiological diagnosis when unilocular or multilocular radiolucencies are identified in an elderly patient's jawbones. A mandibular cyst-like lesion was identified in a 73-year-old patient. The therapeutic decision was cyst enucleation and grafting of the bone defect. The initial presumptive diagnosis was invalidated by the histopathological examination that revealed the features characteristic for the aneurysmal bone cyst. Aneurysmal bone cyst in an elderly patient is a rare condition. © 2018 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.
Laparoscopic management of a large ovarian cyst in an adolescent. A case report.
Eltabbakh, G H; Kaiser, J R
2000-03-01
The safety of laparoscopic management of benign ovarian cysts has been demonstrated. The size of the benign ovarian cyst continues to be a limiting factor for laparoscopic surgery, with most surgeons choosing laparotomy for large cysts. A 15-year-old woman had a 22-cm, benign ovarian cyst extending above the umbilicus that was managed successfully with laparoscopy. We performed prelaparoscopy cyst drainage with a suprapubic Bonanno catheter (Becton Dickinson, Rutherford, New Jersey) followed by laparoscopic cystectomy. Because of its coiled end, the Bonanno catheter is less likely to result in cyst leakage around the aspiration site. With proper patient selection, laparoscopic surgery can be safely applied in a select group of patients with large, benign ovarian cysts.
Apical Cyst Theory: a Missing Link.
Huang, George T-J
2010-10-05
The mechanism of the formation of apical cyst has been elusive. Several theories have long been proposed and discussed speculating how an apical cyst is developed and formed in the jaw bone resulting from endododontic infection. Two popular theories are the nutritional deficiency theory and the abscess theory. The nutritional deficiency theory assumes that the over proliferated epithelial cells will form a ball mass such that the cells in the center of the mass will be deprived of nutrition. The abscess theory postulates that when an abscess cavity is formed in connective tissue, epithelial cells proliferate and line the preexisting cavity because of their inherent tendency to cover exposed connective tissue surfaces. Based on the nature of epithelial cells and the epithelium, nutritional theory is a fairy tale, while abscess theory at best just indicates that abscess may be one of the factors that allows the stratified epithelium to form but not to explain a mechanism that makes the cyst to form. Apical cyst formation is the result of proliferation of resting epithelial cells, due to inflammation, to a sufficient number such that they are able to form a polarized and stratified epithelial lining against dead tissues or foreign materials. These stratified epithelial lining expands along the dead tissue or foreign materials and eventually wrap around them as a spherical sac, i.e. a cyst. The space in the sac is considered the external environment separating the internal (tissue) environment - the natural function of epithelium. This theory may be tested by introducing a biodegradable device able to slowly release epithelial cell mitogens in an in vivo environment implanted with epithelial cells next to a foreign object. This will allow the cells to continuously proliferate which may form a cystic sac wrapping around the foreign object.
Apical Cyst Theory: a Missing Link
Huang, George T.-J.
2012-01-01
Introduction The mechanism of the formation of apical cyst has been elusive. Several theories have long been proposed and discussed speculating how an apical cyst is developed and formed in the jaw bone resulting from endododontic infection. Two popular theories are the nutritional deficiency theory and the abscess theory. The nutritional deficiency theory assumes that the over proliferated epithelial cells will form a ball mass such that the cells in the center of the mass will be deprived of nutrition. The abscess theory postulates that when an abscess cavity is formed in connective tissue, epithelial cells proliferate and line the preexisting cavity because of their inherent tendency to cover exposed connective tissue surfaces. Based on the nature of epithelial cells and the epithelium, nutritional theory is a fairy tale, while abscess theory at best just indicates that abscess may be one of the factors that allows the stratified epithelium to form but not to explain a mechanism that makes the cyst to form. The hypothesis Apical cyst formation is the result of proliferation of resting epithelial cells, due to inflammation, to a sufficient number such that they are able to form a polarized and stratified epithelial lining against dead tissues or foreign materials. These stratified epithelial lining expands along the dead tissue or foreign materials and eventually wrap around them as a spherical sac, i.e. a cyst. The space in the sac is considered the external environment separating the internal (tissue) environment – the natural function of epithelium. Evaluation of the hypothesis This theory may be tested by introducing a biodegradable device able to slowly release epithelial cell mitogens in an in vivo environment implanted with epithelial cells next to a foreign object. This will allow the cells to continuously proliferate which may form a cystic sac wrapping around the foreign object. PMID:25346864
Mixed periapical lesion: an atypical radicular cyst with extensive calcifications.
Ramos-Perez, Flávia Maria de Moraes; Pontual, Andréa dos Anjos; França, Talita Ribeiro Tenório de; Pontual, Maria Luiza dos Anjos; Beltrão, Ricardo Villar; Perez, Danyel Elias da Cruz
2014-01-01
The radicular cyst is an inflammatory odontogenic cyst of endodontic origin. Radiographically, the lesion appears as a periapical radiolucent image. This report describes a very rare case of a mixed periapical radiographic image diagnosed as a radicular cyst. A 37-year-old female patient presented a mixed, well-circumscribed image located in the periapical region of the left maxillary central incisor, which presented unsatisfactory endodontic treatment. Microscopic examination revealed a cavity lined by non-keratinized squamous epithelium and extensive calcifications in the cystic lumen and lining epithelium. Diagnosis of radicular cyst with extensive calcifications was established. Endodontic retreatment was performed and no radiographic signs of recurrence were observed 18 months after treatment. Although very rare, a radicular cyst should be considered in the differential diagnosis of a mixed periapical image associated to teeth with pulp necrosis.
Comparision of Immunohistochemical Expression of CD10 in Odontogenic Cysts
Munisekhar, M.S.; Suri, Charu; Rajalbandi, Santosh Kumar; M.R., Pradeep; Gothe, Pavan
2014-01-01
Background: Expression of CD10 has been documented in various tumors like nasopharyngeal carcinoma, gastric carcinoma, squamous cell carcinoma, odontogenic tumors. Aim: To evaluate and compare CD10 expression in odontogenic cysts like radicular cyst, dentigerous cyst and odontogenic keratocyst (OKC). Materials and Methods: Total 60 cases were included in the study, comprising 20 cases each of radicular, dentigerous and odontogenic keratocyst. Each case was evaluated and compared for immunohistochemical expression of CD10. Results obtained were statistically analysed using ANOVA test followed by post hoc test Tukey-Kramer Multiple Comparisons Test for continuous variable and Chi-square test for discrete variable. Results: More number of cases showing sub-epithelial stromal CD10 expression were found in OKC among the cysts. Conclusion: CD10 expression was more in OKC compared to radicular and dentigerous cysts. PMID:25584313
Reversible CSF cyst related to a functioning ventriculo-peritoneal shunt.
Vajramani, G V; Fugleholm, K
2005-11-01
Although the occurrence of CSF oedema and cyst has been described in presence of a blocked ventriculoperitoneal shunt, especially distal end block, its occurrence in presence of a well functioning shunt has not been described so far. We report a case where a 51-year old lady developed an insidious onset and gradually progressive CSF cyst without any clinical or radiological feature of shunt block over a period of about 2 years. The changes started about 6 months after a course of radiation therapy for an extensive residual supra and infratentorial meningioma. Following surgery, where the cyst was punctured and a new ventricular catheter was inserted, despite well functioning upper and lower end, the cyst gradually disappeared. We review the literature and hypothesize that the radiation-induced changes were responsible for initiation and progression of the cyst.
Waldemer-Streyer, Rachel J; Jacobsen, Ellen
2017-01-01
Background . Steatocystoma multiplex (SM) and eruptive vellus hair cysts (EVHC) are uncommon benign tumors of the pilosebaceous unit. Both SM and EVHC are characterized by smooth, asymptomatic papules or nodules, most commonly presenting on the chest, limbs, and abdomen. Most cases of SM and EVHC are sporadic, although less common autosomal dominant inherited forms have been reported. Main Observation . In this report we present two cases of cutaneous cysts exhibiting characteristics of either SM or EVHC. Both patients presented with numerous 1-2 mm asymptomatic papules and responded well to surgical expression by incision and drainage (I&D). Conclusion . SM and EVHC are similar in clinical presentation and management. Previously reported "hybrid-type" tumors present strong evidence for a relationship between the two lesions pathologically. Due to potential similarity of EVHC and SM cyst contents, I&D and subsequent microscopic examination cannot definitely differentiate between EVHC, SM, and hybrid cysts.
Diagnostic Dilemma: Cerebellopontine Angle Lipoma Versus Dermoid Cyst
Bertot, Brandon; Boghani, Zain; Britz, Gavin
2017-01-01
Both lipomas and dermoid cysts of the cerebellopontine angle are rare tumors. These tumors differ in their embryological origin but share similar features on imaging. Both of these congenital lesions can be found in the cerebellopontine angle (CPA), and symptomatic clinical presentation is dictated by the location of the lesion. This paper demonstrates a unique case in which a CPA lipoma was misidentified as a dermoid cyst, leading to surgical intervention. Further, the paper provides a literature review of CPA lipomas and dermoid cysts to aid readers in further differentiating between these two unique tumors. PMID:29399424
A case of epidermal cyst with pilomatrical differentiation.
Ikoma, Norihiro; Iwashita, Kenichi; Umezawa, Yoshinori; Matsuyama, Takashi; Ohta, Yukinori; Ozawa, Akira; Umemura, Shinobu; Ueyama, Yoshito; Yamazaki, Hitoshi
2004-09-01
A 20-year-old Japanese woman with an epidermal cyst on the back is described. Physical examination revealed a deep blue and round shaped cystic lesion measuring 10 min in diameter. A comedo-like keratotic plug also could be seen at the center. Histologically, the inner surface of the cyst was clearly separated of two types of the cells. The one was layers of epidermal keratinocytes and the other looked like a basal layer of epidermis, which immunohistochemically stained by S-100, HMB-45, cytokeratin (CK19) and Fontana-Masson staining. We diagnosed this case as epidermal cyst with pilomatrical differentiation.
Branchial cysts in two Amazon parrots (Amazona species).
