Unicameral bone cysts: comparison of percutaneous curettage, steroid, and autologous bone marrow injections.

PubMed

Canavese, Federico; Wright, James G; Cole, William G; Hopyan, Sevan

2011-01-01

The purpose of this study was to compare the outcome of percutaneous curettage with intralesional injection of methylprednisolone and bone marrow for unicameral bone cysts (UBCs). This was a retrospective review of 46 children and adolescents with UBC treated with autologous bone marrow injection, methylprednisolone acetate injection or percutaneous curettage alone. Inclusion criteria were a radiological diagnosis of UBC and at least 24 months follow-up from the last procedure. Healing was determined using Neer/Cole 4-grades rating scale. The 3 treatment groups were comparable with regard to age, sex, location of the cyst, and the number of procedures undertaken. At 2 years follow-up, the proportion of patients with satisfactory healing (Neer/Cole grades I and II) was greatest among those who underwent percutaneous curettage (70%) compared with bone marrow injection (21%) and methylprednisolone acetate injection (41%) (P = 0.03). We found no association between healing and age (P = 0.80) nor between healing and sex (P = 0.61). These results suggest that mechanical disruption of the cyst membrane may be helpful in healing of cysts and that this technique may be preferred to simple intralesional injections. Level III.

Unicameral (simple) and aneurysmal bone cysts: the effect of insufficient curettage on recurrence.

PubMed

Çelik, Suat; Uludağ, Abuzer; Tosun, Hacı Bayram; Serbest, Sancar; Gürger, Murat; Kılıç, Sabahattin

2016-01-01

Curettage of the cyst and bone grafting are the most common methods used in the treatment of unicameral bone cysts (UBC) and aneurysmal bone cysts (ABC). Recurrence of these cysts is often associated with insufficient curettage of the cyst during surgery. In this study, we aimed to evaluate the effect of insufficient curettage on recurrence in patients with UBC and ABC. The retrospective study included 18 patients with UBC and 14 patients with ABC that were surgically treated by curettage and bone grafting in our clinic between 2006-2013. Mean age was 19.80 (range, 4-50) years in the patients with UBC and 21.76 (range, 4-56) in the patients with ABC. The diagnosis of the cysts was established both clinically and radiologically. Mean follow-up period was 36 (range, 6-60) months both in the patients with UBC and ABC. The patients with recurrence underwent a second curettage and grafting procedure. Healing and recurrence were evaluated according to modified Neer's scale. Recurrence occurred in 8 patients. Of these, 5 patients underwent a second curettage and grafting procedure and 3 patients were lost to follow-up. Complete healing occurred in all the patients that underwent a second curettage and grafting procedure. The achievement of complete healing in the patients that underwent a second curettage and grafting procedure indicates that the recurrence of UBC and ABC is associated with insufficient curettage.

Unicameral bone cyst of the humeral head: arthroscopic curettage and bone grafting.

PubMed

Randelli, Pietro; Arrigoni, Paolo; Cabitza, Paolo; Denti, Matteo

2009-01-01

Arthroscopic surgery has improved greatly over the past decade. Treatment of various juxta-articular disorders around the shoulder have benefited from endoscopic approaches. Cystic lesions of the shoulder on the scapular side have been treated in this way. This article describes a case of a 29-year-old patient with a unicameral bone cyst on the posterior aspect of the humeral head. Arthroscopic visualization using an accessory posteroinferior portal localized the cyst through the bare area of the humeral head. A cannulated burr was used to create an opening through the cortical wall between the cyst and the joint, and a careful curettage was performed. The cavity was filled with a demineralized bone matrix enriched with autologous blood packed into an arthroscopic cannula and delivered through the accessory portal. The patient reported pain relief immediately postoperatively and at follow-up. This case demonstrates the feasibility of arthroscopic treatment of a simple bone cyst of the humeral head. We believe that the knowledge of the juxta-articular anatomy allows the applications of scope-assisted procedures to be expanded, maximizing the results of a technique that allows a shorter recovery and less painful rehabilitation.

Unicameral (simple) and aneurysmal bone cysts: the effect of insufficient curettage on recurrence

PubMed Central

Çelik, Suat; Uludağ, Abuzer; Tosun, Hacı Bayram; Serbest, Sancar; Gürger, Murat; Kılıç, Sabahattin

2016-01-01

Introduction Curettage of the cyst and bone grafting are the most common methods used in the treatment of unicameral bone cysts (UBC) and aneurysmal bone cysts (ABC). Recurrence of these cysts is often associated with insufficient curettage of the cyst during surgery. In this study, we aimed to evaluate the effect of insufficient curettage on recurrence in patients with UBC and ABC. Methods The retrospective study included 18 patients with UBC and 14 patients with ABC that were surgically treated by curettage and bone grafting in our clinic between 2006-2013. Mean age was 19.80 (range, 4-50) years in the patients with UBC and 21.76 (range, 4-56) in the patients with ABC. The diagnosis of the cysts was established both clinically and radiologically. Mean follow-up period was 36 (range, 6-60) months both in the patients with UBC and ABC. The patients with recurrence underwent a second curettage and grafting procedure. Healing and recurrence were evaluated according to modified Neer's scale. Results Recurrence occurred in 8 patients. Of these, 5 patients underwent a second curettage and grafting procedure and 3 patients were lost to follow-up. Complete healing occurred in all the patients that underwent a second curettage and grafting procedure. Conclusion The achievement of complete healing in the patients that underwent a second curettage and grafting procedure indicates that the recurrence of UBC and ABC is associated with insufficient curettage. PMID:28154666

Epidermoid cyst of the external auditory canal in children: diagnosis and management.

PubMed

Abdel-Aziz, Mosaad

2011-07-01

Epidermoid cyst of the external auditory canal (EAC) is rarely encountered in the clinical practice, but when it occurs, it may cause obstruction of the meatus that necessitates surgical excision. The aims of this study were to present 9 pediatric patients with epidermoid cysts of the EAC and to evaluate the outcome of the surgical technique that has been used in excision. Surgical removal of the cyst was carried out through a simple transmeatal approach, a medially based rectangular skin flap was elevated and the cyst was completely removed. No complications or recurrence have been reported. Epidermoid cyst should be listed in the differential diagnosis of EAC masses; it appears on computed tomography as a cystic mass in the outer cartilaginous part of EAC that is usually limited to the soft tissue with no bone erosion. It can be removed easily through simple transmeatal approach with high success rate and no morbidity.

Diagnosing aneurysmal and unicameral bone cysts with magnetic resonance imaging.

PubMed

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.

Treatment of a Simple Bone Cyst Using a Cannulated Hydroxyapatite Pin

PubMed Central

Shirai, Toshiharu; Tsuchiya, Hiroyuki; Terauchi, Ryu; Tsuchida, Shinji; Mizoshiri, Naoki; Ikoma, Kazuya; Fujiwara, Hiroyoshi; Miwa, Shinji; Kimura, Hiroaki; Takeuchi, Akihiko; Hayashi, Katsuhiro; Yamamoto, Norio; Kubo, Toshikazu

2015-01-01

Abstract Simple bone cysts (SBCs) are benign bone tumors. However, the treatment of SBCs remains controversial because of their healing rate and the invasiveness of surgery. The purpose of the present study was to evaluate the treatment of SBCs using a cannulated hydroxyapatite (HA) pin. A total of 43 patients (35 males, 8 females; mean age 12.1 years; age range, 5–22 years) with SBCs were treated with continuous decompression by inserting ceramic HA pins between 1989 and 2014. The SBCs were located in the calcaneus in 23, the humerus in 15, the femur in 3, and the pelvis in 2 cases. In all patients, minimal fenestration of the cyst wall and curettage and multiple drilling in the cyst wall were performed, followed by insertion of the HA pin. The mean follow-up period was 26.6 months. Operating time, healing period, risk factors for recurrence, and the cure rate were evaluated. Healing was achieved without intervention in 38 patients after a mean of 6.4 months. Two patients had persistent small residual cysts, which had no changes after 1 year at the latest follow-up. There were 5 patients with recurrences (humerus 4, femur 1), who were cured by curettage and artificial bone grafting. The final healing rate by cannulation only using an HA pin was 88.2%. On Fisher exact test, age, site of SBCs, and distance from the physis were found to be significantly associated with SBC recurrence (P < 0.05). In the present study, cannulation using an HA pin for SBCs was found to be a useful technique, particularly for calcaneal cysts, because it is a minimally invasive procedure with a high cure rate. In patients <10 years, involvement of the humerus and contact with the growth plate were significant risk factors for SBC recurrence. PMID:26107670

Cystic fibrous dysplasia in the long bone.

PubMed

Bahk, Won-Jong; Kang, Yong-Koo; Rhee, Seung-Koo; Chung, Yang-Guk; Lee, An-Hee; Bahk, Yong-Whee

2007-10-01

Prominent osteolysis associated with "ground glass" density of fibrous dysplasia may indicate cystic change or sarcomatous transformation. This complication has been reported only sporadically in the long bones. This article presents clinical, radiographic, and pathologic findings, and outcome of simple curettage and bone graft observed in a series of 8 patients with prominent cystic fibrous dysplasia of the long bone. Magnetic resonance imaging features provide a basis for separation of benign cystic change from malignant transformation. However, biopsy is necessary to distinguish nonspecific cystic degeneration from secondary aneurysmal bone cyst. Simple curettage with allo-chip-bone graft is an effective treatment for cystic fibrous dysplasia.

Evaluation of Spontaneous Bone Regeneration after Enucleation of Large Cysts of the Jaws using Radiographic Computed Software.

PubMed

Wagdargi, Shivaraj S; Rai, Kirthi Kumar; Arunkumar, K V; Katkol, Basavraj; Arakeri, Gururaj

2016-06-01

Spontaneous regeneration of bone is commonly seen in the small surgical defects caused by enucleation of cysts. However, in case of large surgical defects caused by the enucleation, spontaneous regeneration of bone is a rare phenomenon and it depends on factors, such as age of the patient, intact periosteum, and proper stabilization. The study included 16 patients, who reported to the department of oral and maxillofacial surgery with the complaint of pain and swelling in the jaws diagnosed as cyst. The sample included equal numbers of male and female subjects aged between 15 and 40 years. Panoramic radiographs were taken pre- and postoperatively on day 2 of the enucleation. The dimensions of the cyst were evaluated on the radiograph according to the proforma. Subsequent radiographs were taken at regular intervals of 1.5, 3, and 6 months using standard parameters and were analyzed using MCID™ analysis software of imaging research. Mean reduction was seen in up to 39 and 60% in the cystic cavity size and increase in the mean density up to 59 and 90.2% at 3 and 6 months intervals respectively. Spontaneous bone regeneration was seen even after primary closure of the large cystic defect without the need for placement of foreign substances or grafts and it also eliminated the complications resulting from placement of foreign substance. Further studies are required in a larger sample with longer follow-up durations to confirm the outcome of the present work for the benefit of patients. The present study depicted that spontaneous bone regeneration can occur with accepted results after simple enucleation of jaw cyst without the aid of any graft material. Hence, simple enucleation may be considered as a first line of treatment modality for cystic lesion of the jaws. This simplifies the surgical procedure, decreases the economic and biologic costs, and reduces the risk of postoperative complications. Follow-up is necessary along with patient's compliance for the success of treatment.

Pathologic fracture of the distal radius in a 25-year-old patient with a large unicameral bone cyst.

PubMed

Massen, Felix; Baumbach, Sebastian; Volkmer, Elias; Mutschler, Wolf; Grote, Stefan

2014-06-13

Distal radius fractures (DRF) are often referred to as osteoporosis indicator fractures as their incidence increases from age 45. In the group of young adults, distal radius fractures normally result from high-energy trauma. Wrist fractures in young patients without adequate trauma thus raise suspicion of a pathologic fracture. In this report we present the case of a fractured unicameral bone cyst (UBC) at the distal radius in a young adult.To the author's best knowledge, this is the first detailed report in an UBC at the distal radius causing a pathologic DRF in an adult patient. A 25-year-old otherwise healthy male presented to our Emergency Department after a simple fall on his right outstretched hand. Extended diagnostics revealed a pathologic, dorsally displaced, intra-articular distal radius fracture secondary to a unicameral bone cyst occupying almost the whole metaphysis of the distal radius. To stabilize the fracture, a combined dorsal and volar approach was used for open reduction and internal fixation. A tissue specimen for histopathological examination was gathered and the lesion was filled with an autologous bone graft harvested from the ipsilateral femur using a reamer-irrigator-aspirator (RIA) system. Following one revision surgery due to an intra-articular step-off, the patient recovered without further complications. Pathologic fractures in young patients caused by unicameral bone cysts require extended diagnostics and adequate treatment. A single step surgical treatment is reasonable if fracture and bone cyst are treated appropriately. Arthroscopically assisted fracture repair may be considered in intra-articular fractures or whenever co-pathologies of the carpus are suspected.

A study of 23 unicameral bone cysts of the calcaneus: open chip allogeneic bone graft versus percutaneous injection of bone powder with autogenous bone marrow.

PubMed

Park, Il-Hyung; Micic, Ivan Dragoljub; Jeon, In-Ho

2008-02-01

The treatment of unicameral bone cyst varies from percutaneous needle biopsy, aspiration and local injection of steroid, autologous bone marrow, or demineralized bone matrix to curettage and open bone-grafting. The purpose of this study was to compare the results of open chip allogeneic bone graft versus percutaneous injection of demineralized bone powder with autogenous bone marrow in management of calcaneal cysts. Twenty-three calcaneal unicameral cysts in 20 patients were treated. Lyophilized irradiated chip allogeneic bone (CAB) and autogenous bone marrow were used for treatment of 13 cysts in 11 patients, and 10 cysts in 9 patients were treated with percutaneous injection of irradiated allogeneic demineralized bone powder (DBP) and autogenous bone marrow. There were 11 males and 9 female patients with mean age of 17 years. The patients were followed for an average of 49.4 months. Complete healing was achieved in 9 cysts treated with chip allogeneic bone and in 5 cysts treated with powdered bone. Four cysts treated with CAB and 3 cysts treated with DBP healed with a defect. Two cysts treated with powdered bone and autogenous bone marrow were classified as persistent. No infections or pathological fractures were observed during the followup period. Percutaneous injection of a mixture of allogeneic bone powder with autogenous bone marrow is a minimal invasive method and could be an effective alternative in the treatment of unicameral calcaneal bone cysts. The postoperative morbidity was low, the hospital stay was brief, and patient's comfort for unrestricted activity was enhanced.

[Epidermal cyst and osteolysis of the cranial vault].

PubMed

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.

Assessment of spontaneous resolution of idiopathic bone cavity.

PubMed

Battisti, Maíra de Paula Leite; Soares, Mariana Quirino Silveira; Rubira, Cássia Maria Fischer; Bullen, Izabel Regina Fischer Rubira de; Lauris, José Roberto Pereira; Damante, José Humberto

2018-01-01

Idiopathic Bone Cavity (IBC) or Simple Bone Cyst (SBC) is a non- epithelialized bone cavity with serosanguinous fluid content or empty. There is a literature debate regarding its pathogenesis that remains unclear. The main treatment option is the surgical exploration, although there are successful cases described in the literature in which just a follow-up with clinical and radiographic evaluation was performed. Objective This study aimed to assess the spontaneous resolution of idiopathic bone cavity untreated by surgery. Material and Methods Twenty-one patients diagnosed with surgically untreated IBC were submitted to a follow-up protocol modified from Damante, Guerra, and Ferreira5 (2002). A clinical and radiographic evaluation was performed in 13 patients (13/21), while eight patients (8/21) were only radiographically evaluated. Three observers evaluated the panoramic radiographs of 21 patients and the Kappa test was performed by intra and inter-examiners. Inductive and descriptive statistics were applied to the results. Results Only one patient had a positive response to palpation and percussion of the teeth in the cyst area. Most of the cysts evaluated were rated as 3 (lesion "in involution"), 4 (lesion "almost completely resolved"), or 5 ("completely resolved"). Conclusions We observed progressive spontaneous resolution of IBC. Most cysts were found in the recovery process in different follow-up periods. Patient's follow-up, without surgery, may be considered after the diagnosis based on epidemiological, clinical, and radiographic features of the lesion.

Management strategy for unicameral bone cyst.

PubMed

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.

Pathologic fracture of the distal radius in a 25-year-old patient with a large unicameral bone cyst

PubMed Central

2014-01-01

Background Distal radius fractures (DRF) are often referred to as osteoporosis indicator fractures as their incidence increases from age 45. In the group of young adults, distal radius fractures normally result from high-energy trauma. Wrist fractures in young patients without adequate trauma thus raise suspicion of a pathologic fracture. In this report we present the case of a fractured unicameral bone cyst (UBC) at the distal radius in a young adult. To the author’s best knowledge, this is the first detailed report in an UBC at the distal radius causing a pathologic DRF in an adult patient. Case presentation A 25-year-old otherwise healthy male presented to our Emergency Department after a simple fall on his right outstretched hand. Extended diagnostics revealed a pathologic, dorsally displaced, intra-articular distal radius fracture secondary to a unicameral bone cyst occupying almost the whole metaphysis of the distal radius. To stabilize the fracture, a combined dorsal and volar approach was used for open reduction and internal fixation. A tissue specimen for histopathological examination was gathered and the lesion was filled with an autologous bone graft harvested from the ipsilateral femur using a reamer-irrigator-aspirator (RIA) system. Following one revision surgery due to an intra-articular step-off, the patient recovered without further complications. Conclusions Pathologic fractures in young patients caused by unicameral bone cysts require extended diagnostics and adequate treatment. A single step surgical treatment is reasonable if fracture and bone cyst are treated appropriately. Arthroscopically assisted fracture repair may be considered in intra-articular fractures or whenever co-pathologies of the carpus are suspected. PMID:24925068

Treatment outcomes of the simple bone cyst: A comparative study of 2 surgical techniques using artificial bone substitutes.

PubMed

Higuchi, Takashi; Yamamoto, Norio; Shirai, Toshiharu; Hayashi, Katsuhiro; Takeuchi, Akihiko; Kimura, Hiroaki; Miwa, Shinji; Abe, Kensaku; Taniguchi, Yuta; Tsuchiya, Hiroyuki

2018-05-01

Simple bone cysts (SBCs) are benign lesions of unknown etiology. Because of its high relapse rate, they occasionally need a long period of treatment and restriction of activities in children and adolescent. Although various treatment modalities with variable differing outcomes have been described in the literature, no consensus has been reached regarding the standard treatment. The purpose of this study was to evaluate the outcome of a minimally invasive technique that uses a ceramic hydroxyapatite cannulated pin (HA pin) for the treatment of SBCs.Between 1998 and 2015, we have treated 75 patients with SBCs either with continuous decompression by inserting HA pins after curettage and multiple drilling (group 1, n = 39 patients) or with calcium phosphate cement (CPC) filling after curettage (group 2, n = 36 patients). These patients were retrospectively analyzed for recurrence-free survival (RFS) and factors implicated in SBC recurrence.Seventy-five patients (50 man and 25 females) with a mean age of 17.5 ± 11.6 years and a histopathologically confirmed diagnosis of SBCs were included. The mean follow-up period was 33 ± 25.3 months. RFS were 88% at 1 year and 81% at 5 years. Residual or progressing cysts were observed in 12 patients after the surgery and 10 of them underwent additional surgery. Recurrence rate was significantly higher in patients under the age of 10 years (P = .01), in long bone cysts (P = .01), and in active phase cysts (P = .003) (log-rank test). Multivariate analysis results revealed that age less than 10 years was an independent risk factor of recurrence (P = .04). No significant difference in recurrence rate was observed between groups 1 and 2. However, the mean operating time was significantly shorter in group 1. (62.4 ± 25.6 vs 110.5 ± 48.4 minutes in group 2).Continuous decompression using HA pin is a less invasive surgical technique for the treatment of SBCs compared with CPC filling and has a high healing rate. The relapse rate was still high when the cysts were caused in children aged less than 10 years, located in the long bone, or remained adjacent to the epiphysis. Level 3, Retrospective comparative study.

Application of three-dimensional rendering in joint-related ganglion cysts.

PubMed

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 with standard MR imaging. We believe that these joint-related cysts have a common pathogenesis; they dissect through a capsular rent and follow the path of least resistance; they may form simple cysts by dissecting out into the soft tissue, or more complex cysts by dissecting within the epineurium of nerves or adventitia of vessels (along an articular branch), or various combinations of all of these types of cysts. Understanding the pathogenesis for cyst formation will improve surgical management and outcomes. We have adapted this 3D technique to enhance the visualization of cysts occurring at other joints.

Bilateral diaphyseal bone cysts of the tibia mimicking shin splints in a young professional athlete--a case report and depiction of a less-invasive surgical technique.

PubMed

Toepfer, Andreas; Harrasser, Norbert; Lenze, Ulrich; Liska, Franz; Mühlhofer, Heinrich; von Eisenhart-Rothe, Rüdiger; Banke, Ingo J

2015-08-23

Medial tibial stress syndrome is one of the most common causes of exertional leg pain in runners whereas musculoskeletal tumors and tumor-like lesions are rare encounters in orthopedic sports medicine practice. Unicameral (simple) bone cyst is a well-known tumor-like lesions of the bone typically affecting children and adolescents. Bilateral occurrence is very rare though and has never been reported before in both tibiae. Failing to accurately diagnose a tumorous lesion can entail far-reaching consequences for both patients and physicians. We report the case of large bilateral unicameral bone cysts of the diaphyseal tibiae mimicking medial tibial stress syndrome in a 17-year old professional athlete. This is the first report of symmetric tibial unicameral bone cysts in the literature. The patient complained about persisting shin splint-like symptoms over 5 months despite comprehensive conservative treatment before MRI revealed extensive osteolytic bone lesions in both diaphyseal tibiae. The patient-tailored, less-invasive surgical procedure, allowing the patient to return to his competitive sports level symptom-free 3 months after surgery and to eventually qualify for this years Biathlon Junior World Championships, is outlined briefly. Pathogenesis and various treatment options for this entity will be discussed. This report will help to raise awareness for musculoskeletal tumors as differential diagnosis for therapy-refractory symptoms in young athletes and encourage medical staff involved in sports medicine and athlete support to perform early high quality imaging and initiate sufficient surgical treatment in similar cases. Moreover, our less-invasive surgical procedure aiming for a fast return to sports might be an optimal compromise between traditional open curettage with low risk of recurrence and a soft tissue-saving and bone-sparing minimal-invasive technique.

Determining the best treatment for simple bone cyst: a decision analysis.

PubMed

Lee, Seung Yeol; Chung, Chin Youb; Lee, Kyoung Min; Sung, Ki Hyuk; Won, Sung Hun; Choi, In Ho; Cho, Tae-Joon; Yoo, Won Joon; Yeo, Ji Hyun; Park, Moon Seok

2014-03-01

The treatment of simple bone cysts (SBC) in children varies significantly among physicians. This study examined which procedure is better for the treatment of SBC, using a decision analysis based on current published evidence. A decision tree focused on five treatment modalities of SBC (observation, steroid injection, autologous bone marrow injection, decompression, and curettage with bone graft) were created. Each treatment modality was further branched, according to the presence and severity of complications. The probabilities of all cases were obtained by literature review. A roll back tool was utilized to determine the most preferred treatment modality. One-way sensitivity analysis was performed to determine the threshold value of the treatment modalities. Two-way sensitivity analysis was utilized to examine the joint impact of changes in probabilities of two parameters. The decision model favored autologous bone marrow injection. The expected value of autologous bone marrow injection was 0.9445, while those of observation, steroid injection, decompression, and curettage and bone graft were 0.9318, 0.9400, 0.9395, and 0.9342, respectively. One-way sensitivity analysis showed that autologous bone marrow injection was better than that of decompression for the expected value when the rate of pathologic fracture, or positive symptoms of SBC after autologous bone marrow injection, was lower than 20.4%. In our study, autologous bone marrow injection was found to be the best choice of treatment of SBC. However, the results were sensitive to the rate of pathologic fracture after treatment of SBC. Physicians should consider the possibility of pathologic fracture when they determine a treatment method for SBC.

Surgical management of calcaneal unicameral bone cysts.

PubMed

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.

The estimation of bone cyst volume using the Cavalieri principle on computed tomography images.

PubMed

Say, Ferhat; Gölpınar, Murat; Kılınç, Cem Yalın; Şahin, Bünyamin

2018-01-01

To evaluate the volume of bone cyst using the planimetry method of the Cavalieri principle. A retrospective analysis was carried out on data from 25 computed tomography (CT) images of patients with bone cyst. The volume of the cysts was calculated by two independent observers using the planimetry method. The procedures were repeated 1 month later by each observer. The overall mean volume of the bone cyst was 29.25 ± 25.86 cm 3 . The mean bone cyst volumes calculated by the first observer for the first and second sessions were 29.18 ± 26.14 and 29.27 ± 26.19 cm 3 , respectively. The mean bone cyst volumes calculated by the second observer for the first and second sessions were 29.32 ± 26.36 and 29.23 ± 26.36 cm 3 , respectively. Statistical analysis showed no difference and high agreement between the first and second measurements of both observers. The Bland-Altman plots showed strong intraobserver and interobserver concordance in the measurement of the bone cyst volume. The mean total time necessary to obtain the cyst volume by the two observers was 5.27 ± 2.30 min. The bone cyst of the patients can be objectively evaluated using the planimetry method of the Cavalieri principle on CT. This method showed high interobserver and intraobserver agreement. This volume measurement can be used to evaluate cyst remodeling, including complete healing and cyst recurrence.

Management of unicameral bone cyst by using freeze dried radiation sterilized bone allograft impregnate with autogenous bone marrow.

PubMed

Datta, N K; Das, K P; Alam, M S; Kaiser, M S

2014-07-01

Unicameral bone cyst is a common benign bone tumor and most frequent cause of the pathological fracture in children. We have started a prospective study for that treatment of unicameral bone cyst by using freeze dried radiation sterilized bone allograft impregnated with autogenous bone marrow in the department of Orthopaedics, Bangabandhu Sheikh Mujib Medical University (BSMMU) during May 1999 to April 2012. Aim of this study was to see Freeze dried radiation sterilized bone allograft impregnate with autogenous bone marrow a satisfactory graft material in the treatment of unicameral bone cyst as well as factors such as patients age, sex, cyst size and site of lesion influence on cyst healing. A total 35 patients of unicameral bone cyst were operated. In this study out of 35 patients, male were 22(62.86%) and female were 13(37.14). Male Female ratio 22:13(1.70:1) Age of the patients ranging from 2 years 6 month to 20 years, mean age 12.18 years more common 11 years to 20 years 29(82.86%) patients. Common bones sites involvements are proximal end of Humerus 20(57.14%), proximal end of Femur 7(20 %), proximal end of Tibia 3(8.57%), Calcanium 2(5.71%), proximal end of Ulna 1(2.86%), shaft of Radius 1(2.86%) and Phalanx 1(2.86%). Final clinical outcome of unicameral bone cyst treated by thorough curettage of cavity and tightly filled with freeze dried radiation sterilized bone allograft impregnate with autogenous bone marrow in which healed (success rate) 88.57% (31) and recurrence rate is 11.43% (4). P value is <0.001. Follow up period was 6 month to 11 years. From our study it was realized that freeze dried radiation sterilized bone allograft impregnated with autogenous bone marrow is useful graft material for healing of the lesional area as well as restoring structural integrity for the treatment of unicameral bone cyst.

Bone cysts after osteochondral allograft repair of cartilage defects in goats suggest abnormal interaction between subchondral bone and overlying synovial joint tissues.

PubMed

Pallante-Kichura, Andrea L; Cory, Esther; Bugbee, William D; Sah, Robert L

2013-11-01

The efficacy of osteochondral allografts (OCAs) may be affected by osseous support of the articular cartilage, and thus affected by bone healing and remodeling in the OCA and surrounding host. Bone cysts, and their communication pathways, may be present in various locations after OCA insertion and reflect distinct pathogenic mechanisms. Previously, we analyzed the effect of OCA storage (FRESH, 4°C/14d, 4°C/28d, FROZEN) on cartilage quality in fifteen adult goats after 12months in vivo. The objectives of this study were to further analyze OCAs and contralateral non-operated (Non-Op) CONTROLS from the medial femoral condyle to (1) determine the effect of OCA storage on local subchondral bone (ScB) and trabecular bone (TB) structure, (2) characterize the location and structure of bone cysts and channels, and (3) assess the relationship between cartilage and bone properties. (1) Overall bone structure after OCAs was altered compared to Non-Op, with OCA samples displaying bone cysts, ScB channels, and ScB roughening. ScB BV/TV in FROZEN OCAs was lower than Non-Op and other OCAs. TB BV/TV in FRESH, 4°C/14d, and 4°C/28d OCAs did not vary compared to Non-Op, but BS/TV was lower. (2) OCAs contained "basal" cysts, localized to deeper regions, some "subchondral" cysts, localized near the bone-cartilage interface, and some ScB channels. TB surrounding basal cysts exhibited higher BV/TV than Non-Op. (3) Basal cysts occurred (a) in isolation, (b) with subchondral cysts and ScB channels, (c) with ScB channels, or (d) with subchondral cysts, ScB channels, and ScB erosion. Deterioration of cartilage gross morphology was strongly associated with abnormal μCT bone structure. Evidence of cartilage-bone communication following OCA repair may favor fluid intrusion as a mechanism for subchondral cyst formation, while bone resorption at the graft-host interface without affecting overall bone and cartilage structure may favor bony contusion mechanism for basal cyst formation. These findings suggest that cysts occurring after OCAs may result from aberrant mechanobiology due to (1) altered compartmentalization that normally separates overlying cartilage and subchondral bone, either from distinct ScB channels or more general ScB plate deterioration, and (2) bone resorption at the basal graft-host interface. © 2013.

Unicameral and aneurysmal bone cysts.

PubMed

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.

Bone Cysts After Osteochondral Allograft Repair of Cartilage Defects in Goats Suggest Abnormal Interaction Between Subchondral Bone and Overlying Synovial Joint Tissues

PubMed Central

Pallante-Kichura, Andrea L.; Cory, Esther; Bugbee, William D.; Sah, Robert L.

2013-01-01

The efficacy of osteochondral allografts (OCA) may be affected by osseous support of the articular cartilage, and thus affected by bone healing and remodeling in the OCA and surrounding host. Bone cysts, and their communication pathways, may be present in various locations after OCA insertion and reflect distinct pathogenic mechanisms. Previously, we analyzed the effect of OCA storage (FRESH, 4°C/14d, 4°C/28d, FROZEN) on cartilage quality in fifteen adult goats after 12 months in vivo. The objectives of this study were to further analyze OCA and contralateral non-operated (Non-Op) CONTROLS from the medial femoral condyle to (1) determine the effect of OCA storage on local subchondral (ScB) and trabecular (TB) bone structure, (2) characterize the location and structure of bone cysts and channels, and (3) assess the relationship between cartilage and bone properties. (1) Overall bone structure after OCA was altered compared to Non-Op, with OCA samples displaying bone cysts, ScB channels, and ScB roughening. ScB BV/TV in FROZEN OCA was lower than Non-Op and other OCA. TB BV/TV in FRESH, 4°C/14d, and 4°C/28d OCA did not vary compared to Non-Op, but BS/TV was lower. (2) OCA contained “basal” cysts, localized to deeper regions, some “subchondral” cysts, localized near the bone-cartilage interface, and some ScB channels. TB surrounding basal cysts exhibited higher BV/TV than Non-Op. (3) Basal cysts occurred (a) in isolation, (b) with subchondral cysts and ScB channels, (c) with ScB channels, or (d) with subchondral cysts, ScB channels, and ScB erosion. Deterioration of cartilage gross morphology was strongly associated with abnormal μCT bone structure. Evidence of cartilage-bone communication following OCA repair may favor fluid intrusion as a mechanism for subchondral cyst formation, while bone resorption at the graft-host interface without affecting overall bone and cartilage structure may favor bony contusion mechanism for basal cyst formation. These findings suggest that cysts occurring after OCA may result from aberrant mechanobiology due to (1) altered compartmentalization that normally separates overlying cartilage and subchondral bone, either from distinct ScB channels or more general ScB plate deterioration, and (2) bone resorption at the basal graft-host interface. PMID:23958821

Prevalence of simple and complex sacral perineural Tarlov cysts in a French cohort of adults and children.

PubMed

Kuhn, Félix P; Hammoud, Sonia; Lefèvre-Colau, Marie-Martine; Poiraudeau, Serge; Feydy, Antoine

2017-02-01

To determine the prevalence of simple and complex sacral perineural Tarlov cysts (TCs) in a cohort of children and adults. Retrospective observational epidemiological study assessing 1100 consecutive sacral magnetic resonance (MR) studies, including 100 children and adolescents. All patients underwent 1.5T MR imaging with T1 and T2 weighted image acquisitions in sagittal and axial planes. All perineural cysts affecting the sacral nerve roots S1-S4 were quantitatively and qualitatively assessed. Two hundred and sixty-three sacral TCs were found in 132 adult patients (13.2%), with a female predominance (68%). None was found in children. The prevalence of TCs increased with age. The average number of cysts per patient was 2.0±1.2 with a maximum of 6 cysts in a single patient. Most of the cysts (87.5%) showed a homogenous central fluid collection and a parietal course of the nerve fibers. Complex patterns were present in 33 cysts (12.5%) within which 28 cysts showed endocystic crossing of nerve fibers and 5 cysts contained internal septations. Seventy cysts (26.6%) eroded the adjacent bone and 13 cysts (4.9%) extended to the pelvis. The prevalence of sacral TCs in our cohort corresponded to 13%, with a female predominance. Interestingly no TCs were found in children or adolescents (<18 years). In relation to the non-negligible percentage of complex cysts with internal septations, or endocystic crossing of nerve fibers, pre-interventional characterization of sacral TCs might help to choose an appropriate procedure in the treatment of rare symptomatic variants. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Minimal invasive surgery for unicameral bone cyst using demineralized bone matrix: a case series.

PubMed

Cho, Hwan Seong; Seo, Sung Hwa; Park, So Hyun; Park, Jong Hoon; Shin, Duk Seop; Park, Il Hyung

2012-07-29

Various treatments for unicameral bone cyst have been proposed. Recent concern focuses on the effectiveness of closed methods. This study evaluated the effectiveness of demineralized bone matrix as a graft material after intramedullary decompression for the treatment of unicameral bone cysts. Between October 2008 and June 2010, twenty-five patients with a unicameral bone cyst were treated with intramedullary decompression followed by grafting of demineralized bone matrix. There were 21 males and 4 female patients with mean age of 11.1  years (range, 3-19 years). The proximal metaphysis of the humerus was affected in 12 patients, the proximal femur in five, the calcaneum in three, the distal femur in two, the tibia in two, and the radius in one. There were 17 active cysts and 8 latent cysts. Radiologic change was evaluated according to a modified Neer classification. Time to healing was defined as the period required achieving cortical thickening on the anteroposterior and lateral plain radiographs, as well as consolidation of the cyst. The patients were followed up for mean period of 23.9 months (range, 15-36 months). Nineteen of 25 cysts had completely consolidated after a single procedure. The mean time to healing was 6.6 months (range, 3-12 months). Four had incomplete healing radiographically but had no clinical symptom with enough cortical thickness to prevent fracture. None of these four cysts needed a second intervention until the last follow-up. Two of 25 patients required a second intervention because of cyst recurrence. All of the two had a radiographical healing of cyst after mean of 10 additional months of follow-up. A minimal invasive technique including the injection of DBM could serve as an excellent treatment method for unicameral bone cysts.

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.

Unicameral bone cysts treated by injection of bone marrow or methylprednisolone.

PubMed

Chang, C H; Stanton, R P; Glutting, J

2002-04-01

In 79 consecutive patients with unicameral bone cysts we compared the results of aspiration and injection of bone marrow with those of aspiration and injection of steroid. All were treated by the same protocol. The only difference was the substance injected into the cysts. The mean radiological follow-up to detect activity in the cyst was 44 months (12 to 108). Of the 79 patients, 14 received a total of 27 injections of bone marrow and 65 a total of 99 injections of steroid. Repeated injections were required in 57% of patients after bone marrow had been used and in 49% after steroid. No complications were noted in either group. In this series no advantage could be shown for the use of autogenous injection of bone marrow compared with injection of steroid in the management of unicameral bone cysts.

Continuous decompression of unicameral bone cyst with cannulated screws: a comparative study.

PubMed

Brecelj, Janez; Suhodolcan, Lovro

2007-09-01

We determined the role of mechanical decompression in the resolution of unicameral bone cyst. A total of 69 children with unicameral bone cysts were treated either by (i) open curettage and bone grafting, (ii) steroid injection or (iii) cannulated screw insertion. During a mean follow-up of 69 months (range, 12-58), the cysts were evaluated by radiological criteria. The healing rates in the three groups were 25, 12 and 29% after the first treatment, and a further 50, 19 and 65% after the second. The study has demonstrated the advantages of the decompression technique for unicameral bone cysts over other treatment modalities studied.

Elastic Stable Intramedullary Nailing (ESIN), Orthoss® and Gravitational Platelet Separation - System (GPS®): An effective method of treatment for pathologic fractures of bone cysts in children

PubMed Central

2011-01-01

Background The different treatment strategies for bone cysts in children are often associated with persistence and high recurrence rates of the lesions. The safety and clinical outcomes of a combined mechanical and biological treatment with elastic intramedullary nailing, artificial bone substitute and autologous platelet rich plasma are evaluated. Methods From 02/07 to 01/09 we offered all children with bone cysts the treatment combination of elastic intramedullary nailing (ESIN), artificial bone substitute (Orthoss®) and autologous platelet rich plasma, concentrated by the Gravitational Platelet Separation (GPS®) - System. All patients were reviewed radiologically for one year following the removal of the intramedullary nailing, which was possible because of cyst obliteration. Results A cohort of 12 children (4 girls, 8 boys) was recruited. The mean patient age was 11.4 years (range 7-15 years). The bone defects (ten humeral, two femoral) included eight juvenile and four aneurysmal bone cysts. Five patients suffered from persistent cysts following earlier unsuccessful treatment of humeral bone cyst after pathologic fracture; the other seven presented with acute pathologic fractures. No peri- or postoperative complications occurred. The radiographic findings showed a total resolution of the cysts in ten cases (Capanna Grade 1); in two cases a small residual cyst remained (Capanna Grade 2). The intramedullary nails were removed six to twelve months (mean 7.7) after the operation; in one case, a fourteen year old boy (Capanna Grade 2), required a further application of GPS® and Orthoss® to reach a total resolution of the cyst. At follow-up (20-41 months, mean 31.8 months) all patients showed very good functional results and had returned to sporting activity. No refracture occurred, no further procedure was necessary. Conclusions The combination of elastic intramedullary nailing, artificial bone substitute and autologous platelet rich plasma (GPS®) enhances the treatment of bone cysts in children, with no resulting complications. PMID:21314981

Chondroblastoma of the patella with aneurysmal bone cyst.

PubMed

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.

Odontogenic cysts in three dogs: one odontogenic keratocyst and two dentigerous cysts.

PubMed

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.

Traumatic bone cyst resembling apical periodontitis.

PubMed

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.

Recurrence of a Unicameral Bone Cyst in the Femoral Diaphysis.

PubMed

Kim, Hyun Se; Lim, Kyung Sup; Seo, Sung Wook; Jang, Seung Pil; Shim, Jong Sup

2016-12-01

Diaphyseal unicameral bone cysts of the long bone are generally known to originate near the growth plate and migrate from the metaphysis to the diaphysis during skeletal growth. In the case of unicameral bone cysts of diaphyseal origin, recurrence at the same location is extremely rare. We report a case of recurrence of a unicameral bone cyst in the diaphysis of the femur that developed 8 years after treatment with curettage and bone grafting. We performed bone grafting and lengthening of the affected femur with an application of the Ilizarov apparatus over an intramedullary nail to treat the cystic lesion and limb length discrepancy simultaneously.

Recurrence of a Unicameral Bone Cyst in the Femoral Diaphysis

PubMed Central

Kim, Hyun Se; Lim, Kyung Sup; Seo, Sung Wook; Jang, Seung Pil

2016-01-01

Diaphyseal unicameral bone cysts of the long bone are generally known to originate near the growth plate and migrate from the metaphysis to the diaphysis during skeletal growth. In the case of unicameral bone cysts of diaphyseal origin, recurrence at the same location is extremely rare. We report a case of recurrence of a unicameral bone cyst in the diaphysis of the femur that developed 8 years after treatment with curettage and bone grafting. We performed bone grafting and lengthening of the affected femur with an application of the Ilizarov apparatus over an intramedullary nail to treat the cystic lesion and limb length discrepancy simultaneously. PMID:27904734

Pathologic fracture through a unicameral bone cyst of the pelvis: CT-guided percutaneous curettage, biopsy, and bone matrix injection.

PubMed

Tynan, Jennifer R; Schachar, Norman S; Marshall, Geoffrey B; Gray, Robin R

2005-02-01

Unicameral bone cysts of the pelvis are extremely rare. A 19-year old man presented with a pathologic fracture through a pelvic unicameral bone cyst. He was treated with computed tomography-guided percutaneous curettage, biopsy, and demineralized bone matrix injection. Treatment has proven successful in short-term follow-up.

Mandibular aneurysmal bone cyst in an elderly patient: Case report.

PubMed

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.

Flexible intramedullary nailing for unicameral cysts in children's long bones : Level of evidence: lV, case series.

PubMed

Glanzmann, Michael C; Campos, Lautaro

2007-07-01

The purpose of this study was to evaluate the outcome of flexible intramedullary nailing for unicameral bone cysts in terms of function and osseous consolidation. Twenty-two unicameral bone cysts in children's long bones were treated by flexible intramedullary nailing. In 13 cases the bone cyst was diagnosed in a traumatic event leading to a pathologic fracture. Fifteen patients were referred to our clinic after failed conservative treatment. In 16 patients the cyst was located in the humerus, and in 6 patients in the femur. Mean duration of follow-up after surgery was 24 months. According to Capanna's criteria healing was obtained in 20 cases with a mean time of 16 months. Sixteen cysts healed completely. Four lesions were classified as grade 2, meaning that residual radiolucencies were radiographically visible at the latest follow-up. Two recurrences of humeral cysts were seen at 16 and 18 months postoperatively. The complication rate was minimal. Due to the immediate stabilization of the lesion aftercare becomes facile. This method allows prompt mobilization and early weight bearing without the necessity of a plaster cast. Further it prevents effectively the most common complication, a re-fracture or a pathologic fracture. Therefore we propose this surgical procedure as the treatment of choice for unicameral bone cysts in children's long bones.

Unicameral bone cyst of the calcaneum.

PubMed

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.

Treatment of a unicameral bone cyst in a dog using a customized titanium device.

PubMed

Nojiri, Ayami; Akiyoshi, Hideo; Ohashi, Fumihito; Ijiri, Atsuki; Sawase, Osamu; Matsushita, Tomiharu; Takemoto, Mitsuru; Fujibayashi, Shunsuke; Nakamura, Takashi; Yamaguchi, Tsutomu

2015-01-01

A 4-year-old Shih-Tzu, referred for an enlarged left carpus, was diagnosed with a unicameral bone cyst. A customized titanium device was inserted into cystic lesion and fixed by titanium screws. Sufficient strength of the affected bone with the device inserted to maintain limb function was established after resection of contents of cystic lesion. There was no deterioration of the lesion of bone cyst, and acceptable function of the affected limb with no clinical signs of lameness was maintained during 36 months follow-up. The results of this study demonstrated that bone cyst curettage and use of a customized titanium device could provide an effective alternative treatment of huge lesion of unicameral bone cysts with the intent of preventing pathologic fractures.

Treatment of a unicameral bone cyst in a dog using a customized titanium device

PubMed Central

NOJIRI, Ayami; AKIYOSHI, Hideo; OHASHI, Fumihito; IJIRI, Atsuki; SAWASE, Osamu; MATSUSHITA, Tomiharu; TAKEMOTO, Mitsuru; FUJIBAYASHI, Shunsuke; NAKAMURA, Takashi; YAMAGUCHI, Tsutomu

2014-01-01

ABSTRACT A 4-year-old Shih-Tzu, referred for an enlarged left carpus, was diagnosed with a unicameral bone cyst. A customized titanium device was inserted into cystic lesion and fixed by titanium screws. Sufficient strength of the affected bone with the device inserted to maintain limb function was established after resection of contents of cystic lesion. There was no deterioration of the lesion of bone cyst, and acceptable function of the affected limb with no clinical signs of lameness was maintained during 36 months follow-up. The results of this study demonstrated that bone cyst curettage and use of a customized titanium device could provide an effective alternative treatment of huge lesion of unicameral bone cysts with the intent of preventing pathologic fractures. PMID:25319515

Minimal invasive surgery for unicameral bone cyst using demineralized bone matrix: a case series

PubMed Central

2012-01-01

Background Various treatments for unicameral bone cyst have been proposed. Recent concern focuses on the effectiveness of closed methods. This study evaluated the effectiveness of demineralized bone matrix as a graft material after intramedullary decompression for the treatment of unicameral bone cysts. Methods Between October 2008 and June 2010, twenty-five patients with a unicameral bone cyst were treated with intramedullary decompression followed by grafting of demineralized bone matrix. There were 21 males and 4 female patients with mean age of 11.1 years (range, 3–19 years). The proximal metaphysis of the humerus was affected in 12 patients, the proximal femur in five, the calcaneum in three, the distal femur in two, the tibia in two, and the radius in one. There were 17 active cysts and 8 latent cysts. Radiologic change was evaluated according to a modified Neer classification. Time to healing was defined as the period required achieving cortical thickening on the anteroposterior and lateral plain radiographs, as well as consolidation of the cyst. The patients were followed up for mean period of 23.9 months (range, 15–36 months). Results Nineteen of 25 cysts had completely consolidated after a single procedure. The mean time to healing was 6.6 months (range, 3–12 months). Four had incomplete healing radiographically but had no clinical symptom with enough cortical thickness to prevent fracture. None of these four cysts needed a second intervention until the last follow-up. Two of 25 patients required a second intervention because of cyst recurrence. All of the two had a radiographical healing of cyst after mean of 10 additional months of follow-up. Conclusions A minimal invasive technique including the injection of DBM could serve as an excellent treatment method for unicameral bone cysts. PMID:22839754

Unicameral Bone Cyst of the Medial Cuneiform.

PubMed

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.

Unicameral Bone Cyst of the Medial Cuneiform: A Case Report.

PubMed

Schick, Faith A; Daniel, Joseph N; Miller, Juliane S

2016-02-17

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.

Maxillary bone epithelial cyst in an adult miniature schnauzer.

PubMed

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.

CT findings of a unicameral calcaneal bone cyst containing a fluid-fluid level.

PubMed

Gallagher, Thomas A; Lim-Dunham, Jennifer E; Vade, Aruna

2007-03-01

Calcaneal unicameral bone cysts often contain fluid, but rarely contain fluid-fluid levels. We present a case focusing on the CT findings of a large calcaneal bone cyst with a fluid-fluid level and a review of the literature.

Lateral approach for maxillary sinus membrane elevation without bone materials in maxillary mucous retention cyst with immediate or delayed implant rehabilitation: case reports.

PubMed

Han, Ji-Deuk; Cho, Seong-Ho; Jang, Kuk-Won; Kim, Seong-Gwang; Kim, Jung-Han; Kim, Bok-Joo; Kim, Chul-Hun

2017-08-01

This case series study demonstrates the possibility of successful implant rehabilitation without bone augmentation in the atrophic posterior maxilla with cystic lesion in the sinus. Sinus lift without bone graft using the lateral approach was performed. In one patient, the cyst was aspirated and simultaneous implantation under local anesthesia was performed, whereas the other cyst was removed under general anesthesia, and the sinus membrane was elevated in a second process, followed by implantation. In both cases, tapered 11.5-mm-long implants were utilized. With all of the implants, good stability and appropriate bone height were achieved. The mean bone level gain was 5.73 mm; adequate bone augmentation around the implants was shown, the sinus floor was moved apically, and the cyst was no longer radiologically detected. Completion of all of the treatments required an average of 12.5 months. The present study showed that sufficient bone formation and stable implantation in a maxilla of insufficient bone volume are possible through sinus lift without bone materials. The results serve to demonstrate, moreover, that surgical treatment of mucous retention cyst can facilitate rehabilitation. These techniques can reduce the risk of complications related to bone grafts, save money, and successfully treat antral cyst.

Lateral approach for maxillary sinus membrane elevation without bone materials in maxillary mucous retention cyst with immediate or delayed implant rehabilitation: case reports

PubMed Central

2017-01-01

This case series study demonstrates the possibility of successful implant rehabilitation without bone augmentation in the atrophic posterior maxilla with cystic lesion in the sinus. Sinus lift without bone graft using the lateral approach was performed. In one patient, the cyst was aspirated and simultaneous implantation under local anesthesia was performed, whereas the other cyst was removed under general anesthesia, and the sinus membrane was elevated in a second process, followed by implantation. In both cases, tapered 11.5-mm-long implants were utilized. With all of the implants, good stability and appropriate bone height were achieved. The mean bone level gain was 5.73 mm; adequate bone augmentation around the implants was shown, the sinus floor was moved apically, and the cyst was no longer radiologically detected. Completion of all of the treatments required an average of 12.5 months. The present study showed that sufficient bone formation and stable implantation in a maxilla of insufficient bone volume are possible through sinus lift without bone materials. The results serve to demonstrate, moreover, that surgical treatment of mucous retention cyst can facilitate rehabilitation. These techniques can reduce the risk of complications related to bone grafts, save money, and successfully treat antral cyst. PMID:28875144

The Role of Diffusion-Weighted Magnetic Resonance Imaging in the Differential Diagnosis of Simple and Hydatid Cysts of the Liver.

PubMed

Aksoy, S; Erdil, I; Hocaoglu, E; Inci, E; Adas, G T; Kemik, O; Turkay, R

2018-02-01

The present study indicates that simple and hydatid cysts in liver are a common health problem in Turkey. The aim of the study is to differentiate different types of hydatid cysts from simple cysts by using diffusion-weighted images. In total, 37 hydatid cysts and 36 simple cysts in the liver were diagnosed. We retrospectively reviewed the medical records of the patients who had both ultrasonography and magnetic resonance imaging. We measured apparent diffusion coefficient (ADC) values of all the cysts and then compared the findings. There was no statistically meaningful difference between the ADC values of simple cysts and type 1 hydatid cysts. However, for the other types of hydatid cysts, it is possible to differentiate hydatid cysts from simple cysts using the ADC values. Although in our study we cannot differentiate between type I hydatid cysts and simple cysts in the liver, diffusion-weighted images are very useful to differentiate different types of hydatid cysts from simple cysts using the ADC values.

Unicameral bone cyst of the calcaneus - minimally invasive endoscopic surgical treatment. Case report.

PubMed

Stoica, Ioan Cristian; Pop, Doina Mihaela; Grosu, Florin

2017-01-01

The role of arthroscopic surgery for the treatment of various orthopedic pathologies has greatly improved during the last years. Recent publications showed that benign bone lesion may benefit from this minimally invasive surgical method, in order to minimize the invasiveness and the period of immobilization and to increase visualization. Unicameral bone cysts may be adequately treated by minimally invasive endoscopic surgery. The purpose of the current paper is to present the case report of a patient with a unicameral bone cyst of the calcaneus that underwent endoscopically assisted treatment with curettage and bone grafting with allograft from a bone bank, with emphasis on the surgical technique. Unicameral bone cyst is a benign bone lesion, which can be adequately treated by endoscopic curettage and percutaneous injection of morselized bone allograft in symptomatic patients.

Aneurysmal bone cyst: a hereditary disease?

PubMed

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.

Three-part head-splitting proximal humerus fracture through a unicameral bone cyst.

PubMed

Younghein, John A; Eskander, Mark S; DeAngelis, Nicola A; Wixted, John J

2012-06-01

Unicameral bone cysts are rare in adults and are most often found incidentally on radiographs. However, they can persist from the adolescent period and may be present in locations that predispose to or exacerbate fractures.This article describes a case of a healthy 40-year-old woman who sustained a proximal humerus trauma that involved a large unicameral bone cyst, resulting in a 3-part head-splitting fracture. The epiphyseal location of the cyst contributed to the severity and extent of the fracture that resulted from a simple fall. Given the age of the patient, open reduction and internal fixation with a locking plate and lag screws was performed. The patient chose open reduction and internal fixation to preserve a hemiarthroplasty procedure in case of future revision. Successful humeral head reconstruction was achieved, and the patient fully recovered. One year postoperatively, the patient underwent arthroscopic debridement to alleviate subjective stiffness and decreased range of motion.Multipart head-splitting fractures require complex repair strategies. The gold standard for the treatment of these injuries is hemiarthroplasty. However, the decision process is difficult in a young patient given the average survival of autoplastic prostheses and the added difficulty of later revision. The current case demonstrates the complexity of decision making resulting from a rare injury in a young, healthy patient and shows that open reduction and internal fixation can provide acceptable reconstruction in such situations. Copyright 2012, SLACK Incorporated.

Unicameral bone cysts: general characteristics and management controversies.

PubMed

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.

Endoscopic Surgery for Symptomatic Unicameral Bone Cyst of the Proximal Femur

PubMed Central

Miyamoto, Wataru; Takao, Masato; Yasui, Youichi; Miki, Shinya; Matsushita, Takashi

2013-01-01

Recently, surgical treatment of a symptomatic unicameral cyst of the proximal femur has been achieved with less invasive procedures than traditional open curettage with an autologous bone graft. In this article we introduce endoscopic surgery for a symptomatic unicameral cyst of the proximal femur. The presented technique, which includes minimally invasive endoscopic curettage of the cyst and injection of a bone substitute, not only minimizes muscle damage around the femur but also enables sufficient curettage of the fibrous membrane in the cyst wall and the bony septum through direct detailed visualization by an endoscope. Furthermore, sufficient initial strength after curettage can be obtained by injecting calcium phosphate cement as a bone substitute. PMID:24892010

Endoscopic Surgery for Symptomatic Unicameral Bone Cyst of the Proximal Femur.

PubMed

Miyamoto, Wataru; Takao, Masato; Yasui, Youichi; Miki, Shinya; Matsushita, Takashi

2013-11-01

Recently, surgical treatment of a symptomatic unicameral cyst of the proximal femur has been achieved with less invasive procedures than traditional open curettage with an autologous bone graft. In this article we introduce endoscopic surgery for a symptomatic unicameral cyst of the proximal femur. The presented technique, which includes minimally invasive endoscopic curettage of the cyst and injection of a bone substitute, not only minimizes muscle damage around the femur but also enables sufficient curettage of the fibrous membrane in the cyst wall and the bony septum through direct detailed visualization by an endoscope. Furthermore, sufficient initial strength after curettage can be obtained by injecting calcium phosphate cement as a bone substitute.

Active unicameral bone cysts in the upper limb are at greater risk of fracture.

PubMed

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.

Unicameral bone cyst in the spinous process of a thoracic vertebra.

PubMed

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.

Successful aspiration and ethanol sclerosis of a large, symptomatic, simple liver cyst: Case presentation and review of the literature

PubMed Central

Blonski, Wojciech C; Campbell, Mical S; Faust, Thomas; Metz, David C

2006-01-01

Simple liver cysts are congenital with a prevalence of 2.5%-4.25%. Imaging, whether by US, CT or MRI, is accurate in distinguishing simple cysts from other etiologies, including parasitic, neoplastic, duct-related, and traumatic cysts. Symptomatic simple liver cysts are rare, and the true frequency of symptoms is not known. Symptomatic simple liver cysts are predominantly large (> 4 cm), right-sided, and more common in women and older patients. The vast majority of simple hepatic cysts require no treatment or follow-up, though large cysts (> 4 cm) may be followed initially with serial imaging to ensure stability. Attribution of symptoms to a large simple cyst should be undertaken with caution, after alternative diagnoses have been excluded. Aspiration may be performed to test whether symptoms are due to the cyst; however, cyst recurrence should be expected. Limited experience with both laparoscopic deroofing and aspiration, followed by instillation of a sclerosing agent has demonstrated promising results for the treatment of symptomatic cysts. Here, we describe a patient with a large, symptomatic, simple liver cyst who experienced complete resolution of symptoms following cyst drainage and alcohol ablation, and we present a comprehensive review of the literature. PMID:16718826

[A long-term follow-up of treatment of adult unicameral bone cysts with allograft of lyophilized cancellous bone].

PubMed

Zhang, Yonggang; Wang, Yan; Cheng, Jiying

2005-08-01

To investigate the long-term clinical results of treatment of adult unicameral bone cyst with cancellous allograft. From 1993 to 1998, 15 patients with unicameral bone cyst were treated by allograft with lyophilized cancellous bone. Among 15 patients, there were 5 males and 10 females, aging 19-41 years with an average of 27 years. The average follow-up time was 7.5 years (6-11 years). The X-ray films were taken and the CT scanning were carried out. The X-ray films showed that the allograft particles became vague 2-3 months after operation, that the allograft particles fused and began to form new bone and the bone density increased 5 months after operation, and that new bone formation completed after 7 months of operation. At the end of follow-up, remodelling in new bone occurred. Recurrence was not found in all patients. The symptom of pain disappeared or relieved obviously. Allograft of lyophilized cancellous bone is an effective treatment for adult unicameral bone cysts.

Simple Kidney Cysts

MedlinePlus

... 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 ...

The "rising bubble" sign: a new aid in the diagnosis of unicameral bone cysts.

PubMed

Jordanov, Martin I

2009-06-01

The observation of a bubble of gas at the most non-dependent margin of a lytic bone lesion which has sustained a pathologic fracture implies that the lesion is hollow and can assist the radiologist in making the diagnosis of a unicameral bone cyst. The imaging studies of two patients who sustained pathologic fractures through unicameral bone cysts and exhibited the "rising bubble" sign are shown. The sign's basis, proper utilization, and potential pitfalls are discussed.

Clinical and radiographic features of solitary and cemento-osseous dysplasia-associated simple bone cysts.

PubMed

Chadwick, J W; Alsufyani, N A; Lam, E W N

2011-05-01

The simple bone cyst (SBC) is a pseudocyst that can occur as a solitary entity in the jaws or may occur in association with cemento-osseous dysplasia (COD). The purpose of this study was to review the clinical and radiographic features of solitary and COD-associated SBCs. Archived imaging reports from the Special Procedures Clinic in Oral and Maxillofacial Radiology at the Faculty of Dentistry at the University of Toronto between 1 January 1989 and 31 December 2009 revealed 23 COD-associated SBCs and 68 solitary SBCs. Almost all solitary and COD-associated SBCs were found in the mandible. Furthermore, 87.0% of COD-associated SBCs were found in females in their fifth decade of life (P < 0.001) while solitary SBCs were found in equal numbers in both sexes in their second decade of life (P < 0.005). COD-associated SBCs were also more likely to cause thinning of the endosteal cortex, bone expansion and scalloping of the superior border between teeth (all P < 0.001) than solitary SBCs that are classically described as having these characteristics. Finally, COD-associated SBC demonstrated a loss of lamina dura more often (P < 0.05) than solitary SBCs. Knowledge of the sporadic association between COD and SBC and their potential radiographic appearances should prevent inappropriate treatment and management of these patients.

[Essential bone cyst of the calcaneus in children. Report of three cases].

PubMed

Antón Rodrigálvarez, L M; Ortega Medina, L; Cabadas González, M I; Aguilar Rodríguez, L

1998-10-01

The purpose of this study was to analyze the properties of essential bone cyst of the calcaneus in childhood, as well as its evolution, and differences with regard to adults. The cases of children with a diagnosis of essential bone cyst of calcaneus in last sixteen years in the pediatric orthopedic unit of San Carlos Clinic have been reviewed. We evaluated the information regarding the clinical history and the radiological and histological date as well as the therapy result with esteroid intracavity therapy and curettage and bone grafting. The radiologic score was done following Södergard criteria and the posttreatment follow-up with Neer's score. The mean age of the patients was 10.3 years. Two of the patients had recurrent heel pain for more than six months. Treatment consisted in intracavitary esteroid in two cases and curettage and bone grafting in all three cases, in two of the cases because of failure of esteroid therapy and in the other because of an atypical X-ray image. In all cases the histological stady identified the existence of a characteristic membrane conective tissue. The postsurgery follow-up a period of half four years has been satisfactory. The essential bone cyst of the calcaneous is exceptional localization in children, frequently symptomatic and resistant to the esteroid intracavitaria contrary to what happens with the essential bone cyst of other localizations and with the essential bone cyst of the calcaneus in the adults. The recurrent heel pain and atipical X-ray image are surgery indications.

[The characteristics of chemical composition of content of unicameral bone cysts depending on their growth stage].

PubMed

Stogov, M V; Luneva, S N; Mitrofanov, A I; Tkachuk, E A

2012-11-01

The article deals with the results of study of chemical composition of solitary cysts and blood serum of 27 patients. The results demonstrated that qualitative composition of f content of unicameral bone cysts is identical to chemical composition of blood serum. The results of analysis of total proteolysis activity and acid phosphatase activity in content of cysts can be used as criteria to determine the stage of cyst growth and to evaluate the effectiveness of applied treatment.

[Remote course of bony cysts in children and adolescents].

PubMed

Lefranc, J

1985-01-01

The author, who in 1955 had published a thesis on the remote results of the treatment of bone cysts on children and teenagers, decided to go back to that subject 30 years later. He was able to gather 203 observations (mostly from Paris Hospitals) followed up for at least 2 years (some of them for more than 30 years) and in 15 of those cases no treatment had been undergone. The pathogenesis of the bone cyst is still unknown, but there are obvious connections between the cystic socket and the vascular metaphysis. Rigault and Padovani had the opportunity to observe, during some injections of contrasting preparation in the humeral cysts that the liquid went quickly into the auxiliary venous system. The bone cysts appear in the spongy tissue of bone metaphysis in full movement. The author thinks that the cystic sockets are made by the gathering of osteolytic bubbles and that the protrusions inside the bone are nothing, but the former limits of those bubbles. The evolution does not always follow the classical pattern and one can often observe--in particular in the humeral localisation--lytic outbreaks on a cyst which growth seemed stationary or on the way of recovery. Those outbreaks with specific evolution bring about either an extension of the socket or the appearance of a new geode. The recovery (total or partial) usually comes after septation of the cavity. It is only at the end of the growth that one can be sure of the stabilization of the remaining lesions. As for the spontaneous disappearance of the cavity, it can take years. Considering the ever encouraging evolution of the bone cysts, one must always be very careful in judging the efficacy of the different treatments that are recommended. The different traumatisms (fractures, surgery or corticoids) bring forth perturbations in the bone socket, according to a pattern that we do not know well. The result is often paradoxical: one bone cyst which was apparently stabilized will awake and spread; another, partially cured after a surgery will have to wait for a fracture of the remaining cavity to disappear completely; other bone cysts which the injections of corticoids have failed to cure will recover after a curettage or vice-versa. Every method, included the bone resections used in some localisations (fibula) can fail.(ABSTRACT TRUNCATED AT 400 WORDS)

Flexible intramedullary nailing for the treatment of unicameral bone cysts in long bones.

PubMed

Roposch, A; Saraph, V; Linhart, W E

2000-10-01

Unicameral bone cyst is characterized by its tenacity and risk of recurrence. Pathological fracture is common and is often the presenting symptom. The objective of the present study was to evaluate the results of flexible intramedullary nailing for the treatment of a unicameral bone cyst with or without a pathological fracture. Flexible intramedullary nailing for the treatment of a unicameral bone cyst was performed in thirty-two patients. Thirty of these patients presented with a pathological fracture; twenty-four were managed immediately with intramedullary nailing, and the other six had been managed conservatively at other clinics before they were referred to our department. The remaining two cysts were detected incidentally. The cyst was located in the humerus in twenty-one patients, in the femur in nine, and in the radius in two. The mean age of the patients at the time of surgery was 9.8 years, and the mean duration of follow-up was 53.7 months. Radiographic evaluation was performed according to the criteria of Capanna et al., and the cyst was classified as completely healed, healed with residual radiolucency (osteolysis), recurred, or having no response. The healing period ranged from three to 105 months. Fourteen cysts healed completely, and sixteen healed with residual radiolucent areas visible on radiographs. There was recurrence of two cysts that had healed with residual radiolucency. All of the cysts in the present study responded to treatment. A change of nails was necessary in nine patients, as the nails had become too short after bone growth. No major complications were observed. Flexible intramedullary nailing provides early stability, which allows early mobilization and thus obviates the need for a plaster cast and decreases the prevalence of the most common complication: a pathological fracture. This method of treatment also allows for an early return to normal activity.

[Adjuvant cryosurgery in the treatment of unicameral bone cysts].

PubMed

Tena-Sanabria, Mario Edgar; Hernández-Hernández, Melissa Jesús; Tena-González, Mario Edgar; Mejía-Aranguré, Juan Manuel

2014-01-01

Multiple treatments have been used for the unicameral bone cyst lesion, such as steroid application, multiple perforations, bone curettages, partial resection and bone grafting. The purpose of this study was to describe the evolution of children with unicameral bone cyst who were treated with cryosurgery as coadjuvant therapy. Cross-sectional descriptive study over the period between January 2001 and December 2006. Twelve patients were studied and treated at the Pediatric Orthopedics Department of the Pediatrics Hospital at the Centro Médico Nacional Siglo XXI. Twelve patients were analyzed; all of them were treated with curettage, cryotherapy and bone grafting. In 7 patients, the lesions were located in the humerus (58.3 %), in 3 in the tibia (25 %), in 1 in the ilio-ischiopubic branch (8.3 %), and in 1 in the clavicle (8.3 %). Follow-up ranged from 12 to 36 months. Bone healing required 2 to 3 months after the surgery; the response was complete in 9 (75 %) patients and partial in 3 (25 %). Function was restored in all cases, without recurrences. Cryosurgery as an adjuvant treatment and autologous or homologous bone grafting prevented local recurrence of unicameral bone cyst lesions, favored bone healing and allowed for a full range of motion functionality without complications.

Investigating a potential biological treatment to prevent pathological fractures caused by unicameral bone cysts in children under 8 years.

