Anterior Cyst Research Articles

Vaginal Bulge is Not Always Prolapse

ObjectiveThe objective of this video is to review a case of a patient that presented to urogynecology clinic for prolapse, but was noted to have anterior vaginal cyst. In this video we review differential diagnosis, embryologic origin of vaginal cyst, excision procedure, imaging and pathology of the vaginal cyst. SettingUrogynecology clinic/operating room ParticipantPatient who presented with anterior vaginal cyst Intervention34yo G0 referred to Urogynecology for a vaginal bulge. On exam she had a 4 cm anterior vaginal cystic mass. The differential diagnosis for benign vaginal cysts is broad including Müllerian or Gartner's (mesonephric) ducts, Skene duct, Bartholin gland, epidermal inclusion, or endometriotic cysts, adenosis, or urethral diverticulum (1,2). Most are secondary to embryological remnants or trauma (3).Müllerian ducts form the fallopian tubes, broad ligament, uterus, cervix and upper part of the vagina. Müllerian epithelium is replaced with squamous epithelium of the urogenital sinus; however, Müllerian epithelium can persist anywhere along the vaginal wall. Thus, Müllerian cysts can be found at any location in the vagina (4).During vaginal cyst work-up, imaging can be helpful to further differentiate the cyst and aid in surgical planning. Our patient had an in-office translabial ultrasound that revealed a fluid filled vaginal cyst that had possible bladder connection. Pelvic MRI showed a 4 cm non-communicating fluid-filled cyst that was abutting the bladder in its entirety. We present imaging and a surgical excision video demonstrating the importance of meticulous dissection directly on the bladder wall. The video also presents histopathology slides with bland, endocervical-type columnar epithelium, leading to the final diagnosis of a Müllerian duct cyst. ConclusionVaginal cysts require careful examination and imaging. Understanding their location is crucial for surgical planning, counseling, and successful patient outcomes.

Clinical analysis of 21 cases of children with ectopic bronchogenic cyst

Objective: To analyze the clinical characteristics, treatment, and prognosis of ectopic bronchogenic cysts in children. Methods: A retrospective analysis was conducted on the data including the clinical characteristics, auxiliary examination and treatment of 21 children with ectopic bronchogenic cysts diagnosed pathologically at Children's Hospital Affiliated to Zhengzhou University from July 2015 to December 2023. There were 16 males and 5 females, with a male-female ratio of 3.2∶1, and the age ranged from 4 days to 8 years old (median age 2 years and 8 months). Results: Among the 21 cases of ectopic bronchogenic cysts, 11 cases were found in the pharynx, with symptoms including dyspnea (4 cases), snoring during sleep (3 cases), and choking on milk(4 cases).Ten cases were found in the head, neck or anterior chest, 5 of these cases had infection history, and 5 showed progressive mass growth.Imaging and endoscopy showed 9 patients underwent preoperative color ultrasonography revealed cystic masses with well-defined boundaries. CT examination was performed on 13 patients, which showed round or nearly round masses with homogeneous density, smooth margins, and regular cyst walls. CT attenuation values ranged from 2 to 52 Hounsfield Units (HU). Four cystic lesions were assessed via MRI, 3 cases demonstrated long T1 and long T2 signals, while 1 case had a slight short T1 and long T2 signal, with high signal intensity on fat-suppressed images. Eleven cases of pharyngopharyngeal cysts were examined by electronic nasopharyngoscopy. The cysts appeared as spherical or ovoid masses with smooth surfaces, close to or slightly light in color with the surrounding tissue, with one cyst presenting with a bluish blue in the oropharynx. All 11 pharyngeal cysts were excised using low-temperature plasma under general anesthesia and intubation assisted by a nasal endoscope. The cysts were pulled and excised as completely as possible.Ten cases of neck and anterior chest cysts were completely excised. Postoperative histopathology confirmed bronchogenic cyst. Twenty-one children were followed up postoperatively for 4 months to 7 years without recurrence, except for 1 patient who was lost to follow-up. Conclusions: Ectopic bronchogenic cysts are uncommon and lack of typical imaging and clinical features.Combination of ultrasonography, CT and MRI is recommended for cases occuered in neck and anterior chest, while electronic nasopharyngoscopy complements pharyngeal evaluations. Surgical intervention is the preferred treatment choice for this disease.

Tumor-Like Lesions in the Craniovertebral Junction: A Case Series, Systematic Review, and Meta-Analysis.