Beaufrère, Hugues; Castillo-Alcala, Fernanda; Holmberg, David L; Boston, Sarah; Smith, Dale A; Taylor, W Michael
2010-03-01
A 37-year-old yellow-crowned Amazon parrot (Amazona ochrocephala) and a 20-year-old red-lored Amazon parrot (Amazona autumnalis) each presented with a large mass localized on the lateral neck. With the first bird, there was no evidence of signs of pain or discomfort, and the bird prehended and swallowed food normally. The second bird showed signs of mild upper-gastrointestinal discomfort. Results of an ultrasound examination and aspiration of the mass on each bird revealed a cystic structure. A computed tomography performed on the second bird revealed a large polycystic mass connected to the pharynx by a lateral tract. During surgical resection, both masses were found to originate from the subpharyngeal area. Based on topography and the histopathologic and immunohistochemical results, the masses were determined to be a second branchial cleft cyst for the first case and a second branchial pouch cyst for the second case. In addition, a carcinoma was present in situ within the epithelium of case 1, and the cyst in case 2 was secondarily infected. Branchial cysts are uncommonly diagnosed in veterinary and human medicine. These 2 cases are the first documented in parrots and appear similar to second branchial cysts reported in adult humans.
Odontogenic Cysts - An Overview.
Nayyer, Namita V; Macluskey, Michaelina; Keys, William
2015-01-01
This article aims to discuss the clinical features, radiological assessment, histopathology and management of a variety of odontogenic cysts. It also highlights the reclassification of odontogenic keratocysts to keratocystic odontogenic tumours.
Renal Epithelial Cyst Formation and Enlargement in vitro: Dependence on cAMP
NASA Astrophysics Data System (ADS)
Mangoo-Karim, Roberto; Uchic, Marie; Lechene, Claude; Grantham, Jared J.
1989-08-01
Cysts, a common abnormality of kidneys, are collections of urine-like fluid enclosed by a continuous layer of epithelial cells. Renal cysts derive from nephrons and collecting ducts and progressively enlarge as a consequence of epithelial proliferation and transepithelial fluid secretion. The initiation of cyst formation and the factors that control cyst enlargement are unknown. We used an in vitro model of renal cysts to explore the role of the cAMP signal transduction system in the formation and expansion of cysts. MDCK cells, cultured in hydrated-collagen gel, produced polarized monolayered epithelial cysts when intracellular cAMP was increased by prostaglandin E1, arginine vasopressin, cholera toxin, forskolin, or 8-bromoadenosine 3',5'-cyclic monophosphate. All agonists were potentiated by 3-isobutyl-1-methylxanthine, a nucleotide phosphodiesterase inhibitor. The cell proliferation component of cyst enlargement was accelerated by cAMP agonists, as shown by the increased growth of MDCK cells in subconfluent monolayers. The fluid secretion component, reflected by the transepithelial movement of fluid across polarized monolayers of MDCK cells grown on permeable supports, was stimulated by cAMP agonists in the basolateral medium. Chloride levels were higher in the cyst fluid and the secreted fluid than in the bathing medium. We conclude that the development of MDCK cysts is dependent on cAMP. This signal transduction system may be an important modulator of epithelial cell proliferation and transepithelial fluid secretion in the kidney.
Aneurysmal bone cyst and other nonneoplastic conditions
DOE Office of Scientific and Technical Information (OSTI.GOV)
Dahlin, D.C.; McLeod, R.A.
1982-08-01
Aneurysmal bone cyst is a benign proliferative tumefaction of bone. Histologic similarities indicate a kinship among classic aneurysmal bone cysts, 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.
Solid sand particle addition can enhance the production of resting cysts in dinoflagellates
NASA Astrophysics Data System (ADS)
Yang, Aoao; Hu, Zhangxi; Tang, Yingzhong
2018-03-01
Resting cysts are an important part of the life cycle for many harmful algal bloom-forming dinoflagellates, and play vital roles in the recurrence and geographical spread of harmful algal blooms. Numerous factors have been suggested to regulate the formation of resting cysts, although only a few have been proven to be significant. Cyst formation can be induced by adverse environmental conditions such as drastic changes in temperature, light, salinity, and nutrient levels, and by biological interactions. In this study, we evaluated the ability of an artificial factor (fine sand particles) to enhance the formation of resting cysts. Fine sand particles were added to cultures of dinoflagellates that are known to produce cysts. The addition of fine sand particles significantly increased both the production rate and final yield of cysts in cultures of Scrippsiella trochoidea, Biecheleria brevisulcata, and Levanderina fissa (= Gymnodinium fissum, Gyrodinium instriatum, Gyrodinium uncatenum). The largest increase in the final yield (107-fold) of cysts as a result of sand addition was in S. trochoidea. However, addition of fine sand particles did not induce cyst formation, or barely affected cyst formation, in Akashiwo sanguinea, Cochlodinium polykrikoides and Pheopolykrikos hartmannii, which are also known to be cyst-producing species. We speculated that addition of sand significantly increased the chances of cell collision, which triggered cyst formation. However, further research is required to test this idea. Importantly, our findings indicate that the addition of fine sand particles is a useful method to obtain a large quantity of cysts in a short time for laboratory studies or tests; for example, if a cyst viability test is being used to assess the effectiveness of ships' ballast water treatment.
Surveillance of Craniopharyngioma Cyst Growth in Children Treated With Proton Radiotherapy
DOE Office of Scientific and Technical Information (OSTI.GOV)
Winkfield, Karen M.; Linsenmeier, Claudia; Yock, Torunn I.
2009-03-01
Purpose: Craniopharyngiomas are benign, slow-growing tumors that frequently contain a cystic component. Even with gross total resection, the cyst can reform and cause symptoms. Fluctuations in cyst volume during radiotherapy (RT) can affect treatment planning and delivery. The aim of this study was to report our experience with cyst enlargement during conformal proton RT for children with craniopharyngioma and to make recommendations regarding mid-treatment surveillance. Methods and Materials: Between January 2001 and August 2007, 24 children (aged {<=}18 years) underwent proton RT at the Massachusetts General Hospital for craniopharyngioma. For all 24 patients, tumor size on magnetic resonance imaging and/ormore » computed tomography was measured before and after RT. Surveillance imaging was available for review on 17 patients. During RT, cyst growth was assessed to determine whether the treatment fields needed to be altered. Results: Of the 17 children who underwent repeat imaging during RT, 6 required intervention because of changes in cyst dimensions. Four patients (24%) had cyst growth beyond the original treatment fields, requiring enlargement of the treatment plan. One patient's treatment field was reduced after a decreased in cyst size. Cyst drainage was performed in another patient to avoid enlargement of the treatment fields. Conclusion: In patients undergoing highly conformal RT for craniopharyngiomas with cysts, routine imaging during treatment is recommended. Surveillance imaging should be performed at least every 2 weeks during proton RT in an attempt to avoid marginal failure. Craniopharyngiomas with large cystic components or enlargement during treatment might require weekly imaging.« less
Bovine IgG subclasses and fertility of Echinococcus granulosus hydatid cysts.
Riesle, Silke; García, María Pía; Hidalgo, Christian; Galanti, Norbel; Saenz, Leonardo; Paredes, Rodolfo
2014-09-15
Hydatidosis is an important zoonotic disease of worldwide distribution, causing important health problems to humans and major economical losses in infected livestock. Echinococcus granulosus, the etiological agent of hydatid disease, induces a humoral immune response in the intermediate host (human and herbivorous) against hydatid cyst antigens. Specifically, IgGs are found in the laminar and germinal layers and inside the lumen of fertile and infertile hydatid cysts. In the germinal layer of infertile cysts IgGs are found in an order of magnitude greater than in the germinal layer of fertile cysts; a fraction of those IgGs are associated with high affinity to germinal layer proteins, suggesting their binding to specific parasite antigens. We have previously shown that those immunoglobulins, bound with high affinity to the germinal layer of hydatid cysts, induce apoptosis leading to cyst infertility. In the present work the presence of IgG1 and IgG2 subclasses in the germinal layer of both fertile and infertile hydatid cysts is reported. IgG1 is the most relevant immunoglobulin subclass present in the germinal layer of infertile cysts and bound with high affinity to that parasite structure. Contrarily, though the IgG2 subclass was also found in the germinal and adventitial layers, those immunoglobulins show low affinity to parasite antigens. We propose that the binding of an IgG1 subclass to parasite antigens present in the germinal layer is involved in the mechanism of cyst infertility. Copyright © 2014 Elsevier B.V. All rights reserved.
Nonsurgical Management of a Periapical Cyst: A Case Report
Dandotikar, Deepakraj; Peddi, Ravigna; Lakhani, Bharvi; Lata, Kamini; Mathur, Aditi; Chowdary, Uday Kumar
2013-01-01
Large periapical lesions, regardless of whether they are granulomas, abscesses or cysts, are primarily caused by root canal infection. Thus the treatment protocol should be elimination of etiological factors in the root canal system rather than their product, apical true cyst. A 10 year old female patient reported to the Department of Pedodontics and Preventive Dentistry, Dr R Ahmed Dental College & Hospital, Kolkata, with the chief complaint of pain and swelling in relation to upper front fractured teeth. Clinical and radiological findings were suggestive of periapical radicular cyst. Non-surgical endodontic therapy was performed using 1% sodium hypochlorite solution irrigant and Calcium hydroxide intra canal medicament. A 12 months follow-up radiographic examination revealed progressive involution of periapical radiolucency without any clinical symptoms. Periapical cysts respond favorably to non-surgical endodontic treatment and should be considered as primary treatment modality. How to cite this article: Dandotikar D, Peddi R, Lakhani B, Lata K, Mathur A, Chowdary U K. Nonsurgical Management of a Periapical Cyst: A Case Report. J Int Oral Health 2013; 5(3):79-84. PMID:24155607
Nonsurgical management of a periapical cyst: a case report.
Dandotikar, Deepakraj; Peddi, Ravigna; Lakhani, Bharvi; Lata, Kamini; Mathur, Aditi; Chowdary, Uday Kumar
2013-06-01
Large periapical lesions, regardless of whether they are granulomas, abscesses or cysts, are primarily caused by root canal infection. Thus the treatment protocol should be elimination of etiological factors in the root canal system rather than their product, apical true cyst. A 10 year old female patient reported to the Department of Pedodontics and Preventive Dentistry, Dr R Ahmed Dental College & Hospital, Kolkata, with the chief complaint of pain and swelling in relation to upper front fractured teeth. Clinical and radiological findings were suggestive of periapical radicular cyst. Non-surgical endodontic therapy was performed using 1% sodium hypochlorite solution irrigant and Calcium hydroxide intra canal medicament. A 12 months follow-up radiographic examination revealed progressive involution of periapical radiolucency without any clinical symptoms. Periapical cysts respond favorably to non-surgical endodontic treatment and should be considered as primary treatment modality. How to cite this article: Dandotikar D, Peddi R, Lakhani B, Lata K, Mathur A, Chowdary U K. Nonsurgical Management of a Periapical Cyst: A Case Report. J Int Oral Health 2013; 5(3):79-84.