PubMed

Ramos-Pascua, Luis R; Sánchez-Herraéz, Sergio; Casas-Ramos, Paula; Molnar Fuentes, Sebastián; Santos Sánchez, José Ángel

2014-10-01

There is no consensus on when and how to treat unicameral bone cysts (UBCs), partly because of a lack of knowledge of the aetiology. To review the different treatment techniques for UBCs and to describe our results with a single injection of autogenous bone marrow (BM) mixed with demineralised bone matrix (DBM) in very young children. We reviewed five patients under the age of 8 years with UBCs treated by percutaneous aspiration and a single injection of BM associated with DBM. The cyst was located in the proximal humerus in four patients and in the proximal femur in one patient. Assessment of the need for surgery was based on the clinical and radiographic suspicion of new pathological fractures. The administration of a second injection, when necessary, was based on the surgeon's judgement regarding the risk of fracture. The mean follow-up after first injection was 41 months. There were no complications related to the procedure, except a non-displaced fracture, which healed without problems. All patients were pain free and progressively resumed their activities without restriction until a new fracture occurred in two cases. According to Capanna's classification, only one case healed completely (grade 1), one lesion was classified as grade 2, and there were three recurrences at 11, 12 and 27 months after initial treatment (grade 3). The final outcome was treatment failure for three out of the five patients. Two patients were treated with a second injection and one patient is waiting for surgery. A single injection of aspirated autogenous BM mixed with DBM in very young children with active UBCs at risk of fracture is very simple, comfortable and safe. Nevertheless, the results seem to be unpredictable and are probably more dependent on the natural evolution of the cyst than on the treatment. Further comparative studies with larger sample numbers are needed.

Mid- and long-term clinical results of surgical therapy in unicameral bone cysts.

PubMed

Hagmann, Sébastien; Eichhorn, Florian; Moradi, Babak; Gotterbarm, Tobias; Dreher, Thomas; Lehner, Burkhard; Zeifang, Felix

2011-12-13

Unicameral (or simple) bone cysts (UBC) are benign tumours most often located in long bones of children and adolescents. Pathological fractures are common, and due to high recurrence rates, these lesions remain a challenge to treat. Numerous surgical procedures have been proposed, but there is no general consensus of the ideal treatment. The aim of this investigation therefore was to study the long-term outcome after surgical treatment in UBC. A retrospective analysis of 46 patients surgically treated for UBC was performed for short and mid-term outcome. Clinical and radiological outcome parameters were studied according to a modified Neer classification system. Long-term clinical information was retrieved via a questionnaire at a minimum follow-up of 10 years after surgery. Forty-six patients (17 female, 29 male) with a mean age of 10.0 ± 4.8 years and with histopathologically confirmed diagnosis of UBC were included. Pathological fractures were observed in 21 cases (46%). All patients underwent surgery for UBC (35 patients underwent curettage and bone grafting as a primary therapy, 4 curettage alone, 3 received corticoid instillation and 4 decompression by cannulated screws). Overall recurrence rate after the first surgical treatment was 39% (18/46), second (17.4% of all patients) and third recurrence (4.3%) were frequently observed and were addressed by revision surgery. Recurrence was significantly higher in young and in male patients as well as in active cysts. After a mean of 52 months, 40 out of 46 cysts were considered healed. Prognosis was significantly better when recurrence was observed later than 30 months after therapy. After a mean follow-up of 15.5 ± 6.2 years, 40 patients acknowledged clinically excellent results, while five reported mild and casual pain. Only one patient reported a mild limitation of range of motion. Our results suggest satisfactory overall long-term outcome for the surgical treatment of UBC, although short-and mid-term observation show a considerable rate of recurrence independent of the surgical technique.

Treatment of Unicameral Bone Cysts of the Proximal Femur With Internal Fixation Lessens the Risk of Additional Surgery.

PubMed

Wilke, Benjamin; Houdek, Matthew; Rao, Rameshwar R; Caird, Michelle S; Larson, A Noelle; Milbrandt, Todd

2017-09-01

Little data exist to guide the treatment of unicameral bone cysts in the proximal femur. Methods of treatment include corticosteroid injections, curettage and bone grafting, and internal fixation. The authors completed a multi-institutional, retrospective review to evaluate their experience with proximal femoral unicameral bone cysts. They posed the following questions: (1) Does internal fixation reduce the risk of further procedures for the treatment of a unicameral bone cyst? (2) Is radiographic healing faster with internal fixation? Following institutional review board approval, the authors conducted a retrospective review of 36 patients treated for a unicameral bone cyst of the proximal femur at their institutions between 1974 and 2014. Medical records and radiographs were reviewed to identify patient demographics and treatment outcomes. Tumor locations included femoral neck (n=13), intertrochanteric (n=16), and subtrochanteric (n=7). Initial treatment included steroid injection (n=2), curettage and bone grafting (n=9), and internal fixation with curettage and bone grafting (n=25). Mean time was 9 months to radiographic healing and 15 months to return to full activity. The number of patients requiring additional surgeries was increased among those who did not undergo internal fixation. There was no difference in time to radiographic healing. However, time to return to normal activities was reduced if patients had received internal fixation. A significant reduction in additional procedures was observed when patients had been treated with internal fixation. Although this did not influence time to radiographic healing, patients did return to normal activities sooner. Internal fixation should be considered in the treatment of proximal femoral unicameral bone cysts. [Orthopedics. 2017; 40(5):e862-e867.]. Copyright 2017, SLACK Incorporated.

Demonstration of a geode by magnetic resonance imaging: a new light on the cause of juxta-articular bone cysts in rheumatoid arthritis.

PubMed

Moore, E A; Jacoby, R K; Ellis, R E; Fry, M E; Pittard, S; Vennart, W

1990-10-01

The magnetic resonance imaging (MRI) features of a rheumatoid arthritic geode are presented. Development of such a cyst from before x ray diagnosis to its coalescence with the wrist joint is described. The evidence suggests that these juxta-articular cysts are not merely an intrusion of the synovial cavity into the bone marrow but start as isolated structures beneath the subchondral bone.

Demonstration of a geode by magnetic resonance imaging: a new light on the cause of juxta-articular bone cysts in rheumatoid arthritis.

PubMed Central

Moore, E A; Jacoby, R K; Ellis, R E; Fry, M E; Pittard, S; Vennart, W

1990-01-01

The magnetic resonance imaging (MRI) features of a rheumatoid arthritic geode are presented. Development of such a cyst from before x ray diagnosis to its coalescence with the wrist joint is described. The evidence suggests that these juxta-articular cysts are not merely an intrusion of the synovial cavity into the bone marrow but start as isolated structures beneath the subchondral bone. Images PMID:2241269

Unicameral bone cyst: a retrospective study of three surgical treatments.

PubMed

Sung, Anthony D; Anderson, Megan E; Zurakowski, David; Hornicek, Francis J; Gebhardt, Mark C

2008-10-01

Between 1979 and 2004, 167 patients younger than 20 years were treated surgically for humeral or femoral unicameral bone cysts with either injection of corticosteroids (steroids), curettage plus bone grafting (curettage), or a combination injection of steroids, demineralized bone matrix, and bone marrow aspirate (SDB) at Children's Hospital of Boston and Massachusetts General Hospital (mean followup, 7.3 years; range, 1 month-27 years). Outcomes included treatment failure (defined clinically as subsequent pathologic fracture or need for retreatment to prevent pathologic fracture) and complications. Information was obtained from medical records and by telephone questionnaire. After one treatment, 84% of cysts treated with steroids experienced failed treatment versus 64% with curettage and 50% with SDB. For unicameral bone cysts requiring retreatment (regardless of first treatment), 76% retreated with steroids had failed treatment versus 63% with curettage and 71% with SDB. Curettage was associated with the lowest rate of posttreatment pathologic fractures and highest rate of pain and other complications. Multivariate logistic regression indicated treatment with steroids alone and younger age were independent predictors of failure. We believe SDB is a reasonable first treatment for unicameral bone cysts in the humerus and femur in patients younger than 20 years, being less invasive yet comparable to curettage in preventing recurrence.

Pathological fracture of the patella due to an atypical located aneurysmal bone cyst: verification by means of ultrasound-guided biopsy.

PubMed

Plaikner, Michaela; Gruber, Hannes; Henninger, Benjamin; Gruber, Leonhard; Kosiol, Juana; Loizides, Alexander

2016-03-01

We report on a rare case of an atypical located aneurysmal bone cyst (ABC) in the patella presenting with pathological fracture after trauma. Using all available diagnostic modalities and by means of ultrasound-guided core-needle biopsy an unclear and suspected pathological fractured cystic bone lesion in the patella of a young man could be further clarified. The acquired images suggested the diagnosis of a pathological fractured aneurysmal bone cyst after mild trauma. However, due to the extraordinary location and clinical presentation the diagnosis was secured by means of ultrasound-guided biopsy through a small cortical gap. As shown in this rare case of an atypical aneurysmal bone cyst of the patella, the quite seldom but sometimes possible ultrasound-guided biopsy of intraosseous lesions can help to achieve the diagnostic clarification and should also be taken into account as a non-standard procedure.

Unicameral Bone Cysts of the Pelvis

PubMed Central

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

Unicameral bone cysts of the pelvis: a study of 16 cases.

PubMed

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).

Unusual localizations of unicameral bone cysts and aneurysmal bone cysts: A retrospective review of 451 cases.

PubMed

Aycan, Osman Emre; Çamurcu, İsmet Yalkın; Özer, Devrim; Arıkan, Yavuz; Kabukçuoğlu, Yavuz Selim

2015-06-01

Unicameral bone cysts (UBC) and aneurysmal bone cysts (ABC) are benign cystic lesions of bone which are easily diagnosed. However, unusual locations may lead to a false diagnosis. Therefore the aim of this retrospective study was to determine the frequency of unusual localizations. The authors studied 451 cases with histopathologically confirmed diagnosis of UBC or ABC, seen between 1981 and 2012. In the UBC group (352 cases) humerus, femur and calcaneus were found to be the most common sites, while acetabulum, scapula, scaphoid, lunatum, metacarpals, metatarsals, toe phalanges and ulna each accounted for less than 1%. In the ABC group (99 cases) the most common sites of involvement were femur, humerus and tibia, while finger phalanges, ilium, acetabulum, pubis, calcaneus, cuboid, and toe phalanges each accounted for only 1%. The differential diagnosis of cystic bone lesions should include both UBC and ABC. Pain complaints plead for the latter, except in case of fracture.

Beware! A simple renal cyst could be a hydatid cyst.

PubMed

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.

[The expression and significance of receptor activator of nuclear factor kappaB ligand and osteoprotegerin in periapical cyst and periapical granuloma].

PubMed

Zhang, Meihua; Yu, Yunzhi; Miao, Yu

2012-08-01

To investigate the expression of receptor activator of nuclear factor kappaB ligand (RANKL) and osteoprotegerin (OPG) in periapical cyst and periapical granuloma by comparison with the expression in the normal periodontal tissue as control, and to identify their functional mechanism in the bone destruction of periapical cyst and granuloma. 20 periapical cyst tissues (cyst group), 20 periapical granuloma tissues (granuloma group), and 20 normal periodontal tissues (control group) were collected respectively. Immunohistochemical technology was performed to detect the expression of RANKL and OPG in above three groups. In cyst group, granuloma group and control group, the expression of RANKL were 75.00 +/- 7.54, 68.40 +/- 6.74 and 29.40 +/- 2.46, respectively. The expression of OPG were 38.10 +/- 7.09, 47.65 +/- 13.85 and 58.60 +/- 5.88, respectively. The differences among the three groups were statistically significant (P<0.05). RANKL and OPG in cysts group were negatively correlated (r=-0.56, P=0.01) and were not correlated with granuloma and control group (P>0.05). RANKL and OPG play roles in the bone absorption of periapical disease. In periapical disease, abnormal expression of RANKL and OPG are detected, RANKL significantly increase, OPG decrease, bone absorption accelerate and osteolytic lesion are observed. In periapical cyst, the bone absorption is more active compared with periapical granuloma.

Treatment of aneurysmal bone cysts of the pelvis and sacrum.

PubMed

Papagelopoulos, P J; Choudhury, S N; Frassica, F J; Bond, J R; Unni, K K; Sim, F H

2001-11-01

Aneurysmal bone cysts are benign, non-neoplastic, highly vascular bone lesions. The purpose of this study was to describe the prevalence, the clinical presentation, and the recurrence rate of aneurysmal bone cysts of the pelvis and sacrum and to examine the diagnostic and therapeutic options and prognosis for patients with this condition. Forty consecutive patients with an aneurysmal bone cyst of the pelvis and/or sacrum were treated from 1921 to 1996. Their medical records and radiographic and imaging studies were reviewed, and histological sections from the cysts were examined. Seventeen lesions were iliosacral, sixteen were acetabular, and seven were ischiopubic. Seven involved the hip joint, and two involved the sacroiliac joint. All twelve sacral lesions extended to more than one sacral segment and were associated with neurological signs and symptoms. Destructive acetabular lesions were associated with pathological fracture in five patients and with medial migration of the femoral head, hip subluxation, and hip dislocation in one patient each. The mean duration of follow-up was thirteen years (range, three to fifty-three years). Thirty-five patients who were initially treated for a primary lesion had surgical treatment (twenty-one had excision-curettage and fourteen had intralesional excision); two patients also had adjuvant radiation therapy. Of the thirty-five patients, five (14%) had a local recurrence noted less than eighteen months after the operation. Of five patients initially treated for a recurrent lesion, one had a local recurrence. At the latest follow-up examination, all forty patients were disease-free and twenty-eight (70%) were asymptomatic. There were two deep infections. Aneurysmal bone cysts of the pelvis and sacrum are usually aggressive lesions associated with substantial bone destruction, pathological fractures, and local recurrence. Current management recommendations include preoperative selective arterial embolization, excision-curettage, and bone-grafting.

The utility of endoscopic radical resection with microdissection electrodes for lingual thyroglossal duct cysts.

PubMed

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.

Dedifferentiated Liposarcoma of the Retroperitoneum With Heterologous Osteosarcomatous Differentiation and a Striking Aneurysmal Bone Cyst-Like Morphology.

PubMed

Van Haverbeke, Carole; Van Dorpe, Jo; Lecoutere, Evelyne; Flucke, Uta; Ferdinande, Liesbeth; Creytens, David

2017-06-01

A 69-year-old woman with a 10-year medical history of recurrent retroperitoneal dedifferentiated liposarcoma presented with a 3-cm large hemorrhagic and multicystic left-sided retroperitoneal mass. Histopathological examination of the resected specimen showed a heterogeneous, high-grade mesenchymal nonlipogenic tumor with areas of osteoblastic/osteosarcomatous differentiation and aneurysmal bone cyst-like features. Based on the clinical presentation, the morphology, and the supportive immunohistochemical and molecular findings (MDM2 overexpression and amplification of the MDM2 gene, respectively), a diagnosis of a dedifferentiated liposarcoma with heterologous osteosarcomatous differentiation and an aneurysmal bone cyst-like morphology was made. To the best of our knowledge, this is the first description of aneurysmal bone cyst-like morphology in dedifferentiated liposarcoma, further expanding the broad morphological spectrum of dedifferentiated liposarcoma.

Nasal dermoid cyst extending through the frontal bone with no sinus tract in a Dalmatian.

PubMed

van der Peijl, G J W; Schaeffer, I G F

2011-02-01

A Dalmatian was presented with a subcutaneous swelling in the dorsal midline between the eyes. No opening in the skin was identified at the dorsal nasal planum and there was no discharge. Positive contrast sinography showed contrast material filling a cyst that extended to the frontal bone. At surgery, the cyst had a tubular shape and was embedded in a fibrous dermal tissue strand running into the bony nasal septum. The nasal dermoid sinus cyst was surgically removed by limited dorsal rhinotomy, followed by excision of the remaining strand from a bony recess in the lamina perpendicularis ethmoidalis. It is proposed that this nasal dermoid cyst that extends through the frontal bone with no sinus tract is classified as a type V subtype c. © 2011 British Small Animal Veterinary Association.

Treatment of Unicameral Bone Cysts of the Calcaneus: A Systematic Review.

PubMed

Levy, David M; Gross, Christopher E; Garras, David N

2015-01-01

The calcaneus is the most common tarsal affected by unicameral bone cysts (UBCs); however, the treatment of calcaneal UBCs remains controversial. The purpose of the present systematic review was to evaluate the treatment modalities for calcaneal UBCs. A systematic review was performed using clinical studies of calcaneal UBCs with a minimum of 1 year of follow-up and level I to IV evidence. Ten studies with 171 patients (181 cysts) were selected. Heel pain and radiographic cyst consolidation were the primary outcomes. A series of Z tests were used to compare the outcomes in the nonoperative and operative groups, cannulated screw and bone augmentation groups, and autografting and allografting groups. All patients treated with open curettage and bone augmentation had significant improvements in heel pain (p < .001). Only 1.1% ± 1.0% of the cysts treated conservatively had healed on radiographs compared with 93.0% ± 13.0% of the cysts after surgery (p < .001). A greater percentage of patients treated with bone augmentation had preoperative heel pain and resolution of that pain than did patients treated with cannulated screws (p < .001). Autografting had a significantly greater percentage of radiographic cyst consolidation than did allografting (97.4% ± 11.1% versus 85.1% ± 15.8%, p < .001, Z = 3.5). Objective outcomes data on calcaneal UBCs are relatively sparse. The results of the present review suggest that open curettage with autograft bone augmentation is the most effective procedure. We would encourage future comparative clinical studies to elucidate differences in UBC treatment modalities. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Unusually large solitary unicameral bone cyst: case report.

PubMed

Singh, Sandeep; Dhammi, Ish Kumar; Arora, Anil; Kumar, Sudhir

2003-01-01

A 15-year-old boy presented with complaints of pain and swelling of the right leg. Radiography revealed a large lytic lesion involving the proximal half of the tibia. The patient was taken to surgery, where the cavity was curetted and packed with allogeneic bone graft. Tissue was sent for histopathological evaluation. The patient was kept in an above-knee cast for 4 months, after which partial weight-bearing was allowed. The histopathological diagnosis was a unicameral bone cyst. A radiograph at 1 year showed incorporation of the graft, but a small part of the cavity was still visible and there was a persistent discharge. The patient was again subjected to allogeneic bone grafting in the remaining cavity. At 3.5 years of follow-up now, the patient is walking unsupported, there is no pain, and the radiograph shows complete obliteration of the cavity. Unicameral bone cysts are usually a few centimeters in size. To the best of our knowledge, a unicameral bone cyst of such a large size has never been reported in the literature.

Unicameral bone cyst of the patella in a young dog.

PubMed

Petazzoni, M; Briotti, F; Beale, B

2015-01-01

This report describes a case of a solitary unicameral patellar bone cyst in a young dog. A five-month-old, male Dobermann Pinscher dog was referred for a 10-day left hindlimb lameness. A mild swelling of the peripatellar soft tissues of the left patella was detected upon physical examination. Signs of pain were elicited upon direct palpation of the patella. Radiographic examination revealed an oval radiolucency within the medullary cavity at the base of the left patella. Radiographic examination, arthroscopy, and histopathology findings supported the diagnosis of a benign patellar bone cyst. The condition was treated by surgical curettage and autogenous bone graft harvested from the ipsilateral proximal tibia. Clinical signs, including lameness and signs of pain upon deep palpation, disappeared three weeks after surgery. Follow-up re-evaluation five years after surgery revealed no recurrence of the cyst and the patient was asymptomatic.

Clinical evaluation of sinus bone graft in patients with mucous retention cyst.

PubMed

Kim, Seong-Beom; Yun, Pil-Young; Kim, Young-Kyun

2016-12-01

Mucous retention cyst refers to a cyst made by expansion due to the blockage of the salivary gland near the maxillary sinus, and it is surrounded by epithelial cells. Most of them are small; therefore, they cannot be found well and are frequently with antral polyp. The aim of this study was to evaluate the clinical prognosis of sinus bone graft in patients with mucous retention cyst. This study was performed retrospectively on 23 patients who had sinus bone graft. Group 1 was 8 patients (10 sinuses) who had a mucous retention cyst, and group 2 was 15 patients (17 sinuses) who had no pathologic history about the maxillary sinus. For these patients, sinus bone graft was performed using the lateral approach technique. The total 51 implants were placed 6.22 weeks on the average after sinus bone graft. Sinus membrane perforation during operation, postoperative complications, marginal bone loss after restorative function, implant success rate, and survival rate were analyzed. There was no complication in group 1, and there were three complications in group 2. In group 2, two cases of implants failed. The types of postoperative complications consisted of two minor infections and one wound dehiscence. Two implants of total 51 implants were removed, and the survival rate of implants was 96.08 % (group 1 100 %, group 2 93.5 %). The total success rate of implants was 92.2 % (group 1 95 %, group 2 90.3 %). The clinical prognosis was not affected by the presence of mucous retention cyst.

Unicameral bone cyst of a cervical vertebral body and lateral mass with associated pathological fracture in a child. Case report and review of the literature.

PubMed

Snell, B E; Adesina, A; Wolfla, C E

2001-10-01

The authors present the case of a 10-year-old girl with a history of cervical trauma in whom a cystic lesion was found to involve all three columns of C-7 with evidence of pathological fracture. Computerized tomography scanning revealed a lytic lesion with sclerotic margins involving the left vertebral body, pedicle, lateral mass, and lamina of C-7 with an associated pathological compression fracture. Magnetic resonance imaging demonstrated mixed signal on both T1- and T2-weighted sequences, with cystic and enhancing solid portions. Magnetic resonance angiography demonstrated anterior displacement of the left vertebral artery at C-7. The patient underwent C-7 subtotal corpectomy and posterior resection of the tumor mass; anterior and posterior fusion were performed in which instrumentation was placed. Histological examination disclosed cystic areas lined by fibromembranous tissue with calcification and osteoid deposits consistent with unicameral bone cyst. Of the four previously reported cases of unicameral bone cysts in the cervical spine, none involved all three columns simultaneously or was associated with pathological fracture. The most common differential diagnostic considerations for cystic lesions in the spine are aneurysmal bone cyst, osteoblastoma, or giant cell tumor of bone. Unicameral bone cyst, in this location, although rare, must be considered in the differential diagnosis and may require resection and spinal reconstruction.

A comparison of treating Unicameral bone cyst using steroids and percutaneous autologous bone marrow aspiration injection.

PubMed

Akram, Muhammad; Farooqi, Faheem Mubashir; Shahzad, Muhammad Latif; Awais, Syed Muhammad

2015-11-01

To compare the results of percutaneous autologous bone aspiration injection and steroids injections in the treatment of unicameral bone cyst. The prospective study was conducted at Mayo Hospital, Lahore, from January 2008 to March 2014, and comprised patients diagnosed radiologically as a case of unicameral bone cyst. The patients were divided into two groups, with group 1 being treated with bone marrow aspiration injection, while group 2 was given steroids injection. Aspiration of bone marrow was done from tibial tuberosity. The 30 patients in the study were divided into two groups of 15(50%) each. In group 1, 8(53.34%) patients and in group 2, 3 (20%) patients achieved healing after the first injection (p<0.05), while overall success rates were 13(86.67%) in group 1, and 11(73.33%) in group 2 (p> 0.05). The mean number of procedures required in group 1 was 1.57± 0.495 (range: 01-3) and for 2.19 ± 1.076 (range: 1-5) in group 2 (p<0.05), and mean interval-to-healing was 14.3 months ± 8.705 (range: 7-36) for group 1 and 12.5 months ± 7.88 (range: 4-32) for group 2 (p> 0.05). Bone marrow aspiration injection was better than steroids in treating unicameral bone cyst.

Treatment of unicameral bone cysts by curettage and packing with plaster-of-Paris pellets. 1978.

PubMed

Peltier, Leonard F; Jones, Richard H

2004-05-01

Long-term follow-up of twenty-six patients with unicameral bone cysts treated by curettage and packing with plaster-of-Paris pellets showed a recurrence in only two cases and no serious complications.

Unicameral bone cyst of the scaphoid: a report of two cases.

PubMed

Javdan, Mohammad; Zarezadeh, Abolghasem; Gaulke, Raulf; Eshaghi, Mohammad Amin; Shemshaki, Hamidreza

2012-08-01

Unicameral bone cysts are benign, fluid-filled lesions that occur mostly in long bones (proximal humerus, 50-60%; femur, 30%) of male children aged 5 to 15 years. Occurrence in the scaphoid of an adult is rare. We report 2 such patients who presented with wrist pain, with and without a history of trauma. Both underwent curettage and bone grafting (harvested from the distal radius) and achieved good functional recovery.

A rare case of osteoblastoma associated to aneurysmal bone cyst of the spine. Case report.

PubMed

Pavanello, Marco; Melloni, Ilaria; Fiaschi, Pietro; Consales, Alessandro; Piatelli, Gianluca; Ravegnani, Marcello; Nozza, Paolo; Gandolfo, Carlo; Cama, Armando

2016-01-01

Osteoblastoma is a rare bone tumour. It is occasionally associated with an aneurysmal bone cyst (ABC). Several treatment strategies can be adopted. We report a challenging case of an osteoblastoma associated with ABC of the lumbar spine in a 2-year-old boy. The pathogenesis and the critical management of the disease are discussed.

Malignant transformation of a unicameral bone cyst in a cat.

PubMed

Berger, Björn; Brühschwein, Andreas; Eddicks, Lina; Meyer-Lindenberg, Andrea

2016-04-01

A unicameral bone cyst in the proximal humerus of a 3-year-old Norwegian forest cat was diagnosed by dynamic contrast-enhanced magnetic resonance imaging, surgical exploration, and histopathology. Surgical curettage and incorporation of bone cement led to full recovery. An osteosarcoma developed at the surgical site 17 months later. Thoracic radiographs showed pulmonary lesions consistent with metastasis.

Malignant transformation of a unicameral bone cyst in a cat

PubMed Central

Berger, Björn; Brühschwein, Andreas; Eddicks, Lina; Meyer-Lindenberg, Andrea

2016-01-01

A unicameral bone cyst in the proximal humerus of a 3-year-old Norwegian forest cat was diagnosed by dynamic contrast-enhanced magnetic resonance imaging, surgical exploration, and histopathology. Surgical curettage and incorporation of bone cement led to full recovery. An osteosarcoma developed at the surgical site 17 months later. Thoracic radiographs showed pulmonary lesions consistent with metastasis. PMID:27041754

Clinical factors affecting pathological fracture and healing of unicameral bone cysts

PubMed Central

2014-01-01

Background Unicameral bone cyst (UBC) is the most common benign lytic bone lesion seen in children. The aim of this study is to investigate clinical factors affecting pathological fracture and healing of UBC. Methods We retrospectively reviewed 155 UBC patients who consulted Nagoya musculoskeletal oncology group hospitals in Japan. Sixty of the 155 patients had pathological fracture at presentation. Of 141 patients with follow-up periods exceeding 6 months, 77 were followed conservatively and 64 treated by surgery. Results The fracture risk was significantly higher in the humerus than other bones. In multivariate analysis, ballooning of bone, cyst in long bone, male sex, thin cortical thickness and multilocular cyst were significant adverse prognostic factors for pathological fractures at presentation. The healing rates were 30% and 83% with observation and surgery, respectively. Multivariate analysis revealed that fracture at presentation and history of biopsy were good prognostic factors for healing of UBC in patients under observation. Conclusion The present results suggest that mechanical disruption of UBC such as fracture and biopsy promotes healing, and thus watchful waiting is indicated in these patients, whereas patients with poor prognostic factors for fractures should be considered for surgery. PMID:24884661

Clinical factors affecting pathological fracture and healing of unicameral bone cysts.

PubMed

Urakawa, Hiroshi; Tsukushi, Satoshi; Hosono, Kozo; Sugiura, Hideshi; Yamada, Kenji; Yamada, Yoshihisa; Kozawa, Eiji; Arai, Eisuke; Futamura, Naohisa; Ishiguro, Naoki; Nishida, Yoshihiro

2014-05-17

Unicameral bone cyst (UBC) is the most common benign lytic bone lesion seen in children. The aim of this study is to investigate clinical factors affecting pathological fracture and healing of UBC. We retrospectively reviewed 155 UBC patients who consulted Nagoya musculoskeletal oncology group hospitals in Japan. Sixty of the 155 patients had pathological fracture at presentation. Of 141 patients with follow-up periods exceeding 6 months, 77 were followed conservatively and 64 treated by surgery. The fracture risk was significantly higher in the humerus than other bones. In multivariate analysis, ballooning of bone, cyst in long bone, male sex, thin cortical thickness and multilocular cyst were significant adverse prognostic factors for pathological fractures at presentation. The healing rates were 30% and 83% with observation and surgery, respectively. Multivariate analysis revealed that fracture at presentation and history of biopsy were good prognostic factors for healing of UBC in patients under observation. The present results suggest that mechanical disruption of UBC such as fracture and biopsy promotes healing, and thus watchful waiting is indicated in these patients, whereas patients with poor prognostic factors for fractures should be considered for surgery.

Mid- and long-term clinical results of surgical therapy in unicameral bone cysts

PubMed Central

2011-01-01

Background Unicameral (or simple) bone cysts (UBC) are benign tumours most often located in long bones of children and adolescents. Pathological fractures are common, and due to high recurrence rates, these lesions remain a challenge to treat. Numerous surgical procedures have been proposed, but there is no general consensus of the ideal treatment. The aim of this investigation therefore was to study the long-term outcome after surgical treatment in UBC. Methods A retrospective analysis of 46 patients surgically treated for UBC was performed for short and mid-term outcome. Clinical and radiological outcome parameters were studied according to a modified Neer classification system. Long-term clinical information was retrieved via a questionnaire at a minimum follow-up of 10 years after surgery. Results Forty-six patients (17 female, 29 male) with a mean age of 10.0 ± 4.8 years and with histopathologically confirmed diagnosis of UBC were included. Pathological fractures were observed in 21 cases (46%). All patients underwent surgery for UBC (35 patients underwent curettage and bone grafting as a primary therapy, 4 curettage alone, 3 received corticoid instillation and 4 decompression by cannulated screws). Overall recurrence rate after the first surgical treatment was 39% (18/46), second (17.4% of all patients) and third recurrence (4.3%) were frequently observed and were addressed by revision surgery. Recurrence was significantly higher in young and in male patients as well as in active cysts. After a mean of 52 months, 40 out of 46 cysts were considered healed. Prognosis was significantly better when recurrence was observed later than 30 months after therapy. After a mean follow-up of 15.5 ± 6.2 years, 40 patients acknowledged clinically excellent results, while five reported mild and casual pain. Only one patient reported a mild limitation of range of motion. Conclusions Our results suggest satisfactory overall long-term outcome for the surgical treatment of UBC, although short-and mid-term observation show a considerable rate of recurrence independent of the surgical technique. PMID:22165900

Successful treatment of unicameral bone cyst by single percutaneous injection of alpha-BSM.

PubMed

Thawrani, Dinesh; Thai, Chia Che; Welch, Robert D; Copley, Lawson; Johnston, Charles E

2009-01-01

Unicameral bone cyst (UBC) is a benign bone lesion, recognized for its high rate of recurrence and need for repeat procedures to achieve healing. We hypothesized that the osteoconductive material apatitic calcium phosphate (alpha-BSM) could be effective in filling and stimulating resolution of UBC. The purpose of this study was to evaluate clinical and radiographic outcomes of UBC treated by a single injection of alpha-BSM. Thirteen patients (6 male, 7 female) with a mean age of 10.5 years, underwent single percutaneous injection of alpha-BSM for presumed UBC. The aspiration of the cysts was followed by vigorous saline lavage using 2 wide bore needles to disrupt the cyst walls. alpha-BSM "paste" was then injected under fluoroscopic guidance. Radiographs were digitized to measure cystic area (millimeter squares) on 2 orthogonal views. Healing was rated according to a modified Neer outcome grading system. Nine of the 13 patients had had pathologic fractures in the past. Eleven of the 13 patients had had past unsuccessful treatment: multiple steroid injections in 6, curettage and bone grafting in 3, and bone marrow and demineralized bone matrix (Grafton) injection in 2. Five cysts were grade 1 (healed 100%), 6 grade 2 (healed >50%), 2 grade 3 (healed <50% with increased cortical thickness), and none grade 4 (recurrence/enlargement). The average resolution of cystic area in 11/13 cysts was 85.7% at final follow-up of 35.8 months (P=0.0001) with 2.8 mm of average gain in cortical thickness (P=0.0018). None of the 13 lesions required an additional procedure or repeat injection. All patients were clinically asymptomatic at latest follow-up. This is the first study quantifying cyst resolution objectively according to actual decrease in area (millimeter squares). A single injection of alpha-BSM is a safe, minimally invasive and efficacious method to treat UBC in the pediatric population.

Lupus pernio: a clinico-radiological study of thirty-five cases.

PubMed

Spiteri, M A; Matthey, F; Gordon, T; Carstairs, L S; James, D G

1985-03-01

Thirty-five patients with lupus pernio were observed in a series of 818 patients with clinical and histological evidence of sarcoidosis. This analysis provides the natural history of lupus pernio and its associated clinico-radiographic features. There was intrathoracic involvement in 74% of patients, upper respiratory tract disease in 54%, reticulo-endothelial involvement in 54%, bone cysts in 43% and ocular lesions in 37%. It predominated in West Indies-born women. Histological confirmation was easily obtained by nasal mucosal biopsy and this could be repeated serially to evaluate the response to various treatments. Nasal bone radiographs showed destruction of the nasal bones, porosis and alteration in bone texture. Peripheral bone cysts were evident in 50% of patients who were radiographed, and in about 50% of these patients, the cysts were found in both hands and feet.

Primary aneurysmal bone cyst of coronoid process

PubMed Central

Goyal, Amit; Tyagi, Isha; Syal, Rajan; Agrawal, Tanu; Jain, Manoj

2006-01-01

Background Aneurysmal bone cysts are relatively uncommon in the facial skeleton. These usually affect the mandible but origin from the coronoid process is even rarer. To the best of our knowledge, this is the first reported case of a coronoid process aneurysmal bone cyst presenting as temporal fossa swelling. Case presentation A 17 year old boy presented with a progressively increasing swelling in the left temporal region developed over the previous 8 months. An expansile lytic cystic lesion originating from the coronoid process of the left mandible and extending into the infratemporal and temporal fossa regions was found on CT scan. It was removed by a superior approach to the infratemporal fossa. Conclusion Aneurysmal bone cyst of the coronoid process can attain enormous dimensions until the temporal region is also involved. A superior approach to the infratemporal fossa is a reasonable approach for such cases, providing wide exposure and access to all parts of the lesion and ensuring better control and complete excision. PMID:16533409

Treatment of unicameral bone cyst: surgical technique.

PubMed

Hou, Hsien-Yang; Wu, Karl; Wang, Chen-Ti; Chang, Shun-Min; Lin, Wei-Hsin; Yang, Rong-Sen

2011-03-01

There is a variety of treatment modalities for unicameral bone cysts, with variable outcomes reported in the literature. Although good initial outcomes have been reported, the success rate has often changed with longer-term follow-up. We introduce a novel, minimally invasive treatment method and compare its clinical outcomes with those of other methods of treatment of this lesion. From February 1994 to April 2008, forty patients with a unicameral bone cyst were treated with one of four techniques: serial percutaneous steroid and autogenous bone-marrow injection (Group 1, nine patients); open curettage and grafting with a calcium sulfate bone substitute either without instrumentation (Group 2, twelve patients) or with internal instrumentation (Group 3, seven patients); or minimally invasive curettage, ethanol cauterization, disruption of the cystic boundary, insertion of a synthetic calcium sulfate bone-graft substitute, and placement of a cannulated screw to provide drainage (Group 4, twelve patients). Success was defined as radiographic evidence of a healed cyst or of a healed cyst with some defect according to the modified Neer classification, and failure was defined as a persistent or recurrent cyst that needed additional treatment. Patients who sustained a fracture during treatment were also considered to have had a failure. The outcome parameters included the radiographically determined healing rate, the time to solid union, and the total number of procedures needed. The follow-up time ranged from eighteen to eighty-four months. Group-4 patients had the highest radiographically determined healing rate. Healing was seen in eleven of the twelve patients in that group compared with three of the nine in Group 1, eight of the twelve in Group 2, and six of the seven in Group 3. Group-4 patients also had the shortest mean time to union: 3.7 ± 2.3 months compared with 23.4 ± 14.9, 12.2 ± 8.5, and 6.6 ± 4.3 months in Groups 1, 2, and 3, respectively. This new minimally invasive method achieved a favorable outcome, with a higher radiographically determined healing rate and a shorter time to union. Thus, it can be considered an option for initial treatment of unicameral bone cysts.

Treatment of unicameral bone cyst: a comparative study of selected techniques.

PubMed

Hou, Hsien-Yang; Wu, Karl; Wang, Chen-Ti; Chang, Shun-Min; Lin, Wei-Hsin; Yang, Rong-Sen

2010-04-01

There is a variety of treatment modalities for unicameral bone cysts, with variable outcomes reported in the literature. Although good initial outcomes have been reported, the success rate has often changed with longer-term follow-up. We introduce a novel, minimally invasive treatment method and compare its clinical outcomes with those of other methods of treatment of this lesion. From February 1994 to April 2008, forty patients with a unicameral bone cyst were treated with one of four techniques: serial percutaneous steroid and autogenous bone-marrow injection (Group 1, nine patients); open curettage and grafting with a calcium sulfate bone substitute either without instrumentation (Group 2, twelve patients) or with internal instrumentation (Group 3, seven patients); or minimally invasive curettage, ethanol cauterization, disruption of the cystic boundary, insertion of a synthetic calcium sulfate bone-graft substitute, and placement of a cannulated screw to provide drainage (Group 4, twelve patients). Success was defined as radiographic evidence of a healed cyst or of a healed cyst with some defect according to the modified Neer classification, and failure was defined as a persistent or recurrent cyst that needed additional treatment. Patients who sustained a fracture during treatment were also considered to have had a failure. The outcome parameters included the radiographically determined healing rate, the time to solid union, and the total number of procedures needed. The follow-up time ranged from eighteen to eighty-four months. Group-4 patients had the highest radiographically determined healing rate. Healing was seen in eleven of the twelve patients in that group compared with three of the nine in Group 1, eight of the twelve in Group 2, and six of the seven in Group 3. Group-4 patients also had the shortest mean time to union: 3.7 +/- 2.3 months compared with 23.4 +/- 14.9, 12.2 +/- 8.5, and 6.6 +/- 4.3 months in Groups 1, 2, and 3, respectively. This new minimally invasive method achieved a favorable outcome, with a higher radiographically determined healing rate and a shorter time to union. Thus, it can be considered an option for initial treatment of unicameral bone cysts.

Treatment of unicameral calcaneal bone cysts in children: review of literature and results using a cannulated screw for continuous decompression of the cyst.

PubMed

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.

A case of dedifferentiated chondrosarcoma arising in the cricoid cartilage that mimicked an aneurysmal bone cyst.

PubMed

Chen, Lixiao; Yu, Ziwei; Jiang, Rui; Dong, Pin; Shen, Bin; Li, Yu

2018-03-01

Dedifferentiated chondrosarcoma of the larynx is a rare and highly malignant tumor. We present the report of a 59-year-old man with dedifferentiated laryngeal chondrosarcoma, which was difficult to diagnose even under microscopic examination. The original diagnosis was an aneurysmal bone cyst, and the final diagnosis was established only after careful consideration of the imaging, surgical, and microscopic findings. In clinical practice, there are many similarities between dedifferentiated chondrosarcoma and aneurysmal bone cysts. Furthermore, it is difficult to identify dedifferentiated laryngeal chondrosarcoma with a giant-cell malignant mesenchymal component. This report describes our experience and discusses this phenomenon.

Distance from the growth plate and Its relation to the outcome of unicameral bone cyst treatment.

PubMed

Haidar, Saadallah George; Culliford, David J; Gent, Edward David; Clarke, Nicholas M P

2011-04-01

Interventions to treat unicameral bone cysts vary. Nonetheless, regardless of the intervention modality, the outcome is not certain. The purpose of this study was to determine if the distance between the growth plate and the cyst can be used to predict the outcome of the treatment. Retrospectively, we assessed the outcome of 39 interventions in nineteen children that were performed between 1994 and 2003. Seventeen different modalities of treatment were employed. There were three female and sixteen male patients. The average age was 8 years. Nine cysts were in the greater trochanter area, three were in the femoral capital area and seven were in the proximal humerus. According to the cyst's distance from the growth plate, at the intervention time, there were 18 cases within less than 2 cm and 21 cases of more than 2 cm. Complete healing was achieved in 10 children (employing seven different modalities). In nine of them, the cysts were more than 2 cm away from the growth plate. In one child, the cyst was within less than 2 cm of the growth plate, however, treatment here involved epiphyseodesis. This study confirmed that, regardless of intervention modality, complete healing was not achievable in those cysts that are within less than 2 cm of an active growth plate. Complete healing was possible in those cysts that are more than 2 cm away from the growth plate. The 2-cm distance from the growth plate could be used as a predictor of treatment outcome of unicameral bone cysts.

[In vitro study on bone resorption of odontogenic cysts and ameloblastomas].

PubMed

Gao, Li; Li, Tie-jun

2005-05-01

To investigate the effect of bone resorption by odontogenic cysts and ameloblastomas in vitro. Fragments of odontogenic cysts (14 odontogenic keratocysts, 6 inflamed odontogenic keratocysts, 5 dentigerous cysts) and ameloblastomas (n = 7) were incubated in vitro for 24 h. The supernatant was then removed into the culture system of SD rat calvaria. After incubation (48 h), the calcium contents of the media were measured by atom spectrophotometer. The supernatant of odontogenic cysts and ameloblastomas was measured for the bone resorption related factors such as IL-6, TNF-alpha, PGE(2), bone Gla-containing protein (BGP) and calcitonin (CT) by a radioimmunoassay system. The calcium released in the calvaria culture media by all the odontogenic lesions was significantly higher than that in the blank controls (P < 0.01). The inflamed odontogenic keratocyst group had a significantly higher calcium concentration than odontogenic keratocyst and ameloblastoma groups (P < 0.05). In addition, the concentration of IL-6, TNF-alpha, PGE(2) and CT in the culture media of all odontogenic lesions were significantly higher than that of the blank controls (P < 0.05). IL-6 concentration in the inflamed and non-inflamed odontogenic keratocyst groups were significantly higher than that of ameloblastoma group (P < 0.05). CT concentration in the inflamed odontogenic keratocyst was significantly higher than those of odontogenic keratocyst and dentigerous cyst groups (P < 0.05). Correlation and regression analysis showed that IL-6 was significantly correlated with the calcium content (P < 0.01). The odontogenic lesions could promote bone resorption in vitro and it is likely to be related to some of the cytokines secreted by the lesions.

Aneurysmal bone cyst of the scapula. A case report.

PubMed

Megas, Panagiotis; Papathanassiou, Zafiria G; Kasimatis, George; Papachristou, Dionysios J

2009-10-01

Aneurysmal bone cyst (ABC) is an uncommon, benign but locally destructive bone lesion of unknown origin. Differential diagnosis can be challenging as it shares common radiological and pathological features with other benign and malignant bone lesions. The degree of diagnostic difficulty grows even more when an unusual location has to be taken into account. We report a rare and challenging case of a large primary ABC located at the scapula of a young male, who was surgically treated with subtotal removal of the scapula.

[Vertebral aneurysmatic bone cyst: study of three cases].

PubMed

Vale, Benjamim Pessoa; Alencar, Francisco José; de Aguiar, Guilherme Brasileiro; de Almeida, Bruno Ribeiro

2005-12-01

Aneurysmatic bone cyst is a hypervascularized, benign lesion locally destructive by its progressive growth with greater incidence in the second decade of life. It lodges preferably in the long bones and vertebrae. The clinical picture varies from pain to local edema and even neurological symptoms when in vertebral location. Three cases of vertebral aneurysmatic bone cyst occurring in childhood and all with neurologic deficit symptoms are described. Computerized tomography and/or magnetic resonance imaging confirmed the diagnosis. Patients underwent surgery to remove the tumor. In one of the cases, pre-operative selective arterial embolization of the lesion was performed. The three patients progressed satisfactorily with neurological improvement, which demonstrated the efficiency of the microsurgical technique for the resection of the spinal tumor. The evolution of the cases and the current treatment are discussed.

[Endoscopic surgery in the treatment of patients with extensive odontogenic cysts].

PubMed

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.

[Spinal cord compression caused by spinal aneurysmal bone cyst (author's transl)].

PubMed

Steimlé, R; Pageaut, G; Jacquet, G; Gehin, P; Sexe, C B

1975-01-01

Spinal aneurysmal bone cyst is sufficiently rare for the authors to report this case with rapid evolution and development of paraplegia. Total removal was achieved, and clinical recovery remained complete six months after operation. The pathogenic, clinical, radiological, histological and therapeutic aspects are briefly reviewed and discussed.

[Odontogenic and nonodontogenic jaw cysts: experience in 25 cases].

PubMed

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.

Intracranial, intradural aneurysmal bone cyst.

PubMed

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.

Periorbital cyst with bone defect in a dog.

PubMed

Ito, Kanako; Asano, Kazushi; Urano, Toshiaki; Ogiwara, Naoki; Seki, Mamiko; Kato, Yuka; Sasaki, Yukie; Teshima, Kenji; Kutara, Kenji; Edamura, Kazuya; Shibuya, Hisashi; Tanaka, Shigeo

2006-07-01

A 4-year-old female Miniature Dachshund was referred with a chief complaint of right periorbital swelling that had not responded to antibiotic therapy. Ultrasonography and fine-needle aspiration revealed that the periorbital lesion had a cystic structure without any inflammatory or neoplastic cells. Computed tomography (CT) showed that the cyst occupied a defect in the periorbital maxillary, lacrimal, and frontal bones and had invaded the nasal cavity. The lesion was histologically suspected by incisional biopsy as an epithelial cyst.

The prevalence of incidental simple ovarian cysts >or= 3 cm detected by transvaginal sonography in early pregnancy.

PubMed

Glanc, Phyllis; Brofman, Nicole; Salem, Shia; Kornecki, Anat; Abrams, Jason; Farine, Dan

2007-06-01

To determine the prevalence of simple ovarian cysts of >or= 3 cm diameter detected by transvaginal sonography (TVS) in a population of asymptomatic women in early pregnancy. We conducted a retrospective review of 10,830 consecutive women presenting prior to 14 weeks' gestational age (GA) for early dating TVS. The records of all women with simple cysts >or= 3 cm in diameter were included. The study population was divided into five groups by GA: >or= 6 weeks; 6.1-8 weeks; 8.1-10 weeks; 10.1-12 weeks; and 12.1-14 weeks. A simple cyst >or= 3 cm in diameter was present in 4.9% of women at >or= 6 weeks' gestation, in 5.1% between 6.1 and 8 weeks, in 5.3% between 8.1 and 10 weeks, in 3.2% between 10.1. and 12 weeks, and in 1.5% between 12 and 14 weeks. Overall, a simple cyst >or= 3 cm was present in 516 women (4.8%). Prior to 10 weeks, 5.1% had simple cysts >or= 3 cm, dropping to 2.7% after 10 weeks, a statistically significant decrease (P<0.0001). Between 10.1 weeks and 12 weeks, the prevalence dropped to 3.2%, and then to 1.5% in the 12.1-14 week group. This investigation provides reference data on the prevalence of detecting simple ovarian cysts >or= 3 cm by TVS in an asymptomatic early pregnancy population. A progressive decline in the frequency of detecting simple ovarian cysts >or= 3 cm begins after 10 weeks' gestational age.

Benign occipital unicameral bone cyst causing lower cranial nerve palsies complicated by iophendylate arachnoiditis

PubMed Central

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

Gadolinium-DTPA enhanced magnetic resonance imaging of bone cysts in patients with rheumatoid arthritis.

PubMed Central

Gubler, F M; Algra, P R; Maas, M; Dijkstra, P F; Falke, T H

1993-01-01

OBJECTIVES--To examine the contents of intraosseous cysts in patients with rheumatoid arthritis (RA) through the signal intensity characteristics on gadolinium-DTPA (Gd-DTPA) enhanced magnetic resonance imaging. METHODS--The hand or foot joints of nine patients with the cystic form of RA (where the initial radiological abnormality consisted of intraosseous cysts without erosions) were imaged before and after intravenous administration of Gd-DTPA. A 0.6 unit, T1 weighted spin echo and T2* weighted gradient echo were used to obtain images in at least two perpendicular planes. RESULTS--Most cysts showed a low signal intensity on the non-enhanced T1 weighted (spin echo) images and a high signal intensity on the T2* weighted (gradient echo) images, consistent with a fluid content. No cyst showed an enhancement of signal intensity on the T1 weighted images after intravenous administration of Gd-DTPA, whereas synovium hyperplasia at the site of bony erosions did show an increased signal intensity after Gd-DTPA. Magnetic resonance imaging detected more cysts (as small as 2 mm) than plain films, and the cysts were located truly intraosseously. In six patients no other joint abnormalities were identified by magnetic resonance imaging; the three other patients also showed, after Gd-DTPA administration, an enhanced synovium at the site of bony erosions. CONCLUSIONS--It is suggested that intraosseous bone cysts in patients with RA do not contain hyperaemic synovial proliferation. The bone cysts in patients with the cystic form of RA may be the only joint abnormality. Images PMID:8257207

Associated aneurysmal bone cyst and cemento-osseous dysplasia: a case report and review of the literature.

PubMed

Jacomacci, Willian Pecin; Veloso Perdigão, João Paulo; Veltrini, Vanessa Cristina; Farah, Gustavo Jacobucci; Tolentino, Elen Souza; Vessoni Iwaki, Lilian Cristina; Iwaki Filho, Liogi

2017-01-01

The purpose of this case report is to describe a previously unpublished association between focal cemento-osseous dysplasia (FCOD) and an aneurysmal bone cyst (ABC) and review the literature with regard to associated benign fibro-osseous lesions and cysts. A 41-year-old woman without a history of trauma presented with asymptomatic swelling in the right side of the mandible. Radiographs of the region revealed a unilocular radiolucent area with radiopaque foci. After aspiration of the lesion was positive for serosanguineous fluid, complete excision of the lesion was performed. Microscopic examination revealed a hybrid ABC and FCOD. The 12-month follow-up showed significant bone repair and no signs of recurrence. A review of the English-language literature from 1980 to 2012 revealed 1 retrospective study, 4 case series, and 18 single-case reports on the topic of cemento-osseous dysplasias, fibro-osseous lesions, and aneurysmal bone cysts. Of 59 cases, none reported an association between an ABC and FCOD. Although fibro-osseous lesions do not require intervention, surgical excision is recommended when they are associated with cysts. This case, in which an ABC and FCOD were associated, reinforces the need for a careful diagnostic process in radiographically mixed lesions that respond positively to aspiration biopsy.

Injection of demineralized bone matrix with bone marrow concentrate improves healing in unicameral bone cyst.

PubMed

Di Bella, Claudia; Dozza, Barbara; Frisoni, Tommaso; Cevolani, Luca; Donati, Davide

2010-11-01

Unicameral bone cysts are benign lesions that usually spontaneously regress with skeletal maturity; however, the high risk of pathologic fractures often justifies treatment that could reinforce a weakened bone cortex. Various treatments have been proposed but there is no consensus regarding the best procedure. We compared the healing rates and failures of two methods of cure based on multiple injections of corticosteroid or a single injection of demineralized bone matrix (DBM) in association with bone marrow concentrate (BMC). We retrospectively reviewed 184 patients who had one of the two treatments for unicameral bone cysts with cortical erosion. Clinical records were reviewed for treatment failures and radiographs for healing in all patients. The minimum followup was 12 months for the Steroids Group (mean, 48 months; range, 12-120 months) and 12 months for the DBM + BMC Group (mean, 20 months; range, 12-28 months). After one treatment we observed a lower healing rate of cysts treated with multiple injections of steroids compared with the healing after the first injection of DBM + BMC (21% versus 58%, respectively). At last followup, 38% healed with steroids and 71% with DBM + BMC. The rate of failure after one steroid injection was higher than after a single injection of BDM + BMC (63% versus 24%, respectively). We observed no difference in fracture rates after treatment between the two groups. A single injection of DBM added with autologous bone marrow concentrate appears to provide a higher healing rate with a lower number of failures compared with a single injection of steroids.

Treated unicameral bone cysts.

PubMed

Weinman, J; Servaes, S; Anupindi, S A

2013-06-01

Unicameral bone cysts (UBCs) are a common benign entity involving the metaphysis of growing bone, occurring within the first two decades of life. Assessment of these lesions, both before and after surgery, is performed routinely utilizing radiographs. We present a review of UBCs at various stages of treatment, including both successful and incomplete healing, and describe the imaging findings throughout their postoperative course. Copyright © 2012 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Translocation (16;20)(p11.2;q13). sole cytogenetic abnormality in a unicameral bone cyst.

PubMed

Richkind, Kathleen E; Mortimer, Errol; Mowery-Rushton, Patricia; Fraire, Armando

2002-09-01

We report the results of cytogenetic analysis of a case of unicameral bone cyst with a t(16;20(p11.2;q13) present as the sole abnormality. To our knowledge, this is only the second report of a cytogenetically characterized tumor of this type.

Epiphora associated with dacryops in a dog.

PubMed

Grahn, B H; Mason, R A

1995-01-01

A six-month-old basset hound was presented with unilateral right epiphora and medial canthal and maxillary bone swelling. Skull radiographs and dacryocystorhinography revealed a nasal cyst, right nasolacrimal duct dilatation, and obstruction. Laboratory examination of the cyst confirmed the diagnosis of dacryops, a cyst of lacrimal gland origin. The cyst was treated successfully with surgical drainage and curettage.

The role of osteoblast cells in the pathogenesis of unicameral bone cysts.

PubMed

Aarvold, Alexander; Smith, James O; Tayton, Edward R; Edwards, Caroline J; Fowler, Darren J; Gent, Edward D; Oreffo, Richard O C

2012-08-01

The pathogenesis of unicameral bone cysts (UBCs) remains largely unknown. Osteoclasts have been implicated, but the role of osteoblastic cells has, to date, not been explored. This study investigated the pathophysiology of UBCs by examining the interactions between the cyst fluid and human bone marrow stromal cells (hBMSCs) and the effect of the fluid on osteogenesis. Fluid was aspirated from two UBCs and analysed for protein, electrolyte and cytokine levels. Graded concentrations of the fluid were used as culture media for hBMSCs to determine the effects of the fluid on hBMSC proliferation and osteogenic differentiation. The fibrocellular lining was analysed histologically and by electron microscopy. Alkaline phosphatase (ALP) staining of hBMSCs that were cultured in cyst fluid demonstrated increased cell proliferation and osteogenic differentiation compared to basal media controls. Biochemical analysis of these hBMSCs compared to basal controls confirmed a marked increase in DNA content (as a marker of proliferation) and ALP activity (as a marker of osteogenic differentiation) which was highly significant (p < 0.001). Osteoclasts were demonstrated in abundance in the cyst lining. The cyst fluid cytokine profile revealed levels of the pro-osteoclast cytokines IL-6, MIP-1α and MCP-1 that were 19×, 31× and 35× greater than those in reference serum. Cyst fluid promoted osteoblastic growth and differentiation. Despite appearing paradoxical that the cyst fluid promoted osteogenesis, osteoblastic cells are required for osteoclastogenesis through RANKL signalling. Three key cytokines in this pathway (IL-6, MIP-1α, MCP-1) were highly elevated in cyst fluid. These findings may hold the key to the pathogenesis of UBCs, with implications for treatment methods.

Epidermoid Cyst of Mandible Ramus: Case Report.

PubMed

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.

A giant cranial aneurysmal bone cyst associated with fibrous dysplasia.

PubMed

Składzieriń, J; Olés, K; Zagólski, O; Moskała, M; Sztuka, M; Strek, P; Wierzchowski, W; Tomik, J

2008-01-01

An aneurysmal bone cyst (ABC) is a rare, benign fibro-osseous lesion, considered a vascular phenomenon secondary to fibrous dysplasia or a giant-cell tumour, and occurs mainly in long bones and vertebrae. In this case report a 16-year-old male presented with massive epistaxis. He was admitted with a 3-year history of chronic rhinitis, headaches, right ocular pain and recurrent epistaxis. CT scans showed a predominantly cystic, expansive mass obstructing both nasal cavities, extending to all paranasal sinuses and both orbits, with evidence of anterior cranial fossa skull base destruction. The patient underwent a craniofacial resection of the tumour performed with an external approach and an immediate reconstruction of the dural defect. Histology confirmed the lesion was an ABC associated with fibrous dysplasia. The patient's recovery was complete. A large facial aneurysmal bone cyst can damage the facial skeleton and skull base, and requires excision by a combined external approach.

Destructive granuloma derived from a liver cyst: A case report

PubMed Central

Kawashita, Yujo; Kamohara, Yukio; Furui, Junichiro; Fujita, Fumihiko; Miyamoto, Shungo; Takatsuki, Mitsuhisa; Abe, Kuniko; Hayashi, Tomayoshi; Ohno, Yasuharu; Kanematsu, Takashi

2006-01-01

We herein report the case of an idiopathic liver cystic mass which aggressively infiltrated the thoraco-abdominal wall. A 74-year-old woman who had a huge cystic lesion in her right hepatic lobe was transferred to our hospital for further examinations. Imaging studies revealed a simple liver cyst, and the cytological findings of intracystic fluid were negative. She was followed up periodically by computed tomography (CT) scans. Seven years later, she complained of a prominence and dull pain in her right thoraco-abdominal region. CT revealed an enlargement of the cystic lesion and infiltration into the intercostal subcutaneous tissue. We suspected the development of a malignancy inside the liver cyst such as cystadenocarcinoma, and she therefore underwent surgery. A tumor extirpation was performed, including the chest wall, from the 7th to the 10th rib, as well as a right hepatic lobectomy. Pathologically, the lesion consisted of severe inflammatory change with epithelioid cell granuloma and bone destruction without any malignant neoplasm. No specific pathogens were evident based on further histological and molecular examinations. Therefore the lesion was diagnosed to be a destructive granuloma associated with a long-standing hepatic cyst. Since undergoing surgery, the patient has been doing well without any signs of recurrence. PMID:16586558

Just a drop of cement: a case of cervical spine bone aneurysmal cyst successfully treated by percutaneous injection of a small amount of polymethyl-methacrylate cement

PubMed Central

Fahed, Robert; Clarençon, Frédéric; Riouallon, Guillaume; Cormier, Evelyne; Bonaccorsi, Raphael; Pascal-Mousselard, Hugues; Chiras, Jacques

2014-01-01

Aneurysmal bone cyst (ABC) is a benign hemorrhagic tumor, commonly revealed by local pain. The best treatment for this lesion is still controversial. We report the case of a patient with chronic neck pain revealing an ABC of the third cervical vertebra. After percutaneous injection of a small amount of polymethyl-methacrylate bone cement, the patient experienced significant clinical and radiological improvement. PMID:25498806

Just a drop of cement: a case of cervical spine bone aneurysmal cyst successfully treated by percutaneous injection of a small amount of polymethyl-methacrylate cement.

PubMed

Fahed, Robert; Clarençon, Frédéric; Riouallon, Guillaume; Cormier, Evelyne; Bonaccorsi, Raphael; Pascal-Mousselard, Hugues; Chiras, Jacques

2014-12-12

Aneurysmal bone cyst (ABC) is a benign hemorrhagic tumor, commonly revealed by local pain. The best treatment for this lesion is still controversial. We report the case of a patient with chronic neck pain revealing an ABC of the third cervical vertebra. After percutaneous injection of a small amount of polymethyl-methacrylate bone cement, the patient experienced significant clinical and radiological improvement. 2014 BMJ Publishing Group Ltd.

Piezosurgery to perform hyoid bone osteotomies in thyroglossal duct cyst surgery.

PubMed

Salgarelli, Attilio Carlo; Robiony, Massimo; Consolo, Ugo; Collini, Marco; Bellini, Pierantonio

2011-11-01

Ultrasonic bone-cutting surgery has been introduced as a feasible alternative to the conventional sharp instruments used in craniomaxillofacial surgery because of its precision and safety. The device used is unique in that the cutting action occurs when the tool is used on mineralized tissues and stops on soft tissues. This work describes the use of piezosurgery for hyoid bone resection in thyroglossal duct cyst surgery, briefly reviews the literature on the surgical technique, and reports our experience with 12 cases.

Harvesting the free fibular graft: A modified approach

PubMed Central

Mukherjee, Amitava Narayan; Pal, Ananda Kisor; Singharoy, Debashis; Baksi, Debadyuti; Nath, Chinmoy

2011-01-01

Background: The conventional technique of free non-vascularized fibular grafting is attended with some amount of morbidity and a long scar. We report a technique with little interference to the surrounding soft tissues to harvest more than one-third of whole length fibula. Patients and Methods: Thirty four patients of average age 23.5 years (range 8 to 51 years) having various pathologies like simple bone cysts (n=9), fibrous dysplasias (n=6), giant cell tumors (n=7), fracture non-union (n=10) and aneurysmal bone cysts (n=2) were taken up for the study. The fibula were harvested by two separate incisions, 1 cm each at proximal and distal extent of proposed donor site for taking out of graft after elevating the periosteum circumferentially using a periosteum stripper. Compression bandage and above knee plaster immobilization was applied to reduce the dead space collection. Results: The mean followup is 34 months. The patients were evaluated clinicoradiology. Thirty three patients showed good results. One patient had fair result due to delayed wound healing from hematoma which was treated surgically. Conclusion: The approach of harvesting fibula suggested by author reduces donor site morbidity and is safer than conventional approach. PMID:21221224

Minimally invasive management of hepatic cysts: indications and complications.

PubMed

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.

Results of percutaneous sclerotherapy and surgical treatment in patients with symptomatic simple liver cysts and polycystic liver disease

PubMed Central

Erdogan, Deha; van Delden, Otto M; Rauws, Erik AJ; Busch, Olivier RC; Lameris, Johan S; Gouma, Dirk J; van Gulik, Thomas M

2007-01-01

AIM: To evaluate the results of the treatment of simple liver cysts (solitary and multiple) and polycystic liver disease (PLD) using percutaneous sclerotherapy and/or surgical procedures in a single tertiary referral centre. METHODS: Retrospective analysis of 54 patients referred for evaluation and possible treatment of simple liver cysts (solitary and multiple) and PLD, from January 1997 to July 2006. RESULTS: Simple liver cysts were treated in 41 pts (76%) with a mean size of 12.6 cm. The most common reason for referral was abdominal pain or discomfort (85%). Percutaneous sclerotherapy was performed as initial treatment in 30 pts, showing cyst recurrence in 6 pts (20%). Surgical treatment was initially performed in 11 pts with cyst recurrence in 3 pts (27%). PLD was treated in 13 pts (24%) with a mean size of the dominant cyst of 13 cm. Percutaneous sclerotherapy for PLD was performed in 9 pts with recurrence in 7 pts (77.8%). Surgical treatment for PLD was undertaken in 4 pts (30.8%) with recurrence in all. Eventually, 2 pts with PLD in the presence of polycystic kidney disease underwent liver- and kidney transplantation because of deterioration of liver and kidney function. CONCLUSION: The majority of patients with simple liver cysts and PLD are referred for progressive abdominal pain. As initial treatment, percutaneous sclerotherapy is appropriate. Surgical deroofing is indicated in case of cyst recurrence after percutaneous sclerotherapy. However, the results of percutaneous sclerotherapy and surgical treatment for PLD are disappointing. Partial liver resection is indicated when there is suspicion of a pre-malignant lesion. PMID:17589926

Radiographic Assessment of Bone Formation Using rhBMP2 at Maxillary Periapical Surgical Defects: A Case Series

PubMed Central

Kumar, M. Hari; Vishalakshi, K.; Sabitha, H.

2016-01-01

Periapical cysts are the most common inflammatory odontogenic cysts arising from untreated dental caries with pulp necrosis and periapical infection. The choice of treatment is often influenced by various factors like size, extension of the lesion, proximity to vital structures, systemic condition and compliance of the patient too. The treatment protocol for management of periapical cysts is still under discussion and options vary from conservative treatment by means of endodontic technique to surgical treatment like decompression or a marsupialisation or even to enucleation. Large bony defect secondary to periapical surgery compromising the tooth integrity often requires bone graft to enhance bone formation and thus restoring function at the earliest. The present case series included 10 patients who had established periapical pathology secondary to history of trauma on upper anterior teeth as well patients with history of carious teeth with an apparent failure in root canal therapy. All ten patients were treated with cyst enucleation and apiceotomy along with 1.4cc Recombinant Human Bone Morphogenetic Protein-2 soaked Absorbable Collagen Sponge implantation at surgical defect. Radiographs and clinical examinations were done upto 3 months to evaluate healing. Radiographic and clinical assessments revealed bone regeneration and restoration of the maxillary surgical defects in all 10 patients. No evidence of graft failure was noted. The Recombinant Human Bone Morphogenetic Protein-2 soaked Absorbable Collagen Sponge carrier is thus proved to be a viable option for the treatment of maxillary periapical surgical defects. PMID:27190972

Radiographic Assessment of Bone Formation Using rhBMP2 at Maxillary Periapical Surgical Defects: A Case Series.

PubMed

Kumar, M Siva; Kumar, M Hari; Vishalakshi, K; Sabitha, H

2016-04-01

Periapical cysts are the most common inflammatory odontogenic cysts arising from untreated dental caries with pulp necrosis and periapical infection. The choice of treatment is often influenced by various factors like size, extension of the lesion, proximity to vital structures, systemic condition and compliance of the patient too. The treatment protocol for management of periapical cysts is still under discussion and options vary from conservative treatment by means of endodontic technique to surgical treatment like decompression or a marsupialisation or even to enucleation. Large bony defect secondary to periapical surgery compromising the tooth integrity often requires bone graft to enhance bone formation and thus restoring function at the earliest. The present case series included 10 patients who had established periapical pathology secondary to history of trauma on upper anterior teeth as well patients with history of carious teeth with an apparent failure in root canal therapy. All ten patients were treated with cyst enucleation and apiceotomy along with 1.4cc Recombinant Human Bone Morphogenetic Protein-2 soaked Absorbable Collagen Sponge implantation at surgical defect. Radiographs and clinical examinations were done upto 3 months to evaluate healing. Radiographic and clinical assessments revealed bone regeneration and restoration of the maxillary surgical defects in all 10 patients. No evidence of graft failure was noted. The Recombinant Human Bone Morphogenetic Protein-2 soaked Absorbable Collagen Sponge carrier is thus proved to be a viable option for the treatment of maxillary periapical surgical defects.

Mycotic cysts: report of 21 cases including eight pheomycotic cysts from Saudi Arabia.

PubMed

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 excision. A second re-excision was curative. Mycotic cysts are uncommonly encountered lesions that can be easily missed, especially in cases with scant fungal elements, thus requiring special stains to detect the organisms. We reported 21 cases of mycotic cyst, including eight pheomycotic cysts, with emphasis on the histopathologic recognition of this unusual entity.

Epidermoid Cyst of Mandible Ramus: Case Report

PubMed Central

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

[Prevalence of postmenopausal simple ovarian cyst diagnosed by ultrasound].

PubMed

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.

Early Recurrence of a Solid Variant of Aneurysmal Bone Cyst in a Young Child After Resection: Technique and Literature Review and Two-year Follow-up After Corpectomy.