Background: Tumor-like lesions at the craniovertebral junction mimic tumors in clinical presentation and imaging. Our study focuses on three common developmental pathologies-epidermoids, dermoids and neurenteric cysts. Methods: We conducted a retrospective analysis of a case series and a meta-analysis of 170 patients from 119 reports. Results: Neurenteric cysts predominated (81.2%). Anterior cysts were linked to neurenteric cysts, while posterior ones correlated with dermoid/epidermoid cysts (p < 0.001). Complications occurred in 27.2% of cases, with cranial nerve paresis being the most common. Most patients had excellent outcomes (75.2%) with low recurrence rates (12%). Dermoid cysts were more associated with anomalies (p < 0.001). Among 138 neurenteric cyst cases, 15 experienced recurrence, with predictors including ages 51-60 and over 70, subtotal resection, complications, and poor outcomes (p < 0.001). Cysts with total resection were significantly less likely to adhere to surrounding brain tissue (p < 0.001). CSF diversion was correlated with older age (p = 0.010) and various complications (p < 0.001). Age affected outcomes, and the hydrocephalus was linked to poor outcomes (p = 0.002). Conclusions: This meta-analysis underscores the importance of total resection in minimizing recurrence rates and emphasizes meticulous preoperative planning and imaging. Our results indicate that rim enhancement (p = 0.047) and poor outcome (p = 0.007) are significant factors associated with recurrence. Additionally, associated anomalies, as well as the patient's age and overall health, significantly influence the surgical outcomes and the likelihood of recurrence.

Imaging characteristics and diagnosis of primary middle mediastinal tumors

Objectives: To investigate the proportion of different histological types and CT enhanced imaging features of primary middle mediastinal lesions in order to improve the understanding of these tumors and the accuracy of preoperative diagnosis. Methods: Retrospective analysis was conducted on 84 patients with primary middle mediastinal lesions and clear histological classifications diagnosed and treated at the Cancer Hospital, Chinese Academy of Medical Sciences from January 2012 to December 2022. Clinical, imaging, and pathological data were collected and classified according to tumor histological classifications. CT imaging manifestations such as tumor location, size, morphology, edge, boundary, internal components, enhancement characteristics, and surrounding tissue invasion were evaluated and recorded. Results: The histological types of the primary middle mediastinal lesions from the 84 patients included mesenchymal tumors, anterior intestinal cysts, giant lymph node hyperplasia, substernal goiter, neuroendocrine carcinoma, lymphohematopoietic system tumors, and mesothelioma, accounting for 28.6%, 27.4%, 14.3%, 3.6%, 11.9%, 9.5%, and 4.8%, respectively. Mesenchymal tumors included peripheral nerve sheath tumors, vascular tumors, adipogenic tumors, solitary fibrous tumors, and synovial sarcoma, accounting for 54.2%, 20.8%, 12.5%, 8.3%, and 4.2%, respectively. The above tumors had diverse imaging manifestations and specific imaging features. Mature fat were found in 3 cases of liposarcoma; Calcification was observed in 2 cases of thyroid nodules and 7 cases of giant lymph node hyperplasia; Enhanced scanning showed significant enhancement in 2 cases of solitary fibrous tumors, 3 cases of thyroid nodules, and 11 cases of giant lymph node hyperplasia; Mediastinal large lymph nodes was observed in 6 cases of lymphoma and 3 cases of mesothelioma; High invasiveness was observed in 4 cases of mesothelioma and 9 cases of neuroendocrine carcinoma. Conclusion: Mediastinal tumors have low incidence rate and rich histological types, and their imaging manifestations are diverse. Preoperative differential diagnosis can be made according to their specific imaging characteristics.

Anterior Subtenon Cyst Formation after Triamcinolone Injection during Ahmed Glaucoma Valve Implantation: A Case Report

Anterior Subtenon Cyst Formation after Triamcinolone Injection during Ahmed Glaucoma Valve Implantation: A Case Report