Laparoscopic management of urachal cyst associated with umbilical hernia.
Gregory, G C; Vijay, R; Ligaj, M; Shiwani, M H
2011-02-01
The urachal cyst is a rare clinical entity of a urachal remnant. It is usually asymptomatic but can present with haematuria, tumour, urachal stone and infection. We present a case of a 63-year-old lady with a body mass index (BMI) of 49 who presented with a painful swelling in the umbilical region associated with an umbilical hernia. An ultrasound and computed tomography (CT) scan showed a suspected herniation of an umbilical remnant cyst through a paraumbilical defect. Laparoscopy confirmed the urachal cyst of 3 cm in size with a band connected with the cyst down to the urinary bladder associated with a 3-cm paraumbilical hernia. We removed the cyst and repaired the hernia laparoscopically uneventfully, after which her recovery was perfect. Radiological and laparoscopic pictures have not been reported in the English literature before. Although this condition is very rare, we suggest that it should be considered in the differential diagnosis of painful paraumbilical swelling. CT scanning and laparoscopy seems to be valuable, especially in obese patients.
Mediastinal Bronchogenic Cyst With Acute Cardiac Dysfunction: Two-Stage Surgical Approach.
Smail, Hassiba; Baste, Jean Marc; Melki, Jean; Peillon, Christophe
2015-10-01
We describe a two-stage surgical approach in a patient with cardiac dysfunction and hemodynamic compromise resulting from a massive and compressive mediastinal bronchogenic cyst. To drain this cyst, video-assisted mediastinoscopy was performed as an emergency procedure, which immediately improved the patient's cardiac function. Five days later and under video thoracoscopy, resection of the cyst margins was impossible because the cyst was tightly adherent to the left atrium. We performed deroofing of this cyst through a right thoracotomy. The patient had an uncomplicated postoperative recovery, and no recurrence was observed at the long-term follow-up visit. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Saraph, Vinay; Zwick, Ernst-Bernhard; Maizen, Claudia; Schneider, Frank; Linhart, Wolfgang E
2004-01-01
Nine unicameral bone cysts of the calcaneus in children were managed surgically using the technique of continuous decompression with titanium cannulated cancellous screws. The average age of the patients at surgery was 12.8 years. At follow-up a minimum of 2 years after surgery, eight cysts showed complete healing; one patient showed healing with residuals. Irritation at the screw insertion site necessitated early removal of the screw in one patient; implant-related problems were not observed in the other patients. Patients were allowed to bear weight after surgery. Implant extraction was performed after full consolidation of the cyst and was uneventful in all patients. A review of the literature and the different treatment modalities used for managing calcaneal cysts is also presented.
Wang, Qinying; Chen, Haihong; Wang, Shenqing
2015-01-01
Objectives: To determine the outcomes of coblation assisted transnasal endoscopic resection of nasopharyngeal cyst. Method: Retrospective chart review outcomes in 12 patients who underwent endoscopic resect cysts of the nasopharynx at our department between 2001 and 2010. Twelve patient, aged 28 to 71 years, with cysts of the nasopharynx. The outcome variables of complications and the rate of recurrence were analyzed, respectively. Results: In 12 cases, retention cysts in 2 cases, branchial cyst in 1 case, adenoid middle fossa cyst infection in 6 cases, Tornwaldt’s cyst in 3 cases. The use of the coblation device was associated with a significant decrease in blood loss. There were no postoperative complications, and the overall follow-up period was 2-7 years and shows no signs of recurrence. Conclusions: We describe transnasal endoscopic procedures to resect cysts of the nasopharynx. We found that radiofrequency coblation is a useful and safe tool associated with minimal blood loss in the resection of these cysts. In our experience, it has been a highly successful, safe, and effective procedure. PMID:26131108
Tornwaldt's cyst presenting only as occipital headache: a case report.
Cho, Hang S; Byeon, Hyung K; Kim, Jun-Hee; Kim, Kyung S
2009-02-01
Tornwaldt's cyst (sometimes called Thornwaldt's cyst) is a rare cause of occipital headache. Owing to the rare occurrence of occipital headache as a symptom of Tornwaldt's cyst, if the patient presented only with occipital headache, this clinical symptom may be falsely perceived as a sign of neurologic disease leading to time-consuming diagnostic examinations that delay the establishment of a correct diagnosis.
Mechanical Characterization of Microengineered Epithelial Cysts by Using Atomic Force Microscopy.
Shen, Yusheng; Guan, Dongshi; Serien, Daniela; Takeuchi, Shoji; Tong, Penger; Yobas, Levent; Huang, Pingbo
2017-01-24
Most organs contain interconnected tubular tissues that are one-cell-thick, polarized epithelial monolayers enclosing a fluid-filled lumen. Such tissue organization plays crucial roles in developmental and normal physiology, and the proper functioning of these tissues depends on their regulation by complex biochemical perturbations and equally important, but poorly understood, mechanical perturbations. In this study, by combining micropatterning techniques and atomic force microscopy, we developed a simple in vitro experimental platform for characterizing the mechanical properties of the MDCK II cyst, the simplest model of lumen-enclosing epithelial monolayers. By using this platform, we estimated the elasticity of the cyst monolayer and showed that the presence of a luminal space influences cyst mechanics substantially, which could be attributed to polarization and tissue-level coordination. More interestingly, the results from force-relaxation experiments showed that the cysts also displayed tissue-level poroelastic characteristics that differed slightly from those of single cells. Our study provides the first quantitative findings, to our knowledge, on the tissue-level mechanics of well-polarized epithelial cysts and offers new insights into the interplay between cyst mechanics and cyst physiology. Moreover, our simple platform is a potentially useful tool for enhancing the current understanding of cyst mechanics in health and disease. Copyright © 2017 Biophysical Society. Published by Elsevier Inc. All rights reserved.
Cystic echinococcosis: late rupture and complication of a stable pulmonary cyst.
Fisher, J; Shargall, Y; Krajden, S; Moid, F; Hoffstein, V
2011-01-01
Cystic echinococcosis is observed worldwide. Traditional management includes an invasive surgical approach with adjunctive chemotherapy. It has been suggested that observation alone may be appropriate in asymptomatic individuals with stable cysts. A case involving a 38-year-old Peruvian man with an asymptomatic bronchogenic cyst (suspected to be due to echinococcus, but never definitely diagnosed) is presented. The cyst was first noted in 1998, and was followed for 10 years during which time he remained asymptomatic with minimal radiographic change. One year later, in 2009, he presented with acute rupture of the cyst causing empyema. The patient required thoracotomy, decortication and resection of the ruptured cyst. Final pathology showed Echinococcus organisms. The patient responded well to treatment with albendazole and praziquantel, and became completely asymptomatic within six months. The present case demonstrates that echinococcal cysts may be at risk of spontaneous rupture, even after many years of clinical stability, thus supporting the case for resection of asymptomatic cysts suspected of being echinococcal at the time of diagnosis. In addition, the case illustrates that medical therapy with albendazole and praziquantel, in conjunction with surgical drainage, can be successful in the treatment of echinococcal empyema.
[Prenatal diagnosis and treatment of fetal choroid plexus cysts].
Liang, Mei-Ying; Wang, Hong-Bin; Huang, Xin; Wei, Yan-Qiu
2007-09-01
To discuss the clinical management and significance of the prenatal diagnosis of Fetal Choroid Plexus Cysts (CPC). From May 2004 to March 2007, 55 cases of fetal CPC diagnosed by B-ultrasound during second trimester were prospectively studied. Each case was studied regarding fetal chromosome karyotype, disappearance weeks of the cyst, the clinical outcome and follow-up results respectively. The cases were diagnosed during 16 - 25 gestational weeks. The diameters of the cysts varied from 0.2 cm to 2.4 cm. There were 25 cases of bilateral cysts and 30 cases of unilateral or 50 cases of isolated CPC and 5 cases of complicated CPC. The cysts of all cases who continued pregnancy disappeared before 28 weeks. Fetal chromosome karyotypes were obtained in 50 cases. Among them, two cases were 18-trisomy, and one case was 21-trisomy. Five cases were terminated pregnancy because of abnormal chromosome karyotype or malformation during second trimester. One neonate was diagnosed as ventricular septal defect among 50 cases of follow up. Among these six cases, three were from advanced-age pregnant women, five cases were with abnormal fetal structure and five cases were with the diameter of bilateral or unilateral cysts more than 1.0 cm. (1) Fetal CPC can be diagnosed during second trimester, and the majority disappear before 28 gestational weeks. (2) High risk factors for fetal abnormal chromosome karyotype may be: advanced-age pregnant women, abnormal structure of fetus, and the diameter of bilateral or unilateral cyst more than 1.0 cm. It is suggested that fetal CPC with the high risks should receive fetal chromosome karyotype test during pregnancy.
Species-Specific Immunodetection of an Entamoeba histolytica Cyst Wall Protein
Kearney, Moira R.; Siddique, Abdullah; Ali, Ibne K.; Gilchrist, Carol A.; Arju, Tuhinur; Hoffstrom, Benjamin; Nguyen, Felicia K.; Petri, William A.; Haque, Rashidul; Cangelosi, Gerard A.