PubMed

Samir Barakat, Ahmed; Alsingaby, Hisham; Shousha, Mootaz; El Saghir, Hesham; Boehm, Heinrich

2018-05-15

Aneurysmal bone cysts (ABCs) are considered to be rare benign tumors that may affect long bones or the vertebral column. Their incidence varies and is reported to be 1.4% of all benign skeletal tumors. The solid-variant aneurysmal bone cyst (S-ABC) is even rarer and constitutes 3.5% to 7% of all vertebral ABCs. We report the case of an Enneking stage 3 S-ABC in a 5-year-old boy at C7 that showed rapid local recurrence after primary excision from posterior and dorsal stabilization requiring ventral corpectomy and posterior excision of the right lateral mass and right posterolateral fusion. Histologic examination disclosed an S-ABC. To our knowledge, this is the first case of S-ABC described in the literature that used both anterior and posterior approaches and complete corpectomy. Over a 2-year period, the patient showed no radiologic or clinical signs of local recurrence with excellent neurologic function. Solid-variant aneurysmal bone cysts are difficult to diagnose and treat, and careful clinical and radiologic assessment should be done to tailor an appropriate surgical plan to prevent recurrence and neurologic sequelae. To the best of our knowledge, there are to date no publications that studied the behavior of this subtype.

Endoscopic surgery for young athletes with symptomatic unicameral bone cyst of the calcaneus.

PubMed

Innami, Ken; Takao, Masato; Miyamoto, Wataru; Abe, Satoshi; Nishi, Hideaki; Matsushita, Takashi

2011-03-01

Open curettage with bone graft has been the traditional surgical treatment for symptomatic unicameral calcaneal bone cyst. Endoscopic procedures have recently provided less invasive techniques with shorter postoperative morbidity. The authors' endoscopic procedure is effective for young athletes with symptomatic calcaneal bone cyst. Case series; Level of evidence, 4. Of 16 young athletes with symptomatic calcaneal bone cyst, 13 underwent endoscopic curettage and percutaneous injection of bone substitute under the new method. Three patients were excluded because of short-term follow-up, less than 24 months. For the remaining 10 patients, with a mean preoperative 3-dimensional size of 23 × 31 × 35 mm as calculated by computed tomography, clinical evaluation was made with the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale just before surgery and at the most recent follow-up (mean, 36.2 months; range, 24-51 months), and radiologic assessment was performed at the most recent follow-up, to discover any recurrence or pathologic fracture. Furthermore, the 10 patients-all of whom returned to sports activities-were asked how long it took to return to initial sports activity level after surgery. Mean ankle-hindfoot scale score improved from preoperative 78.7 ± 4.7 points (range, 74-87) to postoperative 98.0 ± 4.2 points (range, 90-100) (P < .001). Pain and functional scores significantly improved after surgery (P < .01 and P < .05, respectively). Radiologic assessment at most recent follow-up revealed no recurrence or pathologic fracture, with retention of injected calcium phosphate cement in all cases. All patients could return to their initial levels of sports activities within 8 weeks after surgery (mean period, 7.1 weeks; range, 4-8 weeks), which was quite early as compared with past reports. Endoscopic curettage and injection of bone substitute appears to be an excellent option for young athletes with symptomatic calcaneal bone cyst for early return to sports activities, because it has the possibility to minimize the risk of postoperative pathologic fracture and local recurrence after early return to initial level of sports activities.

Unicameral Bone Cysts in the Humerus: Treatment Outcomes.

PubMed

Kadhim, Muayad; Sethi, Samir; Thacker, Mihir M

2016-06-01

Several treatment modalities have been described for the treatment of unicameral bone cysts (UBC). The aim of this study was to examine the outcome of various treatment modalities of UBC in a specific anatomic location, the humerus. This study is a retrospective case-only study of patients with humeral UBC with minimum follow-up of 1 year. Medical records and radiographs were assessed and UBC healing status was determined based on most recent follow-up radiographs and divided into 3 groups (healed, partially healed, and not healed). Descriptive statistics were utilized to summarize study outcome. Sixty-eight patients (54 boys and 14 girls) with humeral UBC comprised the study population. Sixty-four cases (94.1%) presented with a pathologic fracture. Fifty-one cases were in the proximal metaphysis and 17 were in the diaphysis. Mean age at diagnosis was 9.2±3.7 years, and mean follow-up was 4.0±2.6 years. Twenty-five patients were treated with observation, 38 by injection (27 with steroids and 11 with bone marrow), and 5 by open surgery. Patients who underwent open surgery had relatively larger cyst length, width, and cyst index, and all healed or partially healed at last follow-up. UBC persistence was observed in 29% of diaphyseal and 27.5% of metaphyseal cysts. Of the 19 patients with persistence, 8 were treated with observation, 9 with steroid injection, and 2 with bone marrow injection. Inner wall disruption before injection was performed in 17 patients (24% did not heal), whereas 21 patients did not have inner wall disruption (33% did not heal). Twenty patients received >1 injection. Eleven patients complained of pain at the last visit (8 had a persistent cyst, 2 were partially healed, and 1 had a healed UBC). Complete healing of humeral UBC is challenging to achieve irrespective of treatment modality. UBCs treated with open surgery tended to heal better. Unhealed cysts were more likely to be associated with pain. Level III-a retrospective comparative study.

Cystic echinococcosis of the pelvic bone with recurrences: a case report.

PubMed

Jain, Sunila; Chopra, Prem

2011-09-01

Hydatid cysts commonly affect the liver and the lung. However, they rarely involve bones with vertebral column. We hereby report a case of a female patient with cystic echinococcosis of the hip bone and ilium. She presented with a long history of frequent recurrences highlighting the dismal prognosis at this rare site. Resection of the hydatid cyst from the sacroiliac region was done with allograft and autograft (rib graft) with lumbosacroiliac fixation. Follow-up of the patient at 6 months showed no detectable abnormality on radiology and the patient was doing well.

Aneurysmal Bone Cysts of the Spine: Two Case Reports

PubMed Central

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.

PubMed

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.

FROM ANEURYSMAL BONE CYST TO TELANGIECTATIC OSTEOSARCOMA WITH METASTASIS IN INGUINAL LYMPH NODES - CASE REPORT.

PubMed

Janevska, Vesna; Spasevska, Liljana; Samardziski, Milan; Nikodinovskai, Violeta; Zhivadinovik, Julija; Trajkovskai, Elizabeta

2015-01-01

Aneurysmal bone cyst is a benign bone lesion composed of blood filled cystic cavities lined by fibrous septa. Its malignant transformation of is a rare event. We report a case of a lesion in the second metatarsal bone in a 29-year-old male, presented as a slight swelling of the right foot. After the curettage had been done, the diagnosis of aneurysmal bone cyst was made but the recurrence occurred 4 years later. The biopsy of the recurrent tumor showed compact neoplastic tissue consistent with diagnosis of giant cell tumor with malignancy. The malignant component was recognized as a high grade sarcoma with osteoid production. A tumor mass with the whole II metatarsal bone was extirpated and a resected part of fibula was transplanted. A year later, another recurrence occurred, an amputation was performed and a teleangiectatic osteosarcoma with ingvinal lymph nodes metastases was diagnosed. No other tumor mass was confirmed, either clinically or by imaging techniques at the time of his third operation. He died 4 months later with multiple pulmonary metastases. We emphasize the importance of team work in order to achieve the accurate diagnosis, highlighting careful radiological examinations, good sampling and awareness of unusual cases in bone tumor pathology.

Mucous retention cyst of temporal bone: a mimic of cholesteatoma on DW-MRI.

PubMed

Karandikar, Amit; Goh, Julian; Loke, Siu Cheng; Yeo, Seng Beng; Tan, Tiong Yong

2013-01-01

Non-EPI DW imaging is increasingly being used as a sensitive sequence in detecting cholesteatomas especially if CT findings are not confirmatory. Cholesteatoma appears as a hyperintense focus on DWI. We present two cases of mucous retention cysts in the mastoid temporal bone/middle ear cavity, which present as hyperintense on non-EPI DWI and potentially may mimic cholesteatomas. Differentiating between the two conditions is important, as surgery can be avoided in mucous retention cysts. We have also discussed ways to differentiate between these two conditions on MRI. To our knowledge, this entity is not reported previously. © 2013 Elsevier Inc. All rights reserved.

Case report: unicameral bone cysts in a young patient with acquired generalized lipodystrophy.

PubMed

Gregory, James M; Arkader, Alexandre; Bokhari, Aqiba; Bothari, Aqiba; Dormans, John P

2010-05-01

We report the case of a 13-year-old boy with bilateral distal femoral unicameral bone cysts (UBCs) associated with acquired generalized lipodystrophy. As opposed to congenital generalized lipodystrophy, cystic bone lesions in acquired generalized lipodystrophy are rare. After radiographic and histologic confirmation of the UBCs, we performed percutaneous intramedullary decompression, curettage, and grafting. UBCs can be an important manifestation of acquired generalized lipodystrophy. Cystic bone lesions appear to be less common in acquired generalized lipodystrophy than in congenital generalized lipodystrophy, and intramedullary adipose tissue loss may be a predisposing factor for the development of bone lesions in patients with acquired generalized lipodystrophy. When evaluating a patient with lipodystrophy, doctors should recognize the clinical course may include the development of UBCs.

Aneurysmal Bone Cyst: An Analysis of 38 Cases and Report of Four Unusual Surface Ones

PubMed Central

Shooshtarizadeh, Tina; Movahedinia, Sajjadeh; Mostafavi, Hassan; Jamshidi, Khodamorad; Sami, Sam Hajialiloo

2016-01-01

Aneurysmal bone cyst (ABC) is a benign expansile bone tumor, most commonly involving the medulla of long bones. ABC rarely arises within the cortex or in the subperiosteal region, radiographically mimicking other conditions, in particular surface osteosarcomathat is low-grade in nature and may go secondary ABC changes, and telangiectatic osteosarcoma. Both of these are sometimes mistaken microscopically for primary ABC. We review the characteristics of ABC cases in our center and report four unusualsurface ABCs arising in the subperiosteal or cortical region of long bones, identified among 38 histologically proven ABCs during a four-year period in our center. The surface ABCs occurred at an older agewith a predilection for diaphysis of femur, tibia, and humerus. PMID:27200397

A Novel Minimally Invasive Technique for Treatment of Unicameral Bone Cysts

PubMed Central

Zaghloul, Ahmed; Haddad, Behrooz; Khan, Wasim; Grimes, Lisa; Tucker, Keith

2015-01-01

Management of unicameral bone cysts (UBC) remain controversial. These cysts seldom heal spontaneously or even after pathological fracture. Sometimes these cysts can be very large and incredibly troublesome to the patient. Various treatments exist with variable success rates. We present our experience of treating these lesions by continuous drainage. Over a seven year period, six patients with unicameral bone cysts were treated by inserting a modified drain into the wall of the cyst. The aim of surgery was to place the drain in a dependent area of the cyst, through the cortex allowing for continuous drainage. This was achieved through a small incision under radiographic control. A cement restrictor (usually used for femoral canal plugging during total hip replacements) was modified and inserted to prevent closure of the drain site. A redivac drain was passed through the plug into the cyst. The drain was left in place for a week to establish an epithelialized pathway which hopefully would remain patent, into the subcutaneous tissues, after the drain had been removed. There were four males and two females in the group and the age range was 6 -12 years. Four of the lesions were in the upper humerus, one in the proximal femur and the other one in the proximal tibia. Healing was rated according to the modified Neer classification. Grade 1 (healed) and Grade 2 (healed with defect) was defined as excellent outcome. Persistent /Recurrent cysts (Grade 3 and 4) were noted as unsatisfactory. Five cases were completely healed. Only one had a further fracture and there were no recurrent fractures. All the patients reported complete comfort and they all were able to re-engage in recreational activities without restriction. We think that reducing the intra-medullary pressure in these lesions will lead to healing. We report a safe and minimally invasive technique for the management of UBC. PMID:26587064

A Novel Minimally Invasive Technique for Treatment of Unicameral Bone Cysts.

PubMed

Zaghloul, Ahmed; Haddad, Behrooz; Khan, Wasim; Grimes, Lisa; Tucker, Keith

2015-01-01

Management of unicameral bone cysts (UBC) remain controversial. These cysts seldom heal spontaneously or even after pathological fracture. Sometimes these cysts can be very large and incredibly troublesome to the patient. Various treatments exist with variable success rates. We present our experience of treating these lesions by continuous drainage. Over a seven year period, six patients with unicameral bone cysts were treated by inserting a modified drain into the wall of the cyst. The aim of surgery was to place the drain in a dependent area of the cyst, through the cortex allowing for continuous drainage. This was achieved through a small incision under radiographic control. A cement restrictor (usually used for femoral canal plugging during total hip replacements) was modified and inserted to prevent closure of the drain site. A redivac drain was passed through the plug into the cyst. The drain was left in place for a week to establish an epithelialized pathway which hopefully would remain patent, into the subcutaneous tissues, after the drain had been removed. There were four males and two females in the group and the age range was 6 -12 years. Four of the lesions were in the upper humerus, one in the proximal femur and the other one in the proximal tibia. Healing was rated according to the modified Neer classification. Grade 1 (healed) and Grade 2 (healed with defect) was defined as excellent outcome. Persistent /Recurrent cysts (Grade 3 and 4) were noted as unsatisfactory. Five cases were completely healed. Only one had a further fracture and there were no recurrent fractures. All the patients reported complete comfort and they all were able to re-engage in recreational activities without restriction. We think that reducing the intra-medullary pressure in these lesions will lead to healing. We report a safe and minimally invasive technique for the management of UBC.

Soft tissue aneurysmal bone cyst: a rare case in a middle aged patient

PubMed Central

Baker, Kevin S; Gould, Elaine S; Patel, Hiten B; Hwang, Sonya J

2015-01-01

Soft tissue aneurysmal bone cyst is a rare entity, with about 20 cases reported in literature, only 3 of which are in patients over 40 years of age. We present a case of a 41 year old Latin American female who presented for evaluation of atraumatic chest pain with radiation to the left shoulder. Her initial workup was negative, including radiographic imaging of the chest and left shoulder. 4 months later, she presented to her orthopedic surgeon with a palpable mass and mild left shoulder pain. Radiographs acquired at that time demonstrated a 7.0 × 5.5 × 6.7 cm mass with rim calcification in the region of the upper triceps muscle. Subsequent CT imaging showed central areas of hypodensity and thin septations, a few of which were calcified. MR evaluation showed hemorrhagic cystic spaces with multiple fluid-fluid levels and enhancing septations. Surgical biopsy was performed and pathology was preliminarily interpreted as cystic myositis ossificans, however on final review the diagnosis of soft tissue aneurysmal bone cyst was made. The lesion was then surgically excised and no evidence of recurrence was seen on a 3 year post-op radiograph. Following description of our case, we conduct a literature review of the imaging characteristics, diagnosis, and treatment of soft tissue aneurysmal bone cyst. PMID:25926918

Implant placement after marsupialization of a dentigerous cyst.

PubMed

Karamanis, S; Kitharas, T; Tsoukalas, D; Parissis, N

2006-01-01

This paper presents a case of a dentigerous cyst accompanied by a history of inflammation, resorption of the roots of the first molar and the lingual aspect of the distal root of the second molar, and devitalization of the 2 premolars. The treatment option chosen was marsupialization of the cyst, extraction of the involved teeth, endodontic treatment of both premolars, and implant insertion in the area of the first mandibular molar at a later stage. Twelve months postsurgery the area of interest was almost flattened and the radiographic examination revealed total disappearance of the radiolucency. An implant of 15 x 4 mm was inserted in the area of the first mandibular molar. Despite the excellent implant stability achieved, a thin central zone of the defect remained void of bone. After complete excision of soft tissue the defect was filled with an alloplastic bone substitute. Eight months later (20 months postsurgery), the implant was uncovered and the restorative procedure completed. The implant and the crown have been functioning sign and symptom free for 48 months. Marsupialization was preferred instead of enucleation due to (1) proximity of the cyst to the mandibular canal; (2) need for apicectomy of both premolars to gain good access for enucleation; (3) refusal of the patient to undergo a second surgery for bone harvesting; (4) lower probability for postoperative contamination; (5) need of small quantity of bone substitute; (6) easier extraction of the impacted second molar due to its coronal movement. The disadvantages of the treatment were the long healing period and the discomfort of the patient at the early stages of marsupialization. It was judged that the advantages outweighed the disadvantages in this case. We discuss the findings of other authors who support the conservative approach to jaw cysts in a young population, and the concerns that exist in the literature about the ability of osseoconductive graft materials to generate vital bone and achieve implant-to-bone contact.

Cyst-Like Osteolytic Formations in Recombinant Human Bone Morphogenetic Protein-2 (rhBMP-2) Augmented Sheep Spinal Fusion.

PubMed

Pan, Hsin Chuan; Lee, Soonchul; Ting, Kang; Shen, Jia; Wang, Chenchao; Nguyen, Alan; Berthiaume, Emily A; Zara, Janette N; Turner, A Simon; Seim, Howard B; Kwak, Jin Hee; Zhang, Xinli; Soo, Chia

2017-07-01

Multiple case reports using recombinant human bone morphogenetic protein-2 (rhBMP-2) have reported complications. However, the local adverse effects of rhBMP-2 application are not well documented. In this report we show that, in addition to promoting lumbar spinal fusion through potent osteogenic effects, rhBMP-2 augmentation promotes local cyst-like osteolytic formations in sheep trabecular bones that have undergone anterior lumbar interbody fusion. Three months after operation, conventional computed tomography showed that the trabecular bones of the rhBMP-2 application groups could fuse, whereas no fusion was observed in the control group. Micro-computed tomography analysis revealed that the core implant area's bone volume fraction and bone mineral density increased proportionately with rhBMP-2 dose. Multiple cyst-like bone voids were observed in peri-implant areas when using rhBMP-2 applications, and these sites showed significant bone mineral density decreases in relation to the unaffected regions. Biomechanically, these areas decreased in strength by 32% in comparison with noncystic areas. Histologically, rhBMP-2-affected void sites had an increased amount of fatty marrow, thinner trabecular bones, and significantly more adiponectin- and cathepsin K-positive cells. Despite promoting successful fusion, rhBMP-2 use in clinical applications may result in local adverse structural alterations and compromised biomechanical changes to the bone. Copyright © 2017 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

Unicameral bone cysts: a comparison of injection of steroid and grafting with autologous bone marrow.

PubMed

Cho, H S; Oh, J H; Kim, H-S; Kang, H G; Lee, S H

2007-02-01

Open surgery is rarely justified for the initial treatment of a unicameral bone cyst, but there is some debate concerning the relative effectiveness of closed methods. This study compared the results of steroid injection with those of autologous bone marrow grafting for the treatment of unicameral bone cysts. Between 1990 and 2001, 30 patients were treated by steroid injection and 28 by grafting with autologous bone marrow. The overall success rates were 86.7% and 92.0%, respectively (p>0.05). The success rate after the initial procedure was 23.3% in the steroid group and 52.0% in those receiving autologous bone marrow (p<0.05), and the respective cumulative success rates after second injections were 63.3% and 80.0% (p>0.05). The mean number of procedures required was 2.19 (1 to 5) and 1.57 (1 to 3) (p<0.05), the mean interval to healing was 12.5 months (4 to 32) and 14.3 months (7 to 36) (p>0.05), and the rate of recurrence after the initial procedure was 41.7% and 13.3% in the steroid and in the autologous bone marrow groups, respectively (p<0.05). Although the overall rates of success of both methods were similar, the steroid group had higher recurrence after a single procedure and required more injections to achieve healing.

Management of non-neoplastic ovarian cysts with sclerotherapy.

PubMed

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.

Marsupialization of a large dentigerous cyst in the mandible with orthodontic extrusion of three impacted teeth. A case report.

PubMed

Abu-Mostafa, Nedal; Abbasi, Arshad

2017-09-01

The dentigerous cyst (DC) is the most common type of developmental odontogenic cyst. It is usually asymptomatic and associated with the crown of an unerupted or impacted tooth. However, after a long duration, it is likely to cause significant bone resorption, cortical expansion, and tooth displacement. This report presents a large infected DC in the mandible of a 12-year-old female patient. The DC was located inferior to badly decayed primary molars and surrounded three impacted permanent teeth: canine, first premolar, which had a dilacerated root, and second premolar. The DC was treated successfully by marsupialization and extrusion of the impacted teeth. In conclusion, the combination of marsupialization with orthodontic extrusion is a conservative, efficient protocol that stimulates bone healing and promotes the eruption of cyst-associated teeth even if they are deeply impacted, crowded, or have a dilacerated root. Key words: Dentigerous cyst, marsupialization, impacted teeth, orthodontic extrusion, dilacerated root.

Traumatic bone cyst suggestive of large apical periodontitis.

PubMed

Rodrigues, Cleomar Donizeth; Estrela, Carlos

2008-04-01

This case report shows the importance of establishing the correct diagnosis to provide the appropriate treatment options The traumatic bone cyst is a pseudocyst, usually asymptomatic and found by a routine radiographic examination. Unicystic radiolucency is almost always observed, which can involve the periradicular area of teeth, simulating an inflammatory lesion of endodontic origin. Differential diagnosis should include other pathologies, such as odontogenic keratocyst, central giant cell granuloma, and unicystic ameloblastoma. Its etiology and pathogenesis are not yet definitely established. In the present study, after review of the medical and dental histories and clinical and radiographic examination of teeth #24-27 (pulpal vitality test showed positive), the primary diagnosis was traumatic bone cyst. The planning was excisional biopsy. After surgical exploration, only one small blood clot was observed in the intraosseous socket, which was carefully curetted and filled with blood. A clinical and radiographic examination after 6 months showed apical formation and pulpal vitality preserved.

[X-ray computed tomographic aspects of spinal aneurysmal cysts in children].

PubMed

Bernard, C; Hoeffel, J C; Marchal, A L; Vergnat, C; Régent, D

1985-10-01

The interest of CT imaging in a case of aneurysmal bone cyst of the posterior arch of the 6th cervical vertebra in a 10 y.o. child is underlined. The value of intra tumoral densities which are relatively low, inferior to 100 Hounsfield unit is stressed but the most contributory feature in this case was the presence of a fluid level inside the cyst due to different densities of fluid components into the cyst.

Maxillary reconstruction with bone transport distraction and implants after partial maxillectomy.

PubMed

Castro-Núñez, Jaime; González, Marcos Daniel

2013-02-01

Maxillary and mandibular bone defects can result from injury, congenital defect, or accident, or as a consequence of surgical procedures when treating pathology or defects affecting jaw bones. The glandular odontogenic cyst is an infrequent type of odontogenic cyst that can leave a bony defect after being treated by aggressive surgical means. First described in 1987 by Padayachee and Van Wyk, it is a potentially aggressive entity, having a predisposition to recur when treated conservatively, with only 111 cases having been reported hitherto. Most reports emphasize its clinical, radiographic, and histologic features, including a few considerations on rehabilitation for these patients. The aim of this article is to present the case of a 24-year-old male patient who, in 2001, was diagnosed with a glandular odontogenic cyst and to focus on the surgical approach and rehabilitation scheme. We performed an anterior partial maxillectomy. The osseous defect was treated using bone transport distraction. Dental and occlusal rehabilitation was achieved with titanium implants over transported bone and an implant-supported overdenture. A 9-year follow-up shows no evidence of recurrence of the pathology, adequate shape and amount of bone, functional occlusal and dental rehabilitation, and patient's satisfaction. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Case Report: Unicameral Bone Cysts in a Young Patient with Acquired Generalized Lipodystrophy

PubMed Central

Gregory, James M.; Arkader, Alexandre; Bothari, Aqiba

2009-01-01

We report the case of a 13-year-old boy with bilateral distal femoral unicameral bone cysts (UBCs) associated with acquired generalized lipodystrophy. As opposed to congenital generalized lipodystrophy, cystic bone lesions in acquired generalized lipodystrophy are rare. After radiographic and histologic confirmation of the UBCs, we performed percutaneous intramedullary decompression, curettage, and grafting. UBCs can be an important manifestation of acquired generalized lipodystrophy. Cystic bone lesions appear to be less common in acquired generalized lipodystrophy than in congenital generalized lipodystrophy, and intramedullary adipose tissue loss may be a predisposing factor for the development of bone lesions in patients with acquired generalized lipodystrophy. When evaluating a patient with lipodystrophy, doctors should recognize the clinical course may include the development of UBCs. PMID:19924491

[Intra-osseous ganglion cyst of the carpal bones. A review of the literature underlining the importance of systematic computed tomography].

PubMed

Dumas, P; Georgiou, C; Chignon-Sicard, B; Balaguer, T; Lebreton, E; Dumontier, C

2013-02-01

The intraosseous ganglion cyst (IOGC) is a benign and lytic bone tumor affecting mostly the metaphyseal and epiphyseal regions of long bones. Its location on the short bones, including the carpal bones has been little reported in the literature. Our review of the literature shows consensus about the surgical techniques to use, but there is currently no real consensus about its pathophysiology, and its diagnostic work-up. Complications related to this lesion (mainly the risk of pathologic fracture) are potentially serious, and can cause irreversible damage. They therefore require accurate assessment to guide the choice of medical or surgical treatment, including a CT scan, which - we believe - is essential. Copyright © 2012. Published by Elsevier SAS.

Distribution of mast cells and macrophages and expression of interleukin-6 in periapical cysts.

PubMed

Bracks, Igor Vieira; Armada, Luciana; Gonçalves, Lúcio Souza; Pires, Fábio Ramôa

2014-01-01

Mast cells and macrophages are important components of the inflammatory infiltrate found in inflammatory periapical diseases. Several cytokines participate in the mechanisms of inflammation, tissue repair, and bone resorption associated with periapical cysts. The aim of the present study was to evaluate the distribution of mast cells and macrophages and the expression of interleukin-6 (IL-6) in periapical cysts. Thirty periapical cysts were selected for the study, and clinical, demographic, and gross information from the cases was obtained from the laboratory records. Five-micrometer sections stained with hematoxylin-eosin were reviewed for analysis of the microscopic features of the cysts, and 3-μm sections on silanized slides were used for immunohistochemical reactions with anti-tryptase, anti-CD68, and anti-IL-6. There was no statistically significant difference in the mean number of mast cells and macrophages when comparing superficial and deep regions of the fibrous capsule of the cysts. Mean number of mast cells on the superficial region of the fibrous capsule was higher in cysts showing intense superficial inflammation and exocytosis. Macrophages were more commonly found in areas showing IL-6 expression, and IL-6 was less expressed in deep regions of the fibrous capsule in cysts showing greater gross volume. The results reinforced the participation of mast cells and macrophages in the pathogenesis of periapical cysts and suggested that IL-6 is not the major bone resorption mediator in larger periapical cysts. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Acute intraoperative reactions during the injection of calcium sulfate bone cement for the treatment of unicameral bone cysts: a review of four cases.

PubMed

Nystrom, Lukas; Raw, Robert; Buckwalter, Joseph; Morcuende, Jose A

2008-01-01

Unicameral bone cysts can predispose patients to pathologic fracture and deformities of growth. Treatment options vary from continuous decompression with transcortical placement of a cannulated screw to percutaneous aspiration and injection of medical-grade calcium sulfate. From 2005 to 2007, we treated 22 patients with unicameral bone cysts using aspiration and injection of calcium sulfate. Three patients experienced acute laryngospasm and one patient developed tachyarrhythmia, temporarily, associated with injection of calcium sulfate. All reactions occurred in patients under age 18 without predisposing risk factors and resolved spontaneously with supportive care. Although the mechanism is unclear, we hypothesize that these reactions are either due to the nociceptive stimulus of the calcium sulfate injection or a systemic calcium bolus. Clinicians using this product for this indication should be aware that such reactions may occur. We suggest endotracheal intubation and communication to the anesthesiologist about the time of the injection in preparation for these idiopathic responses. Further research is necessary to determine exactly how this reaction occurs and how it can be avoided.

Acute Intraoperative Reactions During the Injection of Calcium Sulfate Bone Cement for the Treatment of Unicameral Bone Cysts: A Review of Four Cases

PubMed Central

Nystrom, Lukas; Raw, Robert; Buckwalter, Joseph; Morcuende, Jose A.

2008-01-01

Unicameral bone cysts can predispose patients to pathologic fracture and deformities of growth. Treatment options vary from continuous decompression with transcortical placement of a cannulated screw to percutaneous aspiration and injection of medical-grade calcium sulfate. From 2005 to 2007, we treated 22 patients with unicameral bone cysts using aspiration and injection of calcium sulfate. Three patients experienced acute laryngospasm and one patient developed tachyarrhythmia, temporarily, associated with injection of calcium sulfate. All reactions occurred in patients under age 18 without predisposing risk factors and resolved spontaneously with supportive care. Although the mechanism is unclear, we hypothesize that these reactions are either due to the nociceptive stimulus of the calcium sulfate injection or a systemic calcium bolus. Clinicians using this product for this indication should be aware that such reactions may occur. We suggest endotracheal intubation and communication to the anesthesiologist about the time of the injection in preparation for these idiopathic responses. Further research is necessary to determine exactly how this reaction occurs and how it can be avoided. PMID:19223954

Nonsurgical Clinical Management of Periapical Lesions Using Calcium Hydroxide-Iodoform-Silicon-Oil Paste

PubMed Central

Al Khasawnah, Qusai; Hassan, Fathi; Malhan, Deeksha; Engelhardt, Markus; Daghma, Diaa Eldin S.; Obidat, Dima; Lips, Katrin S.; Heiss, Christian

2018-01-01

Background The study aim is to avoid tooth extraction by nonsurgical treatment of periapical lesion. It assesses healing progress in response to calcium hydroxide-iodoform-silicon oil paste (CHISP). Numeric Pain Rating Scale was used to validate the approach. Furthermore, CHISP was used to treat cystic lesions secondary to posttraumatic avulsion of permanent teeth. Materials and Methods Over 200 patients with radicular cysts were treated with CHISP through the root canal. Radiographs were used to verify lesion size and position, ensure correct delivery to the site, and monitor the progress of bone healing in the lesion area. Ten males and 10 females were randomly selected for statistical assessment. Results No severe pain, complications, or failure in cyst healing was reported. Complete healing was achieved in an average of 75 days. Furthermore, healing of radicular cyst secondary to posttraumatic tooth avulsion was successful. Conclusion CHISP indicated an antiseptic effect, which enhanced and shortened healing time of periapical lesions. The less invasive procedure avoids tooth extraction and reduces bone resorption. Cyst management with CHISP can remedy failed root canal treatments. The results show a bone regenerative capacity of CHISP suggested in first rapid phase and a second slow phase. PMID:29619378

[Pathologic proximal femoral fractures in children in an unicameral bone cyst].

PubMed

Havránek, P; Pesl, T; Bartonícek, J

2005-01-01

Proximal femoral fractures in children are rare, pathologic fractures being extremely rare. Despite many meanings these fractures are still "unsolved" there are some definite rules for treatment of true accidental injuries. Pathologic fractures are outstanding with their extremely rare incidence. The aim of the study is to overview a large clinical material, find out the incidence of this pathologic fracture, the extent and shape of the unicameral bone cyst (UBC), specific therapeutic approach, technical problems of eventual osteosynthesis, number of reoperations and sequels. Altogether 49 children with 50 accidental and pathologic fractures of proximal part of the femur treated in the Regional Pediatric Trauma Centre of the Department of Pediatric and Trauma Surgery, 3rd Faculty of Medicine, Charles University, Prague. Retrospective and prospective study of children (0 to 15 years of age) treated with proximal femoral accidental and pathologic fractures during the 20 year period (from August 1984 to November 2004). Classification of fractures according to Delbet and Colonna. Diagnosis of bone cyst with plain X-rays, eventually CT scans. During the 20 years period (August 1984 to November 2004) 49 children with 50 proximal femoral fractures were treated in the Department. Four patients sustained a pathologic fracture through an unicameral bone cyst. Two of these latter children were treated by an open reduction and osteosynthesis with the use of the proximal femoral AO-ASIF angled-plate and two children nonoperatively using skeletal traction because of impossibility of insertion of the osteosynthetic material without a damage of the growth plate. Subsequent operations of the UBC were necessary in these two children. All four patients recovered well without sequels. Pathologic fractures in UBC are usually treated nonoperatively and the cyst itself is treated after fracture healing. Proximal femoral impairment is the exception from this rule because of weigh bearing necessity. However, there may be problems with insertion of the implant when the cyst is very near to capital physis and traction treatment is then the method of choice with a delay of operative treatment of the cyst. Pathologic proximal femoral fractures in UBC are extremely rare and need individual approach. Some of them should be operated on the others primarily treated by traction with secondary operation of the cyst. Complications can be frequent.

Elastic stable intramedullary nailing is the best treatment of unicameral bone cysts of the long bones in children?: Prospective long-term follow-up study.

PubMed

de Sanctis, Nando; Andreacchio, Antonio

2006-01-01

Since Virchow first described the unicameral bone cyst (UBC) in 1876, several methods for management were proposed. Currently performed surgical procedures include curettage combined with bone grafting, allografting with freeze-dried crushed cortical bone, use of homologous cancellous bone chips, the application of high-porosity hydroxyapatite, and cryosurgery. Decompression with multiple drill holes and intralesional injections of either steroids or bone marrow have also been used to treat UBC, with variable success rates. Elastic stable intramedullary nailing for the treatment of UBC in long bones has been rapidly gaining popularity. Elastic stable intramedullary nailing for the treatment of a UBC was performed in 56 patients between 1994 and 2003. The follow-up is between 2.1 and 11 years. Nine children were excluded because of short period of follow-up or were lost. The study population consisted of 47 children. The cyst was located in the humerus in 36 patients, in the femur in 11. The mean age of the patients at the time of surgery was 8.9 years. Results were evaluated on plain radiographs according to the classification system of Capanna et al. In our study population of 47 UBCs, 31 (65.9 %) were classified as completely healed, and 16 (34.1%) were healed with residual radiolucency. No recurrence or no response was observed. Each lesion responded to treatment after the nailing. This method can solve in time the pathology, and we feel that, with skilled hands, this method is the best one for UBC treatment in the long bones of the children.

Just a drop of cement: a case of cervical spine bone aneurysmal cyst successfully treated by percutaneous injection of a small amount of polymethyl-methacrylate cement.

PubMed

Fahed, Robert; Clarençon, Frédéric; Riouallon, Guillaume; Cormier, Evelyne; Bonaccorsi, Raphael; Pascal-Mousselard, Hugues; Chiras, Jacques

2016-01-01

Aneurysmal bone cyst (ABC) is a benign hemorrhagic tumor, commonly revealed by local pain. The best treatment for this lesion is still controversial. We report the case of a patient with chronic neck pain revealing an ABC of the third cervical vertebra. After percutaneous injection of a small amount of polymethyl-methacrylate bone cement, the patient experienced significant clinical and radiological improvement. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Solid variant of aneurysmal bone cyst of the thoracic spine: a case report

PubMed Central

2011-01-01

Introduction The solid variant of aneurysmal bone cyst is rare, and only 13 cases involving the spine have been reported to date, including seven in the thoracic vertebrae. The diagnosis is difficult to secure radiographically before biopsy or surgery. Case report An 18-year-old Hispanic man presented to our facility with a one-year history of left chest pain without any significant neurological deficits. An MRI scan demonstrated a 6 cm diameter enhancing multi-cystic mass centered at the T6 vertebral body with involvement of the left proximal sixth rib and extension into the pleural cavity; the spinal cord was severely compressed with evidence of abnormal T2 signal changes. Our patient was taken to the operating room for a total spondylectomy of T6 with resection of the left sixth rib from a single-stage posterior-only approach. The vertebral column was reconstructed in a 360° manner with an expandable titanium cage and pedicle screw fixation. Histologically, the resected specimen showed predominant solid fibroblastic proliferation, with minor foci of reactive osteoid formation, an area of osteoclastic-like giant cells, and cyst-like areas filled with erythrocytes and focal hemorrhage, consistent with a predominantly solid variant of aneurysmal bone cyst. At 16 months after surgery, our patient remains neurologically intact with resolution of his chest and back pain. Conclusions Because of its rarity, location, and radical treatment approach, we considered this case worthy of reporting. The solid variant of aneurysmal bone cyst is difficult to diagnose radiologically before biopsy or surgery, and we hope to remind other physicians that it should be included in the differential diagnosis of any lytic expansile destructive lesion of the spine. PMID:21718507

[Management of a breast cystic syndrome: Guidelines].

PubMed

Uzan, C; Seror, J-Y; Seror, J

2015-12-01

Breast cysts are common, often discovered incidentally or subsequently to pain or palpable mass. The purpose of these recommendations is to describe the sonographic findings for classifying breast cystic lesions, to analyze the value and contribution of various imaging techniques and sampling and to provide a management strategy. Literature review conducted by a small group and then reviewed and validated by the group designated by the Collège national des gynécologues et obstétriciens français (CNGOF) to make recommendations for clinical practice for benign breast lesions. Breast cysts are classified in 3 categories: simple cysts, complicated cysts and complex cysts. For simple cysts, after ultrasound, no further imaging is necessary, cytology is to consider only as analgesic. For complicated cysts, a control at 4-6 months is recommended; the use of cytology depends on the context (familial risk, difficulty of follow-up). In case of complex cyst, sampling by cytology or biopsy is recommended. More assessments of other imaging tests are reported. The sonographic characterization is essential for management of breast cyst. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Risk of refracture through unicameral bone cysts of the proximal femur.

PubMed

Norman-Taylor, Fabian H; Hashemi-Nejad, Aresh; Gillingham, Bruce L; Stevens, David; Cole, William G

2002-01-01

The authors determined the results after traction or traction and hip spica treatment of the initial fractures through unicameral bone cysts of the proximal femur in 20 children. All of the eight displaced fractures healed, but with coxa vara and avascular necrosis in one, coxa vara in a second, and coxa breva in a third. Spontaneous healing of the cyst occurred in three of the eight children; satisfactory healing was achieved and maintained after intralesional corticosteroid injections in four of the eight children. In the remaining child with a displaced fracture, reactivation of the cyst and exercise-related pain, indicative of an incipient refracture, occurred 3 years after initial presentation. All of the 12 undisplaced fractures healed without deformity or avascular necrosis. Intralesional corticosteroids were used in all of the 12 children because none of them showed spontaneous healing of their cysts. Satisfactory radiographic healing was achieved 1 year after presentation in all of the 12 children. However, one or more refractures resulting from reactivation of the cyst occurred in 6 of the 12 children 2 to 5 years after initial presentation. The results of this study indicate that satisfactory radiographic healing needs to be achieved by the end of the first year and needs to be maintained thereafter to prevent refractures.

Comparison of acetic acid and ethanol sclerotherapy for simple renal cysts: clinical experience with 86 patients.

PubMed

Cho, Young Jun; Shin, Ji Hoon

2016-01-01

To compare the efficacy and treatment session numbers of acetic acid to that of ethanol sclerotherapy for the treatment of simple renal cysts. Between February 2004 and June 2013, 86 patients with simple renal cysts underwent percutaneous aspiration and injection of 50 %-acetic-acid (42 cysts) and 95 %-ethanol (44 cysts). The patient demographics, volume reduction rate, number of treatment sessions, and complications were then analyzed. The volume reduction rate was 94.1 ± 7.6 % in the 50 %-acetic acid group and 94.7 ± 11.7 % in the 95 %-ethanol group, and without a statistical difference. The rates of complete remission, partial remission, and no response were 57.1, 42.9 and 0 %, respectively, for the acetic acid group, and 70.5, 25.0, and 4.5 %, respectively, for the ethanol group. No statistical difference was observed between the two groups. Compared to the acetic acid group, the ethanol group had a higher number of treatment sessions, i.e. 1.10 ± 0.30 in the acetic acid group and 1.80 ± 0.79 in the ethanol group. Mild flank pain was a minor complication that occurred in both groups. Acetic acid seems to have equivalent sclerosing effects on simple renal cysts compared with those of ethanol despites of fewer treatment sessions.

Aneurysmal bone cyst of C2 treated with novel anterior reconstruction and stabilization.

PubMed

Rajasekaran, S; Aiyer, Siddharth N; Shetty, Ajoy Prasad; Kanna, Rishi; Maheswaran, Anupama

2016-03-23

Aneurysmal bone cysts (ABC) form 1 % of primary bone tumors. Reported incidence rates are no more than 1.4 to 1,00,000. ABC of spine frequently involves posterior elements and commonly affects the lumbar spine (45 %). We present a case of C2 ABC for the challenges it poses due to the rarity of the lesion, tedious to access location, dilemmas relating to the suitable approach for tumor resection and technically demanding stabilization and reconstruction strategy post resection. Clinical data analysis was performed to discuss a method of novel anterior column reconstruction following resection of a C2 aneurysmal bone cyst in a 8 year old child with anterior and posterior elements being involved. An 8-year-old girl with an aneurysmal bone cyst of the C2 vertebra underwent staged surgery following pre-operative embolisation. First a posterior approach tumor excision with posterior instrumented fusion was performed. Following which, using a modified anterior retropharyngeal approach anterior tumor excision and fibular graft reconstruction between the C1 lateral mass and C2 body was performed. Complete tumor clearance and stable reconstruction was successfully achieved in our patient. Patient showed excellent clinical outcome with radiological fusion. Preoperative embolisation in the treatment of ABC has supplemental advantage by reducing blood loss. Modified anterior retropharyngeal approach allows satisfactory clearance for C1-2 lesion and fibular strut graft between the C1 lateral mass and C2 body can provide a stable graft placement with good chance of fusion. Instability and spinal deformity, whether preexisting or post-excision, should be corrected with reconstruction and stabilization to offer best chance of cure in such cases.

Intraosseous Ganglion Cyst of Olecranon

PubMed Central

Zarezadeh, Abolghasem; Nourbakhsh, Mohsen; Shemshaki, Hamidreza; Etemadifar, Mohammad Reza; Mazoochian, Farhad

2012-01-01

Intraosseous ganglia are benign cysts that usually can be seen in lower extremity; especially around ankle. These cysts have fewer incidences in upper extremity, mainly around the wrist. They are extremely rare in olecranon. These lesions are often asymptomatic. Patient was a 75-year-old man who had trauma many years ago. When he came to our clinic, he complained of severe pain around his elbow that he could not do ordinary activity. He had local tenderness in elbow and 30 degree limitation in extension. In radiography, lytic, multiloculated lesion existed in region of olecranon. After excisional biopsy was done, cavity was cleaned completely with curette and was filled with autogenous bone. At 10-year follow-up, the patient was completely asymptomatic. Control radiograph showed cavity filled completely by bone; there was no evidence of relapse. PMID:22973489

Large Osteoarthritic Cyst Presenting as Soft Tissue Tumour – A Case Report

PubMed Central

Kosuge, DD; Park, DH; Cannon, SR; Briggs, TW; Pollock, RC; Skinner, JA

2007-01-01

Large osteoarthritic cysts can sometimes be difficult to distinguish from primary osseous and soft tissue tumours. We present such a case involving a cyst arising from the hip joint and eroding the acetabulum which presented as a soft tissue malignancy referred to a tertiary bone and soft tissue tumour centre. We discuss the diagnostic problems it may pose, and present a literature review of the subject. PMID:17535605

Percutaneous Treatment of Renal Cysts with OK-432 Sclerosis

PubMed Central

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

Unicameral bone cyst of the proximal tibia in a five year old girl.

PubMed

Tahririan, Mohammadali; Motiffard, Mehdi

2012-01-01

Unicameral bone cysts (UBCs) are benign, osteolytic lesions which are often asymptomatic and are commonly seen in the proximal of humerus and femur. The average age at diagnosis is 9-11 years and there is a male preponderance with a male-to-female ratio of approximately 2-2.5 to 1. We describe a case of 5-year-old girl who presented to orthopedic clinic with a 4-month history of painful limping. Plain radiography of the right knee demonstrated a well-defined lytic lesion in the proximal of the tibia. Open biopsy and then curettage and bone grafting with bone- substitute was performed. The diagnosis of this condition requires a high index of suspicion. This report demonstrates that all UBCs do not have the same clinical patterns and with adequate attention good results can be achieved.

Aneurysmal bone cyst.

PubMed

Rapp, Timothy B; Ward, James P; Alaia, Michael J

2012-04-01

Aneurysmal bone cysts are rare skeletal tumors that most commonly occur in the first two decades of life. They primarily develop about the knee but may arise in any portion of the axial or appendicular skeleton. Pathogenesis of these tumors remains controversial and may be vascular, traumatic, or genetic. Radiographic features include a dilated, radiolucent lesion typically located within the metaphyseal portion of the bone, with fluid-fluid levels visible on MRI. Histologic features include blood-filled lakes interposed between fibrous stromata. Differential diagnosis includes conditions such as telangiectatic osteosarcoma and giant cell tumor. The mainstay of treatment is curettage and bone graft, with or without adjuvant treatment. Other management options include cryotherapy, sclerotherapy, radionuclide ablation, and en bloc resection. The recurrence rate is low after appropriate treatment; however, more than one procedure may be required to completely eradicate the lesion.

Total knee arthroplasty in a rheumatoid arthritic knee with large geode: a case report.

PubMed

Shih, H N; Hsu, K Y; Tan, C F; Hsueh, S; Hsu, R W

1997-09-01

Geodes (subchondral cysts) are a well-known manifestation of rheumatoid arthritis. Solitary cysts or cysts larger than 2 cm are not generally found in the knee joint of patients with rheumatoid arthritis (RA). We report a case of RA involving both knees with a giant geode over the right proximal tibia. Surgical treatment was performed including synovectomy, cyst enucleation and packing of autogenous bone chips followed by primary total knee arthroplasty. The postsurgical result was excellent with the knee restored to good function and complete healing of the cystic lesion.

CT-guided radiofrequency ablation in patients with aneurysmal bone cysts.

PubMed

Zarzour, Osama A; Santiago, Fernando Ruiz; Serrano, Nicolas Olea; Abdallah, Abdelkareem Hassan; El-Sharkawy, Mostafa Ahmad; Mourad, Amr Farouk

2018-03-01

Aneurysmal bone cyst (ABC) is one of most therapeutic challenging lesions for orthopedic surgeons specially in large-sized lesions and lesions, which are very close to important neurovascular structures. In the present study, we express our experience in the treatment of aneurysmal bone cyst by radiofrequency thermal ablation (RFTA). In the last two years, we have treated 20 cases (12 males & 8 females) presented with painful aneurysmal bone cysts in different anatomical locations, the age mean (±SD) is 18.95 ± 8.02 years and median is 17.5 years, the mean size of the lesions (±SD) is: 32.25 ± 7.15 mm & the median (range) is 33.5 mm (18.0-43.0) mm. The treatment was done by (RFTA) only in 11 cases and by (RFTA) with cementation in the other 9 cases, then the patients underwent close clinical follow-up for clinical symptoms by using visual analogue scale (VAS) pain score & radiological follow-up for one month, six months & one year after the procedure. Close follow-up for the patients proved that (RFTA) is a clinically successful &curative treatment as there was significant reduction in the mean (±SD) of the (VAS) pain score in all treated cases from 8.40 ± 1.23 before the intervention to 0.20 ± 0.41 at the end of follow-up period. No recorded post-procedural complications or recurrence during or at the end of the follow-up period. Copyright © 2018 Elsevier B.V. All rights reserved.

Laparoscopic management of peripelvic renal cysts: University of California, San Francisco, experience and review of literature.

PubMed

Camargo, Affonso H L A; Cooperberg, Matthew R; Ershoff, Brent D; Rubenstein, Jonathan N; Meng, Maxwell V; Stoller, Marshall L

2005-05-01

To report our experience and review published reports on the laparoscopic management of peripelvic renal cysts. Peripelvic renal cysts represent a unique subset of renal cysts, as they are rare, commonly symptomatic, and more difficult to treat than simple peripheral renal cysts. Minimally invasive methods for the treatment of peripelvic renal cysts, including laparoscopic decortication, have recently become more common. Four patients who presented with symptomatic peripelvic cysts underwent laparoscopic decortication at our institution. All four were men aged 47 to 65 years. One patient had undergone an unsuccessful prior cyst aspiration. All patients underwent preoperative computed tomography and retrograde pyelography. The mean number of peripelvic cysts per patient was 3.0, and the mean cyst size was 7.1 cm. The mean operative time was 259 minutes (range 240 to 293), and the mean estimated blood loss was 30 mL (range 10 to 50). No evidence of cystic renal cell carcinoma was found on aspiration cytology or cyst wall pathologic examination. The mean hospital stay was 1.3 days. No inadvertent collecting system injuries and no intraoperative or postoperative complications occurred. All 4 patients achieved symptomatic relief and were determined to have radiologic success as determined by the 6-month postoperative computed tomography findings. Laparoscopic ablation of peripelvic renal cysts is more difficult than that of simple peripheral renal cysts and demands a heightened awareness of potential complications and, therefore, more advanced surgical skills. In addition to our experience, a thorough review of published reports found this procedure to be safe and effective with appropriate patient selection.

Mechanical Characterization of Microengineered Epithelial Cysts by Using Atomic Force Microscopy.

PubMed

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.

Sclerotherapy of renal cysts using acetic acid: a comparison with ethanol sclerotherapy.

PubMed

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.

Continuous decompression with intramedullary nailing for the treatment of unicameral bone cysts.

PubMed

Masquijo, Julio Javier; Baroni, Eduardo; Miscione, Horacio

2008-08-01

To evaluate the efficacy of decompression of unicameral bone cysts (UBCs) of the long bones with intramedullary nailing and to compare responses to treatment according to location. We evaluated 48 consecutive patients treated between January 1988 and June 2000. Mean age was 10.3 years. Mean follow-up was 9.8 years. Evaluation was performed according to the radiographic criteria of Capanna. UBCs were located in the proximal humerus (n = 24), humeral shaft (n = 2), proximal femur (n = 19), distal tibia (n = 2) and fibula (n = 1). A total of 62.5% presented a pathological fracture. Successful results were observed in 89.5% (26 total healing, 17 healing with residual radiolucent areas), and there were four recurrences and, in one case, no response to treatment. There was more healing in the humerus than in the femur (92.3% versus 84.2%), and more tendency to restitution ad integrum, although the difference was not statistically significant (P = 0.1499). Intramedullary nailing is a minimally invasive method, which permits early stability and decompresses the cyst allowing healing. Significant differences were not observed among results from different locations.

Treatment for unicameral bone cysts in long bones: an evidence based review.

PubMed

Donaldson, Sandra; Chundamala, Josie; Yandow, Suzanne; Wright, James G

2010-03-20

The purpose of this paper is to perform an evidence based review for treatment of unicameral bone cysts. A search of MEDLINE (1966 to 2009) was conducted and the studies were classified according to levels of evidence. This review includes only comparative Level I-III studies. The systematic review identified 16 studies. There is one level I study, one level II study and the remaining 14 studies are level III. Seven of the sixteen studies had statistically different results: three studies indicated that steroid injection was superior to bone marrow injection or curettage and bone grafting; one study indicated that cannulated screws were superior to steroid injections; one study indicated resection and myoplasty was superior to steroid injection; one study indicated a combination of steroid, demineralized bone matrix and bone marrow aspirate, and curettage and bone grafting were superior to steroid injection; and one study indicated that curettage and bone grafting was superior to non-operative immobilization. Based on one Level I study, including a limited number of individuals, steroid injection seems to be superior to bone marrow injection. As steroid injections have already demonstrated superiority over bone marrow injections in a randomized clinical trial, the next step would be a prospective trial comparing steroid injections with other treatments.

Treatment for unicameral bone cysts in long bones: an evidence based review

PubMed Central

Donaldson, Sandra; Chundamala, Josie; Yandow, Suzanne; Wright, James G.

2010-01-01

The purpose of this paper is to perform an evidence based review for treatment of unicameral bone cysts. A search of MEDLINE (1966 to 2009) was conducted and the studies were classified according to levels of evidence. This review includes only comparative Level I-III studies. The systematic review identified 16 studies. There is one level I study, one level II study and the remaining 14 studies are level III. Seven of the sixteen studies had statistically different results: three studies indicated that steroid injection was superior to bone marrow injection or curettage and bone grafting; one study indicated that cannulated screws were superior to steroid injections; one study indicated resection and myoplasty was superior to steroid injection; one study indicated a combination of steroid, demineralized bone matrix and bone marrow aspirate, and curettage and bone grafting were superior to steroid injection; and one study indicated that curettage and bone grafting was superior to non-operative immobilization. Based on one Level I study, including a limited number of individuals, steroid injection seems to be superior to bone marrow injection. As steroid injections have already demonstrated superiority over bone marrow injections in a randomized clinical trial, the next step would be a prospective trial comparing steroid injections with other treatments. PMID:21808696

Unicameral bone cyst of the proximal tibia in a five year old girl

PubMed Central

Tahririan, Mohammadali; Motiffard, Mehdi

2012-01-01

Unicameral bone cysts (UBCs) are benign, osteolytic lesions which are often asymptomatic and are commonly seen in the proximal of humerus and femur. The average age at diagnosis is 9-11 years and there is a male preponderance with a male-to-female ratio of approximately 2-2.5 to 1. We describe a case of 5-year-old girl who presented to orthopedic clinic with a 4-month history of painful limping. Plain radiography of the right knee demonstrated a well-defined lytic lesion in the proximal of the tibia. Open biopsy and then curettage and bone grafting with bone- substitute was performed. The diagnosis of this condition requires a high index of suspicion. This report demonstrates that all UBCs do not have the same clinical patterns and with adequate attention good results can be achieved. PMID:23248665

Periosteal ganglion: a cause of cortical bone erosion.

PubMed

McCarthy, E F; Matz, S; Steiner, G C; Dorfman, H D

1983-01-01

Three cases of periosteal ganglia of long bones are presented. These lesions are produced by mucoid degeneration and cyst formation of the periosteum to produce external cortical erosion and reactive periosteal new bone. They are not associated with a soft tissue ganglion or an intraosseous lesion. They may radiologically mimic other periosteal lesions or soft tissue neoplasms which erode bone.

[Simultaneous existence of unicameral bone cysts involving the femur and ischium].

PubMed

Makris, Vassilios; Papavasiliou, Kyriakos A; Bobos, Mattheos; Hytiroglou, Prodromos; Kirkos, John M; Kapetanos, George A

2009-01-01

We report a 30-year-old male patient with two unicameral bone cysts (UBC) simultaneously located in the proximal third of the right femur and ipsilateral ischium ramus, respectively. Fine needle biopsies were attempted for both lesions. Biopsy of the femoral lesion under local anesthesia was unsuccessful, so an open biopsy was performed which confirmed the diagnosis of UBC. Biopsy of the ischial lesion was not sufficient for diagnosis. Cytological examination of both specimens showed no other benign or malignant pathology. The femoral lesion was treated with intralesional (due to its large size) excision-curettage, bone grafting, and the introduction of a long gamma locking intramedullary nail to prevent the occurrence of a pathological fracture. The ischial lesion was left untreated and followed conservatively. The patient was free of any symptoms and complications three years postoperatively. This is the first report of an adult patient with UBCs simultaneously located both in a long tubular bone (femur) and a flat bone (ischium ramus).

Pathological fractures in children

PubMed Central

De Mattos, C. B. R.; Binitie, O.; Dormans, J. P.

2012-01-01

Pathological fractures in children can occur as a result of a variety of conditions, ranging from metabolic diseases and infection to tumours. Fractures through benign and malignant bone tumours should be recognised and managed appropriately by the treating orthopaedic surgeon. The most common benign bone tumours that cause pathological fractures in children are unicameral bone cysts, aneurysmal bone cysts, non-ossifying fibromas and fibrous dysplasia. Although pathological fractures through a primary bone malignancy are rare, these should be recognised quickly in order to achieve better outcomes. A thorough history, physical examination and review of plain radiographs are crucial to determine the cause and guide treatment. In most benign cases the fracture will heal and the lesion can be addressed at the time of the fracture, or after the fracture is healed. A step-wise and multidisciplinary approach is necessary in caring for paediatric patients with malignancies. Pathological fractures do not have to be treated by amputation; these fractures can heal and limb salvage can be performed when indicated. PMID:23610658

Boiling sheep liver or lung for 30 minutes is necessary and sufficient to kill Echinococcus granulosus protoscoleces in hydatid cysts

PubMed Central

Li, Jun; Wu, Chuanchuan; Wang, Hui; Liu, Huanyuan; Vuitton, Dominique A.; Wen, Hao; Zhang, Wenbao

2014-01-01

Proper disposal of carcasses and offal after home slaughter is difficult in poor and remote communities and therefore dogs readily have access to hydatid cysts containing offal from livestock, thus completing the parasite cycle of Echinococcus granulosus and putting communities at risk of cystic echinococcosis. Boiling livers and lungs which contain hydatid cysts could be a simple, efficient and energy- and time-saving way to kill the infectious protoscoleces. The aim of this study was to provide precise practical recommendations to livestock owners. Our results show that boiling the whole sheep liver and/or lung, with single or multiple hydatid cysts, for 30 min is necessary and sufficient to kill E. granulosus protoscoleces in hydatid cysts. Advertising on this simple rule in at-risk communities would be an efficient and cheap complement to other veterinary public health operations to control cystic echinococcosis. PMID:25456565

Solid variant of aneurysmal bone cyst of the left parietal bone without preceding trauma.

PubMed

Nestler, Ulf; Wagner, Hans-Joachim; Schaenzer, Anne; Preuss, Matthias

2013-12-01

We report the case of a 17-year-old girl with an indolent, smooth swelling of the left cranial vault that had been developing for 2 months. Complete surgical excision was performed and the defect was closed using artificial bone cement. The integrity of the dura mater was conserved and the patient recovered without neurological deficit. Magnetic resonance imaging (MRI) controls 6 and 18 months after the operation did not find signs of recurrence. The lesion consisted of an elastic bone shell containing bony trabeculae with soft brown-greyish tissue and posthemorrhagic dark fluid. Histological assessment found CD68 positive multinucleated giant cells in a highly cellular fibroblastic matrix surrounding bony lamellar structures, without signs of inflammation or malignancy. Hyperparathyroidism was ruled out by normal serum values for parathyroid hormone, calcium, phosphate, and alkaline phosphatase. Histologically, first diagnosis was giant cell reparative granuloma and reference pathology disclosed aneurysmal bone cyst. The solid variant of aneurysmal bone cyst and the giant cell reparative granuloma can be histologically indistinguishable. Both lesions are only rarely encountered in cranial bones and most published cases affected the cranial base or the jaw, mainly in children or young adults. From a clinical point of view, classification into "outward" lesions (osteolysis of external parts of the vault with preservation of internal tabula) and "inward" lesions (intracranial multicystic lesions with raise of intracranial pressure) has been proposed. Three phases of development can be identified, and spontaneous involution has been described. Both entities are benign, but because in several cases an underlying malignant disease has been found, complete resection and regular follow-up by MRI are recommended. Georg Thieme Verlag KG Stuttgart · New York.

Association between disk position and degenerative bone changes of the temporomandibular joints: an imaging study in subjects with TMD.

PubMed

Cortés, Daniel; Sylvester, Daniel Cortés; Exss, Eduardo; Marholz, Carlos; Millas, Rodrigo; Moncada, Gustavo

2011-04-01

The aim of this study was to determine the frequency and relationship between disk position and degenerative bone changes in the temporomandibular joints (TMJ), in subjects with internal derangement (ID). MRI and CT scans of 180 subjects with temporomandibular disorders (TMD) were studied. Different image parameters or characteristics were observed, such as disk position, joint effusion, condyle movement, degenerative bone changes (flattened, cortical erosions and irregularities), osteophytes, subchondral cysts and idiopathic condyle resorption. The present study concluded that there is a significant association between disk displacement without reduction and degenerative bone changes in patients with TMD. The study also found a high probability of degenerative bone changes when disk displacement without reduction is present. No association was found between TMD and condyle range of motion, joint effusion and/or degenerative bone changes. The following were the most frequent morphological changes observed: flattening of the anterior surface of the condyle; followed by erosions and irregularities of the joint surfaces; flattening of the articular surface of the temporal eminence, subchondral cysts, osteophytes; and idiopathic condyle resorption, in decreasing order.

Unicameral Bone Cyst in the Calcaneus of Mirror Image Twins.

PubMed

Lenze, Ulrich; Stolberg-Stolberg, Josef; Pohlig, Florian; Lenze, Florian; von Eisenhart-Rothe, Rüdiger; Rechl, Hans; Toepfer, Andreas

2015-01-01

Unicameral bone cysts (UBCs) are benign tumor-like lesions that commonly occur in the diaphyseal or metaphyseal region of the long bones within the first 2 decades of life. Until today, the pathogenesis of UBC has been unclear, but mechanisms such as vascular occlusion or a response to trauma have been supposed. During the past decade, in particular, the genetic aspects of the development of this rare lesion have been discussed. We present the first case of mirror image monozygotic twins with a mirror image UBC of the calcaneus. Our findings reinforce the importance of additional studies to understand the significance of cytogenetic factors in the etiology of UBC. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Multiloculated solitary (unicameral) bone cyst in a young dog.

PubMed

Roode, Sarah C; Shive, Heather R; Hoorntje, Willemijn; Bernard, Jennifer; Stowe, Devorah M; Pool, Roy R; Grindem, Carol B

2018-05-21

A 20-month-old female spayed Staffordshire Terrier (22.3 kg) presented to the Orthopedic Surgery Service at North Carolina State University Veterinary Teaching Hospital for evaluation of a 6-week history of toe-touching to nonweight-bearing lameness in the right hind limb. Radiographs of the right stifle revealed a multiloculated lytic lesion of the distal femur, with a large open lytic zone centrally, numerous osseous septations peripherally, and focal areas of cortical thinning and loss. An aspirate of the right distal femoral lesion yielded mildly cloudy serosanguineous fluid. Cytologic examination of the fluid revealed a pleomorphic population of discrete cells that exhibited marked anisocytosis and anisokaryosis and a variable nucleus to cytoplasm (N:C) ratio, which were interpreted as probable neoplastic cells, with few macrophages, and evidence of hemorrhage. Given the clinical signs of pain, lesion size, and concern for malignant neoplasia, amputation of the right hind limb was performed. Histologically, the lesion had undulating walls 1-3 mm thick with a continuous outer layer of dense fibrous tissue and an inner layer composed of reactive cancellous bone with no cortical compacta remaining. Remnants of thin fibrous or fibro-osseous septa projected from the bony wall into the cyst lumen. The final histologic diagnosis was a benign multiloculated solitary (unicameral) bone cyst of the distal right femur. Based on the histopathologic findings, it was speculated that the cells identified on cytology were a mixture of developing osteoclasts, osteoblasts, endothelial, and stromal cells. This is the first report describing the cytologic examination of a solitary bone cyst in veterinary medicine. © 2018 American Society for Veterinary Clinical Pathology.

Treatment of unicameral bone cysts in pediatric patients with an injectable regenerative graft: a preliminary report.

PubMed

Gentile, John V; Weinert, Carl R; Schlechter, John A

2013-01-01

Multiple treatment modalities exist for unicameral bone cysts (UBC), including steroid injection, autologous bone marrow injection, mechanical decompression, intramedullary fixation, curettage, and bone grafting. All have their own potential limitations such as high recurrence rates, cyst persistence, need for multiple procedures, and prolonged immobilization. A minimally invasive regimen consisting of curettage, decompression, and injection of a calcium sulfate-calcium phosphate (CaSO4-CaPO4) composite has been utilized at our institution in an attempt to obtain optimal results for the treatment of UBCs in the pediatric population. We retrospectively evaluated 16 patients with pathologically confirmed UBC who were treated with curettage, decompression, and injection of a calcium sulfate-calcium phosphate composite between April 2006 and August 2010 at a single institution. The average age of the patients at time of surgical intervention was 9.4 years of age (range, 3 to 16 y). Average follow-up was 16 months (range, 6 to 36 mo). Radiographic healing, clinical outcomes, and complications were evaluated. Final follow-up radiographs demonstrated healing in 93.7% (15 of 16) of patients after a single procedure. Complete healing was observed in 14 of 16 patients and partially healed with a defect in 1 of 16 patients. One patient had a persistent cyst but did not wish to receive further treatment. All patients returned to full activities including sports on average at 3.1 months (range, 1 to 6 mo) and were asymptomatic on most recent follow-up. No postoperative complications, including refracture, were observed. Curettage, decompression, and injection of a calcium sulfate-calcium phosphate composite for UBC in the pediatric population demonstrates encouraging results with low recurrence rates and complications compared with conventional methods. Case series, Level of Evidence IV.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Akhan, Okan, E-mail: akhano@tr.net; Islim, Filiz, E-mail: fislim@yahoo.com; Balci, Sinan, E-mail: snnbalci@gmail.com

PurposeThe purpose of our study is to evaluate results of percutaneous aspiration with alcohol sclerotherapy in symptomatic patients with simple hepatic cysts by employing single-session techniques either by a needle or a catheter.Materials and MethodsWe retrospectively included 39 simple hepatic cysts in 35 patients treated via percutaneous aspiration and single-session alcohol sclerotherapy between years 1993 and 2012. Indications were pain (n = 28) or ruling out cystic echinococcus (CE) disease (n = 7). 29 cysts in 26 patients were treated by needle technique (Group A) and ten cysts in nine patients were treated by single-session catheter technique (Group B). Patients were followed for 4–173 monthsmore » (median: 38 months).ResultsAll patients were successfully treated. Before procedure, cyst volumes were 21–676 cc (median: 94 cc). Post-procedure cyst volumes at last follow-up were 0-40 cc (median: 1 cc). The mean decrease in cyst volume was 95.92 ± 2.86 % in all patients (95.96 ± 3.26 % in Group A and 95.80 ± 6.20 % in Group B). There was no statistically significant difference between the volume reduction rates of Group A and Group B. Only one patient, in Group B, developed a major complication, an abscess. Hospitalization period was 1 day for all patients.ConclusionsFor patients with symptomatic simple hepatic cysts smaller than 500 cc in volume by using puncture, aspiration, injection, and reaspiration (PAIR) technique with only needle, single-session alcohol sclerotherapy of 10 min is a safe and effective procedure with high success rate.« less

Injection of Unicameral Bone Cysts with Bone Marrow Aspirate and Demineralized Bone Matrix Avoids Open Curettage and Bone Grafting in a Retrospective Cohort.

PubMed

Gundle, Kenneth R; Bhatt, Etasha M; Punt, Stephanie E; Bompadre, Viviana; Conrad, Ernest U

2017-01-01

Many treatment options exist for unicameral bone cysts (UBC), without clear evidence of superiority. Meta-analyses have been limited by small numbers of patients in specific anatomic and treatment subgroups. The purpose of this study was to report the outcomes of injecting bone marrow aspirate and demineralized bone matrix (BMA/DBM) for the treatment of proximal humerus UBC. Fifty-one patients with proximal humerus lesions treated by BMA/DBM injection were retrospectively reviewed from a single academic medical center. The mean number of injections performed per patient was 2.14 (range 1-5). Eleven patients underwent only one injection (22%), an additional 19 patients completed treatment after two injections (37%), four patients healed after three injections (8%), and one patient healed after four injections (2%). The cumulative success rate of serial BMA/DBM injections was 22% (11/51), 58% (30/51), 67% (34/51), and 69% (35/51). Eleven patients (22%) ultimately underwent open curettage and bone grafting, and five patients (10%) were treated with injection of calcium phosphate bone substitute. A BMA/DBM injection strategy avoided an open procedure in 78% of patients with a proximal humerus UBC. The majority of patients underwent at least 2 injection treatments. Level IV retrospective cohort study.