Arthroscopic Decompression of a Popliteal Cyst

Background: Popliteal (Baker) cysts are enlarged gastrocnemius-semimembranosus bursae leading to swelling in the popliteal fossa. Surgical decompression and capsulectomy is the definitive treatment for symptomatic cysts with arthroscopic or open decompression. Arthroscopic decompression is minimally invasive, entails lower risks, and allows for earlier and more aggressive rehabilitation compared with open excision. Indications: Indications for popliteal cyst decompression include pain and mechanical discomfort refractory to conservative treatment. Further indications are neurovascular compromise secondary to bursal enlargement, including thrombophlebitis, compartment syndrome, limb ischemia, and nerve entrapment. Additional considerations include concurrent pathology requiring surgical intervention. Technique Description: Following standard diagnostic arthroscopy, a Gillquist maneuver is performed to visualize the posteromedial compartment and transverse synovial fold. The operative limb is placed in a modified figure-of-four position. A posteromedial portal is established under spinal needle localization and utilized to debride the anterior capsular wall and cyst contents with an arthroscopic shaver. Attention is paid to the removal of the posterior transverse synovial infold to reduce risk of recurrence. Results: The literature reports favorable outcomes in arthroscopic decompression of popliteal cysts. In comparison of arthroscopic and open decompression, You et al. reported reduced mean operative time and reduced recurrence rate following arthroscopic management. In a retrospective study, Rupp et al. reported increased rates of cyst recurrence with concurrent meniscal and/or chondral injuries highlighting the importance of addressing concurrent intra-articular pathologies during decompression. Discussion/Conclusion: Arthroscopic decompression of symptomatic popliteal cysts can be performed safely and effectively. Arthroscopic approach allows for treatment of concurrent pathologies that predispose to increased rates of cyst recurrence. Nonetheless, rates of recurrence vary widely and therefore further study in treatment technique is necessary. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

Could Novel Radiographic Findings Help Identify Aseptic Tibial Loosening?

BackgroundAseptic loosening following total knee arthroplasty remains one of the leading causes of long-term failure. Radiographic identification of loose implants can be challenging with standard views. The purpose of this study was to compare the incidence of novel radiographic findings of anterior heterotopic bone formation and medial or lateral cyst formation in patients who have aseptic loosening to patients who have well-fixed implants. MethodsA retrospective radiographic review was performed on 48 patients’ revised secondary to aseptic tibial loosening. This cohort was compared to two additional cohorts; 48 patients returning for routine postoperative follow-up (control 1), and 48 patients revised secondary to infection or instability who had well-fixed implants (control 2). ResultsThere were 41 of 48 (85%) patients who had implant loosening and were noted to have anterior heterotopic bone formation compared to 1 of 48 (2%) patients in control 1 and 3 of 48 (6%) patients in control 2 (P ≤ .0001). There were 43 of 48 (90%) patients who had implant loosening and had medial cyst formation compared to 3 of 48 (6%) patients in control 1 and 5 of 48 (10%) in control 2 (P ≤ .0001). There were 42 of 48 (88%) patients who had implant loosening and had lateral cyst formation compared to 2 of 48 (4%) patients in control 1 and 4 of 48 (8%) in control 2 (P ≤ .0001). ConclusionIn this study, we describe novel radiographic findings of anterior heterotopic bone formation and cysts that develop in patients who have aseptic loosening following primary total knee arthroplasty. We believe that these radiographic features may lead to easier identification of aseptic loosening.

A Novel Ultrasound-Guided Approach for the Management of an Anterior Paralabral Cyst of the Hip

A Novel Ultrasound-Guided Approach for the Management of an Anterior Paralabral Cyst of the Hip

Clinico-radiologic characteristics of lacrimal sac area swellings misdiagnosed as dacryocystocele or mucocele.

Several non-lacrimal lesions can present with lacrimal sac area swelling mimicking a dacryocystocele or mucocele with a possibility of misdiagnosis. This study investigates the clinic-radiologic characteristics of the mimicking conditions compared to true lacrimal sac distension. Retrospective, comparative, interventional case series. Patients referred by primary care ophthalmologists between January 2015 and October 2021 with a misdiagnosis of dacryocystocele or lacrimal sac mucocele (n = 39) and an age-matched group of proven true lacrimal sac swelling (TLS group, n = 44). Data collected included demographics, presenting features, investigations, management, histopathology, and outcomes. Both groups were statistically compared for several clinical and radiological variables. Final diagnoses in the mimicking group were skin/subcutaneous swellings (14/39, 35.9%), vascular malformations (10/39, 25.6%), inferomedial anterior orbital cysts (7/39, 17.9%), sino-orbital masses (5/39, 12.8%). Female gender (<0.001), epiphora (p = 0.001), and discharge (p < 0.001) were significantly more frequent in the TLS group. The mimicking group was more likely to be associated with a longer swelling duration (p < 0.001), a swelling extending beyond the lacrimal sac area (p <0.001), orbital signs (p <0.001), and periorbital abnormality. Non-patent lacrimal irrigation (p < 0.001) was significantly more frequent in the TLS group. On imaging, all swellings in the mimicking group were separate from the lacrimal pathway and 94.9% (37/39) extended beyond the lacrimal sac fossa. Various cutaneous, subcutaneous, vascular, inferomedial orbital cystic, and sinonasal pathologies can present with lacrimal sac area swelling and mimic a TLS. A high index of suspicion, a thorough clinical evaluation and proper imaging are essential to avoid a misdiagnosis.