2016-01-01
Entamoeba histolytica causes intestinal disease in endemic settings throughout the world. Diagnosis of E. histolytica infection would be improved by the identification of biomarkers that are expressed by cysts of E. histolytica, but not by cysts of closely related commensal species of Entamoeba. Herein, we describe two novel monoclonal antibodies (1A4 and 1D3) produced against a spacer region of the E. histolytica Jacob2 lectin, an outer cyst wall protein. These reagents demonstrated no cross-reaction to E. dispar recombinant antigen and low picomolar molecular detection limits when paired in ELISA sandwich assays. In an immunofluorescence microscopy assay, the α-Jacob2 murine antibodies labeled cysts of three xenically cultured E. histolytica isolates but did not label cysts of three E. bangladeshi isolates. Monoclonal antibody 1A4 did not cross-react with xenic cultures of three E. dispar isolates, demonstrating specificity to E. histolytica, while monoclonal antibody 1D3 cross-reacted with two out of three E. dispar isolates. Both antibodies labeled cysts in formalin-fixed slides, a potential logistical advantage in some settings. The monoclonal antibody 1A4 was also used in an immunofluorescence microscopy assay with formalin-fixed stool specimens. Seven out of ten ELISA-positive stool specimens exhibited 1A4-labeled cyst-like objects, compared to one out of seven ELISA-negative specimens. These results demonstrate that antibodies generated against the flexible spacer of E. histolytica Jacob2 lectin recognize and bind to Jacob2 protein in whole cysts and are capable of differentiating Entamoeba species in fixed specimens. Thus, Jacob2 is a promising biomarker for use in diagnosing E. histolytica infection. PMID:27152855
De Smet, Arthur A; Graf, Ben K; del Rio, Alejandro Munoz
2011-02-01
Although patients with parameniscal cysts usually have underlying meniscal tears, we noted that this association was less common with anterior lateral cysts. We wished to determine whether the frequency of a meniscal tear underlying a parameniscal cyst varied with cyst location. We reviewed a database of 7,771 knee MR examinations and identified 134 patients with an MR diagnosis of 138 parameniscal cysts and correlative arthroscopy in 78 patients. We reviewed their medical records and MR studies to determine the location of the cysts and presence of an underlying meniscal tear as determined by MRI or arthroscopy. There were 50 lateral and 88 medial parameniscal cysts. Medial meniscal tears were found underlying a cyst in 96% of arthroscopy patients and 86% of patients who had only MR examinations without a location difference in tears (p = 0.68). Meniscal tears were found on MRI or arthroscopy in all 28 patients with a lateral cyst overlying the body or posterior horn of the lateral meniscus, whereas a tear was found on MRI or arthroscopy in only 14 (64%) of 22 patients with cysts adjacent to or extending to the lateral meniscus anterior horn (p = 0.006). Anterior lateral cysts extended medially either into the root or into Hoffa fat-pad, but the type of extension did not correlate with the presence of an underlying meniscal tear. In contrast to medial parameniscal cysts or cysts at other locations adjacent to the lateral meniscus, anteriorly located lateral parameniscal cysts are less likely to have underlying meniscal tears.
Irritant vocal cord dysfunction at first misdiagnosed as reactive airway dysfunction syndrome.
Galdi, Eugenia; Perfetti, Luca; Pagella, Fabio; Bertino, Giulia; Ferrari, Massimo; Moscato, Gianna
2005-06-01
This report describes a case of vocal cord dysfunction at first misdiagnosed as reactive airway dysfunction syndrome (RADS). A woman developed recurrent episodes of cough, dyspnea, and wheezing unresponsive to asthma therapy after irritant exposure to glutaraldehyde. Direct laryngoscopy was performed immediately after the induction of symptoms. Laryngoscopy showed a paradoxical adduction of the vocal cord on inspiration. Vocal cord dysfunction was diagnosed. A case of vocal cord dysfunction occurred after exposure to glutaraldhyde in a person with a history highly suggestive of RADS. Vocal cord dysfunction should always be considered in the differential diagnosis of patients with acute respiratory symptoms after exposure to irritants and with asthma-like symptoms that fail to respond to conventional asthma therapy.
Parapharyngeal cyst: considerations on embryology, clinical evaluation, and surgical management.
Dallan, Iacopo; Seccia, Veronica; Bruschini, Luca; Ciancia, Eugenio; Franceschini, Stefano Sellari
2008-11-01
Branchial cleft anomalies represent a common cause of cervical mass in adults. Describing a case report, we reviewed embryology, clinical elements, and treatment options for parapharyngeal congenital cysts. A case of a parapharyngeal cyst mimicking a tonsillar abscess is presented. A second branchial cleft cyst was hypothesized on a clinical and radiologic basis and then confirmed by histologic data. Magnetic resonance imaging provided fundamental information for the study of the parapharyngeal mass and its relationship with surrounding structures. In literature, surgical excision is the recommended therapy. We removed the cyst through a transcervical approach, with no complications or recurrence after 3 years. In our opinion, cervicotomy should be considered the gold standard approach, even for lesions not palpable in the cervical area. When dealing with a parapharyngeal cyst, second branchial cleft anomalies should be considered. Our experience confirms that cervicotomy is a safe approach to parapharyngeal congenital lesions.
Mechanical obstruction to ventilation from an ovarian cyst during pregnancy.
Beng, D T; Choon, L T
1991-05-01
This report documents the danger of the gravid uterus fixing a large ovarian cyst in a position disadvantageous to diaphragmatic excursion and thereby obstructing ventilation. A 34-year-old pregnant patient presented at 18 weeks amenorrhoea with a large ovarian cyst. She gave a history of exertional dyspnoea and orthopnoea. Clinical examination revealed a grossly enlarged abdomen and a respiratory rate of 28 breaths.min-1. Intraoperatively, ventilation was markedly impaired resulting in cyanosis and bradycardia. This was relieved by drainage of the ovarian cyst. A left lateral tilt with manual traction on the tumour may have avoided this problem. Should the above measures be inadequate, immediate drainage of the cyst is essential. Severe respiratory distress may require ultrasound-guided, percutaneous, aspiration of the cyst preoperatively. However, as in this patient, the absence of gross signs of respiratory failure does not preclude acute ventilatory failure after induction of anaesthesia.
Surgical management of congenital saccular cysts of the larynx.
Ward, R F; Jones, J; Arnold, J A
1995-09-01
Congenital saccular cysts of the larynx are unusual lesions that commonly present with respiratory obstruction in infants and children. The saccular cyst may result from an atresia of the laryngeal saccule orifice or may represent the retention of mucus in the collecting ducts of submucosal glands located around the ventricle. Traditionally, the treatment of the lesions has been endoscopic unroofing or marsupialization. Frequently, this modality requires multiple procedures as well as concomitant tracheotomy. There also have been reports of acquired subglottic stenosis. We have found that removal of the recurrent saccular cyst can be achieved relatively safely and effectively via a lateral cervical approach to the thyrohyoid membrane. We review our experience with four patients with congenital saccular cysts and detail the evaluation and surgical management of these lesions.
Arthroscopic treatment of femoral nerve paresthesia caused by an acetabular paralabral cyst.
Kanauchi, Taira; Suganuma, Jun; Mochizuki, Ryuta; Uchikawa, Shinichi
2014-05-01
This report describes a rare case of femoral nerve paresthesia caused by an acetabular paralabral cyst of the hip joint. A 68-year-old woman presented with a 6-month history of right hip pain and paresthesia along the anterior thigh and radiating down to the anterior aspect of the knee. Radiography showed osteoarthritis with a narrowed joint space in the right hip joint. Magnetic resonance imaging showed a cyst with low T1- and high T2-weighted signal intensity arising from a labral tear at the anterior aspect of the acetabulum. The cyst was connected to the joint space and displaced the femoral nerve to the anteromedial side. The lesion was diagnosed as an acetabular paralabral cyst causing femoral neuropathy. Because the main symptom was femoral nerve paresthesia and the patient desired a less invasive procedure, arthroscopic labral repair was performed to stop synovial fluid flow to the paralabral cyst that was causing the femoral nerve paresthesia. After surgery, the cyst and femoral nerve paresthesia disappeared. At the 18-month follow-up, the patient had no recurrence. There have been several reports of neurovascular compression caused by the cyst around the hip joint. To the authors' knowledge, only 3 cases of acetabular paralabral cysts causing sciatica have been reported. The current patient appears to represent a rare case of an acetabular paralabral cyst causing femoral nerve paresthesia. The authors suggest that arthroscopic labral repair for an acetabular paralabral cyst causing neuropathy can be an option for patients who desire a less invasive procedure. Copyright 2014, SLACK Incorporated.
Unicameral Bone Cyst of the Medial Cuneiform.
Schick, Faith A; Daniel, Joseph N; Miller, Juliane S
2016-09-02
A unicameral bone cyst is a relatively uncommon, benign bone tumor found in the metaphysis of long bones, such as the humerus and the femur, in skeletally immature persons. In the foot, these benign, fluid-filled cavities are most commonly found within the os calcis. We present a case report of a 10-year-old female with a unicameral bone cyst of the medial cuneiform.
An adult case of giant bronchogenic cyst mimicking tension pneumothorax.
Yalcinkaya, Serhat; Vural, A Hakan; Ozal, Hasan
2010-10-01
Bronchogenic cysts are usually discovered only incidentally in the adult. A giant bronchogenic cyst in a 19-year-old woman presenting with pain and shortness of breath was mistaken for tension pneumothorax and initially treated with tube thoracostomy. Giant bullae were diagnosed by computed tomography. Bullae resection was undertaken, but the remaining lung tissue required pneumonectomy. Pathologic examination of the specimen confirmed bronchogenic cyst.
Demographic distribution of odontogenic cysts in Isfahan (Iran) over a 23-year period (1988-2010).
Khosravi, Negin; Razavi, Sayed Mohammad; Kowkabi, Mahsa; Navabi, Amir Arsalan
2013-03-01
Odontogenic cysts are relatively common lesions which can cause different complications. As demographic information is lacking in Iran and specially in Isfahan, the aim of this study was to determine the prevalence of odontogenic cysts according to age, gender and affected area among patients referring to the Oral Pathology Department of the Dental School of Isfahan University of Medical Sciences (Iran) over a 23-year period. A total of 7412 diagnosed lesions recorded in the Oral Pathology Department archives of Isfahan Dental School between 1988 and 2010 were reevaluated, then odontogenic cysts were separated through reviewing microscopic slides according to the 2005 World Health Organization classification and variables such as age, gender, the infected jaw, and its specific region were obtained by SPSS Version 16.0 from the recorded database. 21.62% of the lesions were odontogenic cysts, of which 48.72% were inflammatory and 51.28% were developmental cysts. These cysts were more common in the mandible. The mean age of patients was 29.53 ± 16.1. Male to female ratio was 1.31:1. The four most frequent odontogenic cysts were radicular cysts (35.12%), dentigerous cysts (25.77%), odontogenic keratocysts (22.58%) and residual cysts (12.98%). Odontogenic cysts are fairly frequent jaw lesions (21.62%), of which radicular cyst was the most common cyst. The four most common lesions constituted a sum of 96.45% of the total. In general, the prevalence rates in our study are similar to the studies from other geographic parts of the world but with a lower incidence of inflammatory cysts, higher prevalence of dentigerous cysts and residual cysts and also mandibular predominance for residual cysts.