An Improved Quantitative Real-Time PCR Assay for the Enumeration of Heterosigma akashiwo (Raphidophyceae) Cysts Using a DNA Debris Removal Method and a Cyst-Based Standard Curve.

PubMed

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.

Chondroblastoma with Secondary Aneurysmal Bone Cyst

DTIC Science & Technology

2008-02-01

dysplasia, chondroblastoma, chondromyxoid fibroma, osteochondroma, giant cell tumors, or enchondroma. Chondrosarcoma , osteoblastoma–aggressive variant and...Histology reveals cartilage with a layer of smooth, thin bone surrounding. 2 Chondrosarcomas tend to occur in an older population than most primary bone...mentioned was considered. All of those suspected neoplasms, with the exception of chondrosarcoma , fit this patient’s age group, as all frequently

High doses of bone morphogenetic protein 2 induce structurally abnormal bone and inflammation in vivo.

PubMed

Zara, Janette N; Siu, Ronald K; Zhang, Xinli; Shen, Jia; Ngo, Richard; Lee, Min; Li, Weiming; Chiang, Michael; Chung, Jonguk; Kwak, Jinny; Wu, Benjamin M; Ting, Kang; Soo, Chia

2011-05-01

The major Food and Drug Association-approved osteoinductive factors in wide clinical use are bone morphogenetic proteins (BMPs). Although BMPs can promote robust bone formation, they also induce adverse clinical effects, including cyst-like bone formation and significant soft tissue swelling. In this study, we evaluated multiple BMP2 doses in a rat femoral segmental defect model and in a minimally traumatic rat femoral onlay model to determine its dose-dependent effects. Results of our femoral segmental defect model established a low BMP2 concentration range (5 and 10 μg/mL, total dose 0.375 and 0.75 μg in 75 μg total volume) unable to induce defect fusion, a mid-range BMP2 concentration range able to fuse the defect without adverse effects (30 μg/mL, total dose 2.25 μg in 75 μg total volume), and a high BMP2 concentration range (150, 300, and 600 μg/mL, total dose 11.25, 22.5, and 45 μg in 75 μg total volume) able to fuse the defect, but with formation of cyst-like bony shells filled with histologically confirmed adipose tissue. In addition, compared to control, 4 mg/mL BMP2 also induced significant tissue inflammatory infiltrates and exudates in the femoral onlay model that was accompanied by increased numbers of osteoclast-like cells at 3, 7, and 14 days. Overall, we consistently reproduced BMP2 side effects of cyst-like bone and soft tissue swelling using high BMP2 concentration approaching the typical human 1500 μg/mL.

High Doses of Bone Morphogenetic Protein 2 Induce Structurally Abnormal Bone and Inflammation In Vivo

PubMed Central

Zara, Janette N.; Siu, Ronald K.; Zhang, Xinli; Shen, Jia; Ngo, Richard; Lee, Min; Li, Weiming; Chiang, Michael; Chung, Jonguk; Kwak, Jinny; Wu, Benjamin M.; Ting, Kang

2011-01-01

The major Food and Drug Association–approved osteoinductive factors in wide clinical use are bone morphogenetic proteins (BMPs). Although BMPs can promote robust bone formation, they also induce adverse clinical effects, including cyst-like bone formation and significant soft tissue swelling. In this study, we evaluated multiple BMP2 doses in a rat femoral segmental defect model and in a minimally traumatic rat femoral onlay model to determine its dose-dependent effects. Results of our femoral segmental defect model established a low BMP2 concentration range (5 and 10 μg/mL, total dose 0.375 and 0.75 μg in 75 μg total volume) unable to induce defect fusion, a mid-range BMP2 concentration range able to fuse the defect without adverse effects (30 μg/mL, total dose 2.25 μg in 75 μg total volume), and a high BMP2 concentration range (150, 300, and 600 μg/mL, total dose 11.25, 22.5, and 45 μg in 75 μg total volume) able to fuse the defect, but with formation of cyst-like bony shells filled with histologically confirmed adipose tissue. In addition, compared to control, 4 mg/mL BMP2 also induced significant tissue inflammatory infiltrates and exudates in the femoral onlay model that was accompanied by increased numbers of osteoclast-like cells at 3, 7, and 14 days. Overall, we consistently reproduced BMP2 side effects of cyst-like bone and soft tissue swelling using high BMP2 concentration approaching the typical human 1500 μg/mL. PMID:21247344

Boiling sheep liver or lung for 30 minutes is necessary and sufficient to kill Echinococcus granulosus protoscoleces in hydatid cysts.

PubMed

Li, Jun; Wu, Chuanchuan; Wang, Hui; Liu, Huanyuan; Vuitton, Dominique A; Wen, Hao; Zhang, Wenbao

2014-01-01

Proper disposal of carcasses and offal after home slaughter is difficult in poor and remote communities and therefore dogs readily have access to hydatid cysts containing offal from livestock, thus completing the parasite cycle of Echinococcus granulosus and putting communities at risk of cystic echinococcosis. Boiling livers and lungs which contain hydatid cysts could be a simple, efficient and energy- and time-saving way to kill the infectious protoscoleces. The aim of this study was to provide precise practical recommendations to livestock owners. Our results show that boiling the whole sheep liver and/or lung, with single or multiple hydatid cysts, for 30 min is necessary and sufficient to kill E. granulosus protoscoleces in hydatid cysts. Advertising on this simple rule in at-risk communities would be an efficient and cheap complement to other veterinary public health operations to control cystic echinococcosis. © J. Li et al., published by EDP Sciences, 2014.

Exaggerated inflammatory response after use of recombinant bone morphogenetic protein in recurrent unicameral bone cysts.

PubMed

MacDonald, Kevin M; Swanstrom, Morgan M; McCarthy, James J; Nemeth, Blaise A; Guliani, Teresa A; Noonan, Kenneth J

2010-03-01

Recurrent unicameral bone cysts (UBCs) can result in significant morbidity during a child's physical and emotional development. Multiple treatment options are available and a review of the literature fails to clearly define the optimal treatment for UBCs. Recombinant bone morphogenetic protein (BMP) has been used with success in other disorders of poor bone formation. This manuscript is the first to report on the use of recombinant BMP in the treatment of UBCs. Three patients with recurrent UBCs underwent revision surgery with recombinant BMP. Radiographic and medical review was performed and is reported here. In these patients, the use of BMP failed to fully resolve their UBC; 2 patients had complete recurrence that required further surgery. In addition to poor radiographic results, all patients developed exaggerated inflammatory responses in the acute postoperative period. Each child developed clinically significant limb swelling and pain that mimicked infection. On the basis of our poor radiographic results and a paradoxical clinical result, we no longer recommend the use of recombinant BMP in the manner reported here for the treatment of recurrent UBCs. Level IV, case series.

Chronic subdural hematoma associated with arachnoid cyst. Two case histories with pathological observations.

PubMed

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.

Conservative management of typical pediatric postauricular dermoid cysts.

PubMed

Linkov, Gary; Kanev, Paul M; Isaacson, Glenn

2015-11-01

Congenital dermoid cysts of the skull and face frequently arise in embryonic fusion planes. They may follow these planes to extend intratemporally or intracranially. Advanced imaging and operative techniques are generally recommended for these lesions. Postauricular temporal bone dermoid cysts seem to form a distinct subgroup with a lesser tendency toward deep extension. They may be amenable to more conservative management strategies. With IRB-approval, we queried a prospectively-accrued computerized patient-care database to find all postauricular temporal dermoid lesions surgically managed by a single pediatric otolaryngologist from 2001 to 2014. We reviewed the English-language literature to identify similar series of surgically treated pediatric temporal bone dermoid cysts. Ten postauricular temporal dermoid cysts with pathological confirmation were identified in our surgical series. The average size of the lesions was 1.5 cm (0.3-3 cm). The average age at time of surgery was 4 years (6 months-17 years). No intracranial extension was observed at surgery. There were no recurrences noted on last follow-up (mean 65 months, range 10-150 months). A computerized literature review found no examples of intracranial extension among typical postauricular dermoid cysts. There was no intracranial or temporal extension in our series or among postauricular lesions described in the literature. Given the low incidence of deep extension we advocate neither advanced imaging nor routine neurosurgical consultation for typical postauricular lesions. Dissection in continuity with cranial periosteum facilitates intact removal of adherent lesions. Surgery is curative if the dermoid is removed intact. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Injection of Unicameral Bone Cysts with Bone Marrow Aspirate and Demineralized Bone Matrix Avoids Open Curettage and Bone Grafting in a Retrospective Cohort

PubMed Central

Gundle, Kenneth R.; Bhatt, Etasha M.; Punt, Stephanie E.; Bompadre, Viviana; Conrad, Ernest U.

2017-01-01

Background: Many treatment options exist for unicameral bone cysts (UBC), without clear evidence of superiority. Meta-analyses have been limited by small numbers of patients in specific anatomic and treatment subgroups. The purpose of this study was to report the outcomes of injecting bone marrow aspirate and demineralized bone matrix (BMA/DBM) for the treatment of proximal humerus UBC. Methods: Fifty-one patients with proximal humerus lesions treated by BMA/DBM injection were retrospectively reviewed from a single academic medical center. Results: The mean number of injections performed per patient was 2.14 (range 1-5). Eleven patients underwent only one injection (22%), an additional 19 patients completed treatment after two injections (37%), four patients healed after three injections (8%), and one patient healed after four injections (2%). The cumulative success rate of serial BMA/DBM injections was 22% (11/51), 58% (30/51), 67% (34/51), and 69% (35/51). Eleven patients (22%) ultimately underwent open curettage and bone grafting, and five patients (10%) were treated with injection of calcium phosphate bone substitute. Conclusion: A BMA/DBM injection strategy avoided an open procedure in 78% of patients with a proximal humerus UBC. The majority of patients underwent at least 2 injection treatments. Level of Evidence: Level IV retrospective cohort study. PMID:28694887

[Surgical treatment of perinatal ovarian cysts].

PubMed

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.

Decrease in local volumetric bone mineral density (vBMD) in osteoarthritic joints is associated with the increase in cartilage damage: a pQCT study

NASA Astrophysics Data System (ADS)

Tamaddon, Maryam; Chen, Shen Mao; Vanaclocha, Leyre; Hart, Alister; El-Husseiny, Moataz; Henckel, Johann; Liu, Chaozong

2017-11-01

Osteoarthritis (OA) is the most common type of arthritis and a major cause of disability in the adult population. It affects both cartilage and subchondral bone in the joints. There has been some progress in understanding the changes in subchondral bone with progression of osteoarthritis. However, local changes in subchondral bone such as microstructure or volumetric bone mineral density in connection with the defect in cartilage are relatively unexplored. To develop an effective treatment for progression of OA, it is important to understand how the physical environment provided by the subchondral bone affects the overlying cartilage. In this study we examined the volumetric bone mineral density (vBMD) distribution in the osteoarthritic joint tissues obtained from total hip replacement surgeries due to osteoarthritis, using peripheral quantitative CT (pQCT). It was found that there is a significant decrease in volumetric bone mineral density, which co-localises with the damage in the overlying cartilage. This was not limited to the subchondral bone immediately adjacent to the cartilage defect but continued in the layers below. Bone resorption and cyst formation in the OA tissues were also detected. We observed that the bone surrounding subchondral bone cysts exhibited much higher volumetric bone mineral density than that of the surrounding bones. PQCT was able to detect significant changes in vBMD between OA and non-OA samples, as well as between areas of different cartilage degeneration, which points to its potential as a technique for detection of early OA.

Quantitative analysis of the plain radiographic appearance of nonossifying fibroma.

PubMed

Friedland, J A; Reinus, W R; Fisher, A J; Wilson, A J

1995-08-01

To quantitate radiographic features that distinguish the plain radiographic appearance of nonossifying fibroma (NOF) from other solitary lesions of bone. Seven hundred nine cases of focal bone lesions, including 34 NOFs, were analyzed according to demographic, anatomic, and plain radiographic features. Vector analysis of groups of features was performed to determine those that are most sensitive and specific for the appearance of NOF in contrast to other lesions in the data base. The radiographic appearance of NOFs was most consistently a medullary based (97%), lytic lesion (100%) with geographic bone destruction (100%), marginal sclerosis (97%), and well-defined edges (94%). A statistically significant number of lesions were located in the distal aspect of long bones. Unicameral bone cyst shared the most radiographic features with the NOF. Vector analysis showed a large degree of overlap between NOF and other lesions such as aneurysmal bone cyst, chondromyxoid fibroma, and eosinophilic granuloma. The description that optimized sensitivity and prevalence for detection of NOF is a medullary based, ovoid lesion in the distal or proximal portions of a long bone with well-defined edges, a partial or complete rind of sclerosis, and absence of fallen fragment, periosteal reaction, and cortical disruption. The radiographic appearance of NOF is relatively nonspecific but, using vector analysis, can be better elucidated over current textbook descriptions.

Percutaneous magnetic resonance imaging-guided bone tumor management and magnetic resonance imaging-guided bone therapy.

PubMed

Sequeiros, Roberto Blanco; Fritz, Jan; Ojala, Risto; Carrino, John A

2011-08-01

Magnetic resonance imaging (MRI) is promising tool for image-guided therapy. In musculoskeletal setting, image-guided therapy is used to direct diagnostic and therapeutic procedures and to steer patient management. Studies have demonstrated that MRI-guided interventions involving bone, soft tissue, joints, and intervertebral disks are safe and in selected indications can be the preferred action to manage clinical situation. Often, these procedures are technically similar to those performed in other modalities (computed tomography, fluoroscopy) for bone and soft tissue lesions. However, the procedural perception to the operator can be very different to other modalities because of the vastly increased data.Magnetic resonance imaging guidance is particularly advantageous should the lesion not be visible by other modalities, for selective lesion targeting, intra-articular locations, cyst aspiration, and locations adjacent to surgical hardware. Palliative tumor-related pain management such as ablation therapy forms a subset of procedures that are frequently performed under MRI. Another suitable entity for MRI guidance are the therapeutic percutaneous osseous or joint-related benign or reactive conditions such as osteoid osteoma, epiphyseal bone bridging, osteochondritis dissecans, bone cysts, localized bone necrosis, and posttraumatic lesions. In this article, we will describe in detail the technical aspects of performing MRI-guided therapeutic musculoskeletal procedures as well as the clinical indications.

A novel algorithm for a precise analysis of subchondral bone alterations

PubMed Central

Gao, Liang; Orth, Patrick; Goebel, Lars K. H.; Cucchiarini, Magali; Madry, Henning

2016-01-01

Subchondral bone alterations are emerging as considerable clinical problems associated with articular cartilage repair. Their analysis exposes a pattern of variable changes, including intra-lesional osteophytes, residual microfracture holes, peri-hole bone resorption, and subchondral bone cysts. A precise distinction between them is becoming increasingly important. Here, we present a tailored algorithm based on continuous data to analyse subchondral bone changes using micro-CT images, allowing for a clear definition of each entity. We evaluated this algorithm using data sets originating from two large animal models of osteochondral repair. Intra-lesional osteophytes were detected in 3 of 10 defects in the minipig and in 4 of 5 defects in the sheep model. Peri-hole bone resorption was found in 22 of 30 microfracture holes in the minipig and in 17 of 30 microfracture holes in the sheep model. Subchondral bone cysts appeared in 1 microfracture hole in the minipig and in 5 microfracture holes in the sheep model (n = 30 holes each). Calculation of inter-rater agreement (90% agreement) and Cohen’s kappa (kappa = 0.874) revealed that the novel algorithm is highly reliable, reproducible, and valid. Comparison analysis with the best existing semi-quantitative evaluation method was also performed, supporting the enhanced precision of this algorithm. PMID:27596562

Steroid injections in the treatment of humeral unicameral bone cysts: long-term follow-up and review of the literature.

PubMed

Pavone, V; Caff, G; Di Silvestri, C; Avondo, S; Sessa, G

2014-05-01

Retrospective evaluation of long-term effectiveness of the steroid injections treatment in patients with unicameral bone cysts (UBC). From January 1993 to April 2005, 23 children affected by proximal humeral UBC were evaluated according to the Neer-Cole classification system and treated with serial methylprednisolone acetate's injections. The patients were followed up at 1, 3, 6 and 12 months and then every year until the adolescence. After treatment, in 15 out of 23 patients (65.2%), the humeral cysts were referred, respectively, as Grade 1 and in four as Grade 2. In 4 patients, a refracture occurred. Statistical analysis showed an overall good response in 82.6% of patients at the end of the follow-up. Minor complication including skin discoloration accounted for 13.04%. The steroid injections showed to be an alternative excellent treatment for UBC, with complete healing of the lesions in the majority of cases. This procedure is not expensive, mini-invasive, with low surgical risk and short hospitalization.

Diagnostic Imaging of Pregnant Women – The Role of Magnetic Resonance Imaging

PubMed Central

Bekiesińska-Figatowska, Monika; Romaniuk-Doroszewska, Anna; Szkudlińska-Pawlak, Sylwia; Duczkowska, Agnieszka; Mądzik, Jarosław; Szopa-Krupińska, Martyna; Maciejewski, Tomasz M.

2017-01-01

Summary Background Presentation of magnetic resonance imaging (MRI) findings in pregnant women in the Department of Diagnostic Imaging, Institute of Mother and Child, Warsaw, Poland. Material/Methods Forty-three symptomatic pregnant women underwent MRI between 9 and 33 weeks of gestation (mean of 23 weeks). Moreover, we included 2 pregnant women who underwent fetal MRI and had incidental abnormalities. Results In 9 cases, we excluded the suspected brain abnormalities. In 4 cases, we found unremarkable changes in the brain without clinical significance. One patient was diagnosed with multiple sclerosis, one with cortical dysplasia, one with pineal hemorrhage and one with a brain tumor. On abdominal MRI, 2 patients had normal findings, one patient had colon cancer with a hepatic metastasis, one patient had a hepatic angioma, one patient had an extraadrenal pheochromocytoma, one patient had an abscess in the iliopsoas muscle, 9 patients had myomas, two patients had ovarian simple cysts, two endometrial cysts, three dermoid cysts, one patient had sacrococcygeal teratoma, one patient had a cystadenofibroma (partial borderline tumor), one patient had an androgenic ovarian tumor and two patients had hyperreactio luteinalis. One patient was diagnosed with transient osteoporosis of the hip and one with a stress fracture of the sacral bone. Conclusions Magnetic resonance imaging is the best imaging modality for pregnant women. Although ultrasonography is the method of choice, doubtful cases as well as structures that cannot be examined with ultrasonography can be non-invasively evaluated with MRI. PMID:28507642

Relationship between areas of popliteal cysts and radiological damage in rheumatoid arthritis and in osteoarthritis.

PubMed

Manganelli, P; Salaffi, F; Nervetti, A; Chierici, P; Ferraccioli, G F; Ambanelli, U

1987-01-01

Fifty-five patients, (30 Rheumatoid Arthritis (RA) and 25 Osteoarthritis (OA], with knee synovial effusion and popliteal cysts, visualized through arthrograms, were studied. A relationship was sought between radiological findings and area of the cysts, measured through a millimeter grid. Ten radiological parameters were graded and summed up to obtain a "total knee score". A "total geode score" was also obtained by scoring, separately, the geodes. In addition two specific indexes were used--for comparison--the erosive index, modified after Berens and Lin, in RA and the Kelligren's index in OA. In RA a statistically significant, inverse correlation was found between the x-ray scores and the area of the cysts, while such a relationship was not observed in OA. However, only a third of the cysts accounted for the inverse relationship in RA. Furthermore, two control groups of RA and OA patients revealed a striking association between degree of radiological damage and frequency of popliteal cysts. Therefore, the hypothesis that popliteal cysts might have a protective effect against the articular-bone damage in RA, can be held only in few cases.

Aggressive aneurysmal bone cyst of the maxilla confused with telangiectatic osteosarcoma.

PubMed

Lee, Hyun-Min; Cho, Kyu-Sup; Choi, Kyung-Un; Roh, Hwan-Jung

2012-06-01

Aneurysmal bone cyst (ABC) is a benign, expansile lesion typically affecting the long bones and vertebrae of patients younger than 20 years. Approximately 2% of ABCs occur in the head and neck region, most commonly affecting the mandible. Although the most common co-existing lesion associated with ABCs is the giant cell tumor, ABCs can be radiologically confused with telangiectatic osteosarcoma in cases of aggressive behavior and rapid growth. Here, we report a case of an aggressive ABC of the maxilla confused with telangiectatic osteosarcoma in a patient who underwent several operations for an osteoblastoma that was diagnosed histopathologically. This case highlights the need for a differential diagnosis both radiologically and histopathologically, because ABCs can easily be interpreted as a giant cell tumor or an osteoblastoma, and, on occasion, can be mistaken for osteogenic malignancies. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Aneurysmal bone cyst of the spine.

PubMed

Karparov, M; Kitov, D

1977-01-01

Long term follow up of three patients with aneurysmal bone cysts has allowed us to draw attention to features which facilitate diagnosis and determine adequate treatment. The lesion occurs usually under the age of twenty with a slight female predominance. Treatment consists in complete local excision. Failing this, curettage should be carried out, and this gives good results. The effectiveness of radiotherapy cannot be assessed from our series, but in our opinion it may not be necessary in every case and should be applied judiciously, as postradiation sarcomas have been reported. Special attention must be paid to the tendency for spontaneous regression and cure after incomplete removal, particularly in recurrent cases, with a view to avoiding more aggressive treatment than is necessary. Multilocation (vertebra and distant bone), endothelial proliferation, and obliteration of the lumen of the small blood vessels support the view that this is a vascular lesion.

Locking plate and fibular strut-graft augmentation in the reconstruction of unicameral bone cyst of proximal femur in the paediatric population.

PubMed

Jamshidi, Khodamorad; Mirkazemi, Masoud; Izanloo, Azra; Mirzaei, Alireza

2018-01-01

Several therapeutic strategies have been used for managing unicameral bone cyst (UBC) of the proximal femur. However, there is insufficient evidence to support one treatment over another, and the optimal treatment is controversial. This study aims at describing our experience with surgical reconstruction of paediatric UBCs of the proximal femur using a proximal locking plate and fibular strut allograft. In total, 14 consecutive paediatric patients with Dormans types IB (four cases) and IIB (10 cases) UBC were assessed. Mean patient age was 8.6 ± 2.3 years, and mean follow-up period was 41.7 ± 29.8 months. Six patients (42.8%) were referred with a pathologic fracture. Clinical/radiological outcome and complication rates were evaluated at the final follow-up session. No cysts were Capanna's class III (recurrence) or IV (no response). Complete healing (Capanna's class I) was seen in ten cysts, while four other cysts healed with residual radiolucent areas (Capanna's class II). Mean healing period was 14.1 ± 5.1 (9-24 months). One patient had superficial infection, one heterotopic ossification, and one mild coxa vara, and mean Musculoskeletal Tumor Society (MSTS) score was 99.5%. According to our results, locking plate and fibular strut graft in Dormans classification types IB and IIB results in a favorable outcome in managing UBC of the proximal femur in the paediatric population.

A giant ovarian cyst in a neonate.

PubMed

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.

[Giant epidermoid cyst of the skull with extra and intracranial extension. A case report].

PubMed

Akhaddar, A; Gazzaz, M; El Mostarchid, B; Kadiri, B; Lrhezzioui, J; Boucetta, M

2002-09-01

Intradiploic epidermoid cyst of the skull is a rare clinical entity that can exceptionally grow to a large size with intracranial extension. The authors report the case of a 38-year-old man with a giant epidermoid cyst of the parietal bone with extra and intracranial extension, presenting with focal neurological symptoms. The diagnosis was suggested at imaging (skull radiographs, CT and MRI), and confirmed at histology. Complete removal of the cyst and its capsule was performed followed by cranioplasty. Postoperatively, the patient was discharged free of symptoms. CT scan provides good evaluation of the bony lesion and may suggest intracranial extension. MRI is superior for evaluation of cerebral compression. The pathogenesis, clinical presentation, diagnostic evaluation and therapeutic management of these rare lesions are reviewed.

Traumatic bone cyst suggestive of a chronic periapical abscess: a case report.

PubMed

Kahler, Bill

2011-08-01

Traumatic bone cysts can mimic the signs and symptoms of an endodontic lesion. This case reports on a 19-year-old male patient who was referred for endodontic assessment of a symptomatic tooth with a gingival swelling and a draining sinus at the furcation of a mandibular second molar. Radiographically, a periradicular radiolucency is evident. A prior history of trauma as well as removal of the wisdom teeth was determined. After careful diagnosis unnecessary endodontic intervention was avoided. Surgical exploration, curettage and the generation of a blood clot resulted in healing at the 6 month review appointment. The tooth remained responsive to pulp sensibility testing at that time. © 2010 The Author. Australian Endodontic Journal © 2010 Australian Society of Endodontology.

Neurenteric Cyst or Neuroendodermal Cyst? Immunohistochemical Study and Pathogenesis.

PubMed

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.

Cryosurgery as an effective alternative for treatment of oral lesions in children.

PubMed

Rezende, Karla Mayra; Moraes, Paulo de Camargo; Oliveira, Luciana Butini; Thomaz, Luiz Alexandre; Junqueira, José Luiz Cintra; Bönecker, Marcelo

2014-01-01

Children can exhibit a wide variety of oral pathologies, such as oral lesions, bone lesions, tumors, cysts and cutaneous lesions. Different techniques have been described for the treatment of these lesions, but all of them are invasive. This paper presents a series of cases that demonstrate the clinical efficacy of cryosurgery as an alternative to invasive surgical treatments of the most common oral lesions in children. This technique has been well tolerated by patients due to the absence of anesthesia, rapid healing and minimal bleeding. Cryotherapy has many applications in oral medicine and is an extremely useful alternative in patients to whom surgery is contraindicated due to age or medical history. It is a simple procedure to perform, minimally invasive, low-cost and very effective in pediatric dentistry clinic.

MRI of the temporo-mandibular joint: which sequence is best suited to assess the cortical bone of the mandibular condyle? A cadaveric study using micro-CT as the standard of reference.

PubMed

Karlo, Christoph A; Patcas, Raphael; Kau, Thomas; Watzal, Helmut; Signorelli, Luca; Müller, Lukas; Ullrich, Oliver; Luder, Hans-Ulrich; Kellenberger, Christian J

2012-07-01

To determine the best suited sagittal MRI sequence out of a standard temporo-mandibular joint (TMJ) imaging protocol for the assessment of the cortical bone of the mandibular condyles of cadaveric specimens using micro-CT as the standard of reference. Sixteen TMJs in 8 human cadaveric heads (mean age, 81 years) were examined by MRI. Upon all sagittal sequences, two observers measured the cortical bone thickness (CBT) of the anterior, superior and posterior portions of the mandibular condyles (i.e. objective analysis), and assessed for the presence of cortical bone thinning, erosions or surface irregularities as well as subcortical bone cysts and anterior osteophytes (i.e. subjective analysis). Micro-CT of the condyles was performed to serve as the standard of reference for statistical analysis. Inter-observer agreements for objective (r = 0.83-0.99, P < 0.01) and subjective (κ = 0.67-0.88) analyses were very good. Mean CBT measurements were most accurate, and cortical bone thinning, erosions, surface irregularities and subcortical bone cysts were best depicted on the 3D fast spoiled gradient echo recalled sequence (3D FSPGR). The most reliable MRI sequence to assess the cortical bone of the mandibular condyles on sagittal imaging planes is the 3D FSPGR sequence. MRI may be used to assess the cortical bone of the TMJ. • Depiction of cortical bone is best on 3D FSPGR sequences. • MRI can assess treatment response in patients with TMJ abnormalities.

Lateral periodontal cysts arising in periapical sites: a report of two cases.

PubMed

Nikitakis, Nikolaos G; Brooks, John K; Melakopoulos, Ioannis; Younis, Rania H; Scheper, Mark A; Pitts, Mark A; Al-Mubarak, Hussain; Sklavounou, Alexandra

2010-10-01

The lateral periodontal cyst is an uncommon odontogenic developmental lesion and chiefly arises in the alveolar bone between the roots of a pair of erupted teeth or lateral to a tooth root. Two atypical cases of the lateral periodontal cyst occurring in periapical sites are reported. Both lesions presented as an incidental radiographic finding, appearing as an apical radiolucency with well-circumscribed sclerotic borders. One lesion, initially suspected to be of pulpal origin, persisted after endodontic therapy; the other case was first considered to be an odontogenic keratocyst. A biopsy was performed on each patient for lesional identity. Histopathologic assessment of each lesion was consistent with a lateral periodontal cyst and revealed thin, nonkeratinized epithelial linings containing nodular plaques and clear cells. The cyst walls were thickened and had minimal inflammation. The featured cases show that the lateral periodontal cyst is not always confined to the interradicular region and can masquerade as a lesion of endodontic origin. Aberrant cases warrant long-term surveillance. Copyright © 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Precocious pseudopuberty due to an autonomous ovarian follicular cyst: case report with a review of literatures

PubMed Central

2013-01-01

Background Small follicular cysts are commonly found in the ovaries of prepubertal girls, and in most cases, they are of no clinical importance. These cysts are usually self-limiting and resolve spontaneously. However, occasionally, these cysts may enlarge and continue to produce estrogen, resulting in signs of sexual precocity. Here, we report a case of precocious pseudopuberty associated with an autonomous ovarian follicular cyst. Case presentation A 5.9-year-old girl initially presented to a local clinic with vaginal bleeding and a large unilateral ovarian cyst. At 6 months after the initial acute episode, the patient visited our hospital as the ovarian cyst had persisted and increased in size. Endocrinological examination showed elevated estrogen levels and suppressed gonadotropin levels on GnRH stimulation test. Also, no skin pigmentation or bone anomaly was noted. Based on these observations, laparoscopic cystectomy was performed, and histologic analysis confirmed the diagnosis of a follicular cyst. After the laparoscopic cystectomy, the patient’s hormone levels returned to normal and no ovarian cyst was detected by ultrasound. Conclusions As autonomous ovarian cysts are usually self-limiting disorder, no treatment is necessary. Therefore, surgical management should be deferred as long as possible to avoid the risk of repeat surgery, as pseudoprecocious puberty due to autonomous ovarian cysts can resolve spontaneoulsy and frequently recurs. Precocious pseudopuberty with an ovarian cyst may be due to granulosa cell tumor or may be one symptom of the McCune-Albright Syndrome (MAS). A careful longer-term follow up of patients with autonomous ovarian cysts and/or molecular studies may be necessary in such cases. PMID:23937919

Cartilage and bone damage in rheumatoid arthritis

PubMed Central

Maśliński, Włodzimierz; Prochorec-Sobieszek, Monika; Nieciecki, Michał; Sudoł-Szopińska, Iwona

2018-01-01

Rheumatoid arthritis (RA), which is a chronic inflammatory disease with a multifactorial aetiology, leads to partial or permanent disability in the majority of patients. It is characterised by persistent synovitis and formation of pannus, i.e. invasive synovial tissue, which ultimately leads to destruction of the cartilage, subchondral bone, and soft tissues of the affected joint. Moreover, inflammatory infiltrates in the subchondral bone, which can lead to inflammatory cysts and later erosions, play an important role in the pathogenesis of RA. These inflammatory infiltrates can be seen in magnetic resonance imaging (MRI) as bone marrow oedema (BME). BME is observed in 68–75% of patients in early stages of RA and is considered a precursor of rapid disease progression. The clinical significance of synovitis and bone marrow oedema as precursors of erosions is well established in daily practice, and synovitis, BME, cysts, hyaline cartilage defects and bone erosions can be detected by ultrasonography (US) and MRI. A less explored subject is the inflammatory and destructive potential of intra- and extra-articular fat tissue, which can also be evaluated in US and MRI. Finally, according to certain hypotheses, hyaline cartilage damage may trigger synovitis and lead to irreversible joint damage, and MRI may be used for preclinical detection of cartilage biochemical abnormalities. This review discusses the pathomechanisms that lead to articular cartilage and bone damage in RA, including erosion precursors such as synovitis and osteitis and panniculitis, as well as the role of imaging techniques employed to detect early cartilage damage and bone erosions. PMID:29853727

Solitary Septated Simple Liver Cyst in a Newborn Infant

PubMed Central

Alviedo, Neil; Kent, Amanda; Cohen, Inbal

2015-01-01

Simple liver cysts (SLC) are generally rare and are typically symptomatic when detected in infancy. We present a case of a newborn infant in whom fetal ultrasound and MRI revealed a cystic structure. Postnatal imaging revealed a septated, single cystic structure causing mass effect on the common bile duct and partially obstructing the inferior vena cava. Treatment of a solitary septated SLC was successful by laparoscopic total excision. The infant had an uncomplicated postsurgical course and has done well. PMID:26203457

Germline Proliferation Is Regulated by Somatic Endocytic Genes via JNK and BMP Signaling in Drosophila.

PubMed

Tang, Yaning; Geng, Qing; Chen, Di; Zhao, Shaowei; Liu, Xian; Wang, Zhaohui

2017-05-01

Signals derived from the microenvironment contribute greatly to tumorigenesis . The underlying mechanism requires thorough investigation. Here, we use Drosophila testis as a model system to address this question, taking the advantage of the ease to distinguish germline and somatic cells and to track the cell numbers. In an EMS mutagenesis screen, we identified Rab5 , a key factor in endocytosis, for its nonautonomous role in germline proliferation. The disruption of Rab5 in somatic cyst cells, which escort the development of germline lineage, induced the overproliferation of underdifferentiated but genetically wild-type germ cells. We demonstrated that this nonautonomous effect was mediated by the transcriptional activation of Dpp [the fly homolog of bone morphogenetic protein (BMP)] by examining the Dpp-reporter expression and knocking down Dpp to block germline overgrowth. Consistently, the protein levels of Bam, the germline prodifferentiation factor normally accumulated in the absence of BMP/Dpp signaling, decreased in the overproliferating germ cells. Further, we discovered that the JNK signaling pathway operated between Rab5 and Dpp, because simultaneously inhibiting the JNK pathway and Rab5 in cyst cells prevented both dpp transcription and germline tumor growth. Additionally, we found that multiple endocytic genes, such as avl , TSG101 , Vps25 , or Cdc42 , were required in the somatic cyst cells to restrict germline amplification. These findings indicate that when the endocytic state of the surrounding cells is impaired, genetically wild-type germ cells overgrow. This nonautonomous model of tumorigenesis provides a simple system to dissect the relation between tumor and its niche. Copyright © 2017 by the Genetics Society of America.

[Morphological spectrum of USP6 rearranged lesions].

PubMed

Mechtersheimer, G; Werner, M

2018-03-01

USP6, also known as Tre-2 and TRE17, is an ubiquitase-specific proteinase that was identified more than two decades ago as a potential oncogene when it exhibited transforming properties upon overexpression in NIH 3T3 cells. Until recently, however, little was known about the function and the oncogenetic activation of USP6. The identification of rearrangements of the USP6 gene in aneurysmal bone cyst and in nodular fasciitis has not only led to a better understanding of the pathogenesis of these entities, but is also a useful tool in their diagnosis and differential diagnostic delineation from morphological mimics. In this review, the clinical, pathomorphological, and molecular genetic aspects of aneurysmal bone cyst and of nodular fasciitis, as well as from related lesions, are presented and discussed.

[Laparoscopic treatment of hepatic cysts].

PubMed

Gaspari, A L; Di Lorenzo, N; Sica, G; De Ascentis, G; Rossi, M; Ferranti, F

1995-03-01

Laparoscopic treatment of simple hepatic cysts is reported. Recent indications to conservative surgical treatment for this benign disease are considered and different therapeutic options are analyzed. Surgical technique adopted in two cases observed is illustrated. In conclusion, the Authors consider laparoscopic treatment as an effective method for a mini-invasive surgical approach.

Multiple non-syndromic odontogenic keratocysts in three siblings

PubMed Central

Nirwan, Amit; Wanjari, Sangeeta Panjab; Saikhedkar, Rashmi; Karun, Vinayak

2013-01-01

Occurrence of multiple cysts (MC) involving the jaw is rare. When multiple, it is usually associated with a syndrome. Occurrence of MC without syndromic association is extremely rare. Multiple odontogenic cysts mostly could be odontogenic keratocysts or dentigerous cysts. Odontogenic keratocyst shows involvement of mandible over maxilla, with peak incidence in second and third decade and it is exceedingly rare before 10 years of age. However multiple odontogenic keratocysts found in children are often reflective of nevoid basal cell carcinoma syndrome. Here is a case report which documents multiple jaw cysts involving both the jaws, in three siblings of ages 10, 13 and 17 years with negative parental history. All three reported cases were free of any systemic involvement. As odontogenic keratocyst spreads through bone marrow, destruction is more before any clinical manifestation. Therefore, early detection and intervention are essential in preventing extensive destruction. PMID:23505078

Ganglion cyst arising from the composite occipito-atlanto-axial joint cavity in a cat.

PubMed

Aikawa, T; Sadahiro, S; Nishimura, M; Miyazaki, Y; Shibata, M

2014-01-01

A four-year-old, female spayed Domestic Longhaired cat was referred for evaluation with a two month history of initial inability to jump progressing to ambulatory tetraparesis. Magnetic resonance imaging studies demonstrated a cystic lesion arising from the composite occipito-atlanto-axial joint cavity and extending to the region of the occipital bone and the axis. The lesion surrounded the spinal canal, causing moderate dorsal spinal cord compression at the atlanto-occipital joint. A dynamic myelographic study demonstrated attenuation of the dorsal contrast column at the atlanto-occipital joint when the cervical spine was positioned in extension. Partial excision of the cyst capsule by a ventral approach resulted in long-term (64 months) resolution of clinical signs. Histological evaluation was consistent with a ganglion cyst. An intra-spinal ganglion cyst arising from the composite occipito-atlanto-axial joint cavity may be considered as an uncommon differential diagnosis for cats with cervical myelopathy.

Treatment of a sphenoid sinus mucocele using an endoscope combined with a navigating system: a case report.

PubMed

Nagatani, T; Saito, K; Yoshida, J

2001-09-01

A sphenoid sinus mucocele extending into the middle cranial fossa and the pterygomaxillary fissure was decompressed using an endoscope in combination with a navigation system. A 59-year-old woman was admitted with a 3 month history of retro-ocular pain and right sided exophthalmos. To evaluate the cystic lesion, a fibreoptic endoscope was inserted into the cyst through an erosive defect in the temporal bone. The histopathological appearance of cyst wall tissue confirmed the diagnosis of mucocele. After 4 months, the mucocele had refilled and the exophthalmos had recurred. At reoperation, the cyst was fenestrated using a rigid endoscope combined with a navigation system inserted via a sublabial transmaxillary approach. The proper site of cyst fenestration was precisely determined using the navigation system, permitting complete evacuation of this large lesion with minimal invasiveness. Copyright 2001 Harcourt Publishers Ltd.

Development and reliability of a preliminary Foot Osteoarthritis Magnetic Resonance Imaging Score

PubMed Central

Halstead, Jill; Martín-Hervás, Carmen; Hensor, Elizabeth MA; McGonagle, Dennis; Keenan, Anne-Maree

2017-01-01

Objective Foot osteoarthritis (OA) is very common but under-investigated musculoskeletal condition and there is little consensus as to common MRI imaging features. The aim of this study was to develop a preliminary foot OA MRI score (FOAMRIS) and evaluate its reliability. Methods This preliminary semi-quantitative score included the hindfoot, midfoot and metatarsophalangeal joints. Joints were scored for joint space narrowing (JSN, 0-3), osteophytes (0-3), joint effusion-synovitis and bone cysts (present/absent). Erosions and bone marrow lesions (BMLs) were scored (0-3) and BMLs were evaluated adjacent to entheses and at sub-tendon sites (present/absent). Additionally, tenosynovitis was scored (0-3) and midfoot ligament pathology was scored (present/absent). Reliability was evaluated in 15 people with foot pain and MRI-detected OA using 3.0T MRI multi-sequence protocols and assessed using intraclass correlation coefficients (ICC) as an overall score and per anatomical site (see supplementary data). Results Intra-reader agreement (ICC) was generally good to excellent across the foot in joint features (JSN 0.94, osteophytes 0.94, effusion-synovitis 0.62 and cysts 0.93), bone features (BML 0.89, erosion 0.78, BML-entheses 0.79, BML sub-tendon 0.75) and soft-tissue features (tenosynovitis 0.90, ligaments 0.87). Inter-reader agreement was lower for joint features (JSN 0.60, osteophytes 0.41, effusion-synovitis 0.03) and cysts 0.65, bone features (BML 0.80, erosion 0.00, BML-entheses 0.49, BML sub-tendon -0.24) and soft-tissue features (tenosynovitis 0.48, ligaments 0.50). Conclusion This preliminary FOAMRIS demonstrated good intra-reader reliability and fair inter-reader reliability when assessing the total feature scores. Further development is required in cohorts with a range of pathologies and to assess the psychometric measurement properties. PMID:28572462

Diagnosing and discriminating between primary and secondary aneurysmal bone cysts

PubMed Central

Sasaki, Hiromi; Nagano, Satoshi; Shimada, Hirofumi; Yokouchi, Masahiro; Setoguchi, Takao; Ishidou, Yasuhiro; Kunigou, Osamu; Maehara, Kosuke; Komiya, Setsuro

2017-01-01

Aneurysmal bone cysts (ABCs) are benign bony lesions frequently accompanied by multiple cystic lesions and aggressive bone destruction. They are relatively rare lesions, representing only 1% of bone tumors. The pathogenesis of ABCs has yet to be elucidated. In the present study, a series of 22 cases of primary and secondary ABC from patients treated in Department of Orthopedic Surgery, Kagoshima University Hospital (Kagoshima, Japan) from 2001–2015 were retrospectively analyzed. The average age at the time of diagnosis of primary ABC was 17.9 years. Intralesional curettage and artificial bone grafting were performed in the majority of the patients with primary ABC. The local recurrence rate following curettage for primary ABC was 18%, and the cause of local recurrence was considered to be insufficient curettage. Although no adjuvant therapy was administered during the surgeries, it may assist the prevention of local recurrence in certain cases. The cases of secondary ABC were preceded by benign bone tumors, including fibrous dysplasia, giant cell tumors, chondroblastoma and non-ossifying fibroma. The features of the secondary ABC typically reflected those of the preceding bone tumor. In the majority of cases, distinguishing the primary ABC from the secondary ABC was possible based on characteristic features, including age of the patient at diagnosis and the tumor location. In cases that exhibit ambiguous features, including a soft tissue mass or a thick septal enhancement on the preoperative magnetic resonance images, a biopsy must be obtained in order to exclude other types of aggressive bone tumors, including giant cell tumor, osteosarcoma and telangiectatic osteosarcoma. PMID:28454393

Bioceramic bone graft substitute for treatment of unicameral bone cysts.

PubMed

Fillingham, Y A; Cvetanovich, G L; Haughom, B D; Erickson, B J; Gitelis, S

2016-08-01

To review the outcome of 12 patients who underwent debridement and injection of bioceramic for unicameral bone cyst (UBC). The resorption rate of the bioceramic was estimated by both traditional and novel methods. Records of 10 males and 2 females aged 6 to 34 years who underwent debridement and injection of bioceramic for UBC and were followed up for a mean of 41 (range, 26-57) months were reviewed. Functional outcome was assessed using the selfcompleted Musculoskeletal Tumor Society (MSTS) questionnaire. Radiological outcome was assessed using both original and modified Neer Outcome Rating System. The resorption rate of the bioceramic was estimated using both traditional and novel (ImageJ) methods. The mean MSTS score was 29.7 (range, 28-30) indicating excellent functional outcome. Of the 12 patients, 9 achieved complete healing and 3 had a residual cyst of 1%, 11%, and 52%. The last was considered a local recurrence, and the patient underwent repeat percutaneous injection of the bioceramic 1.5 years later and remained disease-free 4 years later. The mean resorption rate was 29% faster when estimated using the traditional rather than the ImageJ method (0.47 vs. 0.33 cm3/day, p=0.02). In the patient with recurrence, the resorption rate was faster than the average (0.68 vs. 0.33 cm3/day). A single percutaneous injection of the bioceramic for UBC achieved good functional and radiological outcome while avoiding donor-site morbidity.

Long-term results after treatment of extensive odontogenic cysts of the jaws: a review.

PubMed

Wakolbinger, Robert; Beck-Mannagetta, Johann

2016-01-01

The aim was to perform a literature review concerning long-term results after treatment of extensive cysts of the jaws. The following databases were searched: MEDLINE, Cochrane CENTRAL, Cochrane Database of Systematic Reviews, The Cochrane Library, and EMBASE. Case reports and abstracts were excluded. Three hundred fifty-six articles were found, of which 30 were included. Only the minority of the studies reported long-term results. Most authors did not distinguish between temporary complications and permanent deficiencies (incomplete bone healing, permanent sensory deficits). Based on this review, it is recommended to consider primary decompression or marsupialization ± later definitive surgery for the treatment of extensive jaw cysts in order to achieve satisfying clinical results. Complications (occurring within the first 6 months postoperatively, e.g., infection) and remaining deficits (after a minimum of 6 months and not changing over time, e.g., bony or sensory deficit) should be clearly separated from each other. Knowledge of permanent deficits and bone healing after different therapeutic approaches is important for decision making. Patients should be informed not only about complications but also about the risk of permanent deficits for each method.

Van Wyk Grumbach Syndrome: A Rare Consequence of Hypothyroidism.

PubMed

Reddy, Pavan; Tiwari, Kritika; Kulkarni, Abhishek; Parikh, Ketan; Khubchandani, Raju

2018-05-19

Long standing hypothyroidism presenting as an ovarian mass has been well described in literature as the Van Wyk Grumbach syndrome (hypothyroidism, isosexual precocious puberty and ovarian mass). Here, authors report this entity in a 11 y 7 mo old girl child who was referred to a surgeon in view of intestinal obstruction along with a multiloculated ovarian cyst. On evaluation, she was found to have raised serum creatinine, short stature, delayed bone age and pituitary enlargement. She was diagnosed with autoimmune thyroiditis and was started on replacement therapy with thyroxine, after which the ovarian cysts regressed. This entity should be kept in mind in cases of ovarian cysts, especially those with isosexual precocity, to prevent unnecessary evaluation and surgical misadventures.

A new classification system for congenital laryngeal cysts.

PubMed

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.

[Mesenteric cyst in the Instituto Nacional de Salud del Niño, Lima, Peru: a case report].

PubMed

Cucho, Janetliz; Ormeño, Alexis; Valdivieso Falcon, Lidia; Pereyra, Sonia; Ramos Rodríguez, Karen

2013-01-01

Mesenteric cysts are rare abdominal tumors. About 60% of these cysts occurs before 5 years of age and can be located anywhere in the gastrointestinal tract, but are most often found in the small bowel mesentery. The clinical presentation depends on the location and size of the cyst and many cases are asymptomatic and are diagnosed incidentally. The most common symptoms are abdominal pain, bloating, abdominal mass, nausea, vomiting, constipation, diarrhea, weight loss, fever and peritonitis. Complications include torsion, infarction, volvulus formation, perforation, infection, anemia, intracystic hemorrhage, intestinal obstruction and obstructive uropathy. They are typically treated by simple excision, marsupialization or segmental bowel resection and have excellent long-term prognosis.

Orbito-nasal cyst in a young European short-haired cat.

PubMed

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.

Popliteal cysts and subgastrocnemius bursitis are associated with knee symptoms and structural abnormalities in older adults: a cross-sectional study.

PubMed

Cao, Yuelong; Jones, Graeme; Han, Weiyu; Antony, Benny; Wang, Xia; Cicuttini, Flavia; Ding, Changhai

2014-03-03

The role of popliteal cysts and subgastrocnemius bursitis in knee joint homeostasis is uncertain. The aim of this study is to describe cross-sectional associations between popliteal cysts, subgastrocnemius bursitis, knee symptoms and structural abnormalities in older adults. A cross-sectional sample of 900 randomly-selected subjects (mean age 63 years, 48% female) were studied. Knee pain, stiffness and dysfunction were assessed by self-administered Western Ontario McMaster Osteoarthritis Index (WOMAC) questionnaire. Radiographic knee osteophyte and joint space narrowing (JSN) were recorded. Magnetic resonance imaging (MRI) was utilized to assess popliteal cysts, subgastrocnemius bursitis, cartilage defects and bone marrow lesions (BMLs). Popliteal cysts were present in 11.7% and subgastrocnemius bursitis in 12.7% of subjects. Subgastrocnemius bursitis was more common in those with popliteal cyst (36.2% versus 9.7%, P <0.01). In multivariable analyses, popliteal cysts were significantly associated with increased osteophytes in both medial and lateral tibiofemoral compartments while subgastrocnemius bursitis was associated with increased osteophytes and JSN in the medial tibiofemoral compartment. Both were significantly associated with cartilage defects in all compartments, and with BMLs in the medial tibiofemoral compartment. Furthermore, both popliteal cysts and subgastrocnemius bursitis were significantly associated with increased weight-bearing knee pain but these associations became non-significant after adjustment for cartilage defects and BMLs. Popliteal cysts and subgastrocnemius bursitis are associated with increased symptoms as well as radiographic and MRI-detected joint structural abnormalities. Longitudinal data will help resolve if they are a consequence or a cause of knee joint abnormalities.

Popliteal cysts and subgastrocnemius bursitis are associated with knee symptoms and structural abnormalities in older adults: a cross-sectional study

PubMed Central

2014-01-01

Introduction The role of popliteal cysts and subgastrocnemius bursitis in knee joint homeostasis is uncertain. The aim of this study is to describe cross-sectional associations between popliteal cysts, subgastrocnemius bursitis, knee symptoms and structural abnormalities in older adults. Methods A cross-sectional sample of 900 randomly-selected subjects (mean age 63 years, 48% female) were studied. Knee pain, stiffness and dysfunction were assessed by self-administered Western Ontario McMaster Osteoarthritis Index (WOMAC) questionnaire. Radiographic knee osteophyte and joint space narrowing (JSN) were recorded. Magnetic resonance imaging (MRI) was utilized to assess popliteal cysts, subgastrocnemius bursitis, cartilage defects and bone marrow lesions (BMLs). Results Popliteal cysts were present in 11.7% and subgastrocnemius bursitis in 12.7% of subjects. Subgastrocnemius bursitis was more common in those with popliteal cyst (36.2% versus 9.7%, P <0.01). In multivariable analyses, popliteal cysts were significantly associated with increased osteophytes in both medial and lateral tibiofemoral compartments while subgastrocnemius bursitis was associated with increased osteophytes and JSN in the medial tibiofemoral compartment. Both were significantly associated with cartilage defects in all compartments, and with BMLs in the medial tibiofemoral compartment. Furthermore, both popliteal cysts and subgastrocnemius bursitis were significantly associated with increased weight-bearing knee pain but these associations became non-significant after adjustment for cartilage defects and BMLs. Conclusions Popliteal cysts and subgastrocnemius bursitis are associated with increased symptoms as well as radiographic and MRI-detected joint structural abnormalities. Longitudinal data will help resolve if they are a consequence or a cause of knee joint abnormalities. PMID:24581327

[Therapeutic effect of staged treatment for huge mandibular cystic lesions].

PubMed

Zhang, Qing; Fang, Li-hua; Zhou, Ping-xiu; Jv, Duo

2011-12-01

To investigate the therapeutic effect of staged treatment for huge mandibular cystic lesions. The study enrolled 18 cases of huge cystic lesions whose extent in X-ray film exceeded 5 cm from 2005 to 2009 in our hospital, 6 of them presented mal-aligned dentition. Decompression was first given under local anesthesia to make the entire extent gradually reduced to half of its primary extent, then the cysts were enucleated secondarily combined with simultaneous Bio-oss insertion under general anesthesia, followed by X-ray examination monthly to observe the density of bone, and normal orthodontic treatment was given to 6 cases with malocclusion. The lesions reduced to around half of the primary extent in 4 to 6 months after decompression,the density of bone substitute became almost similar to adjacent bone 6 to 12 months after secondary operation, no case had recurrence within 2 to 3 years. 6 cases with malocclusion were corrected after 2 to 3 years of orthodontic therapy. The staged treatment can retain the whole mandible and teeth at the same time of enucleation of the cyst, and achieve excellent aesthetic result combined with orthodontic therapy.

Copeptin is associated with kidney length, renal function, and prevalence of simple cysts in a population-based study.

PubMed

Ponte, Belen; Pruijm, Menno; Ackermann, Daniel; Vuistiner, Philippe; Guessous, Idris; Ehret, Georg; Alwan, Heba; Youhanna, Sonia; Paccaud, Fred; Mohaupt, Markus; Péchère-Bertschi, Antoinette; Vogt, Bruno; Burnier, Michel; Martin, Pierre-Yves; Devuyst, Olivier; Bochud, Murielle

2015-06-01

Arginine vasopressin (AVP) has a key role in osmoregulation by facilitating water transport in the collecting duct. Recent evidence suggests that AVP may have additional effects on renal function and favor cyst growth in polycystic kidney disease. Whether AVP also affects kidney structure in the general population is unknown. We analyzed the association of copeptin, an established surrogate for AVP, with parameters of renal function and morphology in a multicentric population-based cohort. Participants from families of European ancestry were randomly selected in three Swiss cities. We used linear multilevel regression analysis to explore the association of copeptin with renal function parameters as well as kidney length and the presence of simple renal cysts assessed by ultrasound examination. Copeptin levels were log-transformed. The 529 women and 481 men had median copeptin levels of 3.0 and 5.2 pmol/L, respectively (P<0.001). In multivariable analyses, the copeptin level was associated inversely with eGFR (β=-2.1; 95% confidence interval [95% CI], -3.3 to -0.8; P=0.002) and kidney length (β=-1.2; 95% CI, -1.9 to -0.4; P=0.003) but positively with 24-hour urinary albumin excretion (β=0.11; 95% CI, 0.01 to 0.20; P=0.03) and urine osmolality (β=0.08; 95% CI, 0.05 to 0.10; P<0.001). A positive association was found between the copeptin level and the presence of renal cysts (odds ratio, 1.6; 95% CI, 1.1 to 2.4; P=0.02). These results suggest that AVP has a pleiotropic role in renal function and may favor the development of simple renal cysts. Copyright © 2015 by the American Society of Nephrology.

Copeptin Is Associated with Kidney Length, Renal Function, and Prevalence of Simple Cysts in a Population-Based Study

PubMed Central

Ponte, Belen; Pruijm, Menno; Ackermann, Daniel; Vuistiner, Philippe; Guessous, Idris; Ehret, Georg; Alwan, Heba; Youhanna, Sonia; Paccaud, Fred; Mohaupt, Markus; Péchère-Bertschi, Antoinette; Vogt, Bruno; Burnier, Michel; Martin, Pierre-Yves; Devuyst, Olivier

2015-01-01

Arginine vasopressin (AVP) has a key role in osmoregulation by facilitating water transport in the collecting duct. Recent evidence suggests that AVP may have additional effects on renal function and favor cyst growth in polycystic kidney disease. Whether AVP also affects kidney structure in the general population is unknown. We analyzed the association of copeptin, an established surrogate for AVP, with parameters of renal function and morphology in a multicentric population-based cohort. Participants from families of European ancestry were randomly selected in three Swiss cities. We used linear multilevel regression analysis to explore the association of copeptin with renal function parameters as well as kidney length and the presence of simple renal cysts assessed by ultrasound examination. Copeptin levels were log-transformed. The 529 women and 481 men had median copeptin levels of 3.0 and 5.2 pmol/L, respectively (P<0.001). In multivariable analyses, the copeptin level was associated inversely with eGFR (β=−2.1; 95% confidence interval [95% CI], −3.3 to −0.8; P=0.002) and kidney length (β=−1.2; 95% CI, −1.9 to −0.4; P=0.003) but positively with 24-hour urinary albumin excretion (β=0.11; 95% CI, 0.01 to 0.20; P=0.03) and urine osmolality (β=0.08; 95% CI, 0.05 to 0.10; P<0.001). A positive association was found between the copeptin level and the presence of renal cysts (odds ratio, 1.6; 95% CI, 1.1 to 2.4; P=0.02). These results suggest that AVP has a pleiotropic role in renal function and may favor the development of simple renal cysts. PMID:25270071

Incidental pineal cysts in children who undergo 3-T MRI.

PubMed

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.

Zoledronate induces apoptosis in cells from fibro-cellular membrane of unicameral bone cyst (UBC).

PubMed

Yu, John; Chang, Seong-Sil; Suratwala, Sanjeev; Chung, Woo-Sik; Abdelmessieh, Peter; Lee, Hahn-Jun; Yang, Jay; Lee, Francis Young-In

2005-09-01

Unicameral bone cyst (UBC) is a benign cystic lesion in children which is prone to fracture. Various treatments are available, but recurrence after different types of percutaneous injection therapy can cause bone destruction and pathologic fracture. The potential therapeutic effects of anti-resorptive agents, such as bisphosphonates, have not been investigated for UBC. The objective of this study was to characterize the cells from the fibro-cellular membrane of unicameral bone cyst (UBC cells) and to determine whether zoledronate, a nitrogen-containing bisphosphonate, could induce apoptosis in UBC cells. Flow cytometry and immunoblotting were performed in order to determine whether zoledronate induced apoptosis. Cells derived from normal human trabecular bones were used as controls against UBC cells to compare the effect of zoledronate in inducing apoptosis. Immunohisto/cytochemistry (IHC/ICC) and mini-array analyses were performed on tissues and cultured cells. Isolated peripheral blood mononuclear cells were incubated with conditioned media from the UBC cells to determine whether they are capable of inducing osteoclastogenesis. UBC membrane is composed of cells staining positively with CD68, SDF-1, STRO-1 and RANKL, but in vitro cells showed no staining with antibodies to CD68 and STRO-1, suggesting that there was a clonal selection of stromal cells during cell culture. UBC cells also express RUNX2 (runt-related transcription factor-2, core binding factor-1), a key transcription factor for osteoblastic differentiation. In addition, media collected from UBC cells induced a generation of multi-nucleated osteoclast-like cells of peripheral blood mononuclear cells. Zoledronate induced apoptosis of UBC cells in a dose-dependent manner. Apoptosis was evidenced by induction of the active cleaved form of caspase-3. The baseline apoptotic fractions were similar in UBC cells and trabecular bone cells. However, in the overall apoptotic fractions in this study, trabecular bone cells showed 17.2% of apoptosis, significantly lower than 24.2% of UBC cells (p-value=0.007). With the various zoledronate concentrations, mean apoptotic fractions of trabecular bone cells was 19.2%, significantly lower than 27.8% of UBC cells (p-value=0.040). With GGOH co-treatment in various zoledronate concentrations, 15.1% apoptosis was shown in trabecular bone cells, which was not significantly lower than 20.6% of UBC cells (p-value=0.076). This data suggests that zoledronate causes apoptosis in both UBC and trabecular bone cells by inhibition of the mevalonate pathway. In addition to the known anti-osteoclastogenic effect of bisphosphonates, the GGOH inhibitory effects of zoledronate were more prominent in UBC cells than trabecular bone cells, indicating their potential therapeutic role in UBC.

Ovarian Cyst Enlargement in a 14 Year Old Female with Persistent Ascities, Severe Hypothyroidism and Elevated Serum CA-125 Level.

PubMed

Motamed, F; Eftekhari, K; Kiani, M A; Rabbani, A

2012-06-01

A 14 year old female complained of abdominal pain and distention with vomiting. The physical exam showed thyroid enlargement and ascites. The imaging evaluation demonstrated a large ovarian cyst. Laboratory tests depicted hypothyroidism and marked elevation of Carbohydrate antigen 125 (CA-125) levels. As the bone age was 10 years, more retarded than the chronological age, Van Wyk and Grumbach syndrome was suspected. Treatment with thyroid hormone was initiated and the condition improved dramatically with disappearance of symptoms and signs 5 weeks later.

Endoscopically assisted enucleation of a large mandibular periapical cyst.

PubMed

Nestal Zibo, Heleia; Miller, Ene

2011-01-01

Enucleation of large cysts in the jaws is an invasive method that might be associated with complications. Marsupialization is a less invasive alternative method but it involves a prolonged and uncomfortable healing period. This study addresses a contemporaneous and less invasive surgical technique for treating larger mandibular cysts. MATERIALS AND METHODS. A 48-year-old woman presented with a large mandibular apical cyst involving the left parasymphysis, body, ramus and condylar neck, with involvement of the alveolar inferior nerve. The cystic lesion was enucleated using a 30° 4.0 mm endoscopic scope and endoscopic instruments through two small accesses: the ostectomy site of previously performed marsupialization and the alveolus of the involved third molar extracted of the time of the enucleation of the cyst. RESULTS. The endoscopic scope provided good visualization of the whole cystic cavity allowing the removal of any residual pathologic tissue and preservation of the integrity of the involved inferior alveolar nerve. The morbidity of the surgical procedure was extremely reduced. At a 6-month follow-up the patient did not present any symptom of inflammation and a panoramic X-ray showed good bone repair and remodelation. CONCLUSIONS. Endoscopically assisted enucleation proved to be effective method of treating a large mandibular cyst, providing total enucleation with a minimal invasive technique.

Right attitude, right decision and timely planning in surgical pedodontics -scoop out or expose it.

PubMed

Kethineni, Balaji; Peddi, Ravigna; Puppala, Ravindar; Banavath, Sunitha; Chowdary, Uday Kumar; Raj, Deepak

2013-04-01

Radicular cysts are the most common odontogenic cystic lesions of inflammatory origin and are usually asymptomatic and are left unnoticed, until detected by routine radiography. It is managed either by surgical enucleation or marsupialization. Conventional nonsurgical endodontic treatment has a high degree of clinical success, but in certain cases surgical intervention becomes necessary. This is the case report of a patient presenting with unilateral radicular cyst. The lesion is managed by marsupialization using a novel and safe method of separating the soft tissue mass of the periapical lesion which was in proximity to vital and vulnerable anatomical tissue, emphasizing the need of application of treatment in the best interest of patients. The treatment of choice is dependent on the size and localization of the lesion, the bone integrity of the lesions wall and its proximity to vital structure. This case report of radicular cysts emphasis on the advantages and disadvantages of the leading criteria that should be taken into consideration when assessing the treatment modalities for radicular cyst. Odontogenic cysts, Radicular cyst, Marsupialization, Enucleation. How to cite this article: Kethineni B, Peddi R, Puppala R, Sunitha B, Chowdary U K, Raj D. Right Attitude, Right Decision and Timely Planning in Surgical Pedodontics -Scoop Out or Expose It. J Int Oral Health 2013; 5(2):50-54.

DENTAL PULP STEM CELLS AND HUMAN PERIAPICAL CYST MESENCHYMAL STEM CELLS IN BONE TISSUE REGENERATION: COMPARISON OF BASAL AND OSTEOGENIC DIFFERENTIATED GENE EXPRESSION OF A NEWLY DISCOVERED MESENCHYMAL STEM CELL LINEAGE.

PubMed

Tatullo, M; Falisi, G; Amantea, M; Rastelli, C; Paduano, F; Marrelli, M

2015-01-01

Bone regeneration is an interesting field of biomedicine. The most recent studies are aimed to achieve a bone regeneration using mesenchymal stem cells (MSCs) taken from more accessible sites: oral and dental tissues have been widely investigated as a rich accessible source of MSCs. Dental Pulp Stem Cells (DPSCs) and human Periapical Cysts Mesenchymal Stem Cells (hPCy-MSCs) represent the new generation MSCs. The aim of this study is to compare the gene expression of these two innovative cell types to highlight the advantages of their use in bone regeneration. The harvesting, culturing and differentiating of cells isolated from dental pulp as well as from periapical cystic tissue were carried out as described in previously published reports. qRT-PCR analyses were performed on osteogenic genes in undifferentiated and osteogenic differentiated cells of DPSC and hPCy-MSC lineage. Real-time RT-PCR data suggested that both DPSCs and hPCy-MSCs cultured in osteogenic media are able to differentiate into osteoblast/odontoblast-like cells: however, some differences indicated that DPSCs seem to be directed more towards dentinogenesis, while hPCy-MSCs seem to be directed more towards osteogenesis.

Very Large Inflammatory Odontogenic Cyst with Origin on a Single Long Time Traumatized Lower Incisor

PubMed Central

Freitas, Filipe; Andre, Saudade; Moreira, Andre; Carames, Joao

2015-01-01

One of the consequences of traumatic injuries is the chance of aseptic pulp necrosis to occur which in time may became infected and give origin to periapical pathosis. Although the apical granulomas and cysts are a common condition, there appearance as an extremely large radiolucent image is a rare finding. Differential diagnosis with other radiographic-like pathologies, such as keratocystic odontogenic tumour or unicystic ameloblastoma, is mandatory. The purpose of this paper is to report a very large radicular cyst caused by a single mandibular incisor traumatized long back, in a 60-year-old male. Medical and clinical histories were obtained, radiographic and cone beam CT examinations performed and an initial incisional biopsy was done. The final decision was to perform a surgical enucleation of a lesion, 51.4 mm in length. The enucleated tissue biopsy analysis was able to render the diagnosis as an inflammatory odontogenic cyst. A 2 year follow-up showed complete bone recovery. PMID:26393219

Odonto calcifying cyst.

PubMed

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.

Spatial and temporal variability of Alexandrium cyst fluxes in the Gulf of Maine: Relationship to seasonal particle export and resuspension.

PubMed

Pilskaln, C H; Anderson, D M; McGillicuddy, D J; Keafer, B A; Hayashi, K; Norton, K

2014-05-01

Quantification of Alexandrium cyst fluxes through the Gulf of Maine water column is central to understanding the linkage between the source and fate of annual Alexandrium blooms in the offshore waters. These blooms often lead to paralytic shellfish poisoning (PSP) and extensive closures of shellfish beds. We report here on time-series sediment trap deployments completed at four offshore locations in the gulf between 2005 and 2010 as components of two ECOHAB-GOM field programs. Data presented documents the substantial spatial and temporal fluctuations in Alexandrium fundyense cyst fluxes in the gulf. Cyst delivery out of the euphotic zone peaked primarily between July and August following annual spring-summer Alexandrium blooms and was greatest in the western gulf. At all sites, cyst flux maxima to the subsurface waters were rarely coincident with seasonal peaks in the total mass export of particulate material indicating that cyst delivery was primarily via individually sinking cysts. Where persistent benthic nepheloid layers (BNLs) exist, significant sediment resuspension input of cysts to the near-bottom water column was evidenced by deep cyst fluxes that were up to several orders of magnitude greater than that measured above the BNL. The largest cyst fluxes in the BNL were observed in the eastern gulf, suggesting greater resuspension energy and BNL cyst inventories in this region. Temporal similarities between peak cyst export out of the upper ocean and peak cyst fluxes in the BNL were observed and document the contribution of seasonal, newly formed cysts to the BNL. The data however also suggest that many Alexandrium cells comprising the massive, short-lived blooms do not transition into cysts. Time-series flow measurements and a simple 1D model demonstrate that the BNL cyst fluxes reflect the combined effects of tidal energy-maintained resuspension, deposition, and input of cysts from the overlying water column.