C37 CONCOMITANT PARTIAL PERICARDIAL AGENESIS, PERICARDIAL CYST AND POSTERIOR MITRAL VALVE LEAFLET HYPOPLASIA: A CASE REPORT

Abstract Background Pericardial agenesis (1) is a congenital developmental disorder of the pleuro–pericardial membranes that is usually asymptomatic. A pericardial cyst (2) is a congenital cyst composed of mesothelial cells originating most often from the right pericardium. Hypoplasia of the posterior mitral leaflet (3) is congenital and it is very rarely diagnosed in adulthood. These alterations are usually sporadic and not associated. Case presentation A 53–year–old woman with obesity and bronchial asthma was referred to the emergency department for left hemiparesis and concomitant dyspnoea in new–onset atrial fibrillation. A right frontal ischemic stroke was diagnosed. During the hospitalization transthoracic echocardiography was performed showing a large prolapsed anterior mitral leaflet (AML) with an eccentric and significant regurgitation. Transesophageal echocardiography was performed. It confirmed the severity of mitral regurgitation, due to a large AML prolapse, but also showed a severely hypoplastic posterior leaflet (PML). Swinging motion was also reported in the absence of pericardial effusion. In the past the patient was surgically treated for an anterior pericardial cyst that was excised. Old CT images were reviewed and showed the absence of pericardial sheets along posterior and lateral left ventricle walls, which were not contiguous to the cyst (that was anterior). The patient was finally candidated to surgery for mitral valve replacement. Discussion The case report shows a unique case of association between partial pericardial agenesis, pericardial cyst, severe PML hypoplasia with AML prolapse and severe mitral regurgitation. The association of these three anomalies has never been described before. This could indicate a common pathogenetic denominator and therefore the need to look for this combination of structural abnormalities in carriers of even just one of them. Bibliography 1. Lopez D. et al, doi: 10.1016/j.pcad.2016.12.002 2. Khayata M. et al, doi: 10.1007/s11886–019–1153–5 3. Parato VM. et al, doi: 10.4103/jcecho.jcecho_73_17

Novel management of spontaneous onset sclerocorneal cyst in a child

A 2-year-old girl was referred for management of swelling on the nasal side in the right eye. On ophthalmic examination, the right eye showed a subconjunctival cyst extending into the anterior corneal stroma on the nasal side. Ultrasound biomicroscopy of the right eye showed a fluid-filled cystic lesion involving the cornea, with no communication with the anterior chamber. Examination under anesthesia revealed an intrastromal sclerocorneal cyst over the nasal half of cornea, not involving pupillary axis. The cyst was drained, anterior cyst wall excised, scleral lips glued together, and the bare corneoscleral bed covered with amniotic membrane with no recurrence.

Vaginal cysts: An important differential diagnosis in the anterior compartment

IntroductionBenign anterior-vaginal-wall cysts (0.5–1% prevalence) often mimic other structures (e.g. cystoceles). No algorithm for their diagnosis, treatment, recurrence or complication prediction can be derived from existing data. Careful preoperative diagnosis can minimize intraoperative surprises and complications due to differences in cyst origin. MethodsThis retrospective study was performed with data from consecutive patients with anterior vaginal cysts who underwent surgery at the Pelvic Floor Centre, University Women’s Hospital of Jena, within a period of 7 years. Data on patient age, symptoms, history of previous surgery, lesion characteristics, preoperative imaging findings, surgeries, postoperative stays, complications and histological and microbiological findings were collected. ResultsOut of 797 consecutive anterior vaginal prolapse repairs 19 (2.4%) anterior vaginal cystic lesions were found, mean age 47 [standard deviation (SD) 14, range 22–72] years. Symptoms reported were pressure (58%), voiding dysfunction (26%), dyspareunia (5%) and inflammation signs (37%); 26% of cases were asymptomatic. Two patients had received prolapse pessary treatment