Differential diagnosis of periapical cyst using collagen birefringence pattern of the cyst wall.
Ji, Hyo Jin; Park, Se-Hee; Cho, Kyung-Mo; Lee, Suk Keun; Kim, Jin Woo
2017-05-01
Periapical lesions, including periapical cyst (PC), periapical granuloma (PG), and periapical abscess (PA), are frequently affected by chemical/physical damage during root canal treatment or severe bacterial infection, and thus, the differential diagnosis of periapical lesions may be difficult due to the presence of severe inflammatory reaction. The aim of this study was to make differential diagnosis among PC, PG, and PA under polarizing microscope. The collagen birefringence patterns of 319 cases of PC ( n = 122), PG ( n = 158), and PA ( n = 39) obtained using a polarizing microscope were compared. In addition, 6 cases of periodontal fibroma (PF) were used as positive controls. Collagen birefringence was condensed with a thick, linear band-like pattern in PC, but was short and irregularly scattered in PG, and scarce or absent in PA. PF showed intense collagen birefringence with a short, palisading pattern but no continuous band-like pattern. The linear band-like birefringence in PC was ascribed to pre-existing expansile tensile stress of the cyst wall. In this study all PCs ( n = 122) were distinguishable from PGs and PAs by their characteristic birefringence, despite the absence of lining epithelium ( n = 20). Therefore, the authors suggest that the presence of linear band-like collagen birefringence of the cyst wall aids the diagnostic differentiation of PC from PG and PA.
Differential diagnosis of periapical cyst using collagen birefringence pattern of the cyst wall
2017-01-01
Objectives Periapical lesions, including periapical cyst (PC), periapical granuloma (PG), and periapical abscess (PA), are frequently affected by chemical/physical damage during root canal treatment or severe bacterial infection, and thus, the differential diagnosis of periapical lesions may be difficult due to the presence of severe inflammatory reaction. The aim of this study was to make differential diagnosis among PC, PG, and PA under polarizing microscope. Materials and Methods The collagen birefringence patterns of 319 cases of PC (n = 122), PG (n = 158), and PA (n = 39) obtained using a polarizing microscope were compared. In addition, 6 cases of periodontal fibroma (PF) were used as positive controls. Results Collagen birefringence was condensed with a thick, linear band-like pattern in PC, but was short and irregularly scattered in PG, and scarce or absent in PA. PF showed intense collagen birefringence with a short, palisading pattern but no continuous band-like pattern. The linear band-like birefringence in PC was ascribed to pre-existing expansile tensile stress of the cyst wall. Conclusions In this study all PCs (n = 122) were distinguishable from PGs and PAs by their characteristic birefringence, despite the absence of lining epithelium (n = 20). Therefore, the authors suggest that the presence of linear band-like collagen birefringence of the cyst wall aids the diagnostic differentiation of PC from PG and PA. PMID:28503476
Penicillium oxalicum reduces the number of cysts and juveniles of potato cyst nematodes.
Martinez-Beringola, M L; Salto, T; Vázquez, G; Larena, I; Melgarejo, P; De Cal, A
2013-07-01
To test the biocontrol potential of Penicillium oxalicum, a biocontrol agent against fungal diseases and against the potato cyst nematodes (PCNs), Globodera pallida and Globodera rostochiensis. We tested the effect of P. oxalicum on the nematode cysts under laboratory conditions or in soil microcosms. A reduction in the rate of G. pallida juveniles hatching by P. oxalicum was observed when root diffusates from the 'Monalisa' and the 'Désirée' potato cultivar were used (98·6 and 74·1% reduction, respectively). However, the rate of G. pallida juveniles hatching was not significantly reduced when root diffusates from the 'San Pedro' tomato cultivar were used. Penicillium oxalicum also significantly reduced the ability of the G. rostochiensis juveniles to hatch (30·9% reduction) when root diffusates of the 'Désirée' potato cultivars were used. Penicillium oxalicum treatment of the soil significantly reduced the number of G. pallida cysts that were recovered from the soil of each pot that contained the 'Désirée' potato cultivar. Our results show that P. oxalicum is a potential biocontrol inoculant for protecting potato crops against PCNs. Penicillium oxalicum has potential to be used in order to reduce PCNs. Journal of Applied Microbiology © 2013 The Society for Applied Microbiology.
Laser surgery in the treatment of vaginal cysts
NASA Astrophysics Data System (ADS)
Wozniak, Jakub; Dydowicz, Piotr; Opala, Tomasz; Pisarska-Krawczyk, Magdalena; Wilczak, Maciej; Pisarski, Tadeusz
1997-10-01
The authors described the results of treatment of vaginal cysts with CO2 laser under colposcopic control in 12 women. In five of them the recurrent Bartholin's, in another five the Gartner's and in tow the endometrial cysts were diagnosed. All laser surgeries were done in the Department of Reproduction, Institute of Gynecology, Karol Marcinkowski School of Medical Sciences, Poznan, Poland between September 1995 and September 1996. In the authors' opinion the use of CO2 laser is the efficient method of treatment of vaginal cysts. The most of laser procedures are doing as the one-day surgery. There are no serious postoperative complications after laser surgery.
Fluorescence diagnosis of tumor cells in hemangioblastoma cysts with 5-aminolevulinic acid.
Utsuki, Satoshi; Oka, Hidehiro; Sato, Kimitoshi; Shimizu, Satoru; Suzuki, Sachio; Fujii, Kiyotaka
2010-01-01
Peritumoral hemangioblastoma cysts are usually composed of fibrous tissue without tumor cells. The authors describe the first case in which fluorescence with 5-aminolevulinic acid (5-ALA) was used to diagnose a hemangioblastoma tumor in a peritumoral cyst wall. A 27-year-old woman with a homogeneous, enhanced nodular lesion in the right hemisphere of the cerebellum underwent surgical treatment. After the nodular lesion was removed, the cyst region was observed with the aid of a semiconductor laser with a peak wavelength of 405 +/- 1 nm, which was powered using a fiberoptic cable. The cyst region was visualized with strong fluorescence, which disappeared after tissue removal. The fluorescent cyst consisted of tumor cells. The authors conclude that fluorescence diagnosis performed using 5-ALA can inform the choice of removing hemangioblastoma cysts.
Arthroscopic excision of ganglion cysts.
Bontempo, Nicholas A; Weiss, Arnold-Peter C
2014-02-01
Arthroscopy is an advancing field in orthopedics, the applications of which have been expanding over time. Traditionally, excision of ganglion cysts has been done in an open fashion. However, more recently, studies show outcomes following arthroscopic excision to be as good as open excision. Cosmetically, the incisions are smaller and heal faster following arthroscopy. In addition, there is the suggested benefit that patients will regain function and return to work faster following arthroscopic excision. More prospective studies comparing open and arthroscopic excision of ganglion cysts need to be done in order to delineate if there is a true functional benefit. Copyright © 2014 Elsevier Inc. All rights reserved.
Pediatric epidermoid cysts masquerading as ranulas: A case series.
Reddy, Abhita; Kreicher, Kathryn L; Patel, Neha A; Schantz, Stimson; Shinhar, Shai
2016-02-01
Pediatric neck masses represent a variety of differential diagnoses. A common pathology in pediatric cystic neck tumors include ranulas, mucus retention cysts due to salivary gland obstruction. Epidermoid cysts are lesions infrequently encountered in the pediatric population and may appear similarly to ranulas on computed tomography imaging. MRI more easily differentiates these masses, and should therefore be the preferred imaging modality. Due to their distinct intraoperative management, ranulas and epidermoid cysts should be distinguished preoperatively through proper workup. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Relationship between pineal cyst size and aqueductal CSF flow measured by phase contrast MRI.
Bezuidenhout, Abraham F; Kasper, Ekkehard M; Baledent, Olivier; Rojas, Rafael; Bhadelia, Rafeeque A
2018-02-23
Most patients with pineal cysts referred for neurosurgical consultation have no specific symptoms or objective findings except for pineal cyst size to help in management decisions. Our purpose was to assess the relationship between pineal cyst size and aqueductal CSF flow using PC-MRI. Eleven adult patients with pineal cysts (> 1-cm in size) referred for neurosurgical consultations were included. Cyst volume was calculated using 3D T1 images. PC-MRI in axial plane with velocity encoding of 5 cm/sec was used to quantitatively assess CSF flow through the cerebral aqueduct to determine the aqueductal stroke volume, which was then correlated to cyst size using Pearson's correlation. Pineal cysts were grouped by size into small (6/11) and large (5/11) using the median value to compare aqueductal stroke volume using Mann-Whitney test. Patients were 39 ± 13 years (mean ± SD) of age, and 10/11 (91%) were female. There was significant negative correlation between cyst volume and aqueductal stroke volume (r=0.74; p=0.009). Volume of small cysts (4954±2157 mm3) was significantly different compared to large cysts (13752±3738 mm3; p= 0.008). The aqueductal stroke volume of patients harboring large cysts 33±8 μL/cardiac cycle was significantly lower than that of patients with small cysts 96±29 μL/cardiac cycle (p=0.008). Aqueductal CSF flow appears to decrease with increasing pineal cyst size. Our preliminary results provide first evidence that even in the absence of objective neurological findings or hydrocephalus; larger pineal cysts already display decreased CSF flow through the cerebral aqueduct.
A Third Branchial Pouch Cyst Presenting as Stridor in a Child
Wasson, Joseph; Blaney, Sean; Simo, Ricard
2007-01-01
We present a rare case of a third branchial pouch cyst in an 18-month-old child, presenting with stridor and a lateral cervical cystic mass. Differences in the anatomical course of third and fourth branchial cysts, and histological differences between branchial pouch and branchial cleft cysts are discussed. PMID:17316513
Possible Estrogen Dependency in the Pathogenesis of Branchial Cleft Cysts.
Raguse, Jan D; Anagnostopoulos, Ioannis; Doll, Christian; Heiland, Max; Jöhrens, Korinna
2017-01-01
Even though branchial cleft cysts are currently accepted as a congenital anomaly, there is often a long delay until clinical presentation; branchial cleft cysts classically appear in the second to fourth decade of life. Our observation of their occurrence in three pregnant women encouraged us to contemplate a possible hormonal influence. Immunohistological analysis was performed for the evaluation of the estrogen receptor alpha (ER α ) in paraffin-embedded tissue specimens of 16 patients with a diagnosis of branchial cleft cyst, with three of them being pregnant. Expression of ER α was detected within epithelial cells only in branchial cleft cysts in pregnant females; moreover, higher growth fractions (Ki-67/Mib1) were found. The fact that the estrogen receptor was expressed only in pregnant women, in contrast to 13 investigated cases, may suggest that the high level of estrogen in pregnancy is a possible explanation for the spontaneous growth of branchial cleft cysts.