Spatial and temporal variability of Alexandrium cyst fluxes in the Gulf of Maine: Relationship to seasonal particle export and resuspension

PubMed Central

Pilskaln, C.H.; Anderson, D.M.; McGillicuddy, D.J.; Keafer, B.A.; Hayashi, K.; Norton, K.

2014-01-01

Quantification of Alexandrium cyst fluxes through the Gulf of Maine water column is central to understanding the linkage between the source and fate of annual Alexandrium blooms in the offshore waters. These blooms often lead to paralytic shellfish poisoning (PSP) and extensive closures of shellfish beds. We report here on time-series sediment trap deployments completed at four offshore locations in the gulf between 2005 and 2010 as components of two ECOHAB–GOM field programs. Data presented documents the substantial spatial and temporal fluctuations in Alexandrium fundyense cyst fluxes in the gulf. Cyst delivery out of the euphotic zone peaked primarily between July and August following annual spring–summer Alexandrium blooms and was greatest in the western gulf. At all sites, cyst flux maxima to the subsurface waters were rarely coincident with seasonal peaks in the total mass export of particulate material indicating that cyst delivery was primarily via individually sinking cysts. Where persistent benthic nepheloid layers (BNLs) exist, significant sediment resuspension input of cysts to the near-bottom water column was evidenced by deep cyst fluxes that were up to several orders of magnitude greater than that measured above the BNL. The largest cyst fluxes in the BNL were observed in the eastern gulf, suggesting greater resuspension energy and BNL cyst inventories in this region. Temporal similarities between peak cyst export out of the upper ocean and peak cyst fluxes in the BNL were observed and document the contribution of seasonal, newly formed cysts to the BNL. The data however also suggest that many Alexandrium cells comprising the massive, short-lived blooms do not transition into cysts. Time-series flow measurements and a simple 1D model demonstrate that the BNL cyst fluxes reflect the combined effects of tidal energy-maintained resuspension, deposition, and input of cysts from the overlying water column. PMID:25431527

Role of HIF-1α and CASPASE-3 in cystogenesis of odontogenic cysts and tumors.

PubMed

da Costa, Natacha M M; de Siqueira, Adriane S; Ribeiro, André L R; da Silva Kataoka, Maria S; Jaeger, Ruy G; de Alves-Júnior, Sérgio M; Smith, Andrew M; de Jesus Viana Pinheiro, João

2018-01-01

Odontogenic cysts and tumors are the most relevant lesions that affect the gnathic bones. These lesions have in common the formation of cystic areas and this common feature may suggest involvement of similar mechanisms. The hypoxia inducible factor 1 alpha (HIF-1α), a responsive protein to hypoxia and caspase-3, an irreversible apoptosis marker, may contribute to cyst formation. Thus, this study aimed to investigate the immunoexpression of these proteins in odontogenic cysts and tumors. Twenty cases of ameloblastoma, keratocystic odontogenic tumor (KOT) (n = 20), radicular cyst (RC) (n = 18), dentigerous cyst (DC) (n = 11), calcifying cystic odontogenic tumor (n = 8), and dental follicle (DF) (n = 10) were used to investigate HIF-1α and caspase-3 expression in sequential serial cuts by immunohistochemistry. HIF-1α was overexpressed in RC, DC, and ameloblastoma when compared with DF. The basal and sometimes the lower suprabasal layer showed no or very low expression in DC, KOT, and ameloblastoma, the last also showing strong expression in solid epithelial areas and initial cystic formation regions. Caspase-3 was found to be overexpressed in all lesions, with the highest expression in odontogenic cysts compared to tumors. HIF-1α and caspase-3 were localized in similar areas of the same lesions, especially in the epithelium surrounding cystic formations. This study showed distinct immunoexpression of HIF-1α and caspase-3 in odontogenic cyst and tumors, with higher expression observed in odontogenic cysts. These findings suggest a possible correlation between hypoxia, apoptosis, and cystogenesis, leading to understand the mechanisms responsible to cystic formation in odontogenic lesions.

Expression of cytokeratins in odontogenic jaw cysts: monoclonal antibodies reveal distinct variation between different cyst types.

PubMed

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.

Pathological Calcification and Ossification in Relation to Leriche and Policard's Theory.

PubMed

Jones, W; Roberts, R E

1933-05-01

(1) Pathology of calcification and ossification.-The Leriche-Policard theories. Hyperaemia of bone causes decalcification. Reduced blood supply causes sclerosis. Diminution of vascularity of fibrous tissue causes calcification. Excess of calcium, adequate blood supply and fibroblasts give rise to bone anywhere. Subperiosteal ossification. "Myositis ossificans."(2) Radiological significance of density of bone shadows.-Decalcification of disuse, of infections, of neoplasms. Traumatic and infective scquestra. Evidence that a fragment of bone is avascular.(3) Hyperaemic decalcification of bone.-Delayed and non-union of fractures. Kummel's disease. Spontaneous hyperaemic dislocation of the atlas. Hyperaemic decalcification and nephrolithiasis.(4) Anaemic sclerosis of bone.-Syphilitic bone disease. Malignant bone disease. Fragility of sclerosed bone-Paget's, Kienboch's, Kohler's and Panner's, Albers-Schönberg's diseases.(5) Pathological calcification.-Calcification of supraspinatus tendon. Calcification of tumours-angioma, haematoma, and thrombosed vessels, lipoma, cysts, etc. Calcification of semilunar cartilages and intervertebral discs.(6) Pathological ossification.-Ossification of tendons. Ossification of semilunar cartilages.

Cerebro-retinal microangiopathy with calcifications and cysts due to recessive mutations in the CTC1 gene.

PubMed

Bisserbe, A; Tertian, G; Buffet, C; Turhan, A; Lambotte, O; Nasser, G; Alvin, P; Tardieu, M; Riant, F; Bergametti, F; Tournier-Lasserve, E; Denier, C

2015-05-01

Cerebro-retinal microangiopathy with calcifications and cysts (CRMCC) or Coats plus syndrome is a pleiotropic disorder affecting the eyes, brain, bone and gastrointestinal tract. Its primary pathogenesis involves small vessel obliterative microangiopathy. Recently, autosomal recessively inherited mutations in CTC1 have been reported in CRMCC patients. We herein report an adolescent referred to our hospital following new seizures in a context of an undefined multisystem disorder. Cerebral imaging disclosed asymmetrical leukopathy, intracranial calcifications and cysts. In addition, he presented other typical CRMCC features i.e. a history of intrauterine growth retardation, skeletal demineralization and osteopenia, bilateral exudative vitreo-retinopathy reminiscent of Coats disease, recurrent gastrointestinal hemorrhages secondary to watermelon stomach and variceal bleeding of the esophagus due to idiopathic portal hypertension and telangiectatic and angiodysplasic changes in the small intestine and colon, and anemia due to recurrent bleeding and bone marrow abnormalities. The patient was diagnosed with Coats plus syndrome. CTC1 gene screening confirmed the diagnosis with the identification of heterozygous deleterious mutations. CRMCC due to CTC1 mutations has a broad clinical expressivity. Our case report illustrates the main possible associated phenotypes and their complications, demonstrating the need for a careful etiological search in order to initiate appropriate therapeutic and preventive measures. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

[Splenic hydatid cyst. Case report of a pregnant woman].

PubMed

Menéndez-Arzac, Rodrigo; Sanjuán, Alberto; Rebolledo, Gustavo; Márquez, Juan Carlos; Recinos, Elio Germán; Cue, Araceli; Blas, Carolina; Flisser, Ana

2002-01-01

Hydatid disease is caused by larvae of the platyhelminth parasite called Echinococcus; it generally lodges in liver and lung, and less commonly in spleen. In Mexico, hydatid disease has a very low frequency; only few cases of lung disease have been reported. In this paper, case of a 7 weeks pregnant female patient with a simple cyst in spleen identified by ultrasound and tomography is reported. The patient underwent splenectomy. Diagnosis of hydatid cyst was confirmed by histopathology. This case suggests that hydatid disease should be considered as differential diagnosis in every patient with a cystic mass of the spleen.

Penile actinomycosis clinically diagnosed as an epidermal cyst: a case report

PubMed Central

Min, Kyueng-Whan; Park, Sung Yul; Paik, Seung Sam

2012-01-01

A 27-year-old man presented at our hospital with a 1.5cm, spherical, soft and movable subcutaneous mass at the mid portion of the ventral aspect of the penile shaft. The possibility of an epidermal cyst was considered and a simple resection was performed. Histologically, the lesion was a unilocular cyst without an epithelial lining, containing eosinophilic necrotic material and a few dispersed scalloped sheets of actinomycotic granules. The centre of the largest granular body demonstrated many fragments of foreign substance. The patient was treated successfully with combined antibiotic therapy. PMID:22524915

Bacteria associated with cysts of the soybean cyst nematode (Heterodera glycines).

PubMed

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.

Isolated torsion of fallopian tube in a post-menopausal patient: a case report.

PubMed

Ozgun, Mahmut Tuncay; Batukan, Cem; Turkyilmaz, Cagdas; Serin, Ibrahim Serdar

2007-07-20

Isolated fallopian tube torsion after menopause is a rare condition. Here we report the second case of isolated fallopian tube torsion in a post-menopausal woman. A 55-year-old post-menopausal woman presented with right lower abdominal pain. Sonography depicted a simple cystic mass adjacent to the right uterine border. Laparatomy revealed torsion of the right fallopian tube together with a paraovarian cyst. Total abdominal hysterectomy and bilateral salpingo-oophorectomy was performed. Histopathological examination revealed a simple paraovarian cyst with severe congestion, necrosis and hemorrhage. Tubal torsion should be considered in the differential diagnosis of acute lower abdominal pain, even in post-menopausal women.

Is the stripping technique a tissue-sparing procedure in large simple ovarian cysts in children?

PubMed

Arena, Francesco; Romeo, Carmelo; Castagnetti, Marco; Scalfari, GianFranco; Cimador, Marcello; Impellizzeri, Pietro; Villari, Daniela; Zimbaro, Fabrizio; DeGrazia, Enrico

2008-07-01

Stripping of the cystic wall is performed by gynecologists to treat large ovarian cysts. Information in the pediatric population is poor. We prospectively evaluated the pathologic specimens of large ovarian cyst to determine whether the stripping technique is a tissue-sparing procedure even in this age. We evaluated 5 patients. Samples were taken from the intermediate part of the cystic wall and from the layer covering the cyst during excision. The presence of ovarian tissue adjacent to the cyst wall, and the morphological features of the surrounding tissue were both evaluated. Pelvic ultrasound follow-up was also performed. Patients' mean age was 4.5 years (7 days to 12 years). All cysts were removed because all were symptomatic. The mean diameter was 86.6 mm (74-100 mm). Cysts were follicular in 2 cases, serous in other two, and endometriotic in 1 case. Adjacent ovarian tissue was present in 1 of 5 specimens and was approximately 1 to 2 mm in thickness. The layer adjacent to the cystic wall always appeared as normal ovarian tissue. Ultrasound scans at follow-up revealed presence of ovarian tissue. The stripping procedure for large ovarian cyst excision allows to spare the adjacent normal ovarian tissue even in pediatric age because ovarian tissue is rarely excised with the cyst wall during the procedure.

Hydatid disease of the chest

PubMed Central

Xanthakis, D.; Efthimiadis, M.; Papadakis, G.; Primikirios, N.; Chassapakis, G.; Roussaki, A.; Veranis, N.; Akrivakis, A.; Aligizakis, C. J.

1972-01-01

Ninety-one cases of hydatid disease of the chest are reported. Eighty-eight were involving the lung, two the chest wall, and one the mediastinum. All the patients were treated surgically. Conservative operations (simple removal of the parasite and closure of the remaining cavity) were performed in 78 patients, 37 unruptured and 41 ruptured cysts. Late postoperative complications occurred in eleven. In 10 patients, recurrent haemoptysis was the main symptom due to residual cavity in four, bronchiectatic changes in two, and unknown aetiology in four. In one patient, recurrence of multiple cysts occurred in the affected lobe. Radical operations were carried out in 10 patients, including segmental resection in four and lobectomy in six. Conservative operations were performed in all cases of unruptured cysts, with the exception of a giant cyst in which resection was the operation of choice. For ruptured cysts with mild infection conservative operation was also performed. Resection was necessary only in patients with ruptured cysts with suppuration, bronchiectatic changes, and giant cysts replacing a whole lobe. There was no mortality. We believe that conservative operation is the treatment of choice for hydatid disease of the lung. Indications for resection are very limited. Images

Percutaneous drainage without sclerotherapy for benign ovarian cysts.

PubMed

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.

Increased risk of kidney damage among Chinese adults with simple renal cyst.

PubMed

Kong, Xianglei; Ma, Xiaojing; Zhang, Chengyin; Su, Hong; Gong, Xiaojie; Xu, Dongmei

2018-05-04

The presence of simple renal cyst (SRC) has been related to hypertension, the early and long-term allograft function, and aortic disease, but the relationship with kidney damage was still controversial. Accordingly, we conducted a large sample cross-sectional study to explore the association of SRC with indicators of kidney damage among Chinese adults. A total of 42,369 adults (aged 45.8 ± 13.67 years, 70.6% males) who visited the Health Checkup Clinic were consecutively enrolled. SRC was assessed by ultrasonography according to Bosniak category. Multiple regression models were applied to explore the relationships between SRC and indicators of kidney damage [proteinuria (dipstick urine protein ≥ 1+) and decreased estimated glomerular filtration rate (DeGFR) < 60 ml/min/1.73 m 2 ]. Among all participants in the study, the prevalence of SRC was 10.5%. As a categorical outcome, participants with more 1 cyst and with 1 cyst had higher percentage of proteinuria [53 (5.3%) and 93 (2.7%) vs. 596 (1.6%), p < 0.001] and DeGFR [57 (5.7%) and 85 (2.5%) vs. 278 (0.7%), p < 0.001] compared with participants with no cyst. SRC significantly correlated with proteinuria [OR 1.59 (95% CI 1.30-1.95)] and DeGFR [OR 1.97 (95% CI 1.56-2.47)] after adjusting for potential confounders. Furthermore, the results also demonstrated that maximum diameter (per 1 cm increase), bilateral location, and multiple cysts significantly correlated with DeGFR in the multiple logistic regression analysis. The study revealed that SRC significantly correlated with kidney damage and special attention should be paid among Chinese adults with SRC.

A case report of Gorlin–Goltz syndrome as a rare hereditary disorder

PubMed Central

Sirous, Mehri; Tayari, Nazila

2011-01-01

Gorlin–Goltz syndrome is an autosomal dominant and a rare hereditary disease. Diagnosis of this syndrome is based on major and minor criteria. We report a Gorlin–Goltz syndrome in a 25-year-old male who was presented with progressive pain of maxilla and mandible over 5 years. The pain was diffuse and compatible with expansile cyst in alveolar ridges on panoramic radiography. In physical examination, he had coarse face and prognathism. Computer tomography of face revealed two expansile maxillary and one mandibular cyst. Calcification of entire length in falx and tentorium were detected in bone window. PMID:22091315

A case report of Gorlin-Goltz syndrome as a rare hereditary disorder.

PubMed

Sirous, Mehri; Tayari, Nazila

2011-06-01

Gorlin-Goltz syndrome is an autosomal dominant and a rare hereditary disease. Diagnosis of this syndrome is based on major and minor criteria. We report a Gorlin-Goltz syndrome in a 25-year-old male who was presented with progressive pain of maxilla and mandible over 5 years. The pain was diffuse and compatible with expansile cyst in alveolar ridges on panoramic radiography. In physical examination, he had coarse face and prognathism. Computer tomography of face revealed two expansile maxillary and one mandibular cyst. Calcification of entire length in falx and tentorium were detected in bone window.

Is retrograde drilling really useful for osteochondral lesion of talus with subchondral cyst?: A case report.

PubMed

Jeong, Seong-Yup; Kim, Jong-Kil; Lee, Kwang-Bok

2016-12-01

Retrograde drilling is a well accepted procedure for osteochondral lesion of the talus and subchondral cyst with intact overlying cartilage. It has good results in most reports. Compared to anterograde drilling, retrograde drilling can protect the integrity of the articular cartilage. The purpose of this study was to evaluate the suitability of using retrograde drilling for osteochondral lesion with subchondral cyst and discuss the mechanism involved in the development of subchondral cyst. We report a 53-year-old man who had complained left ankle pain that lasted over 6 months which was exacerbated by walking. We diagnosed it as osteochondral lesion of the talus with subchondral cyst. Plain X-ray, computed tomography, and magnetic resonance imaging (MRI) of the ankle. He undertook retrograde drilling without debridement of cartilage. After the surgery, the pain had been subsided for 1 year, although arthritic change had progressed. However, after 5 years of retrograde drilling, he revisited our hospital due to severe ankle pain. Plain X-ray and MRI showed arthritic change of the ankle and multiple cystic formation of talus. Retrograde drilling has some problem because this procedure is not theoretically correct when the development of a subchondral cyst in osteochondral lesion of the talus is considered. In addition, retrograde drilling may impair uninjured bone marrow of the talus, resulting in the development of multiple cystic formations.

Dual Pathology of Mandible

PubMed Central

Rajurkar, Suday G.; Deshpande, Mohan D.; Kazi, Noaman; Jadhav, Dhanashree; Ranadive, Pallavi; Ingole, Snehal

2017-01-01

Aneurysmal Bone cyst (ABC)is a rare benign lesion of the bone which is infrequent in craniofacial region (12%). Rapid growth pattern causing bone expansion and facial asymmetry is a characteristic feature of ABC. Giant cell lesion is another distinct pathological entity. Here we present to you a rare case of dual pathology in an 11 year old female patient who presented with a large expansile lesion in the left hemimandible. All radiographic investigations were suggestive of ABC, aspiration of the lesion resulted in blood aspirate. However only after a histologic examination the dual nature of the lesion was revealed. PMID:29264307

Dual Pathology of Mandible.

PubMed

Rajurkar, Suday G; Deshpande, Mohan D; Kazi, Noaman; Jadhav, Dhanashree; Ranadive, Pallavi; Ingole, Snehal

2017-01-01

Aneurysmal Bone cyst (ABC)is a rare benign lesion of the bone which is infrequent in craniofacial region (12%). Rapid growth pattern causing bone expansion and facial asymmetry is a characteristic feature of ABC. Giant cell lesion is another distinct pathological entity. Here we present to you a rare case of dual pathology in an 11 year old female patient who presented with a large expansile lesion in the left hemimandible. All radiographic investigations were suggestive of ABC, aspiration of the lesion resulted in blood aspirate. However only after a histologic examination the dual nature of the lesion was revealed.

Plunging ranula of the submandibular area

PubMed Central

Sheikhi, Mahnaz; Jalalian, Faranak; Rashidipoor, Roghayeh; Mosavat, Farzaneh

2011-01-01

The term “ranula” is used to describe a diffuse swelling in the floor of the mouth caused by either a mucous extravasation or, less commonly, a mucous retention cyst derived from the major sublingual or submandibular salivary glands. The most common presentation of ranula is a painless, slow-growing, soft, and movable mass located in the floor of the mouth. Ranula may be simple or plunging. Simple ranula often present as masses in the floor of the mouth, limited to the mucous membranes. Diving ranulas extend through the facial plans, usually posterior to the mylohyoid muscle into the neck, and present as cervical masses. Thyroglossal duct cyst, branchial cleft cyst, cystic hygroma, submandibular sialadenitis, intramuscular hemangioma, cystic or neoplastic thyroid disease might be included in differential diagnosis. A variety of surgical procedures have been quoted in the literature ranging from marsupialization, excision of the ranula, sclerotherapy, and excision of the sublingual gland. The recurrence rate varies according to the procedure performed. PMID:23372589

Percutaneous osteoplasty for the treatment of a painful osteochondral lesion of the talus: a case report and literature review.

PubMed

Seo, Sung-Suk; Park, Joo-Yeon; Kim, Hae-Jin; Yoon, Ji-Wook; Park, Sang-Hyun; Kim, Kyung-Hoon

2012-01-01

An osteochondral lesion of the talus (OLT) is a lesion involving the talar articular cartilage and its subchondral bone. OLT is a known cause of chronic ankle pain after ankle sprains in the active population. The lesion causes deep ankle pain associated with weight-bearing, impaired function, limited range of motion, stiffness, catching, locking, and swelling. There are 2 common patterns of OLTs. Anterolateral talar dome lesions result from inversion and dorsiflexion injuries of the ankle at the area impacting against the fibula. Posteromedial lesions result from inversion, plantar flexion, and external rotation injuries of the ankle at the area impacting against the tibial ceiling of the ankle joint. Early diagnosis of an OLT is particularly important because the tibiotalar joint is exposed to more compressive load per unit area than any other joint in the body. Failure of diagnosis can lead to the evolution of a small, stable lesion into a larger lesion or an unstable fragment, which can result in chronic pain, joint instability, and premature osteoarthritis. A 43-year-old man, with a history of ankle sprain one year previously, visited our pain clinic for continuous right ankle pain after walking or standing for more than 30 minutes. There was a focal tenderness on the posteromedial area of the right talus. Imaging studies revealed a posteromedial OLT classified as having a geode form according to the FOG (fractures, osteonecroses, geodes) radiological classification and categorized as a stage 2a lesion on magnetic resonance imaging. The patient was scheduled for aspiration and osteoplasty with hydroxyapatite under arthroscopic and fluoroscopic guidance. A 26-gauge needle was inserted to infiltrate local anesthetics into the skin over the cyst and ankle joint. An arthroscope was placed into the joint to approach the OLT. The arthroscopic view showed that there was no connection between the OLT and the cyst of the talus body. A 13-gauge bone biopsy needle was inserted into the cyst, and aspiration was performed. Aspirated fluid from the cyst was originally white and clear; however, it changed to a blood-tinged, reddish color due to mixing with the incisional blood. After aspiration, contrast medium was injected, and the shape of the spread was observed. Bone cement comprising hydroxyapatite was injected to fill the bone defect of the cyst. A 1.5 mL volume of cement was injected into the talus under vigilant fluoroscopic and arthroscopic monitoring to prevent its dissemination into the joint. There was no cement leakage into the vessels or articular space. Postoperative fluoroscopy and computed tomography images showed bone cement filling of the defect. In the present case, arthroscopic and fluoroscopic guidance was used for aspiration of an OLT and for performing percutaneous osteoplasty with hydroxyapatite for one defect; this treatment decreased pain upon weight bearing and enabled a return to work without any restrictions one week after the procedure. The purpose of this report was to highlight the presence of OLT in chronic ankle pain and to review its management strategies.

Molecular pathology of bone tumours: diagnostic implications.

PubMed

Puls, Florian; Niblett, Angela J; Mangham, D Chas

2014-03-01

Alongside histomorphology and immunohistochemistry, molecular pathology is now established as one of the cornerstones in the tissue diagnosis of bone tumours. We describe the principal molecular pathological techniques employed, and each of the bone tumour entities where their identified characteristic molecular pathological changes can be detected to support and confirm the suspected histological diagnosis. Tumours discussed include fibrous dysplasia, classical and subtype osteosarcomas, central and surface cartilaginous tumours, Ewing's sarcoma, vascular tumours, aneurysmal bone cyst, chordoma, myoepithelioma, and angiomatoid fibrous histiocytoma. This is a rapidly evolving field with discoveries occurring every few months, and some of the newer entities (the Ewing's-like sarcomas), which are principally identified by their molecular pathology characteristics, are discussed. © 2013 John Wiley & Sons Ltd.

[Bone hydatidosis. 12 cases].

PubMed

Jlidi, R; Yaakoubi, M T; Ladeb, M F; Ben Ayeche, M L; Ghannouchi, G; Moula, T

1992-01-01

The hydatic cyst is a parasitic disease caused by the development in man of the larval form of echinococcus granulosus. All parts of the body may be involved, but the liver and lungs are the main locations of the disease. The bone site is rare, accounting for 0.9 to 2% of all hydatic lesions. Between 1982 and 1988, we have compiled 12 cases of hydatic disease of bone. They were located in the skull (4 cases), the iliac bone (4 cases), the omoplate (1 case), the ribs (1 case), the femur (1 case) and the fibula (1 case). These lesions are generally considered as primary, but association with visceral locations was noted in 3 cases in our series.

Primary benign tumors in chiropractic practice and the importance of x-ray diagnosis: A report of two cases

PubMed Central

Pelletier, Jacques C.

1987-01-01

Two cases of primary benign bone tumors were diagnosed radiographically in a chiropractic practice. Although primary osseous tumors are somewhat uncommon, their potential presence emphasizes the importance of x-ray diagnosis as an essential adjunct to chiropractic practice. This procedure may preclude underlying lesions before considering treatment of seemingly uncomplicated injuries. Two such cases are presented: unicameral bone cyst and osteochondroma. ImagesFigure 1Figure 2Figure 3

Immunohistochemical evaluation of inducible nitric oxide synthase in the epithelial lining of odontogenic cysts: A qualitative and quantitative analysis.

PubMed

Akshatha, B K; Karuppiah, Karpagaselvi; Manjunath, G S; Kumarswamy, Jayalakshmi; Papaiah, Lokesh; Rao, Jyothi

2017-01-01

The three common odontogenic cysts include radicular cysts (RCs), dentigerous cysts (DCs), and odontogenic keratocysts (OKCs). Among these 3 cysts, OKC is recently been classified as benign keratocystic odontogenic tumor attributing to its aggressive behavior, recurrence rate, and malignant potential. The present study involved qualitative and quantitative analysis of inducible nitric oxide synthase (iNOS) expression in epithelial lining of RCs, DCs, and OKCs, compare iNOS expression in epithelial linings of all the 3 cysts and determined overexpression of iNOS in OKCs which might contribute to its aggressive behavior and malignant potential. The present study is to investigate the role of iNOS in the pathogenesis of OKCs, DCs, and RCs by evaluating the iNOS expression in the epithelial lining of these cysts. Analysis of iNOS expression in epithelial lining cells of 20 RCs, 20 DCs, and 20 OKCs using immunohistochemistry done. The percentage of positive cells and intensity of stain was assessed and compared among all the 3 cysts using contingency coefficient. Kappa statistics for the two observers were computed for finding interobserver agreement. The percentage of iNOS-positive cells was found to be remarkably high in OKCs (12/20) -57.1% as compared to RCs (6/20) - 28.6% and DCs (3/20) - 14.3%. The interobserver agreement for iNOS-positive percentage cells was arrived with kappa values with OKCs → Statistically significant ( P > 0.000), RCs → statistically significant ( P > 0.001) with no significant values for DCs. No statistical difference exists among 3 study samples in regard to the intensity of staining with iNOS. Increased iNOS expression in OKCs may contribute to bone resorption and accumulation of wild-type p53, hence, making OKCs more aggressive.

Advanced hip osteoarthritis: magnetic resonance imaging aspects and histopathology correlations.

PubMed

Leydet-Quilici, H; Le Corroller, T; Bouvier, C; Giorgi, R; Argenson, J-N; Champsaur, P; Pham, T; de Paula, A Maues; Lafforgue, P

2010-11-01

To correlate magnetic resonance imaging (MRI) aspects of the femoral head with histological findings in advanced hip osteoarthritis (OA), with special emphasis on bone marrow edema (BME). MRI was performed in patients with advanced hip OA scheduled for hip arthroplasty. Coronal T1-, fat-suppressed T2-, T1 with gadolinium intravenous injection sequences were obtained on a 1.5 T MR-scanner within 1 month before surgery. Coronal MR images corresponding to the ligamentum teres plane were analyzed by two independent readers blinded to histological data. Normal bone marrow, subchondral cyst, subchondral fracture, edema-like, necrosis-like, and necrosis MR patterns were reported on a synthesis scheme. After surgery, the femoral heads specimens were cut through the ligamentum teres plane and histologically analyzed for correlations. Twenty-three femoral heads were analyzed (female 56.5%, mean age 64.5 years). Edema-like MR pattern was correlated with histological (H) edema (Kappa (K): 0.77). Necrosis-like MR pattern was correlated with H fibrosis (K: 0.49) and with H necrosis (K: 0.24). Cyst MR pattern was correlated with H bone cysts (K: 0.58). Necrosis MR pattern corresponded to a mixture of histological lesions. Sensitivity and specificity of MRI varied from 26% to 80% and from 86% to 95% respectively. In advanced hip OA, the so-called "BME" MR lesion corresponds to a combination of edema, fibrosis, and necrosis at histopathology. When the classical "BME" is more specifically separated into edema-like and necrosis-like MR patterns, MR Imaging and histological findings show substantial agreement, with edema-like MR pattern mainly corresponding to histological edema. Copyright © 2010 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gwak, Jng Won, E-mail: jjungwonie@hanmail.net; Lee, Seung Hwa, E-mail: gareureung@daum.net; Chung, Hwan Hoon, E-mail: chungmic@korea.ac.kr

We present a case of isolated calyx that was mistaken for a large cyst. A 47-year-old woman was referred for sclerotherapy of a large cystic lesion on her left kidney. Computed tomography (CT) and ultrasound showed that the cystic lesion was a large cyst. We noticed that the cystic lesion was not a typical simple cyst, even after two sessions of catheter-mediated sclerotherapy. Isolated calyx was presumed by medical history review and was confirmed by aspirated fluid analysis and far delayed-phase CT after intravenous contrast injection. We performed meticulous selective arterial embolization for an isolated calyx and inserted a cathetermore » that could be removed without complication.« less

Management of palpable breast lumps. Consensus guideline for family physicians.

PubMed Central

Heisey, R.; Mahoney, L.; Watson, B.

1999-01-01

OBJECTIVE: To describe an approach to managing women who present with palpable breast lumps. QUALITY OF EVIDENCE: Databases were searched from 1990 to 1998 using the search terms breast lumps, breast diseases, and breast cysts. Bibliographies of the articles obtained were searched for further relevant titles. Most evidence on management of breast cysts was obtained from cohort studies. Evidence on family physicians' approach to managing breast lumps is based on a review of the 1998 Canadian consensus guidelines and a review of a 1998 consensus guideline by 12 University of Toronto surgical oncologists (U of T guidelines). MAIN MESSAGE: Family physicians can manage women presenting with breast lumps if they have skill in breast cyst aspiration. Most breast cysts can be cured in minutes, thus avoiding unwarranted anxiety and eliminating unnecessary additional investigations and referrals. Women presenting with solid lesions should be referred to a surgeon. CONCLUSIONS: Breast cyst aspiration is a simple technique family physicians can use to either cure breast lumps or define appropriate cases for referral. PMID:10463093

Cervical Spine Aneurysmal Bone Cysts in the Pediatric Population: A Systematic Review of the Literature.

PubMed

Protas, Matthew; Jones, Lydia W; Sardi, Juan Pablo; Fisahn, Christian; Iwanaga, Joe; Oskouian, Rod J; Tubbs, R Shane

2017-01-01

Cervical spine aneurysmal bone cysts (ABCs) in pediatric patients have not been thoroughly studied. Using PubMed and Google Scholar, a systematic review of the literature was conducted for publications that included patients aged ≤15 years with a confirmed diagnosis of ABC in the cervical spine. Thirty-five studies with a total of 71 patients met the inclusion criteria. Nearly 80% of patients presented with neck or shoulder pain. The axis was the level most frequently involved (34.28%), followed by C5 (24.28%). Posterior elements were most likely to be affected (88.46%) while exclusive involvement of the body was uncommon. To our knowledge, this is the first systematic review of the literature regarding ABCs of the cervical spine in a pediatric population. Spinal ABCs are rarely found in the cervical region, and their treatment remains challenging due to their location, vascularization, and a high overall recurrence rate even with surgical resection. © 2017 S. Karger AG, Basel.

Lymphoma, Koala Retrovirus Infection and Reproductive Chlamydiosis in a Koala (Phascolarctos cinereus).

PubMed

Fabijan, J; Woolford, L; Lathe, S; Simmons, G; Hemmatzadeh, F; Trott, D J; Speight, N

Koala retrovirus (KoRV) infection, thought to be associated with lymphoid neoplasia, and Chlamydia pecorum-related ocular and urogenital disease are both highly prevalent in eastern Australian koala (Phascolarctos cinereus) populations. However, in South Australian koalas, little is known about KoRV infection and C. pecorum-associated disease. We report the first South Australian case of lymphoma in a KoRV-A-positive female koala also affected by severe reproductive chlamydiosis. The koala was from the Mount Lofty Ranges population and was presented with hindlimb lameness. Clinical examination identified right stifle crepitus, enlarged superficial lymph nodes and paraovarian cysts. Necropsy examination revealed extensive cartilage degeneration and loss over the medial femoral condyle, solid femoral bone marrow, mesenteric and ovarian tumours, paraovarian cysts and purulent metritis. Histopathology confirmed lymphoma in the bone marrow, mesenteric lymph nodes and ovary, with infiltration and parenchymal effacement in the pancreas, adrenal glands and other tissues. Lymphoma, KoRV and chlamydiosis are being investigated further in this population. Copyright © 2017 Elsevier Ltd. All rights reserved.

Exophthalmos associated to orbital zygomatic mucocele and complex maxillary malformation in a puppy

PubMed Central

Cirla, Alessandro; Rondena, Marco; Bertolini, Giovanna; Barsotti, Giovanni

2017-01-01

A case of exophthalmos due to zygomatic mucocele in a puppy with ipsilateral segmental maxillary atrophy is reported. A 7-month-old, mixed breed, male dog suffered the sudden-onset of unilateral painful exophthalmos and a gradual swelling of the right temporal region. A compressing, right retrobulbar mass was observed by ultrasound. Computed tomography revealed a large multiloculated cyst-like lesion of the right zygomatic gland projecting into the orbital space, thus displacing the eyeball. The ipsilateral molar part of the maxillary bone was underdeveloped, besides showing crowded, abnormal, multiple, unerupted maxillary molar teeth in the caudal maxillary region. Modified lateral orbitotomy and a selective caudal maxillary bone access were performed. The cyst-like lesion was removed and the zygomatic gland and the wall was collected for histology, which confirmed the mucocele. Clinical and imaging examinations six months after surgery showed neither recurrence of the mucocele nor ocular abnormalities. A possible common pathogenic mechanism involving these two conditions could be hypothesized. PMID:28884074

Primary intraosseous squamous cell carcinoma in odontogenic keratocyst: A rare entity

PubMed Central

Saxena, Chitrapriya; Aggarwal, Pooja; Wadhwan, Vijay; Bansal, Vishal

2015-01-01

Squamous cell carcinoma (SCC) arising from the wall of an odontogenic cyst (also known as primary intraosseous carcinoma) is a rare tumor which occurs only in jaw bones. This tumor was first described by Loos in 1913 as a central epidermoid carcinoma of the jaw. Primary intraosseous carcinomas (PIOC) may theoretically arise from the lining of an odontogenic cyst or de novo from presumed odontogenic cell rests. According to the new histological classification of tumors of the World Health Organization, odontogenic keratocyst is nowadays considered a specific odontogenic tumor and the PIOC derived from it is considered as a specific entity which is different from other PIOCs derived from the odontogenic cysts. The following report describes a case of such extremely rare entity that is primary intraosseous SCC of the mandible derived from an OKC in a 60-year-old male patient with brief review of literature. PMID:26980976

Telangiectatic osteosarcoma--a case report.

PubMed Central

Suh, Y. L.; Chi, J. G.

1989-01-01

Telangiectatic osteosarcoma is a rare and special variant of osteogenic sarcoma with distinct radiologic, gross and microscopic features. This tumor is predominantly lytic, destructive tumor without sclerosis on roentgenogram, and is soft and cystic on gross examination. Histologically aneurysmally dilated spaces lined or traversed by stromal cells producing osteoid are noted. This report concerns a case of telangiectatic osteosarcoma occurring in a 7 years old boy. He presented with pathologic fracture of the right distal tibia, followed by a purely lytic lesion on X-ray examination. This lesion recurred five times during a span of one year. Microscopic features of the biopsy specimen was difficult to differentiate from aneurysmal bone cyst because of prominant blood-filled cyst formation. It was finally identified as osteosarcoma from the below-knee amputation specimen through the close examination for anaplastic osteoid-producing stromal cells in the septa that separate the blood cysts. PMID:2597366

Gingival cyst of the adult: regenerative therapy of associated root exposure. A case report and literature review.

PubMed

Kelsey, W Patrick; Kalmar, John R; Tatakis, Dimitris N

2009-12-01

The gingival cyst of the adult (GCA) is an uncommon developmental cyst of odontogenic origin most frequently seen near mandibular canines and premolars and is routinely treated with excisional biopsy. This article presents a case of a GCA treated with a combined regenerative approach and reviews the GCA literature with an emphasis on the clinical aspects of this lesion. A 54 year-old man presented for treatment of generalized severe chronic periodontitis. Clinical examination revealed a cystic lesion in the gingiva of the mandibular canine-premolar area. Radiographs revealed a well-defined radiolucency in the coronal one-third of the tooth roots. Surgical enucleation of the lesion revealed root exposure of the second premolar. Because of the anatomy of the lesion-associated defect, regenerative treatment, using a combination of freeze-dried bone allograft and a collagen membrane, was considered the therapeutic approach of choice. The biopsy revealed histologic features consistent with a GCA. Clinical and radiographic examinations 1 year post-surgery indicated uneventful soft tissue healing and bone fill of the initial defect. The review of the literature revealed only one other case of root exposure associated with GCA and no previous report of regenerative therapy. In rare instances, a GCA lesion may result in tooth-root exposure. In such cases, a combined regenerative treatment approach may be used to achieve resolution.

Diagnostic problems with parasitic and non-parasitic splenic cysts.

PubMed

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 splenectomy without rupturing and spilling the cysts.

Bacteria Associated with Cysts of the Soybean Cyst Nematode (Heterodera glycines)

PubMed Central

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

Analysis of the ectoenzymes ADA, ALP, ENPP1, and ENPP3, in the contents of ovarian endometriomas as candidate biomarkers of endometriosis.

PubMed

Trapero, Carla; Jover, Lluis; Fernández-Montolí, Maria Eulàlia; García-Tejedor, Amparo; Vidal, August; Gómez de Aranda, Inmaculada; Ponce, Jordi; Matias-Guiu, Xavier; Martín-Satué, Mireia

2018-02-01

The diagnosis of endometriosis, a prevalent chronic disease with a strong inflammatory component, is usually delayed due to the lack of noninvasive diagnostic tests. Purinergic signaling, a key cell pathway, is altered in many inflammatory disorders. The aim of the present work was to evaluate the levels of adenosine deaminase (ADA), alkaline phosphatase (ALP), ecto-nucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1), and ENPP3, elements of purinergic signaling, as biomarker candidates for endometriosis. A case-control comparative study was conducted to determine ADA, ALP, ENPP1 and ENPP3 levels in echo-guided aspirated fluids of endometriomas (case group) and simple ovarian cysts (control group) using the ELISA technique. Adenosine deaminase, ALP, ENPP1, and ENPP3 were present and quantifiable in the contents of endometriomas and simple cysts. There were significant differences in ADA and ENPP1 levels in endometriomas in comparison with simple cysts (2787 U/L and 103.9 ng/mL more in endometriomas, for ADA and ENPP1, respectively). Comparisons of ALP and ENPP3 levels between the two groups did not reveal significant differences. The ectoenzymes ADA and ENPP1 are biomarker candidates for endometriosis. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Receptor activator NFkappaB-ligand and osteoprotegerin protein expression in human periapical cysts and granulomas.

PubMed

Menezes, Renato; Bramante, Clóvis Monteiro; da Silva Paiva, Katiúcia Batista; Letra, Ariadne; Carneiro, Everdan; Fernando Zambuzzi, Willian; Granjeiro, José Mauro

2006-09-01

The purpose of this study was to determine the expression of receptor activator of NFkappaB ligand (RANKL) and osteoprotegerin (OPG) associated with bone destruction in periapical cysts and granulomas. Forty human dental chronic periapical lesions were collected after periapical surgery. The lesions collected were fixed in 10% buffered formalin and histologically processed. At least 2 sections of each specimen were stained with hematoxylin and eosin for microscopic diagnosis. After that, 10 human periapical granulomas and 10 cysts were selected for immunohistochemical analysis for RANKL, OPG, and CD68+. Polymorphonuclear neutrophils, macrophages, endothelial cells, and lymphocytes were stained for RANKL and OPG in both lesions. Epithelial cells were also stained for RANKL and OPG in periapical cysts. Quantitative analysis was conducted and the results were expressed as a ratio of the number of immunostained cells over the total number of cells in the field (n = 100). The ratio of RANKL+/total cells was higher than OPG+/total cells in periapical granulomas (0.553 +/- 0.153 and 0.483 +/- 0.189, respectively; P < .0012; paired t test) and in cysts (0.519 +/- 0.09 and 0.339 +/- 0.117, respectively; P < .0001; paired t test). The ratios of OPG+/total cells (P < .0001; paired t test) and RANKL+/total cells (P < .0322; paired t test) were greater in granulomas than in cysts. However, the ratio RANKL+/OPG+ in granulomas (1.336 +/- 0.723) and cysts (1.404 +/- 0.385) was not significantly different. The ratio of CD68+/total cells was significantly higher in granulomas (0.381 +/- 0.040) than in cysts (0.307 +/- 0.068) (P < .0001; unpaired t test with Welch correction). Taking into account the limitations of the experimental approach employed, our findings indicate the presence of RANKL and OPG in cysts and granulomas, strongly suggesting the involvement of these gene products in the development of periapical lesions.

Primary osseous tumours of the elbow: 60 years of registry experience

PubMed Central

Halai, Mansur; Gupta, Sanjay; Wallace, David; Rymaszewski, Lech; Mahendra, Ashish

2015-01-01

Background We present the largest series of surgically treated primary bone tumours of the elbow in the English literature (75 cases). We sought to identify characteristics specific to these lesions and recommend an investigatory protocol. Methods The national registry and case notes were reviewed between 1954-2014. Tumours were classified according to Enneking's spectrum. Results There were no benign latent cases in this series as these were managed locally. All patients presented with persistent rest pain, with or without swelling. The distal humerus, in contrast to the proximal radius and ulna, was responsible for the majority and the more aggressive cases. Misdiagnosis was evident in 13% of cases; most of which were attributed to simple bone cysts. All patients that were referred required surgical intervention to either establish the diagnosis or for treatment. Benign tumours had a 19% recurrence rate, with giant cell tumour the most aggressive. Malignant tumours carried 39% local recurrence rate and a 5-year mortality of 61%. Conclusions The suspicion of a tumour should be raised in the patient with unremitting, unexplained, non-mechanical bony elbow pain. These echo the NICE recommendations and we recommend prompt specialist referral. With high rates of local recurrence, we recommend close postoperative monitoring. PMID:27582988

L-cysteine protected copper nanoparticles as colorimetric sensor for mercuric ions.

PubMed

Soomro, Razium A; Nafady, Ayman; Sirajuddin; Memon, Najma; Sherazi, Tufail H; Kalwar, Nazar H

2014-12-01

This report demonstrates a novel, simple and efficient protocol for the synthesis of copper nanoparticles in aqueous solution using L-cysteine as capping or protecting agent. UV-visible (UV-vis) spectroscopy was employed to monitor the LSPR band of L-cysteine functionalized copper nanoparticles (Cyst-Cu NPs) based on optimizing various reaction parameters. Fourier Transform Infrared (FTIR) spectroscopy provided information about the surface interaction between L-cysteine and Cu NPs. Transmission Electron Microscopy (TEM) confirmed the formation of fine spherical, uniformly distributed Cyst-Cu NPs with average size of 34 ± 2.1 nm. X-ray diffractometry (XRD) illustrated the formation of pure metallic phase crystalline Cyst-Cu NPs. As prepared Cyst-Cu NPs were tested as colorimetric sensor for determining mercuric (Hg(2+)) ions in an aqueous system. Cyst-Cu NPs demonstrated very sensitive and selective colorimetric detection of Hg(2+) ions in the range of 0.5 × 10(-6)-3.5 × 10(-6) mol L(-1) based on decrease in LSPR intensity as monitored by a UV-vis spectrophotometer. The developed sensor is simple, economic compared to those based on precious metal nanoparticles and sensitive to detect Hg(2+) ions with detection limit down to 4.3 × 10(-8) mol L(-1). The sensor developed in this work has a high potential for rapid and on-site detection of Hg(2+) ions. The sensor was successfully applied for assessment of Hg(2+) ions in real water samples collected from various locations of the Sindh River. Copyright © 2014 Elsevier B.V. All rights reserved.

Endometriosis-associated hydrocele of the canal of Nuck with immunohistochemical confirmation: a case report.

PubMed

Okoshi, Kae; Mizumoto, Masaki; Kinoshita, Koichi

2017-12-21

The canal of Nuck is an embryological vestige of the processus vaginalis, and presents a potential site for endometriosis seeding. Hydroceles in this region are a rare cause of inguinal swelling in females. In addition, endometriosis localized to the canal of Nuck is exceedingly rare. A 44-year-old Japanese woman presented with a painful mass overlying her right pubis. She underwent surgery to completely excise the mass. During surgery, division of the external oblique aponeurosis revealed a cyst that occupied the inguinal canal and it adhered to the transverse fascia, inguinal ligament, and pubic bone. The cyst was dissected from the round ligament, and the defect in the internal inguinal ring was repaired and reinforced with mesh. On macroscopic examination, the cyst had a heterogeneous fibrous aspect with dark brown inclusions. Microscopic examination revealed that the cyst was tortuous, lined by mesothelial-like cells, and accompanied by partial subcapsular hemorrhage. Endometrium-like tissue was observed in the cystic wall. Immunohistochemical staining for podoplanin confirmed the mesothelial origin of the cyst-lining cells. The epithelial cells and stromal cells were positive for estrogen receptors. In this case of an endometriosis-associated hydrocele of the canal of Nuck, the mesothelial origin of the cyst-lining cells and endometriosis were confirmed by positive immunohistochemical staining for podoplanin and estrogen receptors, respectively. We determined that hydrocele resection and reinforcement of the anterior inguinal canal wall (if necessary) are appropriate treatments for this condition.

Fibular hydatid cyst

PubMed Central

Arti, Hamidreza; Darani, Hossein Yousofi

2007-01-01

Hydatid disease is caused by the tapeworm Echinococcus. Genus Echinococcus has different species including Echinococcus vogeli, Echinococcus granulosus and Echinococcus multilucularis. Echinococcus granulosus is the most common cause of hydatid disease in humans. This disease occurs either through direct ingestion of parasite eggs from contact with infected dogs or indirectly from the ingestion of contaminated water or food. Infestation of hydatid disease in humans most commonly occurs in the liver (55-70%), followed by the lungs (18-35%). Bone hydatidosis however is very rare (3%). We present herein a case of hydatid cyst of the fibula, which is an uncommon site for the occurrence of this disease. PMID:21139754

Telangiectatic osteosarcoma of the rib: a rare entity and a potential diagnostic pitfall.

PubMed

Saguem, I; Ayadi, L; Kallel, R; Charfi, S; Bahri, I; Gouiaa, N; Sellami-Boudawara, T

2016-12-01

Osteosarcoma (OS) is a common primary malignant tumor of bones that produces osteoid matrix. Telangiectatic osteosarcoma (TOS) is a rare variant of OS. It affects the long bones especially the lower end of femur and the upper ends of tibia and humerus, a distribution similar to the conventional osteosarcoma. The rib involvement is very infrequent. We present a case of TOS of the rib that posed a diagnostic difficulty owing to its unusual location and to its resemblance to giant cell tumor and aneurysmal bone cyst. Correspondence. © Copyright Società Italiana di Anatomia Patologica e Citopatologia Diagnostica, Divisione Italiana della International Academy of Pathology.

Ultrasound in differential diagnosis of periapical radiolucencies: A radiohistopathological study

PubMed Central

Khambete, Neha; Kumar, Rahul

2015-01-01

Objectives: To evaluate the efficacy of ultrasound in differential diagnosis of periapical radiolucencies. Materials and Methods: Ten patients aged between 19 years and 40 years with periapical lesions associated with anterior maxillary or mandibular teeth were selected and consented for the study. Pre-operative periapical radiographs were obtained. Measurements and provisional diagnoses of the apical areas were made by two specialist observers on two separate occasions. Preoperative ultrasound examinations with Doppler flowmetry were then performed and the images assessed by two specialist observers for the size, contents, vascular supply and a provisional diagnosis made as to whether the lesion was a cyst or granuloma. Endodontic surgery was performed including curettage of the apical tissues to enable histopathological investigation, which provided the gold standard diagnosis. All measurements and findings were compared and statistically analyzed. Results: Total 10 lesions were identified in 10 patients. On periapical radiographs, lesions were readily identified but observers were unable to differentiate granuloma from cyst using either modality. Where sufficient buccal cortical bone had been resorbed, ultrasound imaging was simple but underestimated the size of the lesions compared with periapical radiographs. In all cases, the ultrasound diagnosis agreed with the histopathological gold standard. Conclusion: Ultrasonography (USG) can provide accurate information about the nature of intraosseous lesions of the jaws before any surgical procedure. It is proposed that USG with Doppler flowmetry can provide an additional diagnostic tool without invasive surgery, where treatment option is nonsurgical. PMID:25657525

Simple and rapid staining for detection of Entamoeba cysts and other protozoans with fluorochromes.

PubMed

Kawamoto, F; Mizuno, S; Fujioka, H; Kumada, N; Sugiyama, E; Takeuchi, T; Kobayashi, S; Iseki, M; Yamada, M; Matsumoto, Y

1987-02-01

Three fluorochromes were applied to stain various parasitic protozoans. By double staining with 4',6-diamidino-2-phenylindole and propidium iodide, differentiation of the nuclei from the cytoplasm can easily be achieved within several seconds. The chromatoid bodies in Entamoeba cysts were stained bright red. Plasmodium yoelii at all stages except late trophozoites and young gametocytes was easily identified. In the oocysts of Cryptosporidium sp., the nuclei and cytoplasm of the sporozoites fluoresced bluish white and red, respectively, whereas the residual body appeared blue or green. The third fluorochrome, Calcofluor white M2R, was suitable for detecting the cysts of Entamoeba spp. and Chilomastix mesnili.

Percutaneous nephroscopic management of an isolated giant renal hydatid cyst guided by single-incision laparoscopy using conventional instruments: the Santosh-PGI technique.

PubMed

Kumar, Santosh; Choudhary, Gautam R; Pushkarna, Arawat; Najjapa, Bhuvnesh; Ht, Vatasla

2013-11-01

Isolated renal hydatid rarely presents, but when it does occur, it requires surgical treatment. We report our experience with a novel technique involving percutaneous management of a giant renal hydatid cyst with single-incision laparoscopic assistance. First we performed retrograde ureteropyelogram, which did not show any communication between the cyst and the calyceal. A Veress needle was used for pneumoperitoneum. Three conventional laparoscopic trocars used. Under laparoscopic guidance, we punctured the cyst. The scolicidal solution used was 10% povidone-iodine. The endocyst was removed under vision with grasping forceps through the nephroscope. A Portex drain was placed into the cyst cavity. Percutaneous aspiration and instillation of scolicidal agents followed by re-aspiration have been previously reported. This is an attractive procedure because of its acceptable success rates and reduced morbidity. In our case, simple aspiration of the cyst would not have been successful because the cyst was full of daughter cysts. Also, a blind percutaneous puncture of the cyst and dilatation could have perforated the colon or the mesocolon, which is often wrapped over the surface of such giant cysts thereby making laparoscopic guidance and mobilization of the colon imperative. We devised this unique treatment method for this patient involving three conventional ports at a single umbilical site. We believe this is the first reported case of its kind in the world. Not only this technique is minimally invasive, it is also cost-effective, as only conventional laparoscopic ports and instruments are used during the procedure. © 2013 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd.

Results of a minimally invasive technique for treatment of unicameral bone cysts.

PubMed

Mik, Gökçe; Arkader, Alexandre; Manteghi, Alexander; Dormans, John P

2009-11-01

Unicameral bone cysts are benign bone lesions commonly seen in pediatric patients. Several treatment methods have been described with variable results and high recurrence rates. We previously reported short-term success of a minimally invasive technique that includes combining percutaneous decompression and grafting with medical-grade calcium sulfate pellets. The purpose of this study was to review the additional long-term results with a minimum followup of 24 months (average, 37 months; range, 24-70 months). We identified 55 patients with an average age of 10.8 years (range, 1.3-18 years). Forty-one of 55 lesions occurred in the humerus and femur. Forty-four of 55 (80%) patients had a partial or complete response after initial surgery; of these, seven obtained a partial or complete response after a repeat surgery (cumulative healing rate, 94%). Two patients underwent a third surgery (cumulative healing rate, 98%). One underwent a third repeat surgery (cumulative healing rate, 100%). There were no major complications associated with the procedure. Two patients had a superficial infection that resolved with oral antibiotics. Although some patients required a repeat procedure, complete or partial response at a minimum 24 months' followup was achieved in all patients. Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

A Study to Determine the Best Method of Caring for Certain Short-Stay Surgical Patients at Reynolds Army Community Hospital

DTIC Science & Technology

1988-09-01

Perineoplasty Vaginal cyst, cautery Vaginal web, excision Surgical Patients 95 ORTHOPEDIC Arthrodesis of phalanges Arthroscopy Bone biopsy Bunionectomy...Manipulation of shoulder, knee, or hip Mass excision with scar revision Meniscectomy (if done through arthroscopy ) Metatarsal head, excision unilateral

Ultrasound-guided drainages and sclerotherapy.

PubMed

Lohela, P

2002-02-01

Ultrasonically guided fluid collection and abscess drainage have become routine procedures in various parts of the body. In most cases ultrasound is the only imaging and guidance modality needed; however, it is of the utmost importance to remember that CT and fluoroscopy with contrast often give invaluable information when the true extent of the process has to be determined and when assessing the safest route for the catheter in anatomically complicated areas. The importance of irrigation of the abscess cavity with fluids and the ready use of urokinase should be emphasized. Ethanol sclerotherapy is a simple and safe procedure to treat symptomatic hepatic or renal cysts. Parathyroid adenomas and cysts, as well as thyroid cysts, can also be treated with ethanol sclerotherapy in selected cases. Purified mineral talc has been used in pleurodesis and hydrocele sclerotherapy, whereas doxycycline or ethanol is used for postoperative lymphoceles. Both abscess drainages and sclerotherapy procedures are minimally invasive, simple, safe, inexpensive and reasonably efficacious treatment in many clinical instances and may be at least an alternative to surgical treatment, often offering significant advantages over surgery.

The Life Cycle Stages of Pneumocystis murina Have Opposing Effects on the Immune Response to This Opportunistic Fungal Pathogen

PubMed Central

Evans, Heather M.; Bryant, Grady L.

2016-01-01

The cell wall β-glucans of Pneumocystis cysts have been shown to stimulate immune responses in lung epithelial cells, dendritic cells, and alveolar macrophages. Little is known about how the trophic life forms, which do not have a fungal cell wall, interact with these innate immune cells. Here we report differences in the responses of both neonatal and adult mice to the trophic and cystic life cycle stages of Pneumocystis murina. The adult and neonatal immune responses to infection with Pneumocystis murina trophic forms were less robust than the responses to infection with a physiologically normal mixture of cysts and trophic forms. Cysts promoted the recruitment of nonresident innate immune cells and T and B cells into the lungs. Cysts, but not trophic forms, stimulated increased concentrations of the cytokine gamma interferon (IFN-γ) in the alveolar spaces and an increase in the percentage of CD4+ T cells that produce IFN-γ. In vitro, bone marrow-derived dendritic cells (BMDCs) stimulated with cysts produced the proinflammatory cytokines interleukin 1β (IL-1β) and IL-6. In contrast, trophic forms suppressed antigen presentation to CD4+ T cells, as well as the β-glucan-, lipoteichoic acid (LTA)-, and lipopolysaccharide (LPS)-induced production of interleukin 1β (IL-1β), IL-6, and tumor necrosis factor alpha (TNF-α) by BMDCs. The negative effects of trophic forms were not due to ligation of mannose receptor. Our results indicate that optimal innate and adaptive immune responses to Pneumocystis species are dependent on stimulation with the cyst life cycle stage. Conversely, trophic forms suppress β-glucan-induced proinflammatory responses in vitro, suggesting that the trophic forms dampen cyst-induced inflammation in vivo. PMID:27572330

Diagnosis of neonatal ovarian torsion: Emphasis on prenatal and postnatal sonographic findings.

PubMed

Kim, Hyun Su; Yoo, So-Young; Cha, Min Jae; Kim, Ji Hye; Jeon, Tae Yeon; Kim, Wee Kyoung

2016-06-01

Our aim was to retrospectively review the imaging findings of patients with neonatal ovarian torsion, emphasizing prenatal and postnatal sonographic findings. Eleven patients who had had neonatal ovarian torsion diagnosed surgically (n = 9) or clinicoradiologically (n = 2) were enrolled. Prenatal and postnatal sonographic features, including sequential postnatal change, were reviewed. Clinical and pathologic features were also investigated. All patients except one had a fetal ovarian cyst (mean, 5.3 cm) detected on third-trimester sonography, either simple (n = 6) or complex (n = 4). In all 11 patients, initial postnatal sonography had revealed a complex cyst (mean, 4.7 cm) with intracystic clot or debris, the double-wall sign, a fluid-fluid level, and multiple septation. None of the patients had had symptoms or signs related to the ovarian torsion. Follow-up sonography in seven patients had revealed increased echogenicity of the cyst wall with frequent calcification and a decrease in size of the cyst. In two patients, the interval of the change in cyst position was noted, and autoamputation of the torsed ovary had been surgically confirmed. Serous cystadenoma had been identified in one patient. Neonatal ovarian torsion most commonly manifests as an asymptomatic complex cyst on sonography due to torsion of a fetal ovarian cyst. Serial monitoring of a fetal ovarian cyst for its resolution or changes in its appearance is mandatory for making an early diagnosis of torsion. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44:290-297, 2016. © 2016 Wiley Periodicals, Inc.

A modified intranasal endoscopic excision for nasal vestibular cyst in China.

PubMed

Huang, Zizhen; Li, Jingjia; Yang, Qintai; Li, Peng; Ye, Jin; Liu, Xian; Zhang, Gehua

2015-03-01

This study aimed to improve the surgical removal procedure for nasal vestibular cysts. Twenty-three patients with nasal vestibular cysts underwent surgical removal of the cyst via a transoral sublabial approach and another 30 patients via a modified intranasal endoscopic excision method. The 30 patients were treated with local anesthesia and the roof of the cyst, which was firmly attached to the mucous membrane of the anterior floor of the nasal cavity, was removed transnasally with microdebrider. Bleeding of the opening was stopped by electric coagulation without nasal packing. Among the 30 consecutive patients who underwent the modified surgical procedure, all patients were successfully treated. The mean duration of surgery was 5.7 ± 2.6 min. The mean estimated blood loss was 3.5 ± 2.1 ml. All patients were outpatients. The mean hospital stay was 1 h. The mean total cost was 140. The visual analog scale scores of postoperative pain, pressure and nasal obstruction were 1, 0 and 1, respectively. The incidence rate of postoperative lip swelling or numbness was 0 %. Postoperative endoscopic findings revealed that the cyst was replaced by an air-containing sinus with a persistent opening at the anterolateral nasal floor. There was no recurrence during a mean follow-up of 18 months. The modified intranasal endoscopic excision is a simple, less invasive, low-cost and effective surgical procedure for the treatment of nasal vestibular cysts. It might change the pattern of treatment for nasal vestibular cysts in China.

Novel techniques for biodiversity studies of gordiids and description of a new species of Chordodes (Gordiida, Nematomorpha) from Kenya, Africa.

PubMed

Bolek, Matthew G; Szmygiel, Cleo; Kubat, Austin; Schmidt-Rhaesa, Andreas; Hanelt, Ben

2013-01-01

We review recent advances in the use of non-adult gordiid cyst stages to locate gordiids over large geographical regions and new culturing techniques which can help overcome current difficulties in nematomorph biodiversity studies. Using these techniques, we collected a new species of gordiid as cysts in aquatic snails (Biomphalaria pfeifferi) from the Lake Victoria Basin, western Kenya, Africa and cultured them in the laboratory. We describe the adult free-living male and female worms using morphological (light and scanning electron microscopy) and molecular data as well as the life cycle, mating and oviposition behavior, egg strings, eggs, larvae, and cysts of this new species. Chordodes kenyaensis n. sp. belongs to a large group of African Chordodes in which simple areoles are smooth or superficially structured less so than "blackberry" areoles but contain filamentous projections. Present among the simple areoles are clusters of bulging areoles, crowned and circurmcluster areoles along with thorn and tubercle areoles. In the laboratory, worms developed and emerged within 53-78 days from three, species of laboratory-reared crickets exposed to cysts of this species. Adult male and female C. kenyaensis n. sp. initiated typical Gordian knots within hours to days of being placed together and males deposited masses of sperm on the cloacal region of females. Females began oviposition within a week of copulating and attached egg strings in a continuous zigzag pattern on small branches or air-hoses but never free in the water column. Larvae hatched within two to three weeks, and cysts developed in laboratory-reared and exposed snails within 14-24 days. Morphological characteristics of egg strings, eggs, larvae and cysts of C. kenyaensis were most similar to other gordiids in the genus Chordodes but differed morphologically from other gordiid genera for which similar information is available.

Differentiation of Pancreatic Cyst Types by Analysis of Rheological Behavior of Pancreatic Cyst Fluid

PubMed Central

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

Taenia solium metacestode preparation in rural areas of sub-Saharan Africa: a source for diagnosis and research on cysticercosis.

PubMed

Schmidt, V; Sikasunge, C S; Odongo-Aginya, E; Simukoko, C; Mwanjali, G; Alarakol, S; Ovuga, E; Matuja, W; Kihamia, C; Löscher, T; Winkler, A S; Bretzel, G

2015-03-01

Taenia solium metacestodes/cysts obtained from pig carcasses constitute a primary source for diagnostic tools used for the detection of human cysticercosis. Data on T. solium cyst preparation in Africa is still scarce but required to establish independent reference laboratories. The aim of the present study is a) to present the likely yield of T. solium cyst material by the use of two different preparation methods in the field and b) to investigate its suitability for immunodiagnosis of human cysticercosis. In Zambia, Uganda and Tanzania 670 pigs were screened for T. solium infection. Cysts were prepared by 'shaking method' and 'washing method'. Generated crude antigens were applied in a standard western blot assay. 46 out of 670 pigs (6.9%) were found positive for T. solium (Zambia: 12/367, 3.3%; Uganda: 11/217, 5.1%; Tanzania 23/86, 26.7%). Mean values of 77.7 ml whole cysts, 61.8 ml scolices/membranes and 10.9 ml cyst fluid were obtained per pig. Suitability of collected material for the use as crude antigen and molecular diagnostic techniques was demonstrated. This study clearly shows that T. solium cyst preparation in African settings by simple field methods constitutes an effective way to obtain high quality material as source for diagnostic tools and research purposes.

Octacalcium phosphate collagen composite facilitates bone regeneration of large mandibular bone defect in humans.

PubMed

Kawai, Tadashi; Suzuki, Osamu; Matsui, Keiko; Tanuma, Yuji; Takahashi, Tetsu; Kamakura, Shinji

2017-05-01

Recently it was reported that the implantation of octacalcium phosphate (OCP) and collagen composite (OCP-collagen) was effective at promoting bone healing in small bone defects after cystectomy in humans. In addition, OCP-collagen promoted bone regeneration in a critical-sized bone defect of a rodent or canine model. In this study, OCP-collagen was implanted into a human mandibular bone defect with a longer axis of approximately 40 mm, which was diagnosed as a residual cyst with apical periodontitis. The amount of OCP-collagen implanted was about five times greater than the amounts implanted in previous clinical cases. Postoperative wound healing was satisfactory and no infection or allergic reactions occurred. The OCP-collagen-treated lesion was gradually filled with radio-opaque figures, and the alveolar region occupied the whole of the bone defect 12 months after implantation. This study suggests that OCP-collagen could be a useful bone substitute material for repairing large bone defects in humans that might not heal spontaneously. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Distinct Th1, Th2 and Treg cytokines balance in chronic periapical granulomas and radicular cysts.

PubMed

Teixeira-Salum, Tatiana Beber; Rodrigues, Denise Bertulucci Rocha; Gervásio, Aurélia M; Souza, Cássio J A; Rodrigues, Virmondes; Loyola, Adriano Motta

2010-03-01

Periapical lesions are a host response that involves immune reaction to prevent dissemination of bacteria from an infected root canal. The purpose of this study was to evaluate the levels of nitric oxide (NO), IL-4, TGF-beta, tumor necrosis factor-alpha (TNF-alpha), and interferon-gamma (IFN-gamma) in chronic periapical lesions and to determine their possible association with clinical and radiographic parameters. Seventeen human radicular cysts and 30 periapical granulomas were used in this study. Cytokines and NO were assessed by enzyme-linked immunosorbent assay and by the Griess reaction respectively confirmed by immunohistochemical. TNF-alpha and IFN-gamma were detected in 10% of granulomas and in 41.2% and 70% of radicular cysts. IL-4 was reactive in 24% of cysts, and TGF-beta was positive in all samples. Patients with tenderness showed significantly higher levels of IFN-gamma and IL-4 (P < 0.05). Swelling was associated with high levels of TNF-alpha, IFN-gamma, and IL-4 (P < 0.05). Lesions presenting bone resorption were associated with high levels of NO (P < 0.05). Periapical granulomas display a regulatory environment characterized by high TGF-beta and low inflammatory cytokine levels, while radicular cysts has mist Th1 and Th2 inflammatory reaction with the presence of IFN-gamma, TNF-alpha, and IL-4.

Management of radicular cysts using platelet-rich fibrin and bioactive glass: a report of two cases.

PubMed

Zhao, Jiing-Huei; Tsai, Chung-Hung; Chang, Yu-Chao

2014-07-01

Platelet-rich fibrin (PRF) created by Choukroun's protocol concentrates most platelets and leukocytes from a blood harvest into a single autologous fibrin biomaterial. However, no current data is available concerning the use of PRF for the treatment of periapical lesions. Two cases of radicular cysts were reported using an interdisciplinary approach, including regular endodontic therapy followed by surgical management with PRF and bioactive glass. Two cases of radicular cysts presented as an incidental radiographic finding, appearing as an apical radiolucency with well-circumscribed sclerotic borders. After regular endodontic retreatment, cystic lining/granulation tissues were enucleated and the periradicular bony defect was grafted using PRF and bioactive glass. Then, PRF was applied to serve as a membrane over the grafted defects. Recall periapical radiographs of Case 1 and cone beam computer tomography of Case 2 showed satisfactory healing of the periapical pathosis. In Case 2, the bony defect appeared completely healed at 4 months surgical reentry and the new bone was clinically very dense and mature. The results of these case reports show that the combination of PRF and bioactive glass is an effective modality of regenerative treatment for radicular cysts. Copyright © 2012. Published by Elsevier B.V.

Immunohistochemical evaluation of inducible nitric oxide synthase in the epithelial lining of odontogenic cysts: A qualitative and quantitative analysis

PubMed Central

Akshatha, B K; Karuppiah, Karpagaselvi; Manjunath, G S; Kumarswamy, Jayalakshmi; Papaiah, Lokesh; Rao, Jyothi

2017-01-01

Introduction: The three common odontogenic cysts include radicular cysts (RCs), dentigerous cysts (DCs), and odontogenic keratocysts (OKCs). Among these 3 cysts, OKC is recently been classified as benign keratocystic odontogenic tumor attributing to its aggressive behavior, recurrence rate, and malignant potential. The present study involved qualitative and quantitative analysis of inducible nitric oxide synthase (iNOS) expression in epithelial lining of RCs, DCs, and OKCs, compare iNOS expression in epithelial linings of all the 3 cysts and determined overexpression of iNOS in OKCs which might contribute to its aggressive behavior and malignant potential. Aims: The present study is to investigate the role of iNOS in the pathogenesis of OKCs, DCs, and RCs by evaluating the iNOS expression in the epithelial lining of these cysts. Subjects and Methods: Analysis of iNOS expression in epithelial lining cells of 20 RCs, 20 DCs, and 20 OKCs using immunohistochemistry done. Statistical Analysis Used: The percentage of positive cells and intensity of stain was assessed and compared among all the 3 cysts using contingency coefficient. Kappa statistics for the two observers were computed for finding interobserver agreement. Results: The percentage of iNOS-positive cells was found to be remarkably high in OKCs (12/20) –57.1% as compared to RCs (6/20) – 28.6% and DCs (3/20) – 14.3%. The interobserver agreement for iNOS-positive percentage cells was arrived with kappa values with OKCs → Statistically significant (P > 0.000), RCs → statistically significant (P > 0.001) with no significant values for DCs. No statistical difference exists among 3 study samples in regard to the intensity of staining with iNOS. Conclusions: Increased iNOS expression in OKCs may contribute to bone resorption and accumulation of wild-type p53, hence, making OKCs more aggressive. PMID:29391711

Treatment of unicameral bone cyst: systematic review and meta analysis.

PubMed

Kadhim, Muayad; Thacker, Mihir; Kadhim, Amjed; Holmes, Laurens

2014-03-01

Different treatment modalities have been utilized to treat unicameral bone cyst (UBC), but evidence has not been fully described to support one treatment over another and the optimal treatment is controversial. The aim of this quantitative systematic review was to assess the effectiveness of different UBC treatment modalities. We utilized Pubmed to isolate retrospective studies on patients with UBC who received any kind of treatment. The included studies needed to have a minimum sample size of 15 patients, and have provided data on radiographic healing outcome. Sixty-two articles were selected for the meta-analysis from a total of 463 articles. The cumulative sample size was 3,211 patients with 3,217 UBC, and male to female ratio was 2.2:1. The summary or pool estimate of methylprednisolone acetate (MPA) injection resulted in a healing rate of (77.4 %) that was comparable to bone marrow injection (77.9 %). A higher healing rate was observed with MPA injection when inner wall disruption was performed. The pool estimate of bone marrow with demineralized bone matrix injection was high (98.7 %). UBC healing rate after surgical curettage was comparable whether autograft or allograft was utilized (90 %). UBC treatment with flexible intramedullary nails without curettage provided almost 100% healing rate, while continuous decompression with cannulated screws provided 89 % healing rate. Conservative treatment indicated a healing rate of 64.2, 95 % CI (26.7-101.8). Active treatment for UBC provided variable healing rates and the outcomes were favorable relative to conservative treatment. Due to the heterogeneity of the studies and reporting bias, the interpretation of these findings should be handled with caution.

Targeting receptor-activator of nuclear kappaB ligand in aneurysmal bone cysts: verification of target and therapeutic response.

PubMed

Pelle, Dominic W; Ringler, Jonathan W; Peacock, Jacqueline D; Kampfschulte, Kevin; Scholten, Donald J; Davis, Mary M; Mitchell, Deanna S; Steensma, Matthew R

2014-08-01

Aneurysmal bone cyst (ABC) is a benign tumor of bone presenting as a cystic, expansile lesion in both the axial and appendicular skeleton. Axial lesions demand special consideration, because treatment-related morbidity can be devastating. In similar lesions, such as giant cell tumor of bone (GCTB), the receptor-activator of nuclear kappaB ligand (RANKL)-receptor-activator of nuclear kappaB (RANK) signaling axis is essential to tumor progression. Although ABC and GCTB are distinct entities, they both contain abundant multinucleated giant cells and are osteolytic characteristically. We hypothesize that ABCs express both RANKL and RANK similarly in a cell-type specific manner, and that targeted RANKL therapy will mitigate ABC tumor progression. Cellular expression of RANKL and RANK was determined in freshly harvested ABC samples using laser confocal microscopy. A consistent cell-type-specific pattern was observed: fibroblastlike stromal cells expressed RANKL strongly whereas monocyte/macrophage precursor and multinucleated giant cells expressed RANK. Relative RANKL expression was determined by quantitative real-time polymerase chain reaction in ABC and GCTB tissue samples; no difference in relative expression was observed (P > 0.05). In addition, we review the case of a 5-year-old boy with a large, aggressive sacral ABC. After 3 months of targeted RANKL inhibition with denosumab, magnetic resonance imaging demonstrated tumor shrinkage, bone reconstitution, and healing of a pathologic fracture. Ambulation, and bowel and bladder function were restored at 6 months. Denosumab treatment was well tolerated. Post hoc analysis demonstrated strong RANKL expression in the pretreatment tumor sample. These findings demonstrate that RANKL-RANK signal activation is essential to ABC tumor progression. RANKL-targeted therapy may be an effective alternative to surgery in select ABC presentations. Copyright © 2014 Mosby, Inc. All rights reserved.

Subchondral bone in osteoarthritis: insight into risk factors and microstructural changes

PubMed Central

2013-01-01

Osteoarthritis (OA) is a major cause of disability in the adult population. As a progressive degenerative joint disorder, OA is characterized by cartilage damage, changes in the subchondral bone, osteophyte formation, muscle weakness, and inflammation of the synovium tissue and tendon. Although OA has long been viewed as a primary disorder of articular cartilage, subchondral bone is attracting increasing attention. It is commonly reported to play a vital role in the pathogenesis of OA. Subchondral bone sclerosis, together with progressive cartilage degradation, is widely considered as a hallmark of OA. Despite the increase in bone volume fraction, subchondral bone is hypomineralized, due to abnormal bone remodeling. Some histopathological changes in the subchondral bone have also been detected, including microdamage, bone marrow edema-like lesions and bone cysts. This review summarizes basic features of the osteochondral junction, which comprises subchondral bone and articular cartilage. Importantly, we discuss risk factors influencing subchondral bone integrity. We also focus on the microarchitectural and histopathological changes of subchondral bone in OA, and provide an overview of their potential contribution to the progression of OA. A hypothetical model for the pathogenesis of OA is proposed. PMID:24321104

Subchondral bone in osteoarthritis: insight into risk factors and microstructural changes.

PubMed

Li, Guangyi; Yin, Jimin; Gao, Junjie; Cheng, Tak S; Pavlos, Nathan J; Zhang, Changqing; Zheng, Ming H

2013-01-01

Osteoarthritis (OA) is a major cause of disability in the adult population. As a progressive degenerative joint disorder, OA is characterized by cartilage damage, changes in the subchondral bone, osteophyte formation, muscle weakness, and inflammation of the synovium tissue and tendon. Although OA has long been viewed as a primary disorder of articular cartilage, subchondral bone is attracting increasing attention. It is commonly reported to play a vital role in the pathogenesis of OA. Subchondral bone sclerosis, together with progressive cartilage degradation, is widely considered as a hallmark of OA. Despite the increase in bone volume fraction, subchondral bone is hypomineralized, due to abnormal bone remodeling. Some histopathological changes in the subchondral bone have also been detected, including microdamage, bone marrow edema-like lesions and bone cysts. This review summarizes basic features of the osteochondral junction, which comprises subchondral bone and articular cartilage. Importantly, we discuss risk factors influencing subchondral bone integrity. We also focus on the microarchitectural and histopathological changes of subchondral bone in OA, and provide an overview of their potential contribution to the progression of OA. A hypothetical model for the pathogenesis of OA is proposed.

Hyperostotic Esthesioneuroblastoma: Rare Variant and Fibrous Dysplasia Mimicker

PubMed Central

Knott, Phillip Daniel

2014-01-01

A 65-year-old male presented with a 3-year history of orbital symptoms. An imaging-based diagnosis of fibrous dysplasia involving the skull base was made at another institution. CT showed a diffuse sinonasal mass and ground-glass appearance of the bones of the anterior skull base with bony defects and mucocele formation. MRI demonstrated an accompanying intracranial and orbital rind of soft tissue mass along the hyperostotic bones. FDG-PET showed corresponding intense hypermetabolism. Small cysts were observed at the tumor-brain interface. Biopsy revealed esthesioneuroblastoma with bone infiltration that is compatible with the hyperostotic variant of esthesioneuroblastoma. There are a few cases of hyperostotic esthesioneuroblastoma reported in the literature. PMID:24497807

The Social Amoeba Polysphondylium pallidum Loses Encystation and Sporulation, but Can Still Erect Fruiting Bodies in the Absence of Cellulose

PubMed Central

Du, Qingyou; Schaap, Pauline

2014-01-01

Amoebas and other freely moving protists differentiate into walled cysts when exposed to stress. As cysts, amoeba pathogens are resistant to biocides, preventing treatment and eradication. Lack of gene modification procedures has left the mechanisms of encystation largely unexplored. Genetically tractable Dictyostelium discoideum amoebas require cellulose synthase for formation of multicellular fructifications with cellulose-rich stalk and spore cells. Amoebas of its distant relative Polysphondylium pallidum (Ppal), can additionally encyst individually in response to stress. Ppal has two cellulose synthase genes, DcsA and DcsB, which we deleted individually and in combination. Dcsa- mutants formed fruiting bodies with normal stalks, but their spore and cyst walls lacked cellulose, which obliterated stress-resistance of spores and rendered cysts entirely non-viable. A dcsa-/dcsb- mutant made no walled spores, stalk cells or cysts, although simple fruiting structures were formed with a droplet of amoeboid cells resting on an sheathed column of decaying cells. DcsB is expressed in prestalk and stalk cells, while DcsA is additionally expressed in spores and cysts. We conclude that cellulose is essential for encystation and that cellulose synthase may be a suitable target for drugs to prevent encystation and render amoeba pathogens susceptible to conventional antibiotics. PMID:25113829

Zebrafish mutations affecting cilia motility share similar cystic phenotypes and suggest a mechanism of cyst formation that differs from pkd2 morphants

PubMed Central

Sullivan-Brown, Jessica; Schottenfeld, Jodi; Okabe, Noriko; Hostetter, Christine L.; Serluca, Fabrizio C.; Thiberge, Stephan Y.; Burdine, Rebecca D.

2008-01-01

Zebrafish are an attractive model for studying the earliest cellular defects occurring during renal cyst formation because its kidney (the pronephros) is simple and genes that cause cystic kidney diseases (CKD) in humans, cause pronephric dilations in zebrafish. By comparing phenotypes in three different mutants, locke, swt and kurly, we find that dilations occur prior to 48 hpf in the medial tubules, a location similar to where cysts form in some mammalian diseases. We demonstrate that the first observeable phenotypes associated with dilation include cilia motility and luminal remodeling defects. Importantly, we show that some phenotypes common to human CKD, such as an increased number of cells, are secondary consequences of dilation. Despite having differences in cilia motility, locke, swt and kurly share similar cystic phenotypes, suggesting that they function in a common pathway. To begin to understand the molecular mechanisms involved in cyst formation, we have cloned the swt mutation and find that it encodes a novel leucine rich repeat containing protein (LRRC50), which is thought to function in correct dynein assembly in cilia. Finally, we show that knockdown of polycystic kidney disease 2 (pkd2) specifically causes glomerular cysts and does not affect cilia motility, suggesting multiple mechanisms exist for cyst formation. PMID:18178183

A large epidermoid cyst of breast mimicking carcinoma: A case report and review of literature

PubMed Central

Debnath, Debasish; Taribagil, Savita; Al-Janabi, Khalid J.S.; Inwang, Reggie

2012-01-01

INTRODUCTION Triple assessment of a suspicious breast lesion may not always provide a definite diagnosis. We report a case of epidermoid cyst of breast, which caused diagnostic dilemma in spite of a thorough triple assessment and entailed mastectomy. PRESENTATION OF CASE A 69-year-old woman presented with a large painful retroareolar left breast mass. Clinical examination, ultrasound and mammography were highly suspicious of malignancy. However, core biopsy suggested a benign lesion. Due to size of the lesion and diagnostic uncertainty, various options were discussed with the patient. She opted for a simple mastectomy. The histology confirmed a large epidermoid cyst. DISCUSSION It is rare for an epidermoid cyst to present as such an advanced lesion, mimicking carcinoma. Excision of such a large retroareolar ‘benign’ lesion, however, may sometime entail mastectomy. This is the first reported case of an epidermoid cyst of breast necessitating mastectomy. CONCLUSION Diagnostic dilemma while dealing with a suspected breast cancer is not rare. Involvement of multidisciplinary team as well as patient is important in the decision-making. The report illustrates a rare presentation of a deep seated large epidermoid cyst of breast, which mimicked carcinoma, caused diagnostic confusion and entailed mastectomy. We strongly advocate the option of breast reconstruction in such cases. PMID:22705938

Case report 732. Gout presenting as a large pseudo tumor (tophus) in the proximal end of the tibia.

PubMed

Cope, R; Marsan, R; Castelli, M J

1992-01-01

A case of a large, lytic, tophaceous defect in the upper end of the tibia has been reported in a 44-year-old man as a solitary lesion. The term "gouty tophus" should not be confused with the geode or subchondral bone cyst.

Giant Aneurysmal Bone Cyst of the Anterior Cranial Fossa and Paranasal Sinuses Presenting in Pregnancy: Case Report and Literature Review

PubMed Central

Hnenny, Luke; Roundy, Neil; Zherebitskiy, Victor; Grafe, Marjorie; Mansoor, Atiya; Dogan, Aclan

2015-01-01

Background and Purpose Aneurysmal bone cysts (ABCs) rarely involve the cranium and have seldom been reported in pregnancy. Clinical Presentation We describe a case of a 28-year-old woman who presented at 37 weeks of gestation with 3 months of gradually worsening vision, 10 months of proptosis, and restricted ocular motility on the left. Brain imaging revealed a multicystic enhancing mass measuring 5.9 × 5.3 × 3.7 cm, centered on the cribriform plate on the left, extending into the anterior cranial fossa superiorly as well as the left nasal cavity, maxillary, sphenoid, and frontal sinuses. Her clinical course is described in detail; 3-month postoperative imaging demonstrated no residual mass. Conclusion A literature review revealed five previous cases of ABCs associated with pregnancy. We report a rare case of a giant ABC of fibrous dysplasia involving the paranasal sinuses and anterior cranial fossa. We postulate on the possible influence of pregnancy on the clinical course. PMID:26623230

Primary telangiectatic osteosarcoma of the cervical spine.

PubMed

Turel, Mazda K; Joseph, Vivek; Singh, Vandita; Moses, Vinu; Rajshekhar, Vedantam

2012-04-01

Telangiectatic osteosarcoma (TOS) is one of the 8 subtypes of osteosarcoma that infrequently affects the spine. The radiopathological features of TOS overlap with those of more benign entities, most commonly the aneurysmal bone cyst), and therefore is a significant diagnostic challenge. It is a rare but well-described entity in the thoracolumbar and sacral spine, and to the authors' knowledge has not been previously reported in the cervical spine. The authors report the case of a 15-year-old boy who presented with a 6-month history of neck pain and torticollis. He underwent preoperative glue embolization followed by a staged subtotal C-5 spondylectomy and posterior fusion for a C-5 vertebral body lytic expansile lesion. Histopathological examination showed the lesion to be TOS. The surgery was followed by adjuvant radiation and chemotherapy with a favorable outcome at the 1-year follow-up. This report reiterates that TOS is an important differential diagnosis for aneurysmal bone cyst and giant-cell tumor of the spine, as its biological behavior and clinical outcome differ from those of these more benign lesions, which it mimics.

Odontogenic keratocyst in a cat.

PubMed

LaDouceur, E E B; Walker, K S; Mohr, F C; Murphy, B

2014-01-01

Odontogenic cysts are derived from odontogenic epithelium, can be locally invasive and destructive and have been reported rarely in cats. A 16-year-old, male domestic shorthair cat had a 3-year history of a slowly progressive, right mandibular swelling. Intraoral dental radiographs revealed a multilocular, radiolucent, cystic mass within the right mandible that extended from the distal aspect of the canine tooth to the mesial aspect of the fourth premolar tooth. Radiographically, the mass was associated with distortion and regional destruction of the right mandibular bone and resorption of regional tooth roots. Histological examination of an incisional biopsy sample revealed multiple ruptured cysts lined by stratified squamous epithelium of odontogenic origin with luminal parakeratinization and a prominent palisading basal cell layer. The cyst contained abundant orthokeratotic and parakeratotic keratin. The clinical, radiographical and histological features were consistent with a diagnosis of odontogenic keratocyst, as seen in man. This is the first report of an odontogenic keratocyst in a cat. Copyright © 2014 Elsevier Ltd. All rights reserved.

Combined Percutaneous and Endovascular Treatment of Symptomatic Aneurysmal Bone Cyst of the Spine: Clinical Six Months. Follow-up of Six Cases.

PubMed

Guarnieri, G; Ambrosanio, G; Vassallo, P; Granato, F; Setola, F R; Greco, B; Izzo, R; Muto, M

2010-03-01

We describe the usefulness of endovascular and direct percutaneous treatment as a therapy option for aneurysmal bone cysts (ABCs) of the spine. From January 2007 to December 2008, we treated six consecutive patients with symptomatic ABCs resistant to continuous medical management or with acute clinical onset of paraparesis at cervical, thoracic and lumbar spine level. Two patients were treated after emergency laminectomy. All patients were studied with an MRI protocol and multidetector CT with MPR reconstructions followed by angiographic control before treatment. The procedure was performed under general anaesthesia for all patients. Under CT or fluoroscopy guidance, percutaneous treatment was performed either by direct injection of Glubran(®) diluted at 30% with Lipiodol(®) only, or combined with endovascular treatment by Onyx® injection. Clinical and X-ray follow-up was performed at three and six months. Combined endovascular and percutaneous treatment for ABCs was successful and led to an excellent outcome in five out of six patients with clinical improvement. There were no periprocedural or subsequent clinical complications and the glue resulted in successful selective permanent occlusion with intralesional penetration. Direct sclerotherapy resulted in immediate thrombosis of the malformation with no progression of symptoms. Complete healing was observed in five out of six aggressive lesions. No major complications were noted. At six month follow-up the symptoms had completely resolved and X-ray control showed a partial or total sclerotic reaction of the lesion with stable clinical results (no partial or clinical abnormalities). One patient had a recurrence of the ABC with spinal cord cervical clinical symptomatology. Combined endovascular and percutaneous treatment or direct percutaneous sclerotherapy with glue alone are important, safe, effective therapy options for symptomatic aneurysmal bone cyst. Results are stable and confirmed by clinical and X-ray follow-up six months after treatment.

Bilateral tympanokeratomas (cholesteatomas) with bilateral otitis media, unilateral otitis interna and acoustic neuritis in a dog.

PubMed

Østevik, Liv; Rudlang, Kathrine; Holt Jahr, Tuva; Valheim, Mette; Njaa, Bradley Lyndon

2018-05-22

An aural cholesteatoma, more appropriately named tympanokeratoma, is an epidermoid cyst of the middle ear described in several species, including dogs, humans and Mongolian gerbils. The cyst lining consists of stratified, keratinizing squamous epithelium with central accumulation of a keratin debris. This case report describes vestibular ganglioneuritis and perineuritis in a dog with chronic otitis, bilateral tympanokeratomas and presumed extension of otic infection to the central nervous system. An 11-year-old intact male Dalmatian dog with chronic bilateral otitis externa and sudden development of symptoms of vestibular disease was examined. Due to the dog's old age the owner opted for euthanasia without any further examination or treatment and the dog was submitted for necropsy. Transection of the ears revealed grey soft material in the external ear canals and pearly white, dry material consistent with keratin in the tympanic bullae bilaterally. The brain and meninges were grossly unremarkable. Microscopical findings included bilateral otitis externa and media, unilateral otitis interna, ganglioneuritis and perineuritis of the spiral ganglion of the vestibulocochlear nerve and multifocal to coalescing, purulent meningitis. A keratinizing squamous epithelial layer continuous with the external acoustic meatus lined the middle ear compartments, consistent with bilateral tympanokeratomas. Focal bony erosion of the petrous portion of the temporal bone and squamous epithelium and Gram-positive bacterial cocci were evident in the left cochlea. The findings suggest that meningitis developed secondary to erosion of the temporal bone and ganglioneuritis and/or perineuritis of the vestibulocochlear nerve. Middle ear tympanokeratoma is an important and potentially life-threatening otic condition in the dog. Once a tympanokeratoma has developed expansion of the cyst can lead to erosion of bone and extension of otic infection to the inner ear, vestibulocochlear ganglion and nerve potentially leading to bacterial infection of the central nervous system.

Contemporary management of benign liver tumors.

PubMed

Gibbs, John F; Litwin, Alan M; Kahlenberg, Morton S

2004-04-01

Benign lesions of the liver represent diagnostic dilemmas, clinically and radiographically; however, certain clues can help the extensive differential diagnosis of both benign and malignant processes. Hemangiomas and simple cysts have very distinct and very specific radiographic characteristics, and if diagnosed, no further work-up is necessary. The remaining benign lesions have significant overlap, even though there are some more common characteristics to each of the entities. Still, differentiation of any particular lesion outside simple cysts or hemangioma may be difficult. It is reasonable and relatively simple, with minimal invasiveness, to perform US- or CT-guided, percutaneous core-needle biopsies. It is recommended that core biopsies be performed, because many of the benign entities have some overlapping histologic features, and if fine-needle aspirations are performed, a definitive diagnosis may be difficult to obtain. A definitive pathological diagnosis still cannot be made in some cases, even after needle biopsy. Therefore, a surgical resection or wedge resection may be necessary if a benign process cannot be definitively ruled out.

Bone disease in primary hyperparathyroidism

PubMed Central

Bandeira, Francisco; Cusano, Natalie E.; Silva, Barbara C.; Cassibba, Sara; Almeida, Clarissa Beatriz; Machado, Vanessa Caroline Costa; Bilezikian, John P.

2015-01-01

Bone disease in severe primary hyperparathyroidism (PHPT) is described classically as osteitis fibrosa cystica (OFC). Bone pain, skeletal deformities and pathological fractures are features of OFC. Bone mineral density is usually extremely low in OFC, but it is reversible after surgical cure. The signs and symptoms of severe bone disease include bone pain, pathologic fractures, proximal muscle weakness with hyperreflexia. Bone involvement is typically characterized as salt-and-pepper appearance in the skull, bone erosions and bone resorption of the phalanges, brown tumors and cysts. In the radiography, diffuse demineralization is observed, along with pathological fractures, particularly in the long bones of the extremities. In severe, symptomatic PHPT, marked elevation of the serum calcium and PTH concentrations are seen and renal involvement is manifested by nephrolithiasis and nephrocalcinosis. A new technology, recently approved for clinical use in the United States and Europe, is likely to become more widely available because it is an adaptation of the lumbar spine DXA image. Trabecular bone score (TBS) is a gray-level textural analysis that provides an indirect index of trabecular microarchitecture. Newer technologies, such as high-resolution peripheral quantitative computed tomography (HR-pQCT), have provided further understanding of the microstructural skeletal features in PHPT. PMID:25166047

Fetal bovine serum simultaneously stimulates apoptosis and DNA synthesis in premeiotic stages of spermatogenesis in spiny dogfish (Squalus acanthias) in vitro: modulation by androgen and spermatogenic activity status.

PubMed

McClusky, Leon Mendel

2008-05-01

Using the simple cystic spermatogenesis in the shark testis as a model, we previously reported the relative resistance of immature spermatogonia (stem cell and early-stage spermatogonia) to apoptosis in the normal testis and after spermatoxicant exposure in vivo. Apoptosis was monitored by fluorescence image analysis of living cysts, using the validated acridine orange (AO) vital staining technique. Findings show that FBS simultaneously stimulates both apoptosis and [(3)H]thymidine incorporation in immature spermatogonial clones in a concentration-dependent manner in vitro. Furthermore, androgen inhibits apoptosis and increases cyst viability, more so with 10% FBS than with 1% FBS. All the effects were as a function of spermatogenic activity status but were distinct in early-stage spermatogonial cysts isolated from testes awakening from the previous winter spermatogenic arrest period. Results are discussed in the context of the alternating germ-Sertoli cell population kinetics of early-stage spermatogonial cysts in Squalus acanthias's protracted testicular cycle.

Pathological Calcification and Ossification in Relation to Leriche and Policard's Theory

PubMed Central

Jones, Watson; Roberts, R. E.

1933-01-01

(1) Pathology of calcification and ossification.—The Leriche-Policard theories. Hyperæmia of bone causes decalcification. Reduced blood supply causes sclerosis. Diminution of vascularity of fibrous tissue causes calcification. Excess of calcium, adequate blood supply and fibroblasts give rise to bone anywhere. Subperiosteal ossification. “Myositis ossificans.” (2) Radiological significance of density of bone shadows.—Decalcification of disuse, of infections, of neoplasms. Traumatic and infective scquestra. Evidence that a fragment of bone is avascular. (3) Hyperæmic decalcification of bone.—Delayed and non-union of fractures. Kummel's disease. Spontaneous hyperæmic dislocation of the atlas. Hyperæmic decalcification and nephrolithiasis. (4) Anæmic sclerosis of bone.—Syphilitic bone disease. Malignant bone disease. Fragility of sclerosed bone—Paget's, Kienboch's, Kohler's and Panner's, Albers-Schönberg's diseases. (5) Pathological calcification.—Calcification of supraspinatus tendon. Calcification of tumours—angioma, hæmatoma, and thrombosed vessels, lipoma, cysts, etc. Calcification of semilunar cartilages and intervertebral discs. (6) Pathological ossification.—Ossification of tendons. Ossification of semilunar cartilages. PMID:19989304

The Value of Phenotypes in Knee Osteoarthritis Research.

PubMed

Nelson, Fred R T

2018-01-01

Over the past decade, phenotypes have been used to help categorize knee osteoarthritis patients relative to being subject to disease, disease progression, and treatment response. A review of potential phenotype selection is now appropriate. The appeal of using phenotypes is that they most rely on simple physical examination, clinically routine imaging, and demographics. The purpose of this review is to describe the panoply of phenotypes that can be potentially used in osteoarthritis research. A search of PubMed was used singularly to review the literature on knee osteoarthritis phenotypes. Four phenotype assembly groups were based on physical features and noninvasive imaging. Demographics included metabolic syndrome (dyslipidemia, hypertension, obesity, and diabetes). Mechanical characteristics included joint morphology, alignment, the effect of injury, and past and present history. Associated musculoskeletal disorder characteristics included multiple joint involvement, spine disorders, neuromuscular diseases, and osteoporosis. With the knee as an organ, tissue characteristics were used to focus on synovium, meniscus, articular cartilage, patella fat pad, bone sclerosis, bone cysts, and location of pain. Many of these phenotype clusters require further validation studies. There is special emphasis on knee osteoarthritis phenotypes due to its predominance in osteoarthritic disorders and the variety of tissues in that joint. More research will be required to determine the most productive phenotypes for future studies. The selection and assignment of phenotypes will take on an increasing role in osteoarthritis research in the future.

Primary sacral hydatid cyst. A case report.

PubMed

Joshi, Nayana; Hernandez-Martinez, Alejandro; Seijas-Vazquez, Roberto

2007-10-01

This case report highlights an unusual osseous spinal presentation of a well described disease, hydatidosis. A 59-year-old woman presented with increasing back pain and bilateral radiculopathy. Examination disclosed symptoms of spinal stenosis and urinary incontinence. Radiographs showed an expansive lytic lesion affecting the pelvic bones with destruction of the bone cortex. Laboratory analyses were performed and the patient underwent CT and MRI studies. Serology for Echinococcus was positive. When assessing sciatica, low back pain or lower limb weakness the pelvic cavity should be examined for hidden disease that might explain the neurological symptoms. Hydatid disease of bone should be considered in the differential diagnosis of any bone mass discovered in the human body. Diagnosis was delayed in this case because the pelvic cavity was not studied when radiculopathy symptoms started and there was no coexisting visceral involvement.

[Sclerotherapy of hydrocele and cord cyst with polidocanol. Efficiency study].

PubMed

Merenciano Cortina, F J; Rafie Mazketli, W; Amat Cecilia, M; Romero Pérez, P

2001-01-01

Checking the efficiency (cost/benefit) of the sclerotherapy with polidocanol in our country for the treatment of hydrocele and epididymal cyst. We studies 86 patients with this diagnosis from may of 1995, until april of 2000. We have applied the costs for process according to the indicators of administration-cost our hospital in the year 1999. 79 patient completed the protocol. The overall cure rate was 83.87% with sclerotherapy; 42.3% with first one treatment. Only a 4.5% of the patients had significant pain and a 7.4% others complications. There were necessaries 1.5 sclerotherapies of mean for curation, resulting this treatment 4.78 more cheaper than surgery. The sclerotherapy with polidocanol of the hydrocele or epididymal cyst are an effective treatment, sure, simple, reasonably comfortable and fundamentally, economical.

Apical Cyst Theory: a Missing Link.

PubMed

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

PubMed Central

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

Telangiectatic osteosarcoma.

PubMed

Sangle, Nikhil A; Layfield, Lester J

2012-05-01

Osteosarcoma is one of the most common primary malignant bone tumors in children and adolescents. Telangiectatic osteosarcoma is an unusual variant of osteosarcoma, forming 3% to 10% of all osteosarcomas. Radiographically, these tumors appear as purely lytic destructive lesions located in the metaphyses of long bones. The location and x-ray appearance of telangiectatic osteosarcomas are reminiscent of an aneurysmal bone cyst and can test the acumen of a diagnostic radiologist. Distinguishing between the two entities microscopically can also be quite challenging. Telangiectatic osteosarcoma shows dilated blood-filled spaces lined or traversed by septa containing atypical stromal cells, with or without production of a lacelike osteoid matrix. This review highlights the diagnostic features of telangiectatic osteosarcoma and discusses differential diagnostic considerations, treatment options, and prognostic implications.

Intramuscular keratocyst as a soft tissue counterpart of keratocystic odontogenic tumor: differential diagnosis by immunohistochemistry.

PubMed

Abé, Tatsuya; Maruyama, Satoshi; Yamazaki, Manabu; Essa, Ahmed; Babkair, Hamzah; Mikami, Toshihiko; Shingaki, Susumu; Kobayashi, Tadaharu; Hayashi, Takafumi; Cheng, Jun; Saku, Takashi

2014-01-01

Keratocystic odontogenic tumor (KCOT), a developmental jaw cyst previously referred to as odontogenic keratocyst (OKC), typically arises in the jawbone. In this article, however, we report a case of KCOT located within the temporalis muscle. We compared its immunohistochemical profiles with those of authentic jaw KCOT, orthokeratinized odontogenic cyst, and epidermoid cyst in order to consider whether a soft tissue counterpart of KCOT could be a separate disease entity. The patient was a 46-year-old man with a well-defined cystic lesion within the left temporalis muscle. On computed tomographic images, the lesion was recognized as a cystic lesion, although KCOT was not included in the clinical differential diagnoses. The location of the lesion was not within bone but, rather, within the temporalis muscle that was attached to the jawbones. Our review of the literature has disclosed more than 20 peripheral KCOT cases of the oral mucosa and more than 10 cases of the skin, but only 1 case arising in muscle. Immunohistochemical investigation of the present intramuscular case reveals KCOT-characteristic profiles distinct from the other 3 types of cysts investigated. The results indicate that KCOT-like lesions can arise within soft tissues, although use of the term odontogenic might seem inappropriate in those cases. © 2013.

Immunohistochemical detection of receptor activator nuclear κB ligand and osteoprotegerin in odontogenic cysts and tumors.

PubMed

de Matos, Felipe Rodrigues; de Moraes, Maiara; das Neves Silva, Emília Beatriz; Galvão, Hébel Cavalcanti; de Almeida Freitas, Roseana

2013-11-01

The aim of the present study was to compare the immunohistochemical detection of receptor activator nuclear κB ligand (RANKL) and osteoprotegerin (OPG) in radicular cysts (RCs), dentigerous cysts (DCs), solid ameloblastomas (SAs), and keratocystic odontogenic tumors (KOTs). A total of 20 RCs, 20 DCs, 20 KOTs, 14 dental follicles (DFs), and 18 SAs were evaluated by immunohistochemistry using anti-RANKL and anti-OPG antibodies. The analysis was quantitative, and the number of positive cells was counted in 10 microscopic high-power fields (400×). The DFs, KOTs, and SAs showed higher expression of RANKL than did the RCs and DCs in the epithelium (P < .05). The epithelial expression of OPG was higher in the DFs, KOTs, RCs, and DCs than in the SAs (P < .05). The ratio of OPG less than RANKL was more frequent in SAs and OPG greater than RANKL in DCs (P < .05). Our results have shown differences in RANKL and OPG detection in the odontogenic cysts and tumors studied. The higher RANKL and lower OPG detection in SA could play a role in bone resorption, compatible with the tumor's biologic behavior. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Collagenase-3 expression in periapical lesions: an immunohistochemical study.

PubMed

Bhalla, G; Astekar, M S; Ramesh, G; Kaur, P; Sowmya, G V

2014-08-01

Collagenase-3 (matrix metalloproteinase-13) is a metalloproteinase (MMP) that is associated with bone lesions and exhibits variable expression patterns in odontogenic cysts; it may play a role in regulating focal proliferation and maturation of jaw cyst epithelium. We studied the localization, staining intensity and distribution of collagenase-3 in 13 periapical granulomas with epithelium, 16 periapical granulomas without epithelium and 10 radicular cysts using archived formalin fixed, paraffin embedded tissues. A monoclonal antibody against human collagenase-3 was used to evaluate its expression. Immunohistochemical staining intensities of collagenase-3 in all periapical lesions were (-), 4 (10%); (+), 1 (3%); (++), 22 (56%) and (+++), 12 (31%); differences were not statistically significant. Immunohistochemical distribution of collagenase-3 in epithelial cells was (-), 17 (44%); (+), 17 (44%); (++), 5 (13%); in fibroblasts it was (-), 8 (20%); (+), 23 (59%); (++), 8 (21%); in plasma cells it was (-), 7 (18%); (+), 22 (56%); (++), 10 (26%); in macrophages it was (-), 7 (18%); (+), and 15 (38%); and (++), 17 (44%). Statistically significant differences were found in epithelial cells (p = 0.00) and fibroblasts (p = 0.02), whereas differences were not statistically significant for plasma cells and macrophages. Collagenase-3 may play a role in the conversion of a periapical granuloma with epithelium to radicular cyst. MMP's influence not only epithelial rest cell migration, but also invasion of various stromal cells into granulomatous tissue.

Development and evaluation of an off-the-slide genotyping technique for identifying Giardia cysts and Cryptosporidium oocysts directly from US EPA Method 1623 slides.

PubMed

Ware, M W; Keely, S P; Villegas, E N

2013-07-01

This study developed and systematically evaluated performance and limit of detection of an off-the-slide genotyping procedure for both Cryptosporidium oocysts and Giardia cysts. Slide standards containing flow-sorted (oo)cysts were used to evaluate the off-the-slide genotyping procedure by microscopy and PCR. Results show approximately 20% of cysts and oocysts are lost during staining. Although transfer efficiency from the slide to the PCR tube could not be determined by microscopy, it was observed that the transfer process aided in the physical lysis of the (oo)cysts likely releasing DNA. PCR detection rates for a single event on a slide were 44% for Giardia and 27% for Cryptosporidium, and a minimum of five cysts and 20 oocysts are required to achieve a 90% PCR detection rate. A Poisson distribution analysis estimated the relative PCR target densities and limits of detection, it showed that 18 Cryptosporidium and five Giardia replicates are required for a 95% probability of detecting a single (oo)cyst on a slide. This study successfully developed and evaluated recovery rates and limits of detection of an off-the-slide genotyping procedure for both Cryptosporidium and Giardia (oo)cysts from the same slide. This off-the-slide genotyping technique is a simple and low cost tool that expands the applications of US EPA Method 1623 results by identifying the genotypes and assemblages of the enumerated Cryptosporidium and Giardia. This additional information will be useful for microbial risk assessment models and watershed management decisions. Journal of Applied Microbiology Published [2013]. This article is a U.S. Government work and is in the public domain in the USA.

Laparoscopic Extracorporeal Oophorectomy and Ovarian Cystectomy in Second Trimester Pregnant Obese Patients

PubMed Central

Chung, Maurice K.; Chung, Rosemary P.

2001-01-01

Objectives: To determine whether a modified technique for laparoscopic extracorporal oophorectomy is less complicated and safer than traditional laparoscopic oophorectomy. Methods: Four obese patients in their second trimester underwent open laparoscopy for treatment of large ovarian cysts. A Cook Ob/Gyn special cyst aspirator with a 14-gauge aspirating needle was inserted into the abdomen to drain the ovary through a separate 10-mm port; the site of insertion depends on the location of the ovary. After the cyst was decompressed, the 10-mm incision was enlarged to 3 cm, and either extracorporal oophorectomy or cystectomy was performed. Results: No complications occurred. Average blood loss was less than 15 cc; average carbon dioxide insufflation time was less than 20 minutes. Average operating time was 40 minutes, which was significantly less than traditional laparoscopic oophorectomy. The patients were discharged in less than 23 hours. Patient A had a 500-cc dermoid cyst, and subsequently had a normal vaginal delivery at term. Patient B had a 1600-cc cyst removed. She had a cesarian delivery due to cephalopelvic dispro-portion. Pathological analysis of the specimen identified the mass as a dermoid cyst and serous cystadenoma. Patient C had a 3200-cc ovarian cyst. Currently, she is in her 24th week of gestation. Patient D had a 700-cc simple ovarian cyst removed at her 16th week of gestation. Conclusions: Laparoscopic extracorporal oophorectomy requires significantly less CO2 insufflation time and a shorter operation time, hence, decreasing the adverse effects on the fetus. The enlarged second trimester uterus made traditional laparoscopy more complicated. Performing the procedure extracorporally decreased the possibility of operative complications. PMID:11548835

Strategies To Discover the Structural Components of Cyst and Oocyst Walls

PubMed Central

Bushkin, G. Guy; Chatterjee, Aparajita; Robbins, Phillips W.

2013-01-01

Cysts of Giardia lamblia and Entamoeba histolytica and oocysts of Toxoplasma gondii and Cryptosporidium parvum are the infectious and sometimes diagnostic forms of these parasites. To discover the structural components of cyst and oocyst walls, we have developed strategies based upon a few simple assumptions. Briefly, the most abundant wall proteins are identified by monoclonal antibodies or mass spectrometry. Structural components include a sugar polysaccharide (chitin for Entamoeba, β-1,3-linked glucose for Toxoplasma, and β-1,3-linked GalNAc for Giardia) and/or acid-fast lipids (Toxoplasma and Cryptosporidium). Because Entamoeba cysts and Toxoplasma oocysts are difficult to obtain, studies of walls of nonhuman pathogens (E. invadens and Eimeria, respectively) accelerate discovery. Biochemical methods to dissect fungal walls work well for cyst and oocyst walls, although the results are often unexpected. For example, echinocandins, which inhibit glucan synthases and kill fungi, arrest the development of oocyst walls and block their release into the intestinal lumen. Candida walls are coated with mannans, while Entamoeba cysts are coated in a dextran-like glucose polymer. Models for cyst and oocyst walls derive from their structural components and organization within the wall. Cyst walls are composed of chitin fibrils and lectins that bind chitin (Entamoeba) or fibrils of the β-1,3-GalNAc polymer and lectins that bind the polymer (Giardia). Oocyst walls of Toxoplasma have two distinct layers that resemble those of fungi (β-1,3-glucan in the inner layer) or mycobacteria (acid-fast lipids in the outer layer). Oocyst walls of Cryptosporidium have a rigid bilayer of acid-fast lipids and inner layer of oocyst wall proteins. PMID:24096907

Treatments of various otolaryngological cystic diseases by OK-4321: its indications and limitations.

PubMed

Ohta, Nobuo; Fukase, Shigeru; Suzuki, Yusuke; Ishida, Akihiro; Aoyagi, Masaru

2010-11-01

The aim of this study was to evaluate the indications for, and outcomes and limitations of, OK-432 therapy in various otolaryngological cystic diseases. A retrospective clinical study at Yamagata University School of Medicine and the Fukase Clinic in Japan. Between April 1996 and November 2009 we tried OK-432 therapy in 148 patients with otolaryngological cystic diseases. In cases of plunging ranulas, lymphangiomas, branchial cleft cysts, thyroglossal duct cysts, thyroid cysts, and cervical lymphocele, we aspirated as much of the fluid content of each cystic lesion as possible, and we then replaced the volume of aspirated fluid with about half the volume of OK-432 solution. Disappearance of the lesion was observed in 119 of 148 patients (80%). Marked reduction was observed in 20 of 148 patients (14%). Partial reduction was observed in four patients (3%), and no response was seen in five patients (3%). Plunging ranula, lymphangioma, thyroglossal duct cyst, thyroid cyst, auricular hematoma, and salivary mucocele showed better responses to OK-432 therapy than did branchial cleft cyst. Serious complications with OK-432 therapy were infrequent, and the therapy seemed to have no influence on future surgery. Our results confirmed that OK-432 therapy is simple, easy, safe, and effective and can be used as a substitute for surgery in the treatment of various otolaryngological cystic diseases.

Update from the 4th Edition of the World Health Organization Classification of Head and Neck Tumours: Odontogenic and Maxillofacial Bone Tumors.

PubMed

Wright, John M; Vered, Marilena

2017-03-01

The 4th edition of the World Health Organization's Classification of Head and Neck Tumours was published in January of 2017. This article provides a summary of the changes to Chapter 4 Tumours of the oral cavity and mobile tongue and Chapter 8 Odontogenic and maxillofacial bone tumours. Odontogenic cysts which were eliminated from the 3rd 2005 edition were included in the 4th edition as well as other unique allied conditons of the jaws. Many new tumors published since 2005 have been included in the 2017 classification.

Clinicopathological study of 252 jaw bone periapical lesions from a private pathology laboratory.

PubMed

Lin, Hung-Pin; Chen, Hsin-Ming; Yu, Chuan-Hang; Kuo, Ru-Cheng; Kuo, Ying-Shiung; Wang, Yi-Ping

2010-11-01

Periapical lesions are common sequelae of pulp diseases. This retrospective study evaluated the clinical and histopathological features of periapical lesions sent to a private pathology laboratory by dentists in private clinics. Two hundred and fifty-two consecutive cases of periapical lesions were collected from September 2005 to October 2009. Clinical data and histopathological features of these periapical lesions were reviewed and analyzed. The 252 periapical lesions consisted of 128 periapical granulomas, 117 periapical cysts, and seven periapical scars. These 252 lesions were taken from 252 patients (92 men and 160 women; mean age = 43.6 years; range, 9-81 years). Of the 252 periapical lesions, 186 were found in the maxilla and 66 in the mandible. The most common site for periapical lesions was the maxillary anterior region (134 cases, including 73 granulomas, 54 cysts and 7 scars), and the most frequently involved tooth was the maxillary lateral incisor (64 cases, including 29 granulomas, 31 cysts and 4 scars). Of the 117 periapical cysts, 116 were lined by stratified squamous epithelium and one by mucoepidermoid epithelium. Hyaline bodies were discovered in the lining epithelium of four periapical cysts. Odontogenic epithelial rest, cholesterol cleft, foamy histiocytes, hemosiderin-laden macrophages, dystrophic calcification, foreign bodies, and bacterial clumps were found in five, three, nine, two, 28, 10 and one periapical granulomas, respectively, as well as in six, 11, eight, seven, 19, nine and eight periapical cysts, respectively. Granulomas and cysts were the two most common periapical lesions. Periapical lesions occurred more frequently in female patients and in those in their fourth to fifth decades. The most commonly affected site for periapical lesions was the maxillary anterior region, and the most frequently involved tooth was the maxillary lateral incisor. Copyright © 2010 Formosan Medical Association & Elsevier. Published by Elsevier B.V. All rights reserved.

Fine needle aspiration cytology in lesions of the nose, nasal cavity and paranasal sinuses.

PubMed

Gupta, Nalini; Kaur, Jasleen; Srinivasan, Radhika; Das, Ashim; Mohindra, Satyawati; Rajwanshi, Arvind; Nijhawan, Raje

2011-01-01

To assess the spectrum of lesions in the sinonasal region diagnosed on FNAC. This is a retrospective audit of sinonasal lesions diagnosed on FNAC over a period of 12 years (1998-2009). Out of a total of 79,851 FNACs, 158 (0.2%) were from the sinonasal region. FNAC was non-diagnostic in 20 (12.6%) cases. Infective/inflammatory lesions comprised of 30 (19%) cases including non-specific inflammation (19), fungal infection (7), tuberculosis (2), actinomycosis (1) and filariasis (1). Benign cysts (24; 15.2%) included epidermal inclusion cysts, mucocele and aneurysmal bone cyst. Benign bone tumors (4) comprised of giant cell tumor, fibrous dysplasia, chondroma, and osteoblastoma. Other benign tumors included lipoma (6), hemangioma (5), schwannoma (2), meningioma (1), pleomorphic adenoma (1), sebaceous adenoma (1) and other skin adnexal tumors (3). Malignant epithelial tumors (24; 15.2%) included squamous cell carcinoma (10), basal cell carcinoma (5), poorly differentiated carcinoma (4) and metastatic carcinoma (5). Two cases of chordoma and one case each of dermatofibrosarcoma pertuberance and hemangiopericytoma were seen. Sarcomas included sarcoma, not otherwise specified (4), rhabdomyosarcoma (3), osteosarcoma (2), chondrosarcoma (2), leiomyosarcoma (1), malignant fibrous histiocytoma (1), fibrosarcoma (1) and malignant peripheral nerve sheath tumor (1). There were cases of malignant small round cell tumor (11), non-Hodgkin lymphoma (3), plasmacytoma (2) and malignant melanoma (2). A variety of non-neoplastic and neoplastic conditions can involve the sinonasal region. FNAC is a reliable diagnostic procedure in a good number of cases, especially in the light of clinico-radiological data. Copyright © 2011 S. Karger AG, Basel.

[Development of a technique for recovering Giardia cysts and Cryptosporidium oocysts from fresh vegetables].

PubMed

Di Benedetto, M A; Di Piazza, F; Oliveri, R; Cerame, G; Valenti, R; Firenze, A

2006-01-01

Techniques described for recovering Giardia and Cryptosporidium (oo)cysts from fruit and vegetables are generally inadequate and present variable recovery efficience and elevated costs. The aim of our study was to evaluate the recovery efficiency of a simple and economic technique to apply either to berry vegetables, like tomatoes and peppers, or to large leave vegetables, like lettuce and chicory. The method include contamination and further elution of the vegetables. Then sedimentation of (oo)cysts by centrifugation of the eluate of vegetables and their visualization by means of direct immunofluorescence. The higher recovery values for both protozoa were obtained in large leave vegetables with mean data above 70% for Giardia and 76% for Cryptosporidium, whereas the values observed in the berry vegetables were above 43% for Giardia and above 37% for Cryptosporidium on average.

Gorlin syndrome.

PubMed

Devi, Basanti; Behera, Binodini; Patro, Sibasish; Pattnaik, Subhransu S; Puhan, Manas R

2013-05-01

Gorlin Syndrome, a rare genodermatosis, otherwise known as Nevoid basal cell carcinoma syndrome (NBCCS) is a multisystem disease affecting skin, nervous system, eyes, endocrine glands, and bones. It is characterized by multiple basal cell carcinomas, palmoplantar pits, jaw cysts, and bony deformities like kyphoscoliosis and frontal bossing. We would like to report a case of Gorlin syndrome with classical features, as this is a rare genodermatosis.

Factors affecting tumor ablation during high intensity focused ultrasound treatment.

PubMed

Hassanuddin, Aizan; Choi, Jun-Ho; Seo, Dong-Wan; Ryu, Choong Heon; Kim, Su-Hui; Park, Do Hyun; Lee, Sang Soo; Lee, Sung Koo; Kim, Myung-Hwan

2014-07-01

High intensity focused ultrasound (HIFU) utilizes a targeted extracorporeal focused ultrasound beam to ablate neoplastic pancreatic tissue. We used an in vitro model to examine the effects of bone, metallic stents, plastic stents, metal plates, and cyst-like lesions on HIFU treatment. HIFU was delivered to the phantom models implanted with foreign bodies, and the location, shape, and size of the ablated zones were evaluated. Bone and metallic plates reflected the ultrasound beam, shifting the ablation zone from the focal zone to the prefocal area. In the phantoms containing metal stent, plastic stent, and cyst, most of the ablative energy was reflected to the prefocal area by the surface, with the remainder penetrating through the phantom. The area of the ablated margins was significantly larger in size and volume than the intended focal ablation zone. During HIFU therapy, artificial or anatomical barriers could affect the direction of the ultrasound beams, shifting the ablation zone from the focal area to a prefocal site with a larger than expected ablation zone. These factors should be considered prior to HIFU treatment for pancreatic tumors because they could limit ablation success, in addition to causing complications.

Preoperative easily misdiagnosed telangiectatic osteosarcoma: clinical-radiologic-pathologic correlations.

PubMed

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 preoperative diagnosis of TOS.

Suprascapular Nerve Entrapment Caused by Protrusion of an Intraosseous Ganglion of the Glenoid into the Spinoglenoid Notch: A Rare Cause of Posterior Shoulder Pain

PubMed Central

Terabayashi, Nobuo; Nishimoto, Yutaka; Akiyama, Haruhiko

2017-01-01

We describe a case of suprascapular nerve entrapment caused by protrusion of an intraosseous ganglion of the glenoid into the spinoglenoid notch. A 47-year-old man with left shoulder pain developed an intraosseous cyst in the left glenoid, which came into contact with the suprascapular nerve. The area at which the patient experienced spontaneous shoulder pain was innervated by the suprascapular nerve, and 1% xylocaine injection into the spinoglenoid notch under ultrasonographic guidance relieved the pain. Therefore, we concluded that the protrusion of an intraosseous cyst of the glenoid into the spinoglenoid notch was a cause of the pain, and performed curettage. Consequently, the shoulder pain was resolved promptly without suprascapular nerve complications, and the cyst was histologically diagnosed as an intraosseous ganglion. This case demonstrated that the intraosseous ganglion of the glenoid was a benign lesion but could be a cause of suprascapular nerve entrapment syndrome. Curettage is a useful treatment option for a ganglion inside bone and very close to the suprascapular nerve. PMID:28620557

Uncommon localizations of hydatid cyst. Review of the literature.

PubMed

Salamone, G; Licari, L; Randisi, B; Falco, N; Tutino, R; Vaglica, A; Gullo, R; Porello, C; Cocorullo, G; Gulotta, G

2016-01-01

Hydatid disease is an endemic anthropozoonosis with usual localization in liver and lungs. Rarely it localizes in uncommon sites as spleen, skeleton, kidney, brain, cardiac muscle, peritoneum, sub cutis. Complications of uncommon localizations are the same that for usual ones. Review of the literature on rare and atypical localization of hydatid cysts in soft tissues. Key-words used on Pub-Med [(echinococ OR hydatid) AND (soft tissue OR subcutaneous OR cutaneous)] without time limit. There were found 282 articles; 242 were excluded because of muscular or bone localizations. 40 were coherent. Different variables are taken into account: age, sex, geographic area, anatomic localization of the cyst, dimension, symptoms, signs, mobility, blood exams and specific serological tests, imaging techniques for diagnosis, existing of septa in the structure, treatment, anaesthesia, spillage, neo-adjuvant and adjuvant treatment, follow-up period, recurrent lesions. It would be useful create an homogeneous and standardized collection of data of these rare and potentially life-threatening conditions in order to create guide-line of diagnostic and therapeutic process and create (or adopt) unique classification of the lesions.

A new method for studying population genetics of cyst nematodes based on Pool-Seq and genomewide allele frequency analysis.

PubMed

Mimee, Benjamin; Duceppe, Marc-Olivier; Véronneau, Pierre-Yves; Lafond-Lapalme, Joël; Jean, Martine; Belzile, François; Bélair, Guy

2015-11-01

Cyst nematodes are important agricultural pests responsible for billions of dollars of losses each year. Plant resistance is the most effective management tool, but it requires a close monitoring of population genetics. Current technologies for pathotyping and genotyping cyst nematodes are time-consuming, expensive and imprecise. In this study, we capitalized on the reproduction mode of cyst nematodes to develop a simple population genetic analysis pipeline based on genotyping-by-sequencing and Pool-Seq. This method yielded thousands of SNPs and allowed us to study the relationships between populations of different origins or pathotypes. Validation of the method on well-characterized populations also demonstrated that it was a powerful and accurate tool for population genetics. The genomewide allele frequencies of 23 populations of golden nematode, from nine countries and representing the five known pathotypes, were compared. A clear separation of the pathotypes and fine genetic relationships between and among global populations were obtained using this method. In addition to being powerful, this tool has proven to be very time- and cost-efficient and could be applied to other cyst nematode species. © 2015 Her Majesty the Queen in Right of Canada Molecular Ecology Resources © 2015 John Wiley & Sons Ltd Reproduced with the permission of the Minister of Agriculture and Agri-food.

Noninvasive treatment choice for an aged down syndrome patient presenting a residual periapical cyst.

PubMed

Sperandio, Felipe Fornias; Carli, Marina Lara de; Guimaräes, Eduardo Pereira; Pereira, Alessandro Antônio Costa; Hanemann, Joäo Adolfo Costa

2014-03-01

This is the first report to illustrate the marsupialization as an effective treatment for a Down Syndrome (DS) patient presenting a residual periapical cyst. These cysts occur within the alveolar ridge, usually at the local site of a previously extracted tooth that did not received proper curettage; usually the surgical excision of a cyst and also the vigorous curettage of a socket is very simple, if not for the fact that mentally disabled patients require rapid and non-stressful procedures. The 54-year-old DS patient represented herein received a minimally invasive marsupialization under local anesthesia. Due to the large extent of the lesion, the acrylic resin drain was maintained for 30 days. Through the following period, a daily irrigation of the cystic cavity with saline solution was carried out to prevent a secondary infection within the cystic cavity. A follow-up of 16 months showed no signs of recurrence. Marsupialization of residual periapical cyst is completely effective and safe, even for a DS patient that is considered to be at an advanced age. Marsupialization poses as a minimally invasive choice for mentally disabled patients, even when presenting advanced ages; treatment success was stated by the easy clinical conduct, uneventful postoperative situation and the lack of recurrence along 16 months of follow-up.

Oxygen-rich hierarchical porous carbon derived from artemia cyst shells with superior electrochemical performance.

PubMed

Zhao, Yufeng; Ran, Wei; He, Jing; Song, Yanfang; Zhang, Chunming; Xiong, Ding-Bang; Gao, Faming; Wu, Jinsong; Xia, Yongyao

2015-01-21

In this study, three-dimensional (3D) hierarchical porous carbon with abundant functional groups is produced through a very simple low-cost carbonization of Artemia cyst shells. The unique hierarchical porous structure of this material, combining large numbers of micropores and macropores, as well as reasonable amount of mesopores, is proven favorable to capacitive behavior. The abundant oxygen functional groups from the natural carbon precursor contribute stable pseudocapacitance. As-prepared sample exhibits high specific capacitance (369 F g(-1) in 1 M H2SO4 and 349 F g(-1) in 6 M KOH), excellent cycling stability with capacitance retention of 100% over 10 000 cycles, and promising rate performance. This work not only describes a simple way to produce high-performance carbon electrode materials for practical application, but also inspires an idea for future structure design of porous carbon.

Solid Variant of an Aneurysmal Bone Cyst of the Thoracic Spine.

PubMed

Mehta, Varshil; Padalkar, Pravin; Kale, Maya; Kathare, Ambadas

2017-05-01

The solid variant of an aneurysmal bone cyst (ABC) has been observed very rarely, especially those involving the spine. In this case report, we present a very unusual tumour of the thoracic spine which was managed by 360˚ decompression via posterior-only approach and stabilization. A 16-year-old boy presented to us with a sudden onset of weakness in both lower limbs leading to paraplegia. He also had a history of back and chest pain over the past one year. A collapse of the T5 vertebrae on plain radiograph was observed. The patient was immediately shifted to the operation theatre with an initial plan of a total en bloc spondylectomy of the T5. However, intraoperatively, histology favored a solid-ABC variant rather than a spindle cell tumour or giant cell tumour. Thus, the initial plan was revised to a 360˚ decompression without resecting the body en bloc via a posterolateral approach. After surgery, complete resolution of his sensory and motor dysfunction was achieved. His chest and back pain also resolved. The diseased vertebral body gradually healed and new bone formation was seen at 18 months postoperatively. This case report concludes that a solid variant of an ABC should be considered as a differential diagnosis for tumours involving the spine. An intraoperative frozen section procedure should be undertaken, especially during emergency situations. Early diagnosis and appropriate surgical management play an important role in the successful management of a solid variant of ABC.

Pyogenic granuloma associated with periodontal abscess and bone loss - A rare case report

PubMed Central

Panseriya, Bhrugesh J.; Hungund, Shital

2011-01-01

A diverse group of the pathologic process can produce the enlargement of soft tissues in the oral cavity and often present a diagnostic challenge. This soft tissue enlargement may represent a variation of the normal anatomic structure, inflammatory reaction, cyst, neoplasm, and developmental anomalies. A group of reactive hyperplasias, which develop in response to chronic recurring tissue injury that stimulates an excessive tissue repair response. The pyogenic granuloma (PG) is a reactive enlargement that is an inflammatory response to local irritation such as calculus, a fractured tooth, rough dental restoration, and foreign materials or hormonal (pregnancy tumor) and rarely associated with bone loss. This paper presents a rare case of PG associated with periodontal abscess and bone loss in a 30-year-old male. PMID:22090773

Pyogenic granuloma associated with periodontal abscess and bone loss - A rare case report.

PubMed

Panseriya, Bhrugesh J; Hungund, Shital

2011-07-01

A diverse group of the pathologic process can produce the enlargement of soft tissues in the oral cavity and often present a diagnostic challenge. This soft tissue enlargement may represent a variation of the normal anatomic structure, inflammatory reaction, cyst, neoplasm, and developmental anomalies. A group of reactive hyperplasias, which develop in response to chronic recurring tissue injury that stimulates an excessive tissue repair response. The pyogenic granuloma (PG) is a reactive enlargement that is an inflammatory response to local irritation such as calculus, a fractured tooth, rough dental restoration, and foreign materials or hormonal (pregnancy tumor) and rarely associated with bone loss. This paper presents a rare case of PG associated with periodontal abscess and bone loss in a 30-year-old male.

An ultrastructural analysis of cyst wall development in the metacestode of Hymenolepis diminuta (Cestoda).

PubMed

Richards, K S; Arme, C

1984-12-01

A series of development stages (I-XI) have been devised to describe the development of the cyst wall of the metacestode of Hymenolepis diminuta. The cyst wall possesses tegumentary, muscular, fibrous and inner cyst tissues, the developmental rates and differentiation patterns of which are not identical. The tegumentary tissue differentiates posteriorly. Its microvillus-bearing distal cytoplasm remains simple until scolex retraction, after which rapid increase in depth followed by vacuolation occurs and basal membrane infoldings surround Phase 3 fibrogenesis fibrils. Senescence, which also affects the tegumentary cytons, then ensues. The muscle system development is posteriad and maturation, completed before scolex retraction, is followed by myocyton senescence. Posteriorly differentiated fibroblasts commence Phase 1 fibrogenesis after scolex retraction and the primary fibrous zone is fully established within approximately 6 days. Phase 2 and 3 fibrogenesis develop centrifugally, the fibrils of Phase 2 surrounding the tegumentary cytons and myocytons prior to their senescence, and those of Phase 3 lying more peripherally. The inner cyst tissue, established posteriorly, differentiates anteriorly, centripetally and early, the penultimate stage commencing just before scolex retraction, about 6 days after which the final maturation junctional complexes start development. Neither in vitro excystment nor infectivity of the definitive host can be satisfactorily achieved before the initial development of the primary fibrous zone. This may play a skeletal role during excystment, and is shown to be unaffected by the digestive enzymes which cause loss of cytoplasmic integrity in the outer regions of the cyst.

Efficacy of decalcified freeze-dried bone allograft in the regeneration of small osseous defect: A comparative study

PubMed Central

Jaiswal, Yashmi; Kumar, Sanjeev; Mishra, Vijay; Bansal, Puneet; Anand, Kumar Rakshak; Singh, Sukumar

2017-01-01

Aim: To access the efficacy of decalcified freeze-dried bone allograft (DFDBA) in the regeneration of bone following small osseous defect in minor oral surgery. Objectives: To evaluate the ability of DFDBA to enhance the rate of wound healing and assess radiographic bone density, pain, and infection preoperatively and postoperatively. Materials and Methods: Twenty patients with cysts were assessed. Ten patients were filled with DFDBA (Group 1) and ten without bone graft (Group 2), respectively. Radiographic bone density was assessed on preoperative, intraoperative, and postoperative radiographs on 1st day, 3rd month, and at 6th month using Adobe Photoshop CS6 - Grayscale histogram. Results: Bone density in Group 1 was found to be significantly higher than in Group 2 on 3rd and 6th month postoperatively with a P = 0.024 and P = 0.016 which was statistically significant. The percentage increase in bone density between both the group was determined and yielded no difference over a period of time, but the difference in percentage increase was markedly higher in Group 1 compared to Group 2 at all the time intervals. Conclusion: Bone formed as depicted by bone density is significantly higher when DFDBA is used in small bony defects. PMID:29386818

[Odontogenic adenomatoid tumor. Apropos of 2 cases in Dakar].

PubMed

Cantaloube, D; Larroque, G; Ahounou, J R; Rives, J M; Seurat, P

1987-01-01

Two cases of large adenomatoid odontogenic tumor seen recently in Senegal are thought to be the first cases of this type reported in West Africa. One patient was a 25 year old woman and the other an 11 year old boy, the clinical history and lesions being identical in both cases. Simple enucleation appeared to be the treatment of choice in view of the constantly reported benign nature of these tumors. It is difficult, or almost impossible however, to differentiate this tumor from dentigerous cyst on radiology, justifying routine minute pathologic examination of all operated paradental cysts.

New tumour entities in the 4th edition of the World Health Organization Classification of Head and Neck tumours: odontogenic and maxillofacial bone tumours.

PubMed

Speight, Paul M; Takata, Takashi

2018-03-01

The latest (4th) edition of the World Health Organization Classification of Head and Neck tumours has recently been published with a number of significant changes across all tumour sites. In particular, there has been a major attempt to simplify classifications and to use defining criteria which can be used globally in all situations, avoiding wherever possible the use of complex molecular techniques which may not be affordable or widely available. This review summarises the changes in Chapter 8: Odontogenic and maxillofacial bone lesions. The most significant change is the re-introduction of the classification of the odontogenic cysts, restoring this books status as the only text which classifies and defines the full range of lesions of the odontogenic tissues. The consensus group considered carefully the terminology of lesions and were concerned to ensure that the names used properly reflected the best evidence regarding the true nature of specific entities. For this reason, this new edition restores the odontogenic keratocyst and calcifying odontogenic cyst to the classification of odontogenic cysts and rejects the previous terminology (keratocystic odontogenic tumour and calcifying cystic odontogenic tumour) which were intended to suggest that they are true neoplasms. New entities which have been introduced include the sclerosing odontogenic carcinoma and primordial odontogenic tumour. In addition, some previously poorly defined lesions have been removed, including the ameloblastic fibrodentinoma, ameloblastic fibro-odontoma, which are probably developing odontomas, and the odontoameloblastoma, which is not regarded as an entity. Finally, the terminology "cemento" has been restored to cemento-ossifying fibroma and cemento-osseous dysplasias, to properly reflect that they are of odontogenic origin and are found in the tooth-bearing areas of the jaws.

Comparison of three surgical treatment options for unicameral bone cysts in humerus.

PubMed

Mavčič, Blaž; Saraph, Vinay; Gilg, Magdalena M; Bergovec, Marko; Brecelj, Janez; Leithner, Andreas

2018-04-23

Treatment of unicameral bone cysts (UBC) in the humerus with drainage screws is scarcely reported in the literature. The aim of this retrospective study was to compare drainage screws and alternative treatment methods with respect to the number of required surgical procedures to achieve sufficient UBC healing, postoperative fractures/recurrences/complications, and radiological outcome. Medical archives of two tertiary orthopedic referral centers were screened for all patients who were treated surgically for humeral UBC in the period 1991-2015 with a histologically/cytologically confirmed diagnosis. Sex, age, all surgical procedures, fractures, complications, recurrences, and the final radiological outcome were compared between patients treated with drainage screws, elastic intramedullary nails, or curettage with optional grafting. The study included 106 operated patients with a mean age of 10.3 years, with a mean follow-up of 5.7 years. The average number of UBC-related surgical procedures in sex-matched and age-matched treatment groups was 2.7 with drainage screws, 2.8 with intramedullary nails, and 3.5 with curettage/grafting (P=0.54). Intramedullary nails (odds ratio 0.20) and older age (odds ratio for each year 0.83) predicted a lower risk of postoperative UBC recurrence. Patients with drainage screws had the highest UBC recurrence rates and the lowest rates of changed initial treatment method. There was no difference between the treatment groups in the postoperative fracture rate, complications, or the final radiological outcome. UBC treatment in the humerus therefore requires approximately three surgical procedures, irrespective of the treatment modality chosen. Adding an elastic intramedullary nail to a humeral UBC cyst may reduce recurrence risk and prevent further fractures. Level III - therapeutic retrospective comparative study.