Possible Estrogen Dependency in the Pathogenesis of Branchial Cleft Cysts
Raguse, Jan D.; Jöhrens, Korinna
2017-01-01
Background Even though branchial cleft cysts are currently accepted as a congenital anomaly, there is often a long delay until clinical presentation; branchial cleft cysts classically appear in the second to fourth decade of life. Our observation of their occurrence in three pregnant women encouraged us to contemplate a possible hormonal influence. Methods Immunohistological analysis was performed for the evaluation of the estrogen receptor alpha (ERα) in paraffin-embedded tissue specimens of 16 patients with a diagnosis of branchial cleft cyst, with three of them being pregnant. Results Expression of ERα was detected within epithelial cells only in branchial cleft cysts in pregnant females; moreover, higher growth fractions (Ki-67/Mib1) were found. Conclusion The fact that the estrogen receptor was expressed only in pregnant women, in contrast to 13 investigated cases, may suggest that the high level of estrogen in pregnancy is a possible explanation for the spontaneous growth of branchial cleft cysts. PMID:29410959
Factors promoting in vitro excystation of Giardia muris cysts.
Schaefer, F W; Rice, E W; Hoff, J C
1984-01-01
Giardia muris cysts, isolated from mouse faeces, excysted routinely at levels greater than 90%, when induced in 1X Hanks' supplemented with 17 mM glutathione, 29 mM L-cysteine-HCl, and 50 mM NaHCO3 for 30 minutes at 35 degrees C, followed by washing and suspension in trypsin-Tyrode's solution at pH 8.0. Although trypsin was not required in this final step, it enhanced the escape of the trophozoites from their cysts. G. muris excystation was dependent upon the length of the induction period, pH, oxidation-reduction potential and temperature. Optimal induction conditions for excystation were: an induction period of 5 to 30 min; pH of 2; 120 mV oxidation-reduction potential; and a temperature around 35 degrees C. A gradual decline in excystation occurred as pH and oxidation-reduction potential were changed to 7 and 57 mV, respectively. There was a pronounced increase in excystation percentages with increasing temperatures between 0 and 37 degrees C. At 40 degrees C and above, the G. muris cysts showed signs of inactivation. The thermal death point of G. muris cysts was determined to be about 54 degrees C. G. muris cysts showed no polarity; however, the tail or posterior trophozoite portion always emerged through one end of the cyst first. Cytokinensis began within the first hour after excystation. This method always produced extremely active, normal-looking G. muris trophozoites.
Demographic distribution of odontogenic cysts in Isfahan (Iran) over a 23-year period (1988-2010)
Khosravi, Negin; Razavi, Sayed Mohammad; Kowkabi, Mahsa; Navabi, Amir Arsalan
2013-01-01
Background: Odontogenic cysts are relatively common lesions which can cause different complications. As demographic information is lacking in Iran and specially in Isfahan, the aim of this study was to determine the prevalence of odontogenic cysts according to age, gender and affected area among patients referring to the Oral Pathology Department of the Dental School of Isfahan University of Medical Sciences (Iran) over a 23-year period. Materials and Methods: A total of 7412 diagnosed lesions recorded in the Oral Pathology Department archives of Isfahan Dental School between 1988 and 2010 were reevaluated, then odontogenic cysts were separated through reviewing microscopic slides according to the 2005 World Health Organization classification and variables such as age, gender, the infected jaw, and its specific region were obtained by SPSS Version 16.0 from the recorded database. Results: 21.62% of the lesions were odontogenic cysts, of which 48.72% were inflammatory and 51.28% were developmental cysts. These cysts were more common in the mandible. The mean age of patients was 29.53 ± 16.1. Male to female ratio was 1.31:1. The four most frequent odontogenic cysts were radicular cysts (35.12%), dentigerous cysts (25.77%), odontogenic keratocysts (22.58%) and residual cysts (12.98%). Conclusion: Odontogenic cysts are fairly frequent jaw lesions (21.62%), of which radicular cyst was the most common cyst. The four most common lesions constituted a sum of 96.45% of the total. In general, the prevalence rates in our study are similar to the studies from other geographic parts of the world but with a lower incidence of inflammatory cysts, higher prevalence of dentigerous cysts and residual cysts and also mandibular predominance for residual cysts. PMID:23946730
Lymphatic involvement in the histopathogenesis of mucous retention cyst.
Kundu, Sukalyan; Cheng, Jun; Maruyama, Satoshi; Suzuki, Makoto; Kawashima, Hiroyuki; Saku, Takashi
2007-01-01
Mucous retention cyst results from extravasation of saliva. Our intent was to study the role of lymphatics in its pathogenesis. Twenty-three surgical specimens of mucous retention cyst of the lip were examined for involvement of lymphatic vessels by a comparative immunohistochemical demonstration of lymphatic and blood vascular endothelial cells, as well as lymphatic and salivary contents. Mucous retention cysts were histopathologically classified into three stages: early, intermediate, and advanced. In the early stage, there was diffuse extravasation of mucous material in the interstitium of the lamina propria or the submucosal layer of the oral mucosa. In the intermediate stage, lymphatics, which were clearly revealed and immunohistochemically distinguished from blood vessels by monoclonal antibody D2-40, were dilated and finally ruptured, leaving fragments of lymphatic walls in the periphery of mucous pools. In the advanced stage, thick cyst walls of granulation tissue were formed around mucous retention. Lymphatics were no longer involved in the granulation tissue wall, which was actively driven by blood vessel formation. The results suggest that the lymphatic rupture seems to contribute to the enlargement in the pathogenesis of mucous retention cyst.
Immunohistochemical Assessment of HER3 Expression in Odontogenic Cysts.
Honarmand, Marieh; Saravani, Shirin; Kamyab, Nazanin; Jahantigh, Mehdi; Torabi Parizi, Molouk
2015-11-01
It has been demonstrated that HER3 plays an important role in some human cancers and the HER3 expression is associated with worse survival in solid tumors. This study was conducted to compare HER3 expression in epithelial lining of radicular cysts (RCs), dentigerous cysts (DCs) and odontogenic keratocysts (OKCs). This was a descriptive-analytical study, which assessed all 57 paraffin blocks of RCs, DCs and OKCs (21 RCs, 16 DCs, 20 OKC) from pathological archive of Dentistry College of Zahedan, Iran. The HER3 expression in cytoplasm and membrane was examined by immunohistochemical method. The data collected was analyzed using SPSS16 by ANOVA and Chi-square. P < 0.05 was considered as statistically significant. The HER3 expression had positive results in 52.4% of OKC, 50% of DC and only 20% of RC samples. There was a significant difference between HER3 expression in OKCs and RCs. The HER3 expression in developmental odontogenic cysts was higher than that in inflammatory odontogenic cysts. The higher rate of HER3 expression in OKC may justify inherent growth potential, stimulation-independent proliferation capability, invasive growth and high recurrence rate of the cyst accepted today as a tumor.
[Odontogenic and nonodontogenic jaw cysts: experience in 25 cases].
Ağir, Hakan; Sen, Cenk; Işil, Eda; Unal, Ciğdem; Ustündağ, Emre; Keskin, Gürkan
2008-01-01
We retrospectively evaluated the patients with jaw cysts treated at our center. The study included 25 patients (14 males, 11 females; mean age 33+/-19 years; range 7 to 69 years) who underwent surgery for odontogenic or nonodontogenic jaw cysts. The most common presentation was a swelling in the jaw with or without dental problems. Involvement was in the mandible in 18 patients, and in the maxilla in seven patients. The lesions consisted of eight radicular, six dentigerous, two nasoalveolar, two globulomaxillary cysts, and three keratocysts. Four patients had gingival, nasopalatine, residual, and median mandibular cysts, respectively. Marsupialization, curettage, extensive burring, enucleation, or marginal resection were performed depending on pre- and intraoperative findings. The defects were repaired with a corticocancellous iliac bone block graft in three patients and cancellous iliac bone chips in five patients. During a mean follow-up of 14 months (range 12 to 46 months), recurrence was seen in only one patient with a keratocyst. A good preoperative assessment, complete removal of the cystic lesion, and close radiographic follow-up are essential for a successful outcome in jaw cysts. In selected cases, reconstruction of the defects with autogenous corticocancellous iliac bone graft yields highly satisfactory results.
Congenital orbital cysts of neural tissue in two dogs.
Regnier, Alain; Raymond-Letron, Isabelle; Peiffer, Robert L
2008-01-01
A 3-month-old English Cocker Spaniel and a 6-month-old miniature poodle presented with clinical signs related to an abnormal right eye since birth. In both dogs, the right globe could not be identified and was replaced by a fluctuant intraorbital mass covered by a vascularized mucous membrane. Ultrasonography demonstrated that both masses were cystic structures markedly larger in size than the normal contralateral globes. In both cases, surgical excision revealed a multilobular cyst filling the whole orbital cavity. Histopathologic examination and immunostaining for glial fibrillary acid protein and S100 protein supported a diagnosis of neural cysts associated with ocular dysplasia. The definitive diagnosis was congenital cystic eye and microphthalmos with cyst for the Cocker Spaniel and miniature poodle, respectively. Karyotype was normal in both dogs. Congenital cystic eye and microphthalmos with cyst result from defects in early embryonic life that arise following formation of the optic vesicle and prior to closure of the optic fissure. To the authors' knowledge neither has been reported in the canine species. They should be considered in the differential diagnosis of orbital cysts in dogs.
Role of resting cysts in Chilean Alexandrium catenella dinoflagellate blooms revisited.