Rotator cuff repair with all-suture anchors: a midterm magnetic resonance imaging evaluation of repair integrity and cyst formation.

PubMed

Van der Bracht, Hans; Van den Langenbergh, Tom; Pouillon, Marc; Verhasselt, Skrallan; Verniers, Philippe; Stoffelen, Danny

2018-05-22

This study investigated the feasibility and safety of all-suture anchors in arthroscopic rotator cuff repair. All patients were diagnosed with a rotator cuff tear by ultrasound or magnetic resonance imaging (MRI). Patients with partial tears, massive tears, subscapularis tears, or previous shoulder surgery, were excluded. MRI and clinical outcome were investigated in all patients at 1.58 years (range, 1.0-2.0 years) after rotator cuff repair with all-suture anchors (prospective case series). Integrity of the cuff repair, cyst formation (encapsulated fluid signal around the anchor), ingrowth of the bone into the anchor, and integrity of the bone tunnel border were evaluated for 47 anchors. Clinical results were evaluated using the Constant-Murley score. An MRI evaluation was performed in 20 patients at 1.58 years (range, 1.0-2.0 years) after rotator cuff repair with all-suture anchors. MRI evaluation showed a very small rim of fluid around 10% of the anchors. None of the anchors showed cyst formation with fluid diameter more than twice the anchor diameter. In approximately 90% of the anchors, no fluid could be detected between the anchors and the edge of the bony tunnel. Full rotator cuff integrity was seen in 19 patients. Only 1 patient sustained a retear. Clinical results comparable with an arthroscopic rotator cuff repair using classic anchors were seen. This prospective clinical cohort study shows promising early radiographic and clinical results after arthroscopic rotator cuff repair using all-suture anchors. Copyright © 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Comparison of Giardia lamblia and Giardia muris cyst inactivation by ozone.

PubMed

Finch, G R; Black, E K; Labatiuk, C W; Gyürék, L; Belosevic, M

1993-11-01

Inactivation of Giardia lamblia and Giardia muris cysts was compared by using an ozone demand-free 0.05 M phosphate buffer in bench-scale batch reactors at 22 degrees C. Ozone was added to each trial from a concentrated stock solution for contact times of 2 and 5 min. The viability of the control and treated cysts was evaluated by using the C3H/HeN mouse and Mongolian gerbil models for G. muris and G. lamblia, respectively. The resistance of G. lamblia to ozone was not significantly different from that of G. muris under the study conditions, contrary to previously reported data that suggested G. lamblia was significantly more sensitive to ozone than G. muris was. The simple Ct value for 2 log unit inactivation of G. lamblia was 2.4 times higher than the Ct value recommended by the Surface Water Treatment Rule.

[Dysplastic cysts of the liver: our experience].

PubMed

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.

Nanoceramics on osteoblast proliferation and differentiation in bone tissue engineering.

PubMed

Sethu, Sai Nievethitha; Namashivayam, Subhapradha; Devendran, Saravanan; Nagarajan, Selvamurugan; Tsai, Wei-Bor; Narashiman, Srinivasan; Ramachandran, Murugesan; Ambigapathi, Moorthi

2017-05-01

Bone, a highly dynamic connective tissue, consist of a bioorganic phase comprising osteogenic cells and proteins which lies over an inorganic phase predominantly made of CaPO 4 (biological apatite). Injury to bone can be due to mechanical, metabolic or inflammatory agents also owing pathological conditions like fractures, osteomyelitis, osteolysis or cysts may arise in enameloid, chondroid, cementum, or chondroid bone which forms the intermediate tissues of the body. Bone tissue engineering (BTE) applies bioactive scaffolds, host cells and osteogenic signals for restoring damaged or diseased tissues. Various bioceramics used in BTE can be bioactive (like glass ceramics and hydroxyapatite bioactive glass), bioresorbable (like tricalcium phosphates) or bioinert (like zirconia and alumina). Limiting the size of these materials to nano-scale has resulted in a higher surface area to volume ratio thereby improving multi-functionality, solubility, surface catalytic activity, high heat and electrical conductivity. Nanoceramics have been found to induce osteoconduction, osteointegration, osteogenesis and osteoinduction. The present review aims at summarizing the interactions of nanoceramics and osteoblast/stem cells for promoting the proliferation and differentiation of the osteoblast cells by nanoceramics as superior bone substitutes in bone tissue engineering applications. Copyright © 2017 Elsevier B.V. All rights reserved.

Spontaneous telangiectatic osteosarcoma in a rhesus macaque (Macaca mulatta).

PubMed

Goldschmidt, B; Calado, M I Z; Resende, F C; Caldas, R M; Pinto, L W; Lopes, C A A; França, F G O; Meireles, B S; Souza, I V

2017-04-01

Osteosarcoma (OS) is the most common type of bone cancer, especially in young. Telangiectatic osteosarcoma (TO) is a rare variant of OS, and hence, its occurrence, presentation, and prognosis are poorly understood. A 4-year-old female rhesus monkey presenting lameness and swelling was examined for a mass on the right humerus. Radiography revealed fracture and disorganized structure of bone tissue. Histopathological examination revealed malignant neoplasm composed of anaplastic osteoblasts, which invaded the bone marrow and surrounded blood-filled cysts in the epiphysis and diaphysis forming septa. Cytogenetic analysis showed aneuploid cells, supernumerary AgNORs, and a marker fragment. The neoplasm was diagnosed as TO. To our knowledge, the occurrence of TO and its cytogenetic analysis were reported for the first time in non-human primates. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Cystic urogenital anomalies in ferrets (Mustela putorius furo).

PubMed

Li, X; Fox, J G; Erdman, S E; Lipman, N S; Murphy, J C

1996-03-01

Single or multiple semispherical to bilobulated fluid-filled cystic structures of variable size were observed on the dorsal aspects of the urinary bladder of four male and two female ferrets (Mustela putorius furo). All ferrets had been neutered. On physical examination, the cysts were palpated as caudal abdominal masses. Three of the six ferrets presented with dysuria, and two ferrets had signs compatible with endocrine dysfunction. Adrenal cortical hyperplasia or neoplasia were observed in all of the five ferrets examined. Sex hormones assayed in one of the six ferrets revealed elevated levels of serum estrodiol. The posterior aspect of the cysts was located on and/or attached to the trigone or neck of the bladder, with variable intraluminal communication with the bladder and/or the urethra. The anterior aspect of the cysts projected dorsally or dorsocranially into the caudal abdomen. The cysts were thin walled and contained urinelike fluid (n = 5) or viscous yellow fluid (n = 1). Histologically, the cyst walls were composed of three layers, epithelium, muscle, and serosa, with fibrovascular stroma between layers. The epithelium consisted of simple to stratified transitional, columnar, or squamous epithelial cells. The muscular layer consisted of intermittent bundles and/or single to double layers of continuous to discontinuous smooth muscle. The serosal layer consisted of loose fibrous stroma covered by flattened mesothelial cells. The cystic anomalies in these ferrets were most likely derived from the urogenital glands/ducts or other remnants.

Retrospective study of sonographic findings in bone involvement associated with rotator cuff calcific tendinopathy: preliminary results of a case series*

PubMed Central

Nogueira-Barbosa, Marcello H.; Gregio-Junior, Everaldo; Lorenzato, Mario Muller

2015-01-01

Objective The present study was aimed at investigating bone involvement secondary to rotator cuff calcific tendonitis at ultrasonography. Materials and Methods Retrospective study of a case series. The authors reviewed shoulder ultrasonography reports of 141 patients diagnosed with rotator cuff calcific tendonitis, collected from the computer-based data records of their institution over a four-year period. Imaging findings were retrospectively and consensually analyzed by two experienced musculoskeletal radiologists looking for bone involvement associated with calcific tendonitis. Only the cases confirmed by computed tomography were considered for descriptive analysis. Results Sonographic findings of calcific tendinopathy with bone involvement were observed in 7/141 (~ 5%) patients (mean age, 50.9 years; age range, 42-58 years; 42% female). Cortical bone erosion adjacent to tendon calcification was the most common finding, observed in 7/7 cases. Signs of intraosseous migration were found in 3/7 cases, and subcortical cysts in 2/7 cases. The findings were confirmed by computed tomography. Calcifications associated with bone abnormalities showed no acoustic shadowing at ultrasonography, favoring the hypothesis of resorption phase of the disease. Conclusion Preliminary results of the present study suggest that ultrasonography can identify bone abnormalities secondary to rotator cuff calcific tendinopathy, particularly the presence of cortical bone erosion. PMID:26811551

Retrospective study of sonographic findings in bone involvement associated with rotator cuff calcific tendinopathy: preliminary results of a case series.

PubMed

Nogueira-Barbosa, Marcello H; Gregio-Junior, Everaldo; Lorenzato, Mario Muller

2015-01-01

The present study was aimed at investigating bone involvement secondary to rotator cuff calcific tendonitis at ultrasonography. Retrospective study of a case series. The authors reviewed shoulder ultrasonography reports of 141 patients diagnosed with rotator cuff calcific tendonitis, collected from the computer-based data records of their institution over a four-year period. Imaging findings were retrospectively and consensually analyzed by two experienced musculoskeletal radiologists looking for bone involvement associated with calcific tendonitis. Only the cases confirmed by computed tomography were considered for descriptive analysis. Sonographic findings of calcific tendinopathy with bone involvement were observed in 7/141 (~ 5%) patients (mean age, 50.9 years; age range, 42-58 years; 42% female). Cortical bone erosion adjacent to tendon calcification was the most common finding, observed in 7/7 cases. Signs of intraosseous migration were found in 3/7 cases, and subcortical cysts in 2/7 cases. The findings were confirmed by computed tomography. Calcifications associated with bone abnormalities showed no acoustic shadowing at ultrasonography, favoring the hypothesis of resorption phase of the disease. Preliminary results of the present study suggest that ultrasonography can identify bone abnormalities secondary to rotator cuff calcific tendinopathy, particularly the presence of cortical bone erosion.

Skeletal pathology and variable anatomy in elephant feet assessed using computed tomography

PubMed Central

Dixon, Jonathon J.I.; Warren-Smith, Chris; Hutchinson, John R.; Weller, Renate

2017-01-01

Foot problems are a major cause of morbidity and mortality in elephants, but are underreported due to difficulties in diagnosis, particularly of conditions affecting the bones and internal structures. Here we evaluate post-mortem computer tomographic (CT) scans of 52 feet from 21 elephants (seven African Loxodonta africana and 14 Asian Elephas maximus), describing both pathology and variant anatomy (including the appearance of phalangeal and sesamoid bones) that could be mistaken for disease. We found all the elephants in our study to have pathology of some type in at least one foot. The most common pathological changes observed were bone remodelling, enthesopathy, osseous cyst-like lesions, and osteoarthritis, with soft tissue mineralisation, osteitis, infectious osteoarthriti, subluxation, fracture and enostoses observed less frequently. Most feet had multiple categories of pathological change (81% with two or more diagnoses, versus 10% with a single diagnosis, and 9% without significant pathology). Much of the pathological change was focused over the middle/lateral digits, which bear most weight and experience high peak pressures during walking. We found remodelling and osteoarthritis to be correlated with increasing age, more enthesopathy in Asian elephants, and more cyst-like lesions in females. We also observed multipartite, missing and misshapen phalanges as common and apparently incidental findings. The proximal (paired) sesamoids can appear fused or absent, and the predigits (radial/tibial sesamoids) can be variably ossified, though are significantly more ossified in Asian elephants. Our study reinforces the need for regular examination and radiography of elephant feet to monitor for pathology and as a tool for improving welfare. PMID:28123909

Controlled release of celecoxib inhibits inflammation, bone cysts and osteophyte formation in a preclinical model of osteoarthritis.

PubMed

Tellegen, A R; Rudnik-Jansen, I; Pouran, B; de Visser, H M; Weinans, H H; Thomas, R E; Kik, M J L; Grinwis, G C M; Thies, J C; Woike, N; Mihov, G; Emans, P J; Meij, B P; Creemers, L B; Tryfonidou, M A

2018-11-01

Major hallmarks of osteoarthritis (OA) are cartilage degeneration, inflammation and osteophyte formation. COX-2 inhibitors counteract inflammation-related pain, but their prolonged oral use entails the risk for side effects. Local and prolonged administration in biocompatible and degradable drug delivery biomaterials could offer an efficient and safe treatment for the long-term management of OA symptoms. Therefore, we evaluated the disease-modifying effects and the optimal dose of polyesteramide microspheres delivering the COX-2 inhibitor celecoxib in a rat OA model. Four weeks after OA induction by anterior cruciate ligament transection and partial medial meniscectomy, 8-week-old female rats (n = 6/group) were injected intra-articular with celecoxib-loaded microspheres at three dosages (0.03, 0.23 or 0.39 mg). Unloaded microspheres served as control. During the 16-week follow-up, static weight bearing and plasma celecoxib concentrations were monitored. Post-mortem, micro-computed tomography and knee joint histology determined progression of synovitis, osteophyte formation, subchondral bone changes, and cartilage integrity. Systemic celecoxib levels were below the detection limit 6 days upon delivery. Systemic and local adverse effects were absent. Local delivery of celecoxib reduced the formation of osteophytes, subchondral sclerosis, bone cysts and calcified loose bodies, and reduced synovial inflammation, while cartilage histology was unaffected. Even though the effects on pain could not be evualated directly in the current model, our results suggest the application of celecoxib-loaded microspheres holds promise as novel, safe and effective treatment for inflammation and pain in OA.

Ecto-nucleotidases Activities in the Contents of Ovarian Endometriomas: Potential Biomarkers of Endometriosis

PubMed Central

Texidó, Laura; Romero, Claudia; García-Valero, José; Fernández Montoli, M. Eulalia; Baixeras, Núria; Condom, Enric; Ponce, Jordi; García-Tejedor, Amparo; Martín-Satué, Mireia

2014-01-01

Endometriosis, defined as the growth of endometrial tissue outside the uterus, is a common gynecologic condition affecting millions of women worldwide. It is an inflammatory, estrogen-dependent complex disorder, with broad symptomatic variability, pelvic pain, and infertility being the main characteristics. Ovarian endometriomas are frequently developed in women with endometriosis. Late diagnosis is one of the main problems of endometriosis; thus, it is important to identify biomarkers for early diagnosis. The aim of the present work is to evaluate the ecto-nucleotidases activities in the contents of endometriomas. These enzymes, through the regulation of extracellular ATP and adenosine levels, are key enzymes in inflammatory processes, and their expression has been previously characterized in human endometrium. To achieve our objective, the echo-guided aspirated fluids of endometriomas were analyzed by evaluating the ecto-nucleotidases activities and compared with simple cysts. Our results show that enzyme activities are quantifiable in the ovarian cysts aspirates and that endometriomas show significantly higher ecto-nucleotidases activities than simple cysts (5.5-fold increase for ATPase and 20-fold for ADPase), thus being possible candidates for new endometriosis biomarkers. Moreover, we demonstrate the presence of ecto-nucleotidases bearing exosomes in these fluids. These results add up to the knowledge of the physiopathologic mechanisms underlying endometriosis and, open up a promising new field of study. PMID:25276049

The characterization of small hypoattenuating renal masses on contrast-enhanced CT☆

PubMed Central

Patel, Neesha S.; Poder, Liina; Wang, Zhen J.; Yeh, Benjamin M.; Qayyum, Aliya; Jin, Hua; Coakley, Fergus V.

2011-01-01

Purpose To determine if small hypoattenuating renal masses can be characterized as simple cysts or renal cell carcinomas on contrast-enhanced computed tomography (CT). Materials and methods We retrospectively identified 20 small (≤1.5 cm) hypoattenuating renal masses seen on contrast enhanced CT, consisting of 14 simple cysts and six renal cell carcinomas. Three independent readers recorded subjective visual impression (five-point scale from 1=definitely fluid to 5=definitely solid), CT attenuation, border (well circumscribed or ill defined), and shape (ovoid or irregular) for each lesion. Results The overall area under the receiver operator characteristic curves for subjective visual impression, CT attenuation, border, and shape were 0.97, 0.82, 0.59, and 0.55, respectively. Using dichotomized ratings (1–2=cyst and 3–5=carcinoma), subjective impression had a sensitivity and specificity of 100% and 79–100%, respectively, for the diagnosis of renal cell carcinoma. Using a threshold of 50 Hounsfield Units (HU) or more, CT attenuation had a sensitivity and specificity of 100% and 43–64%, respectively. Conclusion Small hypoattenuating renal masses can be characterized with reasonable accuracy by subjective impression and CT attenuation; lesions that appear solid on visual inspection or have an attenuation value of 50 HU or more are likely to be renal cell carcinoma. © 2009 Elsevier Inc. All rights reserved. PMID:19559352

A Case of Atypical McCune-Albright Syndrome with Vaginal Bleeding

PubMed Central

Rostampour, Noushin; Hashemipour, Mahin; Kelishadi, Roya; Hovsepian, Silva; Hekmatnia, Ali

2011-01-01

Background McCune-Albright syndrome (MAS) is a rare non-inherited disorder characterized by the clinical triad of precocious puberty, cafe-au-lait skin lesions, and fibrous dysplasia of bone. Case Presentation We report a girl with MAS, presenting initially with vaginal bleeding at the age of 17 months. Ultrasonography revealed unilateral ovarian cysts and ureteral and ovarian enlargement. Considering the clinical and paraclinical findings, the patient diagnosed as a case of gonadotropin-independent precocious puberty was treated with medroxy-progestrone acetate (MPA) for three months. During the follow up, recurrent episodes of bleeding, ovarian activation and cyst formation, as well as breast size development were reported. At the age of 5.5 years, fibrous dysplasia was detected, which in coexistence with precocious puberty confirmed the diagnosis of MAS. The patient had no cafe-au-lait skin macles during follow up. Conclusion Considering that clinical manifestations of MAS appear later in the course of recurrent periods of ovarian activation and cyst formation, a careful clinical observation and follow up of patients is necessary and the diagnosis of MAS must be kept in mind in cases with gonadotropin-independent precocious puberty. PMID:23056821

Ultrasound diagnosis and evaluation of fetal tumors.

PubMed

Kurjak, A; Zalud, I; Jurković, D; Alfirević, Z; Tomić, K

1989-01-01

Fetal tumors represent a rare and heterogeneous group of abnormalities. A significant proportion of them can now be diagnosed by using modern high resolution ultrasonic equipment. During 15 years there were 57 fetal tumours detected prenatally. Hygroma colli is the most frequent fetal tumor. It should be emphasized that cystic hygroma generally carries poor prognosis, and after an early diagnosis, termination of pregnancy is most logical approach. Contrary to the general opinion our own experience showed that there are cases in which prognosis could be much better as illustrated with our 4 cases. All of the treated fetuses, after surgical resection, had normal development and are now on the age of 5, 4, 3 and 2 years of life. An ovarian cyst can be suspected if a fluid-filled structure is visualized next to a fetal kidney and female external genitalia are recognizable. The ultrasound finding suggestive of an ovarian cyst is that of a pelvic cystic or complex mass in a female fetus with normal kidneys and urinary bladder and a normal gastrointestinal tract. In most cases, the normal course of fetal ovarian cyst is a spontaneous intrauterine or postnatal involution. Prenatal diagnosis improves neonatal outcome by allowing an appropriate choice of the optimal time, mode and place of delivery in order to avoid accidental and unexpected intrapartum and postnatal complications. The management of a fetus affected by an ovarian cyst depends on the size and on the echo-pattern of the cyst. It remains unclear whether in utero puncture of the cyst and evacuation of its content should be justified in cases of particularly large ovarian cyst. In our opinion intrauterine procedure can be attempted in the presence of large cyst fulfilling the fetal abdomen. We have treated actively two cases of large ovarian cysts by ultrasonically guided puncture before delivery and both fetuses underwent surgery later without complications. If properly performed puncture of the cyst seems to be a low risk procedure in comparison to potential problems that cyst may cause to the fetus or by causing dystocia. Sacrococcygeal teratoma represents the most frequent tumor in the fetuses and newborns. Prenatal diagnosis is usually simple and based on the visualization of tumor of variable size and internal structure. Tumors may appear as completely cystic, mixed or predominantly solid with obvious calcifications. Cystic and calcified tumors are most likely to be benign. Obstetrical management of sacrococcygeal teratoma depends on numerous parameters which include size and texture of the tumor, and gestational age.(ABSTRACT TRUNCATED AT 400 WORDS)

[Progress in the diagnosis of florid cemento-osseous dysplasia].

PubMed

Zhang, P Y; Xiao, C

2018-04-09

Florid cemento-osseous dysplasia (FLCOD) is a rare, extensive bone metabolism disorder, which occurs only in the jaw bone. It is usually asymptomatic for a long time and discovered incidentally during a radiological examination. The characteristics of FLCOD in the initial stages are similar to those of periapical granuloma or jaw cyst, which may lead to misdiagnosis. After the lesion is mature, the imaging findings show that radiopaque with a thin radiolucent peripheral halo, which is crucial for the diagnosis of FLCOD, but other jaw lesions have similar imaging findings. Due to the poor blood supply of the lesion, the alveolar bone of root apices of vital teeth is slow to heal after trauma, increasing the chance of infection, which can lead to the osteomyelitis of the jaws and emerge sequestrum. This paper reviews the aspects of pathogenesis, clinical characteristics, diagnosis, differential diagnosis and treatment.

Distant metastasis of intraosseous dentinogenic ghost cell tumour to the donor site of a bone graft

PubMed Central

Park, H-R; Min, J-H; Huh, K-H; Yi, W-J; Heo, M-S; Lee, S-S; Cho, Y-A

2013-01-01

A dentinogenic ghost cell tumour (DGCT) is an extremely rare odontogenic tumour which is considered as a solid, neoplastic variant of calcifying odontogenic cyst. Intraosseous DGCTs are more aggressive than extraosseous DGCTs and have a high propensity for local recurrence. This report describes a case of a diagnosis of recurrent DGCT at the primary site and a distant donor site. A 25-year-old female patient visited a dental hospital for a complaint of facial swelling for the previous month. Incisional biopsy was performed and the specimen was diagnosed as DGCT. Partial mandibulectomy for tumour resection and iliac bone graft was performed. 2 years later, the tumour recurred on the mandible and iliac bone. The recurrent lesion on the donor site was diagnosed as metastasized DGCT. This report highlights the possibility of distant metastasis occurring at a graft donor site. PMID:23420853

Field portable mobile phone based fluorescence microscopy for detection of Giardia lamblia cysts in water samples

NASA Astrophysics Data System (ADS)

Ceylan Koydemir, Hatice; Gorocs, Zoltan; McLeod, Euan; Tseng, Derek; Ozcan, Aydogan

2015-03-01

Giardia lamblia is a waterborne parasite that causes an intestinal infection, known as giardiasis, and it is found not only in countries with inadequate sanitation and unsafe water but also streams and lakes of developed countries. Simple, sensitive, and rapid detection of this pathogen is important for monitoring of drinking water. Here we present a cost-effective and field portable mobile-phone based fluorescence microscopy platform designed for automated detection of Giardia lamblia cysts in large volume water samples (i.e., 10 ml) to be used in low-resource field settings. This fluorescence microscope is integrated with a disposable water-sampling cassette, which is based on a flow-through porous polycarbonate membrane and provides a wide surface area for fluorescence imaging and enumeration of the captured Giardia cysts on the membrane. Water sample of interest, containing fluorescently labeled Giardia cysts, is introduced into the absorbent pads that are in contact with the membrane in the cassette by capillary action, which eliminates the need for electrically driven flow for sample processing. Our fluorescence microscope weighs ~170 grams in total and has all the components of a regular microscope, capable of detecting individual fluorescently labeled cysts under light-emitting-diode (LED) based excitation. Including all the sample preparation, labeling and imaging steps, the entire measurement takes less than one hour for a sample volume of 10 ml. This mobile phone based compact and cost-effective fluorescent imaging platform together with its machine learning based cyst counting interface is easy to use and can even work in resource limited and field settings for spatio-temporal monitoring of water quality.

Prevalence of computed tomographic subchondral bone lesions in the scapulohumeral joint of 32 immature dogs with thoracic limb lameness.

PubMed

Lande, Rachel; Reese, Shona L; Cuddy, Laura C; Berry, Clifford R; Pozzi, Antonio

2014-01-01

Osteochondrosis is a common developmental abnormality affecting the subchondral bone of immature, large breed dogs. The purpose of this retrospective study was to describe CT lesions detected in scapulohumeral joints of 32 immature dogs undergoing CT for thoracic limb lameness. Eight dogs (14 scapulohumeral joints) had arthroscopy following imaging. Thirteen dogs (19 scapulohumeral joints) were found to have CT lesions, including 10 dogs (16 scapulohumeral joints) with subchondral bone lesions and 3 dogs with enthesopathy of the supraspinatus tendon. In one dog, subchondral bone lesions appeared as large oval defects within the mid-aspect of the glenoid cavities, bilaterally. These lesions resembled osseous cyst-like lesions commonly identified in the horse. This is the first report of such a presentation of a subchondral bone lesion in the glenoid cavity of a dog. In all dogs, small, focal, round or linear lucent defects were visible within the cortical bone at the junction of the greater tubercle and intertubercular groove. These structures were thought to represent vascular channels. Findings from this study support the use of CT as an adjunct modality for the identification and characterization of scapulohumeral subchondral bone lesions in immature dogs with thoracic limb lameness. © 2013 American College of Veterinary Radiology.

[Clinical experience in osteoplastic material Allomatrix-implant and fibrin rich platelets use in surgical treatment of jaw radicular cysts].

PubMed

Kuz'minykh, I A

2009-01-01

Bones forming optimizators applying in surgical dentistry is an important element of jaw destructive processes successful treatment. Today use of osteoplastic materials on the collagen basis is widely spread. One of this challenge solution is FRP and Allomatrix-implant material applying to jaws during surgery operations. We described clinical investigation phase: the estimation of postoperative and remote results of treatment was carried out.

REPRODUCTION IN VITRO OF ENTAMŒBA TETRAGENA AND ENTAMŒBA COLI FROM THEIR CYSTS

PubMed Central

Yoshida, Kazuyoshi

1920-01-01

1. The vegetative forms of amebæ may be developed in vitro from the cysts. 2. The cysts of Entamœba tetragena and Entamœba coli each produce only a single vegetative individual. It has not been observed in vitro that a number of daughter amebæ, corresponding to the number of nuclei present in the cyst, emerge from the mother cyst, as claimed by Casagrandi and Barbagallo, Schaudinn, and a number of other investigators. 3. The daughter nuclei in the cystic stage correspond to the gamete nuclei of other protozoa. The syngamic nuclear union in the case of these two amebæ does not take place in the tetranuclear stage of the cyst, as claimed by Schaudinn and Wenyon, but during reproduction. 4. The process of autogamy of both amebæ is not restricted to two nuclei; it may involve more than two, which unite to form a syncaryon. In the case of all other protozoa, autogamy is restricted to two nuclei. 5. In order to distinguish the two types of autogamy, one has been termed simple autogamy and the other polynuclear autogamy. The latter may again be classified according to the number of nuclei involved, as trinuclear and tetranuclear autogamy. 6. The majority of cysts treated for 5 minutes in a 2 per cent solution of hydrochloric acid survives. 7. It was possible to demonstrate in vitro the developmental cycle of Entamœba tetragena. 8. No evidence of heterogamy has been observed in vitro in Entamœba tetragena or Entamœba coli. 9. The vegetative form of Entamœba tetragena, at a certain stage of its life cycle in vitro, shortly after its formation, has not only one or two, but may have as many as three or four nuclei. PMID:19868451

Percutaneous intramedullary decompression, curettage, and grafting with medical-grade calcium sulfate pellets for unicameral bone cysts in children: a new minimally invasive technique.

PubMed

Dormans, John P; Sankar, Wudbhav N; Moroz, Leslie; Erol, Bülent

2005-01-01

Several treatment options exist for unicameral bone cysts (UBCs), including observation, steroid injection, bone marrow injection, and curettage and bone grafting. These are all associated with high recurrence rates, persistence, and occasional complications. Newer techniques have been described, most with variable success and only short follow-up reported. Because of these factors, a new minimally invasive percutaneous technique was developed for the treatment of UBCs in children. Twenty-eight children with UBCs who underwent percutaneous intramedullary decompression, curettage, and grafting with medical-grade calcium sulfate (MGCS) pellets by the senior author (J.P.D.) between April 2000 and April 2003 were analyzed as part of a pediatric musculoskeletal tumor registry at a large tertiary children's hospital. Four patients were lost to follow-up, and the remaining 24 patients had an average follow-up of 21.9 months (range 4-48 months). Twelve patients were followed for at least 24 months. Six of the 24 children had received previous treatment of their UBC, most often at an outside institution. Follow-up was performed through clinical evaluation and radiographic review. Postoperative radiographs at most recent follow-up showed complete healing, defined as more than 95% opacification, in 22 of 24 patients (91.7%). One patient (4.2%) demonstrated partial healing, defined as 80% to 95% opacification. One patient had less than 80% radiographic healing (4.2%). All 24 patients returned to full activities and were asymptomatic at most recent follow-up. The only complication noted was a superficial suture abscess that occurred in one patient; this resolved with local treatment measures. The new minimally invasive technique of percutaneous intramedullary decompression, curettage, and grafting with MGCS pellets demonstrates favorable results with low complication and recurrence rates compared with conventional techniques. The role of intramedullary decompression as a part of this percutaneous technique is discussed.

Preoperative easily misdiagnosed telangiectatic osteosarcoma: clinical–radiologic–pathologic correlations

PubMed Central

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 TOS, and these features are helpful in making the correct preoperative diagnosis of TOS. PMID:24334494

Nasopharyngeal Carcinoma with Cystic Cervical Metastasis Masquerading as Branchial Cleft Cyst: A Potential Pitfall in Diagnosis and Management.

PubMed

Sai-Guan, Lum; Min-Han, Kong; Kah-Wai, Ngan; Mohamad-Yunus, Mohd-Razif

2017-03-01

Most metastatic lymph nodes from head and neck malignancy are solid. Cystic nodes are found in 33% - 61% of carcinomas arise from Waldeyer's ring, of which only 1.8% - 8% originate are from the nasopharynx. Some cystic cervical metastases were initially presumed to be branchial cleft cyst. This case report aims to highlight the unusual presentation of cystic cervical metastasis secondary to nasopharyngeal carcinoma in a young adult. The histopathology, radiological features and management strategy were discussed. A 36-year-old man presented with a solitary cystic cervical swelling, initially diagnosed as branchial cleft cyst. Fine needle aspiration yielded 18 ml of straw-coloured fluid. During cytological examination no atypical cells were observed. Computed tomography of the neck showed a heterogeneous mass with multiseptation medial to the sternocleidomastoid muscle. Histopathological examination of the mass, post excision, revealed a metastatic lymph node. A suspicious mucosal lesion at the nasopharynx was detected after repeated thorough head and neck examinations and the biopsy result confirmed undifferentiated nasopharyngeal carcinoma. Cystic cervical metastasis may occur in young patients under 40 years. The primary tumour may not be obvious during initial presentation because it mimicks benign branchial cleft cyst clinically. Retrospective review of the computed tomography images revealed features that were not characteristic of simple branchial cleft cyst. The inadequacy of assessment and interpretation had lead to the error in diagnosis and subsequent management. Metastatic head and neck lesion must be considered in a young adult with a cystic neck mass.

Conditional Mesenchymal Disruption of Pkd1 Results in Osteopenia and Polycystic Kidney Disease

PubMed Central

Cao, Li; David, Valentin; Quarles, Leigh Darryl

2012-01-01

Conditional deletion of Pkd1 in osteoblasts using either Osteocalcin(Oc)-Cre or Dmp1-Cre results in defective osteoblast-mediated postnatal bone formation and osteopenia. Pkd1 is also expressed in undifferentiated mesenchyme that gives rise to the osteoblast lineage. To examine the effects of Pkd1 on prenatal osteoblast development, we crossed Pkd1 flox/flox and Col1a1(3.6)-Cre mice, which has been used to achieve selective inactivation of Pkd1 earlier in the osteoblast lineage. Control Pkd1 flox/flox and Pkd1 flox/+, heterozygous Col1a1(3.6)-Cre;Pkd1 flox/+ and Pkd1 flox/null, and homozygous Col1a1(3.6)-Cre;Pkd1 flox/flox and Col1a1(3.6)-Cre;Pkd1 flox/null mice were analyzed at ages ranging from E14.5 to 8-weeks-old. Newborn Col1a1(3.6)-Cre;Pkd1 flox/null mice exhibited defective skeletogenesis in association with a greater reduction in Pkd1 expression in bone. Conditional Col1a1(3.6)-Cre;Pkd1 flox/+ and Col1a1(3.6)-Cre;Pkd1 flox/flox mice displayed a gene dose-dependent decrease in bone formation and increase in marrow fat at 6 weeks of age. Bone marrow stromal cell and primary osteoblast cultures from homozygous Col1a1(3.6)-Cre;Pkd1 flox/flox mice showed increased proliferation, impaired osteoblast development and enhanced adipogenesis ex vivo. Unexpectedly, we found evidence for Col1a1(3.6)-Cre mediated deletion of Pkd1 in extraskeletal tissues in Col1a1(3.6)-Cre;Pkd1 flox/flox mice. Deletion of Pkd1 in mesenchymal precursors resulted in pancreatic and renal, but not hepatic, cyst formation. The non-lethality of Col1a1(3.6)-Cre;Pkd1 flox/flox mice establishes a new model to study abnormalities in bone development and cyst formation in pancreas and kidney caused by Pkd1 gene inactivation. PMID:23029375

Hepatic and pulmonary cystic echinococcosis in a patient from the Central African Republic.

PubMed

Develoux, Michel; Enache-Angoulvant, Adela; Gounant, Valerie; Brian, Emmanuel; Khalil, Antoine; Bazelly, Bernard; Hennequin, Christophe

2011-03-01

Apical lung opacity was diagnosed in an asymptomatic 30 year-old woman native of Central African Republic by routine chest X-ray. CT scan demonstrated an excavated pulmonary mass and revealed a simple hepatic cyst. Tuberculosis was suspected but mycobacterial cultures remained negative. Three months later, ultrasonography showed septations within the hepatic lesion suggestive of cystic echinococcosis. The detection of seric anti-Echinococcus antibodies was positive. Hepatic and pulmonary cysts were removed surgically and association with three-month course of albendazole resulted in a favorable outcome. Cystic echinococcosis is exceptional in Central Africa and to our knowledge never reported from the Central African Republic. Copyright © 2011 Elsevier Ltd. All rights reserved.

Ruptured pulmonary hydatid cyst: a case report.

PubMed

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.

Methodologies for semiquantitative evaluation of hip osteoarthritis by magnetic resonance imaging: approaches based on the whole organ and focused on active lesions.

PubMed

Jaremko, Jacob L; Lambert, Robert G W; Zubler, Veronika; Weber, Ulrich; Loeuille, Damien; Roemer, Frank W; Cibere, Jolanda; Pianta, Marcus; Gracey, David; Conaghan, Philip; Ostergaard, Mikkel; Maksymowych, Walter P

2014-02-01

As a wider variety of therapeutic options for osteoarthritis (OA) becomes available, there is an increasing need to objectively evaluate disease severity on magnetic resonance imaging (MRI). This is more technically challenging at the hip than at the knee, and as a result, few systematic scoring systems exist. The OMERACT (Outcome Measures in Rheumatology) filter of truth, discrimination, and feasibility can be used to validate image-based scoring systems. Our objective was (1) to review the imaging features relevant to the assessment of severity and progression of hip OA; and (2) to review currently used methods to grade these features in existing hip OA scoring systems. A systematic literature review was conducted. MEDLINE keyword search was performed for features of arthropathy (such as hip + bone marrow edema or lesion, synovitis, cyst, effusion, cartilage, etc.) and scoring system (hip + OA + MRI + score or grade), with a secondary manual search for additional references in the retrieved publications. Findings relevant to the severity of hip OA include imaging markers associated with inflammation (bone marrow lesion, synovitis, effusion), structural damage (cartilage loss, osteophytes, subchondral cysts, labral tears), and predisposing geometric factors (hip dysplasia, femoral-acetabular impingement). Two approaches to the semiquantitative assessment of hip OA are represented by Hip OA MRI Scoring System (HOAMS), a comprehensive whole organ assessment of nearly all findings, and the Hip Inflammation MRI Scoring System (HIMRISS), which selectively scores only active lesions (bone marrow lesion, synovitis/effusion). Validation is presently confined to limited assessment of reliability. Two methods for semiquantitative assessment of hip OA on MRI have been described and validation according to the OMERACT Filter is limited to evaluation of reliability.

Linear undisplaced fracture of temporoparietal bone acting as spontaneous early decompressive craniotomy in a neonate

PubMed Central

Vankipuram, Siddharth; Balasubramanium, Srikant; Tyagi, Devendra K.; Savant, H. V.

2015-01-01

Decompressive craniotomy (DC) is used to treat intracranial hypertension associated with traumatic brain injury. Early DC is associated with better outcomes. We present a neonate with a history of fall with computed tomography scan showing a large frontoparietal contusion and associated parietal and temporal bone fracture. This acted as a spontaneous DC causing bony segment to separate due to which the edematous brain could be accommodated. Despite the presence of a large contusion, the child was neurologically intact and medically managed. The neonate presented with a posttraumatic leptomeningeal cyst 2 months later, which had to be repaired surgically. We discuss how a linear undisplaced fracture acts as spontaneous DC and the role of early DC in improving outcomes. PMID:26557171

Brain, Craniofacial, and Dental Lesions of a Free-ranging Gray Wolf (Canis lupus) Implicated in a Human Attack in Minnesota, USA.

PubMed

Schwabenlander, Marc; Stepaniuk, Kevin; Carstensen, Michelle; Armién, Aníbal G

2016-01-01

We describe significant brain, craniofacial, and dental lesions in a free-ranging wolf (Canis lupus) involved in a human attack. On postmortem examination, the wolf presented asymmetric atrophy and bone remodeling affecting the mandible, incisive, maxilla, lacrimal, palatine, frontal, and ethmoid bones. There was an asymmetrical skeletal malocclusion and dental abnormalities including rotated, malpositioned, partially erupted teeth, and an odontogenic cyst associated with an unerupted canine tooth. Brain changes were bilateral loss and atrophy of extensive cortex regions including olfactory bulb, peduncles, and tract, and the frontal lobe. We highlight the relevance of a thorough postmortem examination of wildlife to elucidate disease-based abnormal behavior as the reason for human-animal conflict.

International survey on the management of skin stigmata and suspected tethered cord.

PubMed

Ponger, Penina; Ben-Sira, Liat; Beni-Adani, Liana; Steinbok, Paul; Constantini, Shlomi

2010-12-01

We designed a survey to investigate current international management trends of neonates with lumbar midline skin stigmata suspicious of tethered cord, among pediatric neurosurgeons, focusing on the lower risk stigmata, simple dimples, deviated gluteal folds, and discolorations. Our findings will enable physicians to assess their current diagnosis routine and aid in clarifying management controversies. A questionnaire on the proposed diagnostic evaluation of seven case reports, each accompanied by relevant imaging, was distributed by e-mail to members of the International Society for Pediatric Neurosurgery, the European Society for Pediatric Neurosurgery, and via the PEDS server list between March and August 2008. Sixty-two questionnaires, completed by experienced professionals with a rather uniform distribution of experience levels, were analyzed. Forty-eight percent do not recommend any imaging of simple dimples, 30% recommend US screening and 22% recommend MR. Seventy-nine percent recommend imaging of deviated gluteal fold with 30% recommending MR. Ninety-two percent recommend imaging infants with hemangiomas with 74% recommending MR. MR for sinus tracts is recommended by 90% if sacral and by 98% if lumber. Eighty-four percent recommend MR for filar cyst. Our survey demonstrates that management of low-risk skin stigmata, simple dimple, deviated gluteal fold, and discolorations lacks consensus. In addition, a significant sector of the professional community proposes a work-up of simple dimples, sacral tracts, and filar cysts that contradicts established recommendations. A simple classification system is needed to attain a better approach, enabling correct diagnosis of tethered cord without exposing neonates to unnecessary examinations.

Unilateral flank ovariohysterectomy in guinea pigs (Cavia porcellus).

PubMed

Rozanska, D; Rozanski, P; Orzelski, M; Chlebicka, N; Putowska, K

2016-11-01

To describe a simple, minimally invasive method of ovariohysterectomy via a unilateral flank approach in guinea pigs, for use in routine desexing of healthy female guinea pigs or treatment of ovarian cysts. The subjects of this retrospective study were 41 client-owned guinea pigs submitted for routine desexing or treatment of ovarian cysts. They included 16 healthy female guinea pigs aged 8-12 months (Group 1), and 15 females aged from 9 months to 3 years (Group 2), and 10 females aged from 3 to 7 years (Group 3) with different-sized ovarian cysts. Prior to surgery, the animals received clinical examination, blood testing (complete blood count and serum biochemistry profile) and examination of the abdomen using ultrasonography, to assess the condition of the reproductive tract and ensure the guinea pigs were fit for surgery. Ovariohysterectomy was performed via a unilateral flank incision made close to the erector spinae muscle starting approximately 1 cm caudal to the last rib. Both ovaries, uterine horns, and the uterine cervix were localised, ligated, and dissected through this unilateral retroperitoneal incision. Ovariohysterectomy was successfully completed via a single flank incision in 38/41 (93%) guinea pigs. Three guinea pigs with ovarian cysts from Group 3, which were >6 years old died during surgery due to circulatory and respiratory failure under anaesthesia. In the remaining 38 cases, surgery proceeded without complications. A further two guinea pigs from Group 3 were reluctant to move or eat for the first 3 days after surgery but recovered after provision of supportive care. All 38 animals fully recovered and wound healing was normal. This is the first report of ovariohysterectomy via a unilateral flank incision in guinea pigs. This approach is a simple, minimally invasive and safe alternative to the midline or bilateral flank approaches currently used for surgery of the reproductive tract in guinea pigs.

AMSARA: Accession Medical Standards Analysis & Research Activity 2008 Annual Report

DTIC Science & Technology

2009-02-01

service were prosthetic implants and diseases of the musculoskeletal system and impairments and diseases of the spine, skull, limbs, and extremities...waivers for deviations/curvature of the spine, and one had a waiver for a  15  fracture of the vertebral column (no mention of spinal cord injury). For...pathologic fractures , bone cysts, and aseptic necrosis. Please note, when a majority of codes examined out to the fourth digit do not have a fourth digit

Bone marrow lesions and subchondral bone pathology of the knee.

PubMed

Kon, Elizaveta; Ronga, Mario; Filardo, Giuseppe; Farr, Jack; Madry, Henning; Milano, Giuseppe; Andriolo, Luca; Shabshin, Nogah

2016-06-01

Bone marrow lesions (BMLs) around the knee are a common magnetic resonance imaging (MRI) finding. However, despite the growing interest on BMLs in multiple pathological conditions, they remain controversial not only for the still unknown role in the etiopathological processes, but also in terms of clinical impact and treatment. The differential diagnosis includes a wide range of conditions: traumatic contusion and fractures, cyst formation and erosions, hematopoietic and infiltrated marrow, developmental chondroses, disuse and overuse, transient bone marrow oedema syndrome and, lastly, subchondral insufficiency fractures and true osteonecrosis. Regardless the heterogeneous spectrum of these pathologies, a key factor for patient management is the distinction between reversible and irreversible conditions. To this regard, MRI plays a major role, leading to the correct diagnosis based on recognizable typical patterns that have to be considered together with coexistent abnormalities, age, and clinical history. Several treatment options have been proposed, from conservative to surgical approaches. In this manuscript the main lesion patterns and their management have been analysed to provide the most updated evidence for the differential diagnosis and the most effective treatment.

Accession Medical Standards Analysis and Research Activity

DTIC Science & Technology

2010-01-01

prosthetic implants and diseases of the musculoskeletal system and impairments and diseases of the spine, skull, limbs, and extremities; though...osteoporosis, pathologic fractures , bone cysts, and aseptic necrosis. Please note, when a majority of codes examined out to the fourth digit do not have a...including traumatic amputation, scrotum and testes 56 0.3 44 0.4 47 0.8 40 1.3 Late effect of fracture of lower extremities 89 0.5 64 0.5 44 0.8 22 0.7

Micro-CT evaluation of bone defects: applications to osteolytic bone metastases, bone cysts, and fracture.

PubMed

Buie, Helen R; Bosma, Nick A; Downey, Charlene M; Jirik, Frank R; Boyd, Steven K

2013-11-01

Bone defects can occur in various forms and present challenges to performing a standard micro-CT evaluation of bone quality because most measures are suited to homogeneous structures rather than ones with spatially focal abnormalities. Such defects are commonly associated with pain and fragility. Research involving bone defects requires quantitative approaches to be developed if micro-CT is to be employed. In this study, we demonstrate that measures of inter-microarchitectural bone spacing are sensitive to the presence of focal defects in the proximal tibia of two distinctly different mouse models: a burr-hole model for fracture healing research, and a model of osteolytic bone metastases. In these models, the cortical and trabecular bone compartments were both affected by the defect and were, therefore, evaluated as a single unit to avoid splitting the defects into multiple analysis regions. The burr-hole defect increased mean spacing (Sp) by 27.6%, spacing standard deviation (SpSD) by 113%, and maximum spacing (Spmax) by 72.8%. Regression modeling revealed SpSD (β=0.974, p<0.0001) to be a significant predictor of the defect volume (R(2)=0.949) and Spmax (β=0.712, p<0.0001) and SpSD (β=0.271, p=0.022) to be significant predictors of the defect diameter (R(2)=0.954). In the mice with osteolytic bone metastases, spacing parameters followed similar patterns of change as reflected by other imaging technologies, specifically bioluminescence data which is indicative of tumor burden. These data highlight the sensitivity of spacing measurements to bone architectural abnormalities from 3D micro-CT data and provide a tool for quantitative evaluation of defects within a bone. Copyright © 2013 IPEM. Published by Elsevier Ltd. All rights reserved.

Autogenous Partial Bone Chip Grafting on the Exposed Inferior Alveolar Nerve After Cystic Enucleation.

PubMed

Seo, Mi Hyun; Eo, Mi Young; Cho, Yun Ju; Kim, Soung Min; Lee, Suk Keun

2018-03-01

This prospective study evaluated the clinical effectiveness of the new approach of partial autogenous bone chip grafts for the treatment of mandibular cystic lesions related to the inferior alveolar nerve (IAN). A total of 38 patients treated for mandibular cysts or benign tumors were included in this prospective study and subsequently divided into 3 groups depending on the bone grafting method used: cystic enucleation without a bone graft (group 1), partial bone chip graft covering the exposed IAN (group 2), and autogenous bone graft covering the entire defect (group 3). We evaluated the symptoms, clinical signs, and radiographic changes using dental panorama preoperatively, immediate postoperatively, and at 1, 3, 6, and 12 months postoperatively. Radiographic densities were compared using Adobe Photoshop CS5 (Adobe Systems Inc., San Jose, CA). Repeated measures analysis of variance was used for statistical evaluation with SPSS 22.0 (SPSS Inc, Chicago, IL), and P < 0.05 was considered statistically significant.Radiopacities were the most increased at 1 year postoperative in group 3; groups 2 and 3 did not show statistically significant differences, whereas groups 1 and 3 were statistically significant. In terms of radiographic bone healing with clinical regeneration of the exposed IAN, healing occurred in all patients, although the best healing was achieved in group 2.This autogenous partial bone chip grafting procedure to cover the exposed IAN is suggested as a new surgical protocol for the treatment of cystic lesions associated with the IAN.

Orthodontic Extraction of High-Risk Impacted Mandibular Third Molars in Close Proximity to the Mandibular Canal: A Systematic Review.

PubMed

Kalantar Motamedi, Mahmood Reza; Heidarpour, Majid; Siadat, Sara; Kalantar Motamedi, Alimohammad; Bahreman, Ali Akbar

2015-09-01

Extraction of mandibular third molars (M3s) in close proximity to the mandibular canal has some inherent risks to adjacent structures, such as neurologic damage to teeth, bone defects distal to the mandibular second molar (M2), or pathologic fractures in association with enlarged dentigerous cysts. The procedure for extrusion and subsequent extraction of high-risk M3s is called orthodontic extraction. This is a systematic review of the available approaches for orthodontic extraction of impacted mandibular M3s in close proximity to the mandibular canal and their outcomes. The PubMed, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), DOAJ, Google Scholar, OpenGrey, Iranian Science Information Database (SID), Iranmedex, and Irandoc databases were searched using specific keywords up to June 2, 2014. Studies were evaluated based on predetermined eligibility criteria, treatment approaches, and their outcomes. Thirteen articles met the inclusion criteria. A total of 123 impacted teeth were extracted by orthodontic extraction and 2 cases were complicated by transient paresthesia. Three types of biomechanical approaches were used: 1) using the posterior maxillary region as the anchor for orthodontic extrusion of lower M3s, 2) simple cantilever springs attached to the M3 buttonhole, and 3) cantilever springs tied to a bonded orthodontic bracket on the M3 plus multiple-loop spring wire for distal movement of the M3. Osteo-periodontal status of M2s also improved uneventfully. Despite the drawbacks of orthodontic extraction, removal of deeply impacted M3s using the described techniques is safe with regard to mandibular nerve injury and neurologic damage. Orthodontic extraction is recommended for extraction of impacted M3s that present a high risk of postoperative osteo-periodontal defects on the distal surface of the adjacent M2 and those associated with dentigerous cysts. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Detection of G1 genotype of human cystic echinococcosis in Egypt.

PubMed

Abd El Baki, Mohammad H; El Missiry, Adel M G; Abd El Aaty, Heba E M; Mohamad, Anhar A; Aminou, Heba A R

2009-12-01

The first trial to detect G1 genotype in Egyptian human isolates of hydatid cysts (HC) and serum samples to approach diagnosis of cystic echinococcosis (CE) using human sera by PCR. Using strain specific primers, 27/36 confirmed CE patients (75%) showed G1 specific band in their sera at 254 bp. Specificity was 100% without detecting bands for either other parasitosis, or mass occupying lesions. Using PCR, G1 genotype was detected in 83.3% of HC samples, without significant difference between types of human isolates (pulmonary, hepatic, or multi-organ). G1 genotype detection in human sera was in 75% of CE patients compared to 83.3% in HC samples of the same group of patients proved satisfactory, simple and safer than HCF sampling. IHAT gave sensitivity of 58.3% compared to histopathological examination of surgically removed cysts or examination of hydatid cyst fluid (HCF) for protoscolices (gold standards). The specificity was 70% with false positive reactions with other parasitic infections and mass occupying lesions. PCR detection of G1 genotype in Egyptian animal hydatid cysts showed 90% in camel isolates and 80% in sheep isolates, but pig isolates were negative. The presence of this genotype in a high percentage in camel isolates incriminated sheep strain as the source of CE camel infection. The results may give an explanation to the contradicting results of other studies that did not relay upon molecular aspects.

Training giraffe (Giraffa camelopardalis reticulata) for front foot radiographs and hoof care.

PubMed

Dadone, Liza I; Schilz, Amy; Friedman, Susan G; Bredahl, Jason; Foxworth, Steve; Chastain, Bob

2016-05-01

For a large herd of reticulated giraffes, a mainly operant-based training program was created for front foot radiographs and hoof trims in an effort to diagnose and better manage lameness. Behaviors were shaped in a restricted contact set-up, using a positive reinforcement procedure to teach a series of mastered cued behaviors. This training was used to obtain lateral and lateral oblique front foot radiographs for the entire herd. Radiographs were diagnostic for multiple possible causes of lameness including fractures and osteitis of the distal phalangeal bone, hoof overgrowth, osteoarthritis of the distal interphalangeal joint, rotation of the distal phalangeal bone, sesamoid bone cysts, and sole foreign bodies. By training giraffe for foot radiographs and hoof trims, potential causes of lameness could be identified and better managed. Long-term, the results may help zoos identify best practices for managing and preventing lameness in giraffe. Zoo Biol. 35:228-236, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

An automated technique for potential differentiation of ovarian mature teratomas from other benign tumours using neural networks classification of 2D ultrasound static images: a pilot study

NASA Astrophysics Data System (ADS)

Al-karawi, Dhurgham; Sayasneh, A.; Al-Assam, Hisham; Jassim, Sabah; Page, N.; Timmerman, D.; Bourne, T.; Du, Hongbo

2017-05-01

Ovarian cysts are a common pathology in women of all age groups. It is estimated that 5-10% of women have a surgical intervention to remove an ovarian cyst in their lifetime. Given this frequency rate, characterization of ovarian masses is essential for optimal management of patients. Patients with benign ovarian masses can be managed conservatively if they are asymptomatic. Mature teratomas are common benign ovarian cysts that occur, in most cases, in premenopausal women. These ovarian cysts can contain different types of human tissue including bone, cartilage, fat, hair, or other tissue. If they are causing no symptoms, they can be harmless and may not require surgery. Subjective assessment by ultrasound examiners has a high diagnostic accuracy when characterising mature teratomas from other types of tumours. The aim of this study is to develop a computerised technique with the potential to characterise mature teratomas and distinguish them from other types of benign ovarian tumours. Local Binary Pattern (LBP) was applied to extract texture features that are specific in distinguishing teratomas. Neural Networks (NN) was then used as a classifier for recognising mature teratomas. A pilot sample set of 130 B-mode static ovarian ultrasound images (41 mature teratomas tumours and 89 other types of benign tumours) was used to test the effectiveness of the proposed technique. Test results show an average accuracy rate of 99.4% with a sensitivity of 100%, specificity of 98.8% and positive predictive value of 98.9%. This study demonstrates that the NN and LBP techniques can accurately classify static 2D B-mode ultrasound images of benign ovarian masses into mature teratomas and other types of benign tumours.

Tibial periosteal ganglion cyst: The ganglion in disguise.

PubMed

Reghunath, Anjuna; Mittal, Mahesh K; Khanna, Geetika; Anil, V

2017-01-01

Soft tissue ganglions are commonly encountered cystic lesions around the wrist presumed to arise from myxomatous degeneration of periarticular connective tissue. Lesions with similar pathology in subchondral location close to joints, and often simulating a geode, is the less common entity called intraosseous ganglion. Rarer still is a lesion produced by mucoid degeneration and cyst formation of the periostium of long bones, rightly called the periosteal ganglion. They are mostly found in the lower extremities at the region of pes anserinus, typically limited to the periosteum and outer cortex without any intramedullary component. We report the case of a 62 year-old male who presented with a tender swelling on the mid shaft of the left tibia, which radiologically suggested a juxtacortical lesion extending to the soft tissue or a soft tissue neoplasm eroding the bony cortex of tibia. It was later diagnosed definitively as a periosteal ganglion in an atypical location, on further radiologic work-up and histopathological correlation.

Squamous odontogenic tumor and squamous odontogenic tumor-like proliferations in odontogenic cysts: An updated analysis of 170 cases reported in the literature.

PubMed

Chrcanovic, Bruno Ramos; Gomez, Ricardo Santiago

2018-03-01

To integrate the available data published on squamous odontogenic tumors (SOT) and squamous odontogenic tumor-like proliferations in odontogenic cysts (SOT-LPOC) into a comprehensive analysis of their clinical/radiologic features. An electronic search was undertaken in January 2017. Eligibility criteria included publications having enough clinical/radiological/histological information to confirm a definite diagnosis. A total of 74 publications reporting 110 SOTs (102 central, 8 peripheral) and 60 SOT-LPOC were included. Compared to SOT-LPOC, SOT showed lower mean age, no preference regarding maxilla or mandible localization, significant association with cortical bone perforation, multilocular radiographic appearance, and mobility of the tooth/teeth associated with the lesion. While 5 recurrent SOT were reported after enucleation, no recurrent SOT-LPOC was found. SOT shows a more aggressive biologic behavior than SOT-LPOC, which supports the hypothesis that the two lesions are distinct clinicopathological conditions. Copyright © 2018 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Tibial periosteal ganglion cyst: The ganglion in disguise

PubMed Central

Reghunath, Anjuna; Mittal, Mahesh K; Khanna, Geetika; Anil, V

2017-01-01

Soft tissue ganglions are commonly encountered cystic lesions around the wrist presumed to arise from myxomatous degeneration of periarticular connective tissue. Lesions with similar pathology in subchondral location close to joints, and often simulating a geode, is the less common entity called intraosseous ganglion. Rarer still is a lesion produced by mucoid degeneration and cyst formation of the periostium of long bones, rightly called the periosteal ganglion. They are mostly found in the lower extremities at the region of pes anserinus, typically limited to the periosteum and outer cortex without any intramedullary component. We report the case of a 62 year-old male who presented with a tender swelling on the mid shaft of the left tibia, which radiologically suggested a juxtacortical lesion extending to the soft tissue or a soft tissue neoplasm eroding the bony cortex of tibia. It was later diagnosed definitively as a periosteal ganglion in an atypical location, on further radiologic work-up and histopathological correlation. PMID:28515597

Automated assessment of bone changes in cross-sectional micro-CT studies of murine experimental osteoarthritis.

PubMed

Das Neves Borges, Patricia; Vincent, Tonia L; Marenzana, Massimo

2017-01-01

The degradation of articular cartilage, which characterises osteoarthritis (OA), is usually paired with excessive bone remodelling, including subchondral bone sclerosis, cysts, and osteophyte formation. Experimental models of OA are widely used to investigate pathogenesis, yet few validated methodologies for assessing periarticular bone morphology exist and quantitative measurements are limited by manual segmentation of micro-CT scans. The aim of this work was to chart the temporal changes in periarticular bone in murine OA by novel, automated micro-CT methods. OA was induced by destabilisation of the medial meniscus (DMM) in 10-week old male mice and disease assessed cross-sectionally from 1- to 20-weeks post-surgery. A novel approach was developed to automatically segment subchondral bone compartments into plate and trabecular bone in micro-CT scans of tibial epiphyses. Osteophyte volume, as assessed by shape differences using 3D image registration, and by measuring total epiphyseal volume was performed. Significant linear and volumetric structural modifications in subchondral bone compartments and osteophytes were measured from 4-weeks post-surgery and showed progressive changes at all time points; by 20 weeks, medial subchondral bone plate thickness increased by 160±19.5 μm and the medial osteophyte grew by 0.124±0.028 μm3. Excellent agreement was found when automated measurements were compared with manual assessments. Our automated methods for assessing bone changes in murine periarticular bone are rapid, quantitative, and highly accurate, and promise to be a useful tool in future preclinical studies of OA progression and treatment. The current approaches were developed specifically for cross-sectional micro-CT studies but could be applied to longitudinal studies.

Automated assessment of bone changes in cross-sectional micro-CT studies of murine experimental osteoarthritis

PubMed Central

Vincent, Tonia L.; Marenzana, Massimo

2017-01-01

Objective The degradation of articular cartilage, which characterises osteoarthritis (OA), is usually paired with excessive bone remodelling, including subchondral bone sclerosis, cysts, and osteophyte formation. Experimental models of OA are widely used to investigate pathogenesis, yet few validated methodologies for assessing periarticular bone morphology exist and quantitative measurements are limited by manual segmentation of micro-CT scans. The aim of this work was to chart the temporal changes in periarticular bone in murine OA by novel, automated micro-CT methods. Methods OA was induced by destabilisation of the medial meniscus (DMM) in 10-week old male mice and disease assessed cross-sectionally from 1- to 20-weeks post-surgery. A novel approach was developed to automatically segment subchondral bone compartments into plate and trabecular bone in micro-CT scans of tibial epiphyses. Osteophyte volume, as assessed by shape differences using 3D image registration, and by measuring total epiphyseal volume was performed. Results Significant linear and volumetric structural modifications in subchondral bone compartments and osteophytes were measured from 4-weeks post-surgery and showed progressive changes at all time points; by 20 weeks, medial subchondral bone plate thickness increased by 160±19.5 μm and the medial osteophyte grew by 0.124±0.028 μm3. Excellent agreement was found when automated measurements were compared with manual assessments. Conclusion Our automated methods for assessing bone changes in murine periarticular bone are rapid, quantitative, and highly accurate, and promise to be a useful tool in future preclinical studies of OA progression and treatment. The current approaches were developed specifically for cross-sectional micro-CT studies but could be applied to longitudinal studies. PMID:28334010

Feeding soy protein isolate and oils rich in omega-3 polyunsaturated fatty acids affected mineral balance, but not bone in a rat model of autosomal recessive polycystic kidney disease.

PubMed

Maditz, Kaitlin H; Smith, Brenda J; Miller, Matthew; Oldaker, Chris; Tou, Janet C

2015-02-10

Polycystic kidney disease (PKD), a genetic disorder characterized by multiple cysts and renal failure at an early age. In children, kidney disease is often accompanied by disordered mineral metabolism, failure to achieve peak bone mass, and reduced adult height. Optimizing bone health during the growth stage may preserve against bone loss associated with early renal dysfunction in PKD. Dietary soy protein and omega-3 polyunsaturated fatty acid (n-3 PUFA) have been reported to ameliorate PKD and to promote bone health. The study objective was to determine the bone effects of feeding soy protein and/or n-3 PUFAs in a rat model of PKD. Weanling female PCK rats (n = 12/group) were randomly assigned to casein + corn oil (Casein + CO), casein + soybean oil (Casein + SO), soy protein isolate + soybean oil (SPI + SO) or soy protein isolate + 1:1 soybean oil:salmon oil blend (SPI + SB) for 12 weeks. Rats fed SPI + SO diet had shorter (P = 0.001) femur length than casein-fed rats. Rats fed SPI + SO and SPI + SB diet had higher (P = 0.04) calcium (Ca) and phosphorus (P) retention. However, there were no significant differences in femur and tibial Ca, P or bone mass between diet groups. There were also no significant difference in bone microarchitecture measured by micro-computed tomography or bone strength determined by three-point bending test between diet groups. Early diet management of PKD using SPI and/or n-3 PUFAs influenced bone longitudinal growth and mineral balance, but neither worsened nor enhanced bone mineralization, microarchitecture or strength.

Benign metastasizing leiomyoma presenting as multiple cystic pulmonary nodules: a case report.

PubMed

Choe, Yeong Hun; Jeon, So Yeon; Lee, Yoon Chae; Chung, Myung Ja; Park, Seung Yong; Lee, Yong Chul; Kim, So Ri

2017-09-12

Benign metastatic leiomyoma (BML) is an extremely rare disease. Although uterine leiomyomas are benign histologically, they can metastasize to distant sites. While the incidence is very low, the lung is the organ most frequently affected by BML. Pulmonary BML usually presents as numerous well-defined nodules of various sizes, while the cavitary or cystic features in the nodules are rarely observed on radiologic images. A 52-year-old woman complained of cough and dyspnea for one month. She had been previously diagnosed with uterine leiomyoma and had undergone total hysterectomy about 14 years prior. High-resolution computed tomography (CT) images showed that there were multiple cystic nodules of various sizes in both lungs. Pathologic examination revealed that the pulmonary nodule had complex branching glandular structures lined by a single layer of simple cuboidal to columnar epithelium that was surrounded by abundant spindle cells. Additional immunohistochemistry data suggested that pulmonary nodule diagnosis was BML-associated uterine leiomyoma. In this report, we introduce an interesting case of pulmonary BML that presented as a combination of various kinds of nodules including simple round nodules, simple cysts, and cysts with a solid portion, which are very rare radiologic features of BML in lung. In addition, when the patient is a woman of reproductive age, physicians should meticulously review the gynecological history and suspect BML when there are various cystic pulmonary lesions.

Aneurysmal bone cyst does not hinder the success of kidney transplantation. A case report.

PubMed

Giordano, Mario; Caloro, Giorgia; Gaeta, Alberto; Vergori, Antonio; Santangelo, Luisa; Giordano, Paolo; Ruggieri, Pietro

2015-03-01

Uremic osteodystrophy is an expected complication in subjects with chronic renal insufficiency. It develops gradually and progressively already during the conservative treatment and then during the dialysis treatment. It can present a wide histopathological spectrum including typical alterations (from osteitis fibrosa to osteomalacia and/or mixed lesions) or, more rarely, isolated bone lesions indicative of a brown tumor of the bone. These conditions must be clearly identified in the pretransplant phase, especially if a bone lesion indicative of a pathological condition possibly evolving into a neoplasm is detected fortuitously. We report the case of a 19-yr-old boy with renal insufficiency and candidate for a pre-emptive renal transplantation from a living donor, in whom the diagnosis of ABC of the pubic symphysis - asymptomatic and fortuitously detected while performing instrumental investigations - was suspected through the imaging studies (CT scan, MRI) and was confirmed by the histological examination. This made it possible to perform the renal transplant. The immunosuppressive treatment, which was subsequently administered, was based on steroids, calcineurin inhibitors (tacrolimus), and mycophenolate and did not determine any modification in the radiological aspect of the bone lesion, even after more than one yr from the transplant. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Calcium phosphates: what is the evidence?

PubMed

Larsson, Sune

2010-03-01

A number of different calcium phosphate compounds such as calcium phosphate cements and solid beta-tricalcium phosphate products have been introduced during the last decade. The chemical composition mimics the mineral phase of bone and as a result of this likeness, the materials seem to be remodeled as for normal bone through a cell-mediated process that involves osteoclastic activity. This is a major difference when compared with, for instance, calcium sulphate compounds that after implantation dissolve irrespective of the new bone formation rate. Calcium phosphates are highly biocompatible and in addition, they act as synthetic osteoconductive scaffolds after implantation in bone. When placed adjacent to bone, osteoid is formed directly on the surface of the calcium phosphate with no soft tissue interposed. Remodeling is slow and incomplete, but by adding more and larger pores, like in ultraporous beta-tricalcium phosphate, complete or nearly complete resorption can be achieved. The indications explored so far include filling of metaphyseal fracture voids or bone cysts, a volume expander in conjunction with inductive products, and as a carrier for various growth factors and antibiotics. Calcium phosphate compounds such as calcium phosphate cement and beta-tricalcium phosphate will most certainly be part of the future armamentarium when dealing with fracture treatment. It is reasonable to believe that we have so far only seen the beginning when it comes to clinical applications.

Eggshell-Derived Hydroxyapatite: A New Era in Bone Regeneration.

PubMed

Kattimani, Vivekanand; Lingamaneni, Krishna Prasad; Chakravarthi, Pandi Srinivas; Kumar, T S Sampath; Siddharthan, Arjunan

2016-01-01

Defects of maxillofacial skeleton lead to personal (functional and aesthetic), social and behavioral problems; which make the person to isolate from the main stream of society. So, bone regeneration is the need for proper structure, function, and aesthetics following cyst enucleation, trauma, and tumor ablative surgery; which helps for overall health of the individual. The preliminary study is planned to evaluate and compare the efficacy of eggshell-derived hydroxyapatite (EHA) and synthetic hydroxyapatite (SHA) following cystectomy. Microwave-processed calcium deficient EHA and commercially available SHA are used for grafting. Total 20 patients enrolled in this study, consisting 10 in each group between 20 and 45 years of age. All the patients were evaluated for bone regeneration at first, second, third, and sixth month's interval, postsurgically, using radiovisiograph and clinical parameters. The bone formation characteristics vary at second month when compared to SHA. This difference may be because of the kinetics involved in the regeneration pattern. The pattern of bone healing was trabecular after third month, indicating complete bone formation. The study showed constant raise of density and remained same at the end of study period. Both EHA and SHA graft materials are equally efficient in early bone regeneration. Within the limitations of this study the EHA showed promising results. Which indicates the eggshell waste-bio mineral is worthwhile raw material for the production of HA and is a Go Green procedure. Eggshell-derived hydroxyapatite is economic, compared with SHA.

Impact of radiation history, gender and age on bone quality in sites for orthodontic skeletal anchorage device placement.

PubMed

Konermann, A; Appel, T; Wenghoefer, M; Sirokay, S; Dirk, C; Jäger, A; Götz, W

2015-05-01

Stability of orthodontic miniscrew implants is prerequisite to their success and durability in orthodontic treatment. As investigations revealed a positive correlation of miniscrew stability to periimplant bone quality, it has been the aim of this study to analyze the bone structure of resection preparations of human mandibles histologically by investigating the samples according to age, gender and exposure to radiotherapy. Inflammation- and tumor-free alveolar bone sections from human mandibles (n = 31) with previously diagnosed carcinoma, chronic osteomyelitis or cysts were analyzed histomorphologically and histomorphometrically as to the dimension of trabeculae in cancellous areas. Group A investigated the impact of a history of radiation therapy, group B of gender and group C contrasted biopsies from individuals aging under 60 or over 60 years. Statistics were performed using the Kruskal-Wallis-test. Radiation, gender and age did not significantly influence bone density. The mean bone density averaged 40.7 ± 15.0% of spongiosa for the total collective with a median age of 58.4 years ± 14.7 years. Our findings provide new information on bone quality, thus contributing to a more precise evaluation of the parameters affecting and those not affecting miniscrew implant stability. On the basis of these results, the formulation of clinical guidelines for risk assessment of therapeutic approaches in patients prior to insertion of orthodontic skeletal anchorage devices seems to be conceivable. Copyright © 2014 Elsevier GmbH. All rights reserved.

Homozygous TREM2 mutation in a family with atypical frontotemporal dementia.

PubMed

Le Ber, Isabelle; De Septenville, Anne; Guerreiro, Rita; Bras, José; Camuzat, Agnès; Caroppo, Paola; Lattante, Serena; Couarch, Philippe; Kabashi, Edor; Bouya-Ahmed, Kawtar; Dubois, Bruno; Brice, Alexis

2014-10-01

TREM2 mutations were first identified in Nasu-Hakola disease, a rare autosomal recessive disease characterized by recurrent fractures because of bone cysts and presenile dementia. Recently, homozygous and compound heterozygous TREM2 mutations were identified in rare families with frontotemporal lobar degeneration (FTLD) but without bone involvement. We identified a p.Thr66Met heterozygous mutation in a new consanguineous Italian family. Two sibs had early onset autosomal recessive FTLD without severe bone disorders. Atypical signs were present in this family: early parietal and hippocampus involvement, parkinsonism, epilepsy, and corpus callosum thickness on brain magnetic resonance imaging. This study further demonstrates the implication of TREM2 mutations in FTLD phenotypes. It illustrates the variability of bone phenotype and underlines the frequency of atypical signs in TREM2 carriers. This and previous studies evidence that TREM2 mutation screening should be limited to autosomal recessive FTLD with atypical phenotypes characterized by: (1) a very young age at onset (20-50 years); (2) early parietal and hippocampal deficits; (3) the presence of seizures and parkinsonism; (4) suggestive extensive white matter lesions and corpus callosum thickness on brain magnetic resonance imaging. Copyright © 2014 Elsevier Inc. All rights reserved.

Homozygous TREM2 mutation in a family with atypical frontotemporal dementia

PubMed Central

Bras, José; Camuzat, Agnès; Caroppo, Paola; Lattante, Serena; Couarch, Philippe; Kabashi, Edor; Bouya-Ahmed, Kawtar; Dubois, Bruno; Brice, Alexis

2014-01-01

TREM2 mutations were first identified in Nasu-Hakola disease, a rare autosomal recessive disease characterized by recurrent fractures because of bone cysts and presenile dementia. Recently, homozygous and compound heterozygous TREM2 mutations were identified in rare families with frontotemporal lobar degeneration (FTLD) but without bone involvement. We identified a p.Thr66Met heterozygous mutation in a new consanguineous Italian family. Two sibs had early onset autosomal recessive FTLD without severe bone disorders. Atypical signs were present in this family: early parietal and hippocampus involvement, parkinsonism, epilepsy, and corpus callosum thickness on brain magnetic resonance imaging. This study further demonstrates the implication of TREM2 mutations in FTLD phenotypes. It illustrates the variability of bone phenotype and underlines the frequency of atypical signs in TREM2 carriers. This and previous studies evidence that TREM2 mutation screening should be limited to autosomal recessive FTLD with atypical phenotypes characterized by: (1) a very young age at onset (20–50 years); (2) early parietal and hippocampal deficits; (3) the presence of seizures and parkinsonism; (4) suggestive extensive white matter lesions and corpus callosum thickness on brain magnetic resonance imaging. PMID:24910390

Incidentally detected non-palpable testicular tumours in adults at scrotal ultrasound: impact of radiological findings on management Radiologic review and recommendations of the ESUR scrotal imaging subcommittee.

PubMed

Rocher, Laurence; Ramchandani, Parvati; Belfield, Jane; Bertolotto, Michele; Derchi, Lorenzo E; Correas, Jean Michel; Oyen, Raymond; Tsili, Athina C; Turgut, Ahmet Tuncay; Dogra, Vikram; Fizazi, Karim; Freeman, Simon; Richenberg, Jonathan

2016-07-01

The increasing detection of small testicular lesions by ultrasound (US) in adults can lead to unnecessary orchiectomies. This article describes their nature, reviews the available literature on this subject and illustrates some classical lesions. We also suggest recommendations to help characterization and management. The ESUR scrotal imaging subcommittee searched for original and review articles published before May 2015 using the Pubmed and Medline databases. Key words used were 'testicular ultrasound', 'contrast-enhanced sonography', 'sonoelastography', 'magnetic resonance imaging', 'testis-sparing surgery', 'testis imaging', 'Leydig cell tumour', 'testicular cyst'. Consensus was obtained amongst the members of the subcommittee, urologist and medical oncologist. Simple cysts are frequent and benign, and do not require follow up or surgery. Incidentally discovered small solid testicular lesions detected are benign in up to 80 %, with Leydig cell tumours being the most frequent. However, the presence of microliths, macrocalcifications and hypoechoic areas surrounding the nodule are findings suggestive of malignant disease. Asymptomatic small testicular lesions found on ultrasound are mainly benign, but findings such as microliths or hypoechoic regions surrounding the nodules may indicate malignancy. Colour Doppler US remains the basic examination for characterization. The role of newer imaging modalities in characterization is evolving. • Characterization of testicular lesions is primarily based on US examination. • The role of MRI, sonoelastography, contrast-enhanced ultrasound is evolving. • Most small non-palpable testicular lesions seen on ultrasound are benign simple cysts. • Leydig cell tumours are the most frequent benign lesions. • Associated findings like microliths or hypoechoic regions may indicate malignancy.

Randomized study of percutaneous ureteroscopic plasma column electrode decortication and laparoscopic decortication in managing simple renal cyst.

PubMed

Liu, Weiguang; Zhang, Chengrong; Wang, Bohan; Li, Bao; Gao, Guojun; Sun, Guobao; Sun, Yuansheng; Lin, Guiting

2018-04-01

To assess the safety and efficacy of a novel technology referred to as percutaneous ureteroscopic plasma column electrode (PCE) by comparing laparoscopic decortication in the management of simple renal cyst (SRC). Between March 2016 and June 2017, 53 patients with SRCs were randomized to divided into two groups, the PCE group (24 patients), or laparoscope group (29 patients). The operative time, blood loss, days of drainage, catheter, and hospital stay and complications were compared with the two groups. All patients were followed- up to 6 months after treatment. No patients had intraoperative complications such as hemopneumothorax, adjacent organ injury, infection or hemorrhage shock. In the PCE group and laparoscope group: the mean operation time was 34.1±8.2 vs. 58.4±16.7 min (P<0.05). The mean blood loss was 2.0±1.16 vs. 9.7±4.09 mL (P<0.05). The mean postoperative indwelling drainage tube time was 2.5±1.5 vs. 2.9±1.09 d (P>0.05). The mean intra-urethral indwelling catheter time was 2.1±0.88 vs. 2.0±1.15 d (P>0.05). The mean postoperative hospital stay was 3.0±1.7 vs. 3.7±1.53 (P>0.05). One patient in electrode group was suffered from rupture of the collecting system during the operation, and was treated by indwelling D-J stent. During follow up, no cysts recurrence was found. Percutaneous ureteroscopic PCE decortication is a safe, minimally invasive and effective therapy to treat SRCs, with equal efficacy and advantages in shortening the operation time and reducing the amount of intraoperative bleeding compared with laparoscopic decortication.

Magnetic resonance imaging of the knee

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mink, J.H.; Reicher, M.A.; Crues, J.V.

1987-01-01

Introducing a comprehensive, practical guide to the use of magnetic resonance imaging (MRI) in detecting and evaluating knee disorders and planning arthroscopic surgery) This book integrates MRI findings with pertinent anatomy, physiology, and clinical signs to assist radiologists in selecting imaging protocols and interpreting scans. Detailed chapters focus on magnetic resonance imaging of the menisci and ligaments and evaluation of osteonecrosis, osteochondrosis, and osteochondritis. The authors demonstrate the potential of MRI for diagnosing various knee disorders such as arthritis, fractures, popliteal cysts, synovial disease, plicae, popliteal artery aneurysms, tumors, and bone marrow disorders.

Understanding interannual, decadal level variability in paralytic shellfish poisoning toxicity in the Gulf of Maine: The HAB Index

NASA Astrophysics Data System (ADS)

Anderson, Donald M.; Couture, Darcie A.; Kleindinst, Judith L.; Keafer, Bruce A.; McGillicuddy, Dennis J., Jr.; Martin, Jennifer L.; Richlen, Mindy L.; Hickey, J. Michael; Solow, Andrew R.

2014-05-01

A major goal in harmful algal bloom (HAB) research has been to identify mechanisms underlying interannual variability in bloom magnitude and impact. Here the focus is on variability in Alexandrium fundyense blooms and paralytic shellfish poisoning (PSP) toxicity in Maine, USA, over 34 years (1978-2011). The Maine coastline was divided into two regions - eastern and western Maine, and within those two regions, three measures of PSP toxicity (the percent of stations showing detectable toxicity over the year, the cumulative amount of toxicity per station measured in all shellfish (mussel) samples during that year, and the duration of measurable toxicity) were examined for each year in the time series. These metrics were combined into a simple HAB Index that provides a single measure of annual toxin severity across each region. The three toxin metrics, as well as the HAB Index that integrates them, reveal significant variability in overall toxicity between individual years as well as long-term, decadal patterns or regimes. Based on different conceptual models of the system, we considered three trend formulations to characterize the long-term patterns in the Index - a three-phase (mean-shift) model, a linear two-phase model, and a pulse-decline model. The first represents a “regime shift” or multiple equilibria formulation as might occur with alternating periods of sustained high and low cyst abundance or favorable and unfavorable growth conditions, the second depicts a scenario of more gradual transitions in cyst abundance or growth conditions of vegetative cells, and the third characterizes a ”sawtooth” pattern in which upward shifts in toxicity are associated with major cyst recruitment events, followed by a gradual but continuous decline until the next pulse. The fitted models were compared using both residual sum of squares and Akaike's Information Criterion. There were some differences between model fits, but none consistently gave a better fit than the others. This statistical underpinning can guide efforts to identify physical and/or biological mechanisms underlying the patterns revealed by the HAB Index. Although A. fundyense cyst survey data (limited to 9 years) do not span the entire interval of the shellfish toxicity records, this analysis leads us to hypothesize that major changes in the abundance of A. fundyense cysts may be a primary factor contributing to the decadal trends in shellfish toxicity in this region. The HAB Index approach taken here is simple but represents a novel and potentially useful tool for resource managers in many areas of the world subject to toxic HABs.

Understanding interannual, decadal level variability in paralytic shellfish poisoning toxicity in the Gulf of Maine: the HAB Index

PubMed Central

Anderson, Donald M.; Couture, Darcie A.; Kleindinst, Judith L.; Keafer, Bruce A.; McGillicuddy, Dennis J.; Martin, Jennifer L.; Richlen, Mindy L.; Hickey, J. Michael; Solow, Andrew R.

2013-01-01

A major goal in harmful algal bloom (HAB) research has been to identify mechanisms underlying interannual variability in bloom magnitude and impact. Here the focus is on variability in Alexandrium fundyense blooms and paralytic shellfish poisoning (PSP) toxicity in Maine, USA, over 34 years (1978 – 2011). The Maine coastline was divided into two regions -eastern and western Maine, and within those two regions, three measures of PSP toxicity (the percent of stations showing detectable toxicity over the year, the cumulative amount of toxicity per station measured in all shellfish (mussel) samples during that year, and the duration of measurable toxicity) were examined for each year in the time series. These metrics were combined into a simple HAB Index that provides a single measure of annual toxin severity across each region. The three toxin metrics, as well as the HAB Index that integrates them, reveal significant variability in overall toxicity between individual years as well as long-term, decadal patterns or regimes. Based on different conceptual models of the system, we considered three trend formulations to characterize the long-term patterns in the Index – a three-phase (mean-shift) model, a linear two-phase model, and a pulse-decline model. The first represents a “regime shift” or multiple equilibria formulation as might occur with alternating periods of sustained high and low cyst abundance or favorable and unfavorable growth conditions, the second depicts a scenario of more gradual transitions in cyst abundance or growth conditions of vegetative cells, and the third characterizes a ”sawtooth” pattern in which upward shifts in toxicity are associated with major cyst recruitment events, followed by a gradual but continuous decline until the next pulse. The fitted models were compared using both residual sum of squares and Akaike's Information Criterion. There were some differences between model fits, but none consistently gave a better fit than the others. This statistical underpinning can guide efforts to identify physical and/or biological mechanisms underlying the patterns revealed by the HAB Index. Although A. fundyense cyst survey data (limited to 9 years) do not span the entire interval of the shellfish toxicity records, this analysis leads us to hypothesize that major changes in the abundance of A. fundyense cysts may be a primary factor contributing to the decadal trends in shellfish toxicity in this region. The HAB Index approach taken here is simple but represents a novel and potentially useful tool for resource managers in many areas of the world subject to toxic HABs. PMID:24948849

Acromegalic arthropathy in various stages of the disease: an MRI study.

PubMed

Claessen, K M J A; Canete, A Navas; de Bruin, P W; Pereira, A M; Kloppenburg, M; Kroon, H M; Biermasz, N R

2017-06-01

Arthropathy is a prevalent and invalidating complication of acromegaly with a characteristic radiographic phenotype. We aimed to further characterize cartilage and bone abnormalities associated with acromegalic arthropathy using magnetic resonance imaging (MRI). Twenty-six patients (23% women, mean age 56.8 ± 13.4 years), with active ( n  = 10) and controlled acromegaly ( n  = 16) underwent a 3.0 T MRI of the right knee. Osteophytes, cartilage defects, bone marrow lesions and subchondral cysts were assessed by the Knee Osteoarthritis Scoring System (KOSS) method. Cartilage thickness and cartilage T2 relaxation times, in which higher values reflect increased water content and/or structural changes, were measured. Twenty-five controls (52% women, mean age: 59.6 ± 8.0 years) with primary knee OA were included for comparison. Both in active and controlled acromegaly, structural OA defects were highly prevalent, with thickest cartilage and highest cartilage T2 relaxation times in the active patients. When compared to primary OA subjects, patients with acromegaly seem to have less cysts (12% vs 48%, P  = 0.001) and bone marrow lesions (15% vs 80%, P  = 0.006), but comparable prevalence of osteophytosis and cartilage defects. Patients with acromegaly had 31% thicker total joint cartilage ( P  < 0.001) with higher cartilage T2 relaxation times at all measured sites than primary OA subjects ( P  < 0.01). Patients with active acromegaly have a high prevalence of structural OA abnormalities in combination with thick joint cartilage. In addition, T2 relaxation times of cartilage are high in active patients, indicating unhealthy cartilage with increased water content, which is (partially) reversible by adequate treatment. Patients with acromegaly have a different distribution of structural OA abnormalities visualized by MRI than primary OA subjects, especially of cartilage defects. © 2017 European Society of Endocrinology.

[Scintigraphic detection of osteoblast activity after implantation of BAS-0 bioactive glass-ceramic material into long bone defects].

PubMed

Sponer, P; Urban, K; Urbanová, E

2006-06-01

The aim of the study was to demonstrate, by three-phase bone scintigraphy, radionuclide uptake at the site of defects in long bones filled with the non-resorbable bioactive glass-ceramic material BAS-0 at a long follow-up. Twenty patients, 14 men and 6 women, operated on between 1990 and 2000 for benign bone tumors or tumor-like lesions localized in the femur, tibia or humerus were comprised in the study. Their average age at the time of operation was 14 years (range, 8 to 24). The diagnoses based on histological examination included juvenile bone cysts in 11, aneurysmal bone cyst in five, non-ossifying fibroma in two, and fibrous dysplasia in two patients. The lesions were localized in the femur, humerus and tibia in 11, five and four patients, respectively. The metaphysis was affected in eight and the diaphysis in 12 patients. Clinical, radiological and scintigraphic examinations were carried out at 2 to 12 years (7 years on average) after surgery. The clinical evaluation included subjective complaints and objective findings. Radiographs were made in standard projections and the osteo-integration of glass-ceramic material was investigated. Three-phase bone scans were made and the healthy and the affected limbs in each patient were compared by means of an index. Radionuclide uptake was considered normal when the index value was equal to 1.0, mildly increased at an index value of 1.2, moderately increased at 1.2-1.5 and markedly increased at an index value higher than 1.5. The clinical evaluation showed that, in the patients with glass-ceramic filling of metaphyses, six had no subjective complaints and two reported transient pain. In the patients with implants in diaphyses, subjective complaints were recorded in nine and no complaints in three patients. No inflammatory changes in soft tissues were found. No restriction in weightbearing of the limb treated was reported by any of the patients. On radiography, 18 patients were free from any disease residue or recurrence. Two patients had a residual defect. The bioactive glass-ceramic material BAS-0 was completely incorporated in all patients. On three-phase bone scans, radionuclide distribution on the flow phase and soft tissue phase was symmetrical in both limbs of all patients. For the metaphyseal location of implants, the delayed images demonstrated physiological radionuclide distribution in one patient, mildly increased distribution (index up to 1.2) in four, increased uptake (index up to 1.5) in two patients, and highly increased uptake (index above 1.5) in one patient. For the diaphyseal location of implants, the delayed scans demonstrated slightly increased radionuclide distribution in two, markedly increased in two and highly increased uptake in eight patients. The tissue during incorporation of a non-resorbable synthetic material is influenced by stress-shielding. This changes local mechanical signals, which has a negative effect on the adjacent bone tissue. Stress accumulating at the interface of a rigid implant and bone tissue may result in pain, and is detected by scintigraphy as an increased nucleotide uptake, particularly in diaphyseal grafts. This paper presents problems associated with implantation of the non-resorbable bioactive glass-ceramic material BAS-0 in the treatment of diaphyseal defects of long bones. The results show that, for filling of the defects described herein, non-resorbable glass-ceramic materials are not suitable.

Combining Ultrasound Pulse-Echo and Transmission Computed Tomography for Quantitative Imaging the Cortical Shell of Long Bone Replicas

NASA Astrophysics Data System (ADS)

Shortell, Matthew P.; Althomali, Marwan A. M.; Wille, Marie-Luise; Langton, Christian M.

2017-11-01

We demonstrate a simple technique for quantitative ultrasound imaging of the cortical shell of long bone replicas. Traditional ultrasound computed tomography instruments use the transmitted or reflected waves for separate reconstructions but suffer from strong refraction artefacts in highly heterogenous samples such as bones in soft tissue. The technique described here simplifies the long bone to a two-component composite and uses both the transmitted and reflected waves for reconstructions, allowing the speed of sound and thickness of the cortical shell to be calculated accurately. The technique is simple to implement, computationally inexpensive and sample positioning errors are minimal.

Analysis on clinical characteristics of intracranial Arachnoid Cysts in 488 pediatric cases

PubMed Central

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 IACs. PMID:26770437

Radiographic evaluation for AVN following distal metatarsal Stoffella bunion osteotomy.

PubMed

Klein, Christian; Zembsch, Alexander; Dorn, Ulrich

2009-01-01

Avascular necrosis of the metatarsal head, delayed bone healing and nonunion are complications that may occur after distal first metatarsal osteotomies. Intraoperative damage to the extraosseous blood supply, the location of the osteotomy and postoperative vasospasm have been cited as possible causes of such changes. We evaluated Stoffella's subcapital osteotomies which were performed at our department for the correction of moderate to severe hallux valgus deformities. Standardized radiographs of 300 feet, taken 6weeks, 3 months, and 6 months postoperatively and at the final followup were examined with regard to postoperative AVN or signs of delayed bone healing. Of 228 patients, 202 were women and 26 were men. The patients' mean age was 49 years, and the mean followup was 12 months. In 278 cases the radiographs revealed an unremarkable first metatarsal head. Seventeen cases showed diffuse or localized osteopenia or small cysts in the subchondral bone. These changes fully resolved on subsequent radiographs. The X-rays of two patients revealed progressive narrowing of the joint space, irregular contours on the surface of the joint and an abnormal bone structure. The patients subsequently developed a characteristic picture of avascular necrosis, in one case combined with nonunion. Three patients had delayed bone healing, but ultimately healed successfully. Ischemic changes in bone are known to occur after distal first metatarsal osteotomies. There is a very low incidence of postoperative perfusion problems after Stoffella;s technique, even with lateral soft tissue release.

Subchondral bone remodeling is related to clinical improvement after joint distraction in the treatment of ankle osteoarthritis

PubMed Central

Intema, F.; Thomas, T.P.; Anderson, D.D.; Elkins, J.M.; Brown, T.D.; Amendola, A.; Lafeber, F.P.J.G.; Saltzman, C.L.

2011-01-01

Objective In osteoarthritis (OA), subchondral bone changes alter the joint’s mechanical environment and potentially influence progression of cartilage degeneration. Joint distraction as a treatment for OA has been shown to provide pain relief and functional improvement through mechanisms that are not well understood. This study evaluated whether subchondral bone remodeling was associated with clinical improvement in OA patients treated with joint distraction. Method Twenty-six patients with advanced post-traumatic ankle OA were treated with joint distraction for three months using an Ilizarov frame in a referral center. Primary outcome measure was bone density change analyzed on CT scans. Longitudinal, manually segmented CT datasets for a given patient were brought into a common spatial alignment. Changes in bone density (Hounsfield Units (HU), relative to baseline) were calculated at the weight-bearing region, extending subchondrally to a depth of 8 mm. Clinical outcome was assessed using the ankle OA scale. Results Baseline scans demonstrated subchondral sclerosis with local cysts. At one and two years of follow-up, an overall decrease in bone density (−23% and −21%, respectively) was observed. Interestingly, density in originally low-density (cystic) areas increased. Joint distraction resulted in a decrease in pain (from 60 to 35, scale of 100) and functional deficit (from 67 to 36). Improvements in clinical outcomes were best correlated with disappearance of low-density (cystic) areas (r=0.69). Conclusions Treatment of advanced post-traumatic ankle OA with three months of joint distraction resulted in bone density normalization that was associated with clinical improvement. PMID:21324372

Clinical evaluation and radiographic assessment of bone lysis of the AES total ankle replacement.

PubMed

Besse, Jean-Luc; Brito, Nuno; Lienhart, Christophe

2009-10-01

AES mobile-bearing total ankle replacement is evolved from the Buechel Pappas model. We report medium-term results of a prospective study with AES. All patients who underwent AES TAR for ankle arthritis, by a single surgeon, from 2003 to 2006 were included, excluding neurologic disease, talar osteonecrosis and malalignment more than 20 degrees. All were reviewed at 6 months, 1 year, and at yearly intervals thereafter. X-rays were analyzed by three observers, using a 10-zone protocol. Fifty consecutive AES implants in 47 patients (mean age, 56 years; range, 21 to 79 year) were included, with at least 2 years' followup (mean 40 months). Preoperative diagnosis was mainly post-traumatic (50%) and osteoarthritis secondary to instability (36%). Associated procedures were performed in 38%. Eighty-two percent had good functional results. The mean AOFAS score rose from 36.9 +/- 1.7 preoperatively to 85.4 +/- 12, dorsiflexion from 3 degrees to 7.3 degrees, and plantarflexion from 30.8 degrees to 37.8 degrees. Two ankles underwent secondary arthrodesis for talar subsidence and mechanical dislocation. Ninety-eight percent of implants were well positioned at 90 degrees +/-4. Mean prosthesis ROM on X-ray was 22.1 degrees. There were tibia/implant interface cysts (greater than 5 mm) in 62% of cases, and talar/implant interface cysts in 43%. Although functional outcomes were comparable to the other mobile TAR in the literature, bone lysis with the AES prosthesis was more frequent with risk of subsidence. We therefore stopped implantation of this prosthesis and recommend preventive grafting for severe lysis.

Simple Signaling Molecules for Inductive Bone Regenerative Engineering

PubMed Central

Nelson, Stephen J.; Deng, Meng; Sethuraman, Swaminathan; Doty, Stephen B.; Lo, Kevin W. H.; Khan, Yusuf M.; Laurencin, Cato T.

2014-01-01

With greater than 500,000 orthopaedic procedures performed in the United States each year requiring a bone graft, the development of novel graft materials is necessary. We report that some porous polymer/ceramic composite scaffolds possess intrinsic osteoinductivity as shown through their capacity to induce in vivo host osteoid mineralization and in vitro stem cell osteogenesis making them attractive synthetic bone graft substitutes. It was discovered that certain low crystallinity ceramics partially dissociate into simple signaling molecules (i.e., calcium and phosphate ions) that induce stem cells to endogenously produce their own osteoinductive proteins. Review of the literature has uncovered a variety of simple signaling molecules (i.e., gases, ions, and redox reagents) capable of inducing other desirable stem cell differentiation through endogenous growth factor production. Inductive simple signaling molecules, which we have termed inducerons, represent a paradigm shift in the field of regenerative engineering where they can be utilized in place of recombinant protein growth factors. PMID:25019622

Stimulation of interleukin-6 production of periodontal ligament cells by Porphyromonas endodontalis lipopolysaccharide.

PubMed

Ogura, N; Shibata, Y; Kamino, Y; Matsuda, U; Hayakawa, M; Oikawa, T; Takiguchi, H; Izumi, H; Abiko, Y

1994-12-01

Interleukin-6 (IL-6), which is a multifunctional cytokine, has important roles in acute and chronic inflammation and may also be implicated in bone resorption. We examined the IL-6 production in periodontal ligament (PDL) cells which were treated with lipopolysaccharide (LPS) from several oral inflammatory pathogens. The LPS from Porphyromonas endodontalis, which was isolated from infected root canals and radicular cyst fluids, was more potent than the LPS from any other periodontal organisms examined. P. endodontalis LPS stimulated IL-6 release from PDL cells in a time- and dose-dependent manner. Northern blot hybridization analysis revealed that the IL-6 mRNA level in PDL cells was increased by P. endodontalis LPS. These results suggest that stimulation of the IL-6 release of PDL cells by P. endodontalis LPS may have a role in the progression of inflammation and alveolar bone resorption in periodontal and periapical diseases.

Case report 673: Telangiectic osteogenic sarcoma.

PubMed

Liu, S K; Thacher, C

1991-01-01

A case is presented of a telangiectatic osteogenic sarcoma involving the left third metatarsal of a 4-year-old male Great Dane dog. Radiographs revealed a diaphyseal, expanding, lytic lesion with minimal intralesional sclerosis and a sclerotic rim in the proximal portion. The lesion contained a large amount of blood. The biopsy specimens consisted of spaces which were outlined by fibrous osteoid or granulation tissue. There were islands of multinuclear giant cells and/or fibrous osteoid tissue. A diagnosis of aneurysmal bone cyst was made. The lesion was treated by curettage and insertion of cancellous bone graft but was progressive 10 weeks after treatment. The lesion was further curetted, and these biopsy specimens consisted of aneurysmally dilated spaces and areas of anaplastic sarcomatous cells with mitotic figures and osteoid production, characteristic of telangiectatic osteogenic sarcoma. The dog was euthanized as the owner requested; an autopsy was not performed.

A suspected malignancy in osteolytic bone tumour of the thumb

PubMed Central

Mattiassich, Georg; Ensat, Florian; Hager, Martina; Wechselberger, Gottfried

2012-01-01

A 75-year-old male patient was referred to our institution owing to a painful and gradually developing lesion of the thumb with suspicious malignancy. The patient was suffering from a swollen, red, tender left thumb for 3 months. An old scar at the finger pulp could be traced from an old minor trauma. The x-ray revealed an osteolytic lesion in the terminal phalanx of the non-dominant hand that raised concerns of malignancy. Additional investigations such as ultrasound, CT-scan and MRI have been performed to get better insight to the lesion. After performing a biopsy, no malignant cells were found. Owing to the local destroying effect of the lesion and the clinical signs of the patient, the lesion was excised in total. The histopathological evaluation confirmed the tumour as a rare intraosseous epidermoid cyst. A bone graft after resection was not needed. The postoperative follow-up of the patient was uneventful. PMID:23109418

Dandy-Walker syndrome together with occipital encephalocele.

PubMed

Cakmak, A; Zeyrek, D; Cekin, A; Karazeybek, H

2008-08-01

Dandy-Walker malformation is an anomaly characterized by dysgenesis of the foramina of Magendie and Lushka in the upper 4(th) ventricle, hypoplasia of the cerebellar vermis and agenesis of the corpus callosum. Encephalocele is diagnosed from the calvarium defect, cerebrospinal fluid (CSF) and herniation of the meninges. It is the rarest neural tube defect. A 7 x 9 cm encephalocele was found on physical examination of a 6-day old baby boy patient. From cranial magnetic resonance, it was seen that the posterior fossa was enlarged with cysts and there was agenesis of the vermis. A connection was established between the ventricle and the development of cysts on the posterior fossa. These findings were evaluated as significant from the aspect of Dandy-Walker malformation. The extension of the bone defect in the left occipital area towards the posterior, and the cranio-caudal diameter reaching 9 cm was seen to be in accordance with encephalocele. It is rare for Dandy-Walker syndrome to occur together with occipital encephalocele. The authors present a case of Dandy-Walker syndrome together with occipital encephalocele.

Rare Nonneoplastic Cysts of Pancreas

PubMed Central

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

[Treatment of Osteochondral Lesions in the Ankle: A Guideline from the Group "Clinical Tissue Regeneration" of the German Society of Orthopaedics and Traumatology (DGOU)].

PubMed

Aurich, M; Albrecht, D; Angele, P; Becher, C; Fickert, S; Fritz, J; Müller, P E; Niemeyer, P; Pietschmann, M; Spahn, G; Walther, M

2017-02-01

Background: Osteochondral lesions (OCL) of the ankle are a common cause of ankle pain. Although the precise pathophysiology has not been fully elucidated, it can be assumed that a variety of factors are responsible, mainly including traumatic events such as ankle sprains. Advances in arthroscopy and imaging techniques, in particular magnetic resonance imaging (MRI), have improved the possibilities for the diagnosis of OCLs of the ankle. Moreover, these technologies aim at developing new classification systems and modern treatment strategies. Material and Methods: This article is a review of the literature. Recommendations of the group "Clinical Tissue Regeneration" of the German Society of Orthopaedics and Traumatology (DGOU) for the treatment of OCLs of the ankle are presented. The review gives a concise overview on the results of clinical studies and discusses advantages and disadvantages of different treatment strategies. Results: Non-operative treatment shows good results for selected indications in children and adolescents, especially in early stages of osteochondritis dissecans (OCD). However, surgical treatment is usually indicated in OCLs in adolescents and adults, depending on the size and location of the lesion. Various arthroscopic and open procedures are frequently employed, including reattachment of the fragment, local debridement of the lesion with fragment removal and curettage of the lesion, bone marrow-stimulation by microfracture or microdrilling (antegrade or retrograde), and autologous matrix-induced chondrogenesis (AMIC®) - with or without reconstruction of a subchondral bone defect or cyst by autologous cancellous bone grafting. Isolated subchondral cysts with an intact cartilage surface can be treated by retrograde drilling and possibly additional retrograde bone grafting. For larger defects or as salvage procedure, osteochondral cylinder transplantation (OATS® or Mosaicplasty®) or matrix-induced autologous chondrocyte transplantation (MACT) are recommended. Transplantation of so-called (osteochondral) mega grafts, such as autologous bone grafts or allografts, are used for very large osteochondral defects that cannot be reconstructed otherwise. Implantation of the so-called "small metal implants" - such as HemiCAP Talus® - is reserved for selected cases after failed primary reconstruction. Corrective osteotomies are indicated in accompanying axial malalignments. Conclusions: There are several different treatment strategies for OCLs, but clinical studies are rare and evidence is limited. Therefore, interventional studies, e.g. randomised controlled trials (RCTs), but also observational studies, e.g. based on data of the Cartilage Registry of the German Society of Orthopaedics and Traumatology (www.knorpelregister-dgou.de), are needed and are recommended by the authors. Georg Thieme Verlag KG Stuttgart · New York.

Thrombotic thrombocytopenic purpura presenting with pathologic fracture: a case report.

PubMed

Berber, Ilhami; Erkurt, Mehmet Ali; Kuku, Irfan; Kaya, Emin; Unlu, Serkan; Ertem, Kadir; Nizam, Ilknur

2014-08-01

Thrombotic thrombocytopenic purpura is an acute syndrome with abnormalities in multiple organ systems, which becomes manifest with microangiopathic hemolytic anemia and thrombocytopenia. The hereditary or acquired deficiency of ADAMTS-13 activity leads to an excess of high molecular weight von Willebrand factor multimers in plasma, leading to platelet aggregation and diffuse intravascular thrombus formation, resulting in thrombotic thrombocytopenic purpura. Thrombotic lesions occurring in TTP leads to ischemia and convulsion. Depending on the properties of the bony tissue, fractures are divided into three groups as traumatic, pathological, and stress fractures. A pathologic fracture is a broken bone caused by disease leading to weakness of the bone. This process is most commonly due to osteoporosis, but may also be due to other pathologies such as cancer, infections, inherited bone disorders, or a bone cyst. We herein report a case with a pathologic fracture due to convulsion secondary to thrombotic thrombocytopenic pupura. Thrombotic lesions occurring in TTP may lead to ischemia and convulsion, as in our patient and pathological fractures presented in our case report may occur as a result of severe muscle contractions associated with convulsive activity. Thrombotic thrombocytopenic pupura is a disease that involves many organ systems and thus may have a very wide spectrum of clinical presentations. Copyright © 2014. Published by Elsevier Ltd.

[Prevalence and clinicopathological characteristics of giant cell tumors].

PubMed

Estrada-Villaseñor, E G; Linares-González, L M; Delgado-Cedillo, E A; González-Guzmán, R; Rico-Martínez, G

2015-01-01

The frequency of giant cell tumors reported in the literature is very variable. Considering that our population has its own features, which distinguish it from the Anglo-Saxon and Asian populations, we think that both the frequency and the clinical characteristics of giant cell tumors in our population are different. The major aim of this paper was to determine the frequency and clinicopathological characteristics of giant cell tumors of the bone. A cross-sectional descriptive study was conducted of the cases diagnosed at our service as giant cell tumors of the bone from January to December 2013. The electronic clinical records, radiologic records and histologic slides from each case were reviewed. Giant cell tumors represented 17% of total bone tumors and 28% of benign tumors. Patients included 13 females and 18 males. The most frequent locations of giant cell tumors were: the proximal tibia, 9 cases (29%), and the distal femur, 6 cases (19%). Forty-five percent of giant cell tumors were associated with aneurysmal bone cyst (ABC) (14 cases) and one case (3%) was malignant. The frequency of giant cell tumors in this case series was intermediate, that is, higher than the one reported in Anglo-Saxon countries (usually low), but without reaching the frequency rates reported in Asian countries (high).

Vascular Spaces in Compact Bone: A Technique to Correct a Common Misinterpretation of Structure

ERIC Educational Resources Information Center

Locke, M.; Dean, Rob L.

2003-01-01

Old bones are often discolored by the grime that infiltrates spaces in the matrix once occupied by blood vessels. This suggested that allowing dry bone to absorb colorants might be a useful way to show the three dimensional complexity of bone vascularization. The authors have developed a simple way to show blood vessels spaces in bone at a glance…

[TITANIUM NICKELIDE TECHNOLOGIES IN MINIMALLY INVASIVE SURGERY OF KIDNEY AND UPPER URINARY TRACT].

PubMed

Feofilov, L V

2015-01-01

The most common pathology of the kidney and upper urinary tract includes nephrolithiasis, ureteral strictures and renal cysts. In the treatment of patients with these diseases, the majority of surgeons prefer minimally invasive techniques, including endoscopic surgery. The complication rate of percutaneous surgery is a major factor in encouraging the search for new treatments. We have analyzed the results of 402 x-ray-endoscopic operations performed with the use of technologies based on titanium nickelide materials in patients with nephrolithiasis, ureteral strictures and kidney cysts. The high effectiveness and reliability of porous titanium nickelide cryoapplicator was noted in control of percutaneous channel bleeding and prevention. The proposed suspension nephropexy with fine titanium granules in coexisting nephrolithiasis and nephroptosis demonstrated 1.5 times greater effectiveness compared to the traditional nephropexy, reducing duration of nephrostomy and rehabilitation by almost 3 times. The proposed methods of intubation by permanent and temporary stents with shape memory after percutaneous ureteropelvic junction stricture correction are promising in the treatment of patients with this pathology of the upper urinary tract. Application of titanium nickelide implants in simple renal cyst surgery has led to a significant increase in the effectiveness of these operations, improvement in long-term results and patients' quality of life.

Angiomyofibroblastoma of the vulva: a case report of a pedunculated variant and review of the literature.

PubMed

Sims, Shireen Madani; Stinson, Kathryn; McLean, Frederick W; Davis, John D; Wilkinson, Edward J

2012-04-01

Angiomyofibroblastoma (AMF) is a benign mesenchymal tumor usually found in the vulva. We reviewed 70 cases of vulvar AMF that have been reported in the English-language literature and report 1 case of a pedunculated variant. Our case brings the total reported to 71 and is only the fourth pedunculated variant reported. This 50-year-old woman presented to our gynecology clinic with a 1-year history of a left labial mass. It began as pea-sized, and rapidly grew to 12 cm in diameter. Physical examination demonstrated a 12-cm pedunculated soft mass arising from the left labia majora. The clinical diagnosis was aggressive angiomyxoma, and a simple excision was performed. The final pathology demonstrated AMF. The patient remains free from tumor at 4 years of follow-up. Seventy-one cases were summarized. The mean age at presentation was 45 years. The lesions were equally distributed between the left (52%) and right (48%). The most common clinical diagnosis was a Bartholin gland cyst (46%) or lipoma (15%). The mean duration of the lesion before seeking treatment was 29 months, and the mean diameter at presentation was 5.9 cm. All of the patients were treated with simple excision. The mean duration of follow-up was 37 months. There was 1 report of sarcomatous transformation 2 years after initial treatment. Angiomyofibroblastoma is a rare benign tumor that most often occurs in the vulva. Differential diagnosis may include aggressive angiomyxoma, Bartholin cyst, or lipoma. The treatment of choice is simple total excision, which is usually curative.

Long-term outcome of free fibula osteocutaneous flap and massive allograft in the reconstruction of long bone defect.

PubMed

Halim, Ahmad Sukari; Chai, Siew Cheng; Wan Ismail, Wan Faisham; Wan Azman, Wan Sulaiman; Mat Saad, Arman Zaharil; Wan, Zulmi

2015-12-01

Reconstruction of massive bone defects in bone tumors with allografts has been shown to have significant complications including infection, delayed or nonunion of allograft, and allograft fracture. Resection compounded with soft tissue defects requires skin coverage. A composite osteocutaneous free fibula offers an optimal solution where the allografts can be augmented mechanically and achieve biological incorporation. Following resection, the cutaneous component of the free osteocutaneous fibula flaps covers the massive soft tissue defect. In this retrospective study, the long-term outcome of 12 patients, who underwent single-stage limb reconstruction with massive allograft and free fibula osteocutaneous flaps instead of free fibula osteal flaps only, was evaluated. This study included 12 consecutive patients who had primary bone tumors and had follow-up for a minimum of 24 months. The mean age at the time of surgery was 19.8 years. A total of eight patients had primary malignant bone tumors (five osteosarcomas, two chondrosarcomas and one synovial sarcoma), and four patients had benign bone tumors (two giant-cell tumors, one aneurysmal bone cyst, and one neurofibromatosis). The mean follow-up for the 12 patients was 63 months (range 24-124 months). Out of the 10 patients, nine underwent lower-limb reconstruction and ambulated with partial weight bearing and full weight bearing at an average of 4.2 months and 8.2 months, respectively. In conclusion, augmentation of a massive allograft with free fibula osteocutaneous flap is an excellent alternative for reducing the long-term complication of massive allograft and concurrently addresses the soft tissue coverage. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Femoroacetabular impingement: bone marrow oedema associated with fibrocystic change of the femoral head and neck junction.

PubMed

James, S L J; Connell, D A; O'Donnell, P; Saifuddin, A

2007-05-01

To describe the association of bone marrow oedema adjacent to areas of fibrocystic change at the femoral head and neck junction in patients with femoroacetabular impingement. The clinical and imaging findings in six patients with bone marrow oedema adjacent to an area of fibrocystic change at the femoral head and neck junction are presented. There were five males and one female (age range 19-42 years, mean age 34.5 years). Three patients were referred with a clinical suspicion of femoroacetabular impingement, two with suspected osteoid osteoma and one with a clinical diagnosis of sciatica. The volume of bone marrow oedema (grade 1: 0-25%, grade 2: 26-50%, grade 3: 51-75% and grade 4: 76-100% of the femoral neck width), presence of labral and articular cartilage abnormality, joint effusion, and femoral head and neck morphology were recorded. Magnetic resonance imaging (MRI) identified fibrocystic change in the anterolateral aspect of the femoral head and neck junction in all cases (mean size 9 mm, range 5-14 mm, three multilocular and three unilocular cysts). The volume of oedema was variable (one grade 1, two grade 2, one grade 3 and two grade 4). All patients had abnormality of the anterosuperior labrum with five patients demonstrating chondral loss. An abnormal femoral head and neck junction was identified in five patients. The radiological finding of fibrocystic change at the anterosuperior femoral neck with or without bone marrow oedema should prompt the search for femoroacetabular impingement. Bone marrow oedema may rarely be identified adjacent to these areas of cystic change and should be considered in the differential diagnosis of bone marrow oedema in the femoral neck.

Effects of short-term gentle treadmill walking on subchondral bone in a rat model of instability-induced osteoarthritis.

PubMed

Iijima, H; Aoyama, T; Ito, A; Yamaguchi, S; Nagai, M; Tajino, J; Zhang, X; Kuroki, H

2015-09-01

Subchondral bone cyst (SBC) growth, caused by osteoclast activity during early knee osteoarthritis (OA) pathogenesis, should be treated to prevent further progressions of OA. In the present study, we evaluated the effects of gentle treadmill walking on subchondral bone and cartilage changes in an experimental rat model of destabilized medial meniscus (DMM). Twelve-week-old Wistar rats underwent DMM surgery in their right knee and sham surgery in their left knee and were assigned to either the sedentary group or walking group (n = 42/group). Animals in the walking group were subjected to treadmill exercise 2 days after surgery, which included walking for 12 m/min, 30 min/day, 5 days/week for 1, 2, and 4 week(s). Subchondral bone and cartilage changes were evaluated by micro-CT analysis, histological analysis, and biomechanical analysis. Treadmill walking had a tendency to suppress SBC growth, which was confirmed by micro-CT (P = 0.06) and positive staining for tartrate-resistant acid phosphatase (TRAP) activity for the osteoclast number per bone surface (P = 0.09) 4 weeks after surgery. These changes coincide with the prevention of cartilage degeneration as evaluated by the Osteoarthritis Research Society International (OARSI) score (P < 0.05) and biomechanically softening (P < 0.05). Furthermore, treadmill walking could suppressed increasing osteocyte deaths (P < 0.01), which was positively correlated with the OARSI score (r = 0.77; P < 0.01). These results indicate biomechanical and biological links exist between cartilage and subchondral bone; preventive effects of treadmill walking on subchondral bone deterioration might be partly explained by the chondroprotective effects. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Clinical signs and histologic findings in dogs with odontogenic cysts: 41 cases (1995-2010).

PubMed

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.

Surgical treatment for hypopharyngeal cysts with a side-opened direct laryngoscope.

PubMed

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.

Pre-radiographic MRI findings are associated with onset of knee symptoms: the most study

PubMed Central

Javaid, M. K.; Lynch, J. A.; Tolstykh, I.; Guermazi, A.; Roemer, F.; Aliabadi, P.; McCulloch, C.; Curtis, J.; Felson, D.; Lane, N. E.; Torner, J.; Nevitt, M.

2010-01-01

Summary Objective Magnetic resonance imaging (MRI) has greater sensitivity to detect osteoarthritis (OA) damage than radiographs but it is uncertain which MRI findings in early OA are clinically important. We examined MRI abnormalities detected in knees without radiographic OA and their association with incident knee symptoms. Method Participants from the Multicenter Osteoarthritis Study (MOST) without frequent knee symptoms (FKS) at baseline were eligible if they also lacked radiographic features of OA at baseline. At 15 months, knees that developed FKS were defined as cases while control knees were drawn from those that remained without FKS. Baseline MRIs were scored at each subregion for cartilage lesions (CARTs); osteophytes (OST); bone marrow lesions (BML) and cysts. We compared cases and controls using marginal logistic regression models, adjusting for age, gender, race, body mass index (BMI), previous injury and clinic site. Results 36 case knees and 128 control knees were analyzed. MRI damage was common in both cases and controls. The presence of a severe CART (P = 0.03), BML (P = 0.02) or OST (P = 0.02) in the whole knee joint was more common in cases while subchondral cysts did not differ significantly between cases and controls (P > 0.1). Case status at 15 months was predicted by baseline damage at only two locations; a BML in the lateral patella (P = 0.047) and at the tibial subspinous subregions (P = 0.01). Conclusion In knees without significant symptoms or radiographic features of OA, MRI lesions of OA in only a few specific locations preceded onset of clinical symptoms and suggest that changes in bone play a role in the early development of knee pain. Confirmation of these findings in other prospective studies of knee OA is warranted. PMID:19919856

Revascularization of diaphyseal bone segments by vascular bundle implantation.

PubMed

Nagi, O N

2005-11-01

Vascularized bone transfer is an effective, established treatment for avascular necrosis and atrophic or infected nonunions. However, limited donor sites and technical difficulty limit its application. Vascular bundle transplantation may provide an alternative. However, even if vascular ingrowth is presumed to occur in such situations, its extent in aiding revascularization for ultimate graft incorporation is not well understood. A rabbit tibia model was used to study and compare vascularized, segmental, diaphyseal, nonvascularized conventional, and vascular bundle-implanted grafts with a combination of angiographic, radiographic, histopathologic, and bone scanning techniques. Complete graft incorporation in conventional grafts was observed at 6 months, whereas it was 8 to 12 weeks with either of the vascularized grafts. The pattern of radionuclide uptake and the duration of graft incorporation between vascular segmental bone grafts (with intact endosteal blood supply) and vascular bundle-implanted segmental grafts were similar. A vascular bundle implanted in the recipient bone was found to anastomose extensively with the intraosseous circulation at 6 weeks. Effective revascularization of bone could be seen when a simple vascular bundle was introduced into a segment of bone deprived of its normal blood supply. This simple technique offers promise for improvement of bone graft survival in clinical circumstances.

Effects and mechanism of OK-432 therapy in various neck cystic lesions.

PubMed

Ohta, Nobuo; Fukase, Shigeru; Watanabe, Tomoo; Ito, Tsukasa; Aoyagi, Masaru

2010-11-01

Our results confirmed that OK-432 therapy is simple, easy, safe, and effective and can be used as a substitute for surgery in the treatment of benign neck cysts. In OK-432 therapy, inflammatory cytokines may play important roles in shrinkage of the cystic spaces. The aim of this study was to evaluate the outcome and mechanism of action of OK-432 therapy in benign neck cysts. We tried OK-432 therapy in 83 patients with benign neck cysts between April 1997 and August 2009. We aspirated as much of the fluid content of each cystic lesion as possible, and then replaced the volume of aspirated fluid with about half the volume of OK-432 solution. We evaluated the mechanism of action of OK-432 in 43 of the patients. The intracystic fluid in the cysts was aspirated before and after OK-432 therapy, and cytokine production in each aspirate was analyzed by ELISA. Disappearance of the lesion was observed in 63 of 83 patients (76%). Marked reduction was observed in 13 of the 83 patients (16%). Partial reduction was observed in two patients (2%) and no response was seen in five (6%). Local discomfort at the injection site and low-grade fever were side effects observed in half of the patients, but such problems resolved within a few days. No local scarring or deformity of the injected sites occurred in any patient. We performed OK-432 therapy on an outpatient basis without hospitalization. Levels of various cytokines, including tumor necrosis factor, interleukin-8, interleukin-6, interferon gamma, and vascular endothelial growth factor, were significantly elevated in each aspirate after OK-42 therapy.

Diagnostic imaging of solitary tumors of the spine: what to do and say.

PubMed

Rodallec, Mathieu H; Feydy, Antoine; Larousserie, Frédérique; Anract, Philippe; Campagna, Raphaël; Babinet, Antoine; Zins, Marc; Drapé, Jean-Luc

2008-01-01

Metastatic disease, myeloma, and lymphoma are the most common malignant spinal tumors. Hemangioma is the most common benign tumor of the spine. Other primary osseous lesions of the spine are more unusual but may exhibit characteristic imaging features that can help the radiologist develop a differential diagnosis. Radiologic evaluation of a patient who presents with osseous vertebral lesions often includes radiography, computed tomography (CT), and magnetic resonance (MR) imaging. Because of the complex anatomy of the vertebrae, CT is more useful than conventional radiography for evaluating lesion location and analyzing bone destruction and condensation. The diagnosis of spinal tumors is based on patient age, topographic features of the tumor, and lesion pattern as seen at CT and MR imaging. A systematic approach is useful for recognizing tumors of the spine with characteristic features such as bone island, osteoid osteoma, osteochondroma, chondrosarcoma, vertebral angioma, and aneurysmal bone cyst. In the remaining cases, the differential diagnosis may include other primary spinal tumors, vertebral metastases and major nontumoral lesions simulating a vertebral tumor, Paget disease, spondylitis, echinococcal infection, and aseptic osteitis. In many cases, vertebral biopsy is warranted to guide treatment.

A comparison of Giardia microti and Spironucleus muris cysts in the vole: an immunocytochemical, light, and electron microscopic study.

PubMed

Januschka, M M; Erlandsen, S L; Bemrick, W J; Schupp, D G; Feely, D E

1988-06-01

We have shown that cysts of the genus Spironucleus share many common morphological features with Giardia cysts including: 2-4 nuclei, flagellar axonemes, a distinct cyst wall, and they even display the same immunostaining as Giardia cysts when labeled with antibodies specific for Giardia cyst wall. A direct comparison of Spironucleus muris and Giardia microti cysts have revealed that cysts of S. muris are significantly smaller than cysts of G. miroti. At the ultrastructural level, the cyst walls are similar in fibrillar appearance, but the width of the S. muris cyst wall is significantly less than that of G. microti. The cysts of S. muris also differ from G. microti in that they contain a striated rootlet fiber, flagellar sheath, and numerous glycogen rosettes. Characteristic features of Giardia include the adhesive disc and median body. Although the cysts of Spironucleus and Giardia are similar in appearance, these unique morphological features can be used to distinguish between the 2 protozoa and should be employed in the detection of Giardia cysts in water samples.

Midline cystic malformations of the brain: imaging diagnosis and classification based on embryologic analysis.

PubMed

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.

Dual lumbar bronchogenic and arachnoid cyst presenting with sciatica and left foot drop.

PubMed

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.

Echinococcus granulosus equinus: an ultrastructural study of murine tissue response to hydatid cysts.

PubMed

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.

Macrophage polarization differs between apical granulomas, radicular cysts, and dentigerous cysts.

PubMed

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 formation.

Locations of lesser tuberosity cysts and their association with subscapularis, supraspinatus, and long head of the biceps tendon disorders.

PubMed

Celikyay, Fatih; Yuksekkaya, Ruken; Deniz, Caglar; Inal, Sermet; Gokce, Erkan; Acu, Berat

2015-12-01

Humeral head cysts are not uncommon in individuals with rotator cuff disorders. The cysts are usually considered an indicator of rotator cuff pathologies; however, they may have different meanings in different regions. To determine the frequency of cysts within and adjacent to the lesser tuberosity and the relationship between these cysts and subscapularis, supraspinatus, and long head of the biceps tendon (LHBT) disorders. We retrospectively reviewed 760 consecutive shoulder magnetic resonance imaging (MRI) examinations. Among these MRIs, we selected a group of patients with cysts located around the lesser tuberosity. The study population was also divided into two subgroups, patients with cysts within the lesser tuberosity and those with cysts adjacent to the lesser tuberosity. In addition to the number and size of cysts, the MRI appearance of the tendons was evaluated. Eighty-one (10.7%) patients had cysts within and/or adjacent to the lesser tuberosity, 34 (42%) patients had cysts within the lesser tuberosity, and 47 (58%) patients had cysts adjacent to it. LHBT and subscapularis tendon disorders were significantly related to more than one cyst. In a univariate analysis, cysts within the lesser tuberosity were significantly associated with LHBT and subscapularis tendon disorders; however, multivariate analyses showed that only LHBT disorders were significantly associated with cysts within the lesser tuberosity. Cysts within the lesser tuberosity were less common than cysts adjacent to it. LHBT and subscapularis tendon disorders were more frequently found in patients with more than one cyst within and/or adjacent to the lesser tuberosity. In addition, cysts within the lesser tuberosity were associated with LHBT disorders. © The Foundation Acta Radiologica 2014.

Prevalence and distribution of odontogenic cysts in a Mexican sample. A 753 cases study.

PubMed

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.

Developmental odontogenic cysts of jaws: a clinical study of 245 cases.

PubMed

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).

Prevalence and distribution of odontogenic and nonodontogenic cysts in a Turkish Population

PubMed Central

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

[Application of acupoint anatomy localization method with colorful tube in education of acupoint anatomy].

PubMed

Song, Shi-Lin

2013-04-01

To seek a precise and simple method for localization of acupoint in anatomical experiment teaching. Medical bone needles were inserted into acupoints. Then, self-mode copper probe needles were thrust along the center of the bone needles to open the inner structures of acuppoints. And probe needles were replaced by colored plastic tubes. Finally, bone needles were withdrawn so as to fix the plastic tubes into the acupoints to facilitate the later cutting. This method for acupoint anatomic positioning is of low cost with accurate positioning and simple manipulation, which has advantages in strong experimental and innovative values.

A cumulative analysis of odontogenic cysts from major dental institutions of Bangalore city: A study of 252 cases

PubMed Central

Ramachandra, Prashanth; Maligi, Prathima; Raghuveer, HP

2011-01-01

Background: The objective of this study was to perform a cumulative analysis of odontogenic cysts obtained from the data of major dental institutions of Bangalore city, as well as to evaluate their distribution during a 5-year period and compare the results with other international studies. Materials and Methods: Data for the study were obtained from the reports of patients diagnosed with odontogenic cysts between 2005 and 2010 from different dental institutions of Bangalore. Case records of patients that fit the histological classification of the World Health Organization (WHO) (2005) were included in the study and the following variables were analyzed: age, gender, anatomic location, and histological type. Results: In a total of 252 cyst specimens diagnosed, 79.76% were odontogenic cysts and 20.24% were nonodontogenic cysts. Among the odontogenic cysts most frequent lesions were radicular cysts (50.25%), followed by keratocysts (27.36%) and dentigerous cysts (22.39%). Conclusions: Our study provides a cumulative data of odontogenic cysts in the population of Bangalore city. The results of our study showed a similar frequency of odontogenic cysts as compared to other populations of the world, with radicular cyst being identified as the most frequent odontogenic cyst. Keratocyst was the second most common cyst followed by dentigerous cyst. PMID:21731270

A cumulative analysis of odontogenic cysts from major dental institutions of Bangalore city: A study of 252 cases.

PubMed

Ramachandra, Prashanth; Maligi, Prathima; Raghuveer, Hp

2011-01-01

The objective of this study was to perform a cumulative analysis of odontogenic cysts obtained from the data of major dental institutions of Bangalore city, as well as to evaluate their distribution during a 5-year period and compare the results with other international studies. Data for the study were obtained from the reports of patients diagnosed with odontogenic cysts between 2005 and 2010 from different dental institutions of Bangalore. Case records of patients that fit the histological classification of the World Health Organization (WHO) (2005) were included in the study and the following variables were analyzed: age, gender, anatomic location, and histological type. In a total of 252 cyst specimens diagnosed, 79.76% were odontogenic cysts and 20.24% were nonodontogenic cysts. Among the odontogenic cysts most frequent lesions were radicular cysts (50.25%), followed by keratocysts (27.36%) and dentigerous cysts (22.39%). Our study provides a cumulative data of odontogenic cysts in the population of Bangalore city. The results of our study showed a similar frequency of odontogenic cysts as compared to other populations of the world, with radicular cyst being identified as the most frequent odontogenic cyst. Keratocyst was the second most common cyst followed by dentigerous cyst.

Vertebral sarcoidosis: demonstration of bone involvement by computerized axial tomography

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dinerstein, S.L.; Kovarsky, J.

1984-08-01

A report is given of a rare case of vertebral sarcoidosis with negative conventional spinal x-ray films, yet with typical cystic lesions of the spine found incidentally during abdominal computerized axial tomography (CAT). The patient was a 28-year-old black man, who was admitted for evaluation of a 1 1/2-year history of diffuse myalgias, intermittent fever to 102 F orally, bilateral hilar adenopathy, and leukopenia. A technetium polyphosphate bone scan revealed diffuse areas of increased uptake over the sternum, entire vertebral column, and pelvis. Conventional x-ray films of the cervical, thoracic, and lumbar spine, and an AP view of the pelvismore » were all normal. Chest x-ray film revealed only bilateral hilar adenopathy. During the course of an extensive negative evaluation for infection, an abdominal CAT scan was done, showing multiple, small, sclerotic-rimmed cysts at multiple levels of the lower thoracic and lumbar spine. Bone marrow biopsy revealed only changes consistent with anemia of chronic disease. Mediastinal lymph node biopsy revealed noncaseating granulomas. A tentative diagnosis of sarcoidosis was made, and treatment with prednisone, isoniazid and rifampin was begun. Within two weeks of initiation of prednisone therapy, the patient was symptom-free. A repeat technetium polyphosphate bone scan revealed only a small residual area of mildly increased uptake over the upper thoracic vertebrae.« less

Gastrointestinal manifestations of mitochondrial disorders: a systematic review

PubMed Central

Finsterer, Josef; Frank, Marlies

2016-01-01

Mitochondrial disorders (MIDs) due to respiratory-chain defects or nonrespiratory chain defects are usually multisystem conditions [mitochondrial multiorgan disorder syndrome (MIMODS)] affecting the central nervous system (CNS), peripheral nervous system, eyes, ears, endocrine organs, heart, kidneys, bone marrow, lungs, arteries, and also the intestinal tract. Frequent gastrointestinal (GI) manifestations of MIDs include poor appetite, gastroesophageal sphincter dysfunction, constipation, dysphagia, vomiting, gastroparesis, GI pseudo-obstruction, diarrhea, or pancreatitis and hepatopathy. Rare GI manifestations of MIDs include dry mouth, paradontosis, tracheoesophageal fistula, stenosis of the duodeno-jejunal junction, atresia or imperforate anus, liver cysts, pancreas lipomatosis, pancreatic cysts, congenital stenosis or obstruction of the GI tract, recurrent bowel perforations with intra-abdominal abscesses, postprandial abdominal pain, diverticulosis, or pneumatosis coli. Diagnosing GI involvement in MIDs is not at variance from diagnosing GI disorders due to other causes. Treatment of mitochondrial GI disease includes noninvasive or invasive measures. Therapy is usually symptomatic. Only for myo-neuro-gastro-intestinal encephalopathy is a causal therapy with autologous stem-cell transplantation available. It is concluded that GI manifestations of MIDs are more widespread than so far anticipated and that they must be recognized as early as possible to initiate appropriate diagnostic work-up and avoid any mitochondrion-toxic treatment. PMID:28286566

An analysis of oral biopsies extracted from 1995 to 2009, in an oral medicine and surgery unit in Galicia (Spain).

PubMed

Sixto-Requeijo, Raquel; Diniz-Freitas, Marco; Torreira-Lorenzo, Juan-Carlos; García-García, Abel; Gándara-Rey, José M

2012-01-01

To conduct an analysis of the frequency of oral lesions in biopsies over a 14-year period in the Oral Medicine, Oral Surgery and Implantology Unit. We conducted a retrospective study of biopsies removed from 1995-2009, recording data regarding age, sex, location of the lesions, biopsy types, anatomical and pathological diagnosis and definitive diagnosis. Of the 562 patients studied, the average age was 51.8 years, with a standard deviation of 18.5 (range 5-96). The distribution by sex was 318 (56.6%) women and 244 (43.4%) men. The most common diagnostic category was mucosal pathologies in 37.9% of cases, followed by odontogenic cysts in 27.8%. Malignant tumors accounted for 3.9% of cases, oral squamous cell carcinomas were the most frequent malignancy, appearing in 22 cases. Bisphosphonate-related osteonecrosis of the jaws was the most common injury within the bone lesions group. Following the performance of 647 biopsies on 562 patients, we can say that the most common injury was radicular cysts (appearing in 108 cases), having found statistical differences in relation to the patients' sex and age.

Quantitative assessment of silver-stained nucleolar organizer region in odontogenic cysts to correlate the growth and malignant potentiality.

PubMed

Biswas, Sailendra Nath; Paul, R R; Ray, Jay Gopal; Majumdar, Sumit; Uppala, Divya

2017-01-01

The most common and important odontogenic cyst involving jaws is the odontogenic keratocyst (OKC) or primordial cyst, the dentigerous cyst and the radicular cyst. These cysts all though do not show similar behavior, they all have the potentiality to recur. Silver nitrate staining of the nucleolar organizer regions (AgNORs) of the benign and malignant lesions is becoming very useful as a diagnostic indicator. Thus, the aim of this study is to assess the diagnostic potential of AgNORs in the cystic epithelium of common odontogenic cysts. Archived specimens of odontogenic cysts were stained with hematoxylin and eosin stain and AgNOR stain. The comparative evaluation of the AgNOR counts was done among the three varieties of odontogenic cysts, i.e., radicular cysts, dentigerous cysts and OKC and were observed that the mean for OKC was significantly higher than that of radicular cyst. Therefore, AgNor could be used as an efficient tool for comparative evaluation of microscopic features such as epithelial thickness, surface keratinization and mural proliferation in dentigerous cyst to that of the AgNOR count.

Nonsurgical root canal therapy of large cyst-like inflammatory periapical lesions and inflammatory apical cysts.

PubMed

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.

Histologic and immunohistochemical characteristics of cutaneous cysts in Goltz-Gorlin syndrome: clues for differentiation of nonsyndromic cysts.

PubMed

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.

Prevalence and distribution of odontogenic cysts in a Mexican sample. A 753 cases study

PubMed Central

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

Demographic distribution of odontogenic cysts in Isfahan (Iran) over a 23-year period (1988-2010)

PubMed Central

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

Demographic distribution of odontogenic cysts in Isfahan (Iran) over a 23-year period (1988-2010).

PubMed

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.

Location, sidedness, and sex distribution of intracranial arachnoid cysts in a population-based sample.

PubMed

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.

A New Classification for Pathologies of Spinal Meninges-Part 2: Primary and Secondary Intradural Arachnoid Cysts.

PubMed

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

Disappearance of Renal Cysts Included in Ice Ball During Cryoablation of Renal-Cell Carcinoma: A Potential Therapy for Symptomatic Renal Cysts?

PubMed

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.

Follow-up of pineal cysts in children: is it necessary?

PubMed

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.

Comparison of MRI segmentation techniques for measuring liver cyst volumes in autosomal dominant polycystic kidney disease.

PubMed

Farooq, Zerwa; Behzadi, Ashkan Heshmatzadeh; Blumenfeld, Jon D; Zhao, Yize; Prince, Martin R

To compare MRI segmentation methods for measuring liver cyst volumes in autosomal dominant polycystic kidney disease (ADPKD). Liver cyst volumes in 42 ADPKD patients were measured using region growing, thresholding and cyst diameter techniques. Manual segmentation was the reference standard. Root mean square deviation was 113, 155, and 500 for cyst diameter, thresholding and region growing respectively. Thresholding error for cyst volumes below 500ml was 550% vs 17% for cyst volumes above 500ml (p<0.001). For measuring volume of a small number of cysts, cyst diameter and manual segmentation methods are recommended. For severe disease with numerous, large hepatic cysts, thresholding is an acceptable alternative. Copyright © 2017 Elsevier Inc. All rights reserved.

Developmental Odontogenic Cysts of Jaws: A Clinical Study of 245 Cases

PubMed Central

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

Risk factors for pediatric arachnoid cyst rupture/hemorrhage: a case-control study.

PubMed

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.

CT of trauma to the abnormal kidney

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rhyner, P.; Federle, M.P.; Jeffrey, R.B.

Traumatic injuries to already abnormal kidneys are difficult to assess by excretory urography and clinical evaluation. Bleeding and urinary extravasation may accompany minor trauma; conversely, underlying tumors, perirenal hemorrhage, and extravasation may be missed on urography. Computed tomography (CT) was performed in eight cases including three neoplasms, one adult polycystic disease, one simple renal cyst, two hydronephrotic kidneys, and one horseshoe kidney. CT provided specific and clinically useful information in each case that was not apparent on excretory urography.

Cyclin d1 expression in odontogenic cysts.

PubMed

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.