Mardones, Jorge I; Bolch, Chris; Guzmán, Leonardo; Paredes, Javier; Varela, Daniel; Hallegraeff, Gustaaf M
2016-05-01
The detection of sparse Alexandrium catenella-resting cysts in sediments of southern Chilean fjords has cast doubts on their importance in the recurrence of massive toxic dinoflagellate blooms in the region. The role of resting cysts and the existence of different regional Chilean populations was studied by culturing and genetic approaches to define: (1) cyst production; (2) dormancy period; (3) excystment success; (4) offspring viability and (5) strain mating compatibility. This study newly revealed a short cyst dormancy (minimum 69 days), the role of key abiotic factors (in decreasing order salinity, irradiance, temperature and nutrients) controlling cyst germination (max. 60%) and germling growth rates (up to 0.36-0.52div.day -1 ). Amplified fragment length polymorphism (AFLP) characterization showed significant differences in genetic distances (GD) among A. catenella populations that were primarily determined by the geographical origin of isolates and most likely driven by oceanographic dispersal barriers. A complex heterothallic mating system pointed to variable reproductive compatibility (RCs) among Chilean strains that was high among northern (Los Lagos/North Aysén) and southern populations (Magallanes), but limited among the genetically differentiated central (South Aysén) populations. Field cyst surveys after a massive 2009 bloom event revealed the existence of exceptional high cyst densities in particular areas of the fjords (max. 14.627cystscm -3 ), which contrast with low cyst concentrations (<221.3cystscm -3 ) detected by previous oceanographic campaigns. In conclusion, the present study suggests that A. catenella resting cysts play a more important role in the success of this species in Chilean fjords than previously thought. Results from in vitro experiments suggest that pelagic-benthic processes can maintain year-round low vegetative cell concentrations in the water column, but also can explain the detection of high cysts aggregations after the
Ameloblastomatous Change in Radicular Cyst of The Jaw in a Nigerian Population.
Omoregie, F O; Sede, M A; Ojo, A M
2015-06-01
To determine the incidence, age, gender, jaw-sites and subtypes of radicular cyst, and to determine the incidence of ameloblastomatous change in radicular cyst in a Nigerian population. A 10-year retrospective analysis of all diagnosed orofacial lesions in the Department of Oral Pathology and Medicine, University of Benin Teaching Hospital, Benin City, Nigeria. From the 785 diagnosed orofacial lesions within the study period; there were 54 (6.9%) cases of radicular cysts of the jaws. The peak age group was the 3(rd) decade (n=23, 42.6%) with a mean age of 31 ± 1.7 years. There were 29 (53.7%) males and 25 (46.3%) females, giving a ratio of 1.2:1. The mandible was the commonest jaw-site (n=32, 59.3%). There were 12 (22.2%) cases of periapical cyst which were significantly associated with anterior maxillary site (n=8, 14.8%) [p=0.001]. Seven (13.0%) cases of cystic ameloblastoma were diagnosed among the radicular cysts, with a predilection of the lesions for 3(rd) and 4(th) decades of life (n=6, 11.1%), and posterior mandible (n=5, 9.3%). This study showed a low incidence of radicular cyst of the jaw among orofacial lesions and a relatively higher incidence of ameloblastomatous change in radicular cyst compared to previous reports. Immuno-histochemical examination is recommended to differentiate radicular cyst with ameloblastomatous-like change from cystic ameloblastoma arising from radicular cyst.
Evaluation of collagen in connective tissue walls of odontogenic cysts--a histochemical study.
Vij, Ruchieka; Vij, Hitesh; Rao, Nirmala N
2011-03-01
The purpose of this study was to evaluate the nature of collagen in the connective tissue walls of odontogenic cysts, like the odontogenic keratocyst (OKC), dentigerous cyst and radicular cyst using picrosirius red stained sections. Furthermore, it was intended to assess if the capsular connective tissue can affect the nature of overlying epithelium, thus emphasizing the role of epithelial-mesenchymal interactions in biological behaviour of the cysts. The material for the study included 51 formalin-fixed paraffin-embedded tissue blocks (15 odontogenic keratocyst, 15 dentigerous cysts, 15 radicular cysts and four normal mucosa and two dental follicular tissue as controls), retrieved from the Department of Oral Pathology and Microbiology, MCODS, Manipal. Tissue blocks were sectioned at 5-μm thickness, stained with picrosirius red stain and observed with polarization and light microscopy. Few sections of OKC and dentigerous cyst exhibited greenish-yellow birefringence in sub-epithelial region, whereas others showed a yellowish-orange birefringence under polarization microscopy. Most radicular cysts had yellowish-orange to orange birefringence. Shift in colour in case OKC and dentigerous cyst was attributed to the presence of inflammation in those sections. These regions also exhibited either a change in phenotype or thickness of overlying epithelium. This technique can be used to study the nature of collagen fibres in odontogenic cyst walls. Further studies with an increased sample size and using various epithelial and mesenchymal markers and ssDNA antibodies should be carried out to confirm the effect of epithelial-mesenchymal interactions on the nature of epithelium of odontogenic cysts. © 2010 John Wiley & Sons A/S.
Sclerotherapy of renal cysts using acetic acid: a comparison with ethanol sclerotherapy.
Cho, D S; Ahn, H S; Kim, S I; Kim, Y S; Kim, S J; Jeon, G S; Won, J H
2008-12-01
This study compared percutaneous sclerotherapy using 50% acetic acid with that using 99% ethanol for patients with simple renal cysts. The study included 72 simple renal cysts in 64 patients (male/female ratio = 31/33; age range, 31-75 years). Under fluoroscopic guidance, the cyst fluid was aspirated completely. Sclerotherapy was then performed using 50% acetic acid for 32 cysts and 99% ethanol for 40 cysts. The volumes of each renal cyst before and after sclerotherapy were compared using ultrasonography or CT. Medical records were reviewed to analyse any complications. The mean follow-up period was 21.5 months (range, 3-75 months). The mean remnant volume of the cyst after sclerotherapy was 2.6% of the initial volume in the acetic acid group and 14.0% in the ethanol group. The rates of complete remission, partial remission and treatment failure were 90.6%, 9.4% and 0%, respectively, in the acetic acid group, and 60.0%, 30.0% and 10.0%, respectively, in the ethanol group. There were no complications related to sclerotherapy in either group. In conclusion, acetic acid is a safe and effective sclerosing agent, with clinical results superior to those of ethanol, and is an alternative to ethanol for sclerotherapy of renal cysts.
Ciliates from ancient permafrost: Assessment of cold resistance of the resting cysts.
Shatilovich, Anastasia; Stoupin, Daniel; Rivkina, Elizaveta
2015-06-01
There is evidence that resting cysts of soil ciliates and numerous taxa of other protists can survive in permafrost for thousands of years at subzero temperatures; however, our knowledge about mechanisms of long term cryobiosis remains incomplete. In order to better understand the means by which ancient cysts survive, we investigated resistance to cyclical supercooling stress of resting cysts of the soil ciliate Colpoda steinii (Colpodida, Ciliophora). Three clonal strains were used for comparison, isolated from Siberian tundra soil, ancient Holocene (5-7,000 y) and late Pleistocene (32-35,000 y) permafrost sediments. To determine the viability of the ancient and contemporary ciliate cysts we improved and validated a cultivation-independent method of vital fluorescent staining with a combination of two nucleic acid binding dyes, acridine orange and propidium iodide. The viability of Colpoda steinii cysts during low-temperature experiments was measured using both the proposed vital fluorescent staining method and standard germination test. Our results indicate that the dual-fluorescence technique is a more accurate, rapid, and efficient method for estimating cyst viability. We found that cysts of ancient ciliates display lower tolerance to the impact of cyclical cold compared to cysts of contemporary ciliates from Siberian permafrost affected soils. Copyright © 2015 Elsevier GmbH. All rights reserved.
Trichilemmal cyst nevus: a new complex organoid epidermal nevus.
Tantcheva-Poor, Iliana; Reinhold, Katja; Krieg, Thomas; Happle, Rudolf
2007-11-01
A 31-year-old woman had an organoid nevus characterized by multiple trichilemmal cysts arranged in a bandlike pattern. The involved streaks followed Blaschko's lines and were covered, in addition, by multiple filiform hyperkeratoses and comedo-like plugs. Some histopathologic features of this complex nevus were reminiscent of those of well-established organoid nevi such as nevus comedonicus, porokeratotic eccrine nevus, or hair follicle nevus, but the presence of multiple large trichilemmal cysts was a conspicuously distinctive abnormality. Consequently, we propose for this new organoid nevus the names "trichilemmal cyst nevus" or "nevus trichilemmocysticus."
Laparoscopic excision of an epidermoid cyst arising from the deep abdominal wall.
Ishikawa, Hajime; Nakai, Takuya; Ueda, Kazuki; Haji, Seiji; Takeyama, Yoshifumi; Ohyanagi, Harumasa
2009-10-01
Epidermoid cysts are the most common type of cutaneous cyst. However, their occurrence in the deep abdominal wall has not yet been reported. Here, we present the case of a 60-year-old woman who developed an epidermoid cyst in the deep abdominal wall, which was resected laparoscopically. The patient presented with right upper quadrant abdominal pain on admission to our hospital. Computed tomography revealed cholecystolithiasis and an incidentally identified well-defined hypoattenuating mass (62 x 47 x 65 mm) in the deep abdominal wall on the left side of the navel. We performed laparoscopic complete resection of the abdominal wall tumor followed by cholecystectomy. The excised specimen was a cyst covered with a smooth thin membrane and contained sludge. Histopathologic examination revealed an epidermoid cyst. This is a very rare case with no previous reports on a similar type of epidermoid cyst.
Fatal Liver Cyst Rupture Due to Anabolic Steroid Use: A Case Presentation.
Hansma, Patrick; Diaz, Francisco J; Njiwaji, Chantel
2016-03-01
Liver cysts are commonly found incidentally from imaging scans or at autopsy. These benign neoplasms vary in size and represent a heterogeneous group of disorders, for which the demographics, risk factors, apparent inciting event, clinical presentation, and outcome are varied. Complications that can develop from a liver cyst include development of spontaneous hemorrhage, infection, and/or obstruction. Although the etiology of liver cysts varies, fatal rupture of a hemorrhagic liver cyst due to anabolic steroid use is a rare occurrence. In fact, there are few reported cases in journal literature. We report a case of a fatal liver cyst rupture with resultant hemoperitoneum in the presence of anabolic steroid (stanozolol) use.
Reduction rate by decompression as a treatment of odontogenic cysts.
Oliveros-Lopez, L; Fernandez-Olavarria, A; Torres-Lagares, D; Serrera-Figallo, M-A; Castillo-Oyagüe, R; Segura-Egea, J-J; Gutierrez-Perez, J-L
2017-09-01
Odontogenic cysts are defined as those cysts that arise from odontogenic epithelium and occur in the tooth-bearing regions of the jaws. Cystectomy, marsupialization or decompression of odontogenic cyst are treatment approach to this pathology. The aim of this study was to evaluate the effectiveness of the decompression as the primary treatment of the cystic lesions of the jaws and them reduction rates involving different factors. 23 patients with odontogenic cysts of the jaws, previously diagnosed by anatomical histopathology (follicular cysts (7) and radicular cysts (16)) underwent decompression as an initial treatment. Clinical examination and pre and post panoramic radiograph were measured and analyzed. In addition, data as gender, age, time reduction and location of the lesion were collected. Significant results were obtained in relation to the location of lesions and the reduction rate (p<0.01). In a higher initial lesion, a greater reduction rate was observed (p<0.05). Decompression as an initial treatment of cystic lesions of the jaws was effective; it reduces the size of the lesions avoiding a possible damage to adjacent structures. Cystic lesions in the mandible, regardless of the area where they occur will have a higher reduction rate if it is compared with the maxilla. Similar behavior was identified in large lesions compared to smaller.
c-Myc oncogene expression in selected odontogenic cysts and tumors: An immunohistochemical study
Moosvi, Zama; Rekha, K
2013-01-01
Aim: To investigate the role of c-Myc oncogene in selected odontogenic cysts and tumors. Materials and Methods: Ten cases each of ameloblastoma, adenomatoid odontogenic tumor (AOT), odontogenic keratocyst (OKC), dentigerous cyst, and radicular cyst were selected and primary monoclonal mouse anti-human c-Myc antibody was used in a dilution of 1: 50. Statistical Analysis was performed using Mann Whitney U test. Results: 80% positivity was observed in ameloblastoma, AOT and OKC; 50% positivity in radicular cyst and 20% positivity in dentigerous cyst. Comparison of c-Myc expression between ameloblastoma and AOT did not reveal significant results. Similarly, no statistical significance was observed when results of OKC were compared with ameloblastoma and AOT. In contrast, significant differences were seen on comparison of dentigerous cyst with ameloblastoma and AOT and radicular cyst with AOT. Conclusion: From the above data we conclude that (1) Ameloblastoma and AOT have similar proliferative potential and their biologic behavior cannot possibly be attributed to it. (2) OKC has an intrinsic growth potential which is absent in other cysts and reinforces its classification as keratocystic odontogenic tumor. PMID:23798830
Forensic Identification of Bipartite Patella Misdiagnosed as Patella Fracture.
Ma, Jingyuan; Shi, Fang; Huang, Chongya; Gu, Shanzhi
2017-07-01
Bipartite patella is recognized as a developmental anomaly of ossification. Most of them are asymptomatic and are discovered incidentally. Bipartite patella is sometimes misdiagnosed as a patella fracture, because the x-ray images of both these conditions may appear very similar. In this case, the patient complained of left knee pain after x-ray films revealed a fracture-like line in the left patella. The patient was then diagnosed as having a patella fracture. In China, the injury degree is categorized as serious injury, minor injury, and trivial injury. As the injury degree of patellar fracture is identified as minor injury, the defendant who injured the patient will be sentenced to prison for ≤3 years. However, the defendant objected to this judgment and applied for the second evaluation of injury degree. On the basis of the site of injury, clinical manifestations, and imaging findings, we diagnosed the patient with bipartite patella which belongs to normal anatomic variant. Therefore, the injury degree of the patient was not minor injury. © 2017 American Academy of Forensic Sciences.
Ectopic Thymic Cyst of the Subglottis: Considerations for Diagnosis and Management.
Ahmad, Iram; Kirby, Patricia; Liming, Bryan
2018-03-01
To share the diagnostic and management challenges created by an extremely rare airway lesion-the subglottic ectopic thymic cyst. Case report and literature review. We review the presentation, management, and clinical course of an infant who presented with a subglottic mass that was histologically confirmed as a thymic cyst. A brief literature review supplements the case presentation Results: We present the third described case of an ectopic thymic cyst presenting as a subglottic mass. The differential diagnosis of subglottic masses in neonates consists primarily of subglottic hemangioma and mucous retention cysts. Otolaryngologists must be prepared for unexpected findings when dealing with critical airways. We compare the presentation and management of our patient with the 2 previously described cases. We propose an embryologic theory for the origin of these rare lesions. An ectopic thymic cyst is a rare and unexpected cause of neonatal stridor. Management of pediatric airway lesions must allow for unexpected findings at the time of diagnostic and therapeutic endoscopy. The appropriate management of subglottic thymic cysts is poorly defined, but close surveillance for recurrence is mandatory.
Sensitivity of free-living amoeba trophozoites and cysts to water disinfectants.
Dupuy, Mathieu; Berne, Florence; Herbelin, Pascaline; Binet, Marie; Berthelot, Nelsie; Rodier, Marie-Hélène; Soreau, Sylvie; Héchard, Yann
2014-03-01
Free-living amoebae are naturally present in water. These protozoa could be pathogenic and could also shelter pathogenic bacteria. Thus, they are described as a potential hazard for health. Also, free-living amoebae have been described to be resistant to biocides, especially under their cyst resistant form. There are several studies on amoeba treatments but none of them compare sensitivity of trophozoites and cysts from different genus to various water disinfectants. In our study, we tested chlorine, monochloramine and chlorine dioxide on both cysts and trophozoites from three strains, belonging to the three main genera of free-living amoebae. The results show that, comparing cysts to trophozoites inactivation, only the Acanthamoeba cysts were highly more resistant to treatment than trophozoites. Comparison of the disinfectant efficiency led to conclude that chlorine dioxide was the most efficient treatment in our conditions and was particularly efficient against cysts. In conclusion, our results would help to adapt water treatments in order to target free-living amoebae in water networks. Copyright © 2013 Elsevier GmbH. All rights reserved.
Regional cyst concentration as a prognostic biomarker for polycystic kidney disease
NASA Astrophysics Data System (ADS)
Warner, Joshua D.; Irazabal, Maria V.; Torres, Vicente E.; King, Bernard F.; Erickson, Bradley J.
2014-03-01
Polycystic kidney disease (PKD) is a major cause of renal failure. Despite recent advances in understanding the biochemistry and genetics of PKD, the functional mechanisms underpinning the declines in renal function observed in the disorder are not well established. No studies investigating the distribution of cysts within polycystic kidneys exist. This work introduces regional cyst concentration as a new biomarker for evaluation of patients suffering from PKD. We derive a method to define central and peripheral regions of the kidney, approximating the anatomical division between cortex and medulla, and apply it to two cohorts of ten patients with early/mild or late/severe disease. Our results from the late/severe cohort show peripheral cyst concentration correlates with the current standard PKD biomarker, total kidney volume (TKV), signi cantly better than central cyst concentration (p < 0.05). We also find that cyst concentration was globally increased in the late/severe cohort (p << 0.01) compared to the early/mild cohort, for both central and peripheral regions. These findings show cysts in PKD are not distributed homogeneously throughout the renal tissues.
Endoscopic management of intrabiliary-ruptured hepatic hydatid cyst.
Singh, Virendra; Reddy, Deevaguntla Chandrasekhar; Verma, Ganga Ram; Singh, Gurpreet
2006-06-01
Intrabiliary rupture of hepatic hydatid cyst causes serious morbidity and mortality. These patients are usually managed surgically. We evaluated the feasibility and outcome of an alternative method of treatment of these patients. Seven patients with ruptured hepatic hydatid into the biliary tract underwent endoscopic treatment consisting of endoscopic sphincterotomy, cyst material extraction and hypertonic saline lavage via nasocystic catheter. Median age of patients was 40 years (range 17-50 years) with a male:female ratio of 2:5. Abdominal pain, jaundice and fever were seen in all patients. Six out of seven patients were positive for hydatid serology. All patients were successfully treated by endoscopic sphincterotomy, clearance of cyst material and hypertonic saline lavage. On a follow-up of 6 months to 4 years (median, 3.5 years), ultrasonography, computed tomography of the abdomen and magnetic resonance imaging of the abdomen showed a complete cure. There were no complications related to procedure. This study demonstrates endoscopic treatment as one of the therapeutic options of ruptured hepatic hydatid cyst into the biliary tract.
Percutaneous Method of Management of Simple Bone Cyst
Lakhwani, O. P.
2013-01-01
Introduction. Simple bone cyst or unicameral bone cysts are benign osteolytic lesions seen in metadiaphysis of long bones in growing children. Various treatment modalities with variable outcomes have been described in the literature. The case report illustrates the surgical technique of minimally invasive method of treatment. Case Study. A 14-year-old boy was diagnosed as active simple bone cyst proximal humerus with pathological fracture. The patient was treated by minimally invasive percutaneous curettage with titanium elastic nail (TENS) and allogenic bone grafting mixed with bone marrow under image intensifier guidance. Results. Pathological fracture was healed and allograft filled in the cavity was well taken up. The patient achieved full range of motion with successful outcome. Conclusion. Minimally invasive percutaneous method using elastic intramedullary nail gives benefit of curettage cyst decompression and stabilization of fracture. Allogenic bone graft fills the cavity and healing of lesion by osteointegration. This method may be considered with advantage of minimally invasive technique in treatment of benign cystic lesions of bone, and the level of evidence was therapeutic level V. PMID:23819089
Lopes, Cristiane Barbosa; Armada, Luciana; Pires, Fábio Ramôa
2018-07-01
The aim of the present study was to compare the immunoexpression of CD34, intercellular adhesion molecule-1 (ICAM-1), and podoplanin and the presence of mast cells with clinical, demographic, radiologic, and histologic features from periapical granulomas, periapical cysts, and residual cysts. Thirty-one lesions (5 granulomas, 15 periapical cysts, and 11 residual cysts) were selected. Histologic sections in silanized slides were used for the immunohistochemical reactions. The analysis of the images was performed by using an optical microscope, and data were analyzed with 5% significance (P < .05). Cysts presented atrophic and hyperplastic epithelium in 11 cases (35.5%) and 15 cases (48.8%), respectively (P > .05). The intensity of the inflammatory infiltrate was similar when comparing the 3 groups (P > .05). CD34 and podoplanin expression and the presence of mast cells were similar when comparing the 3 groups; ICAM-1 expression was more intense in granulomas than cysts (P < .05). There were no statistically significant differences associated with the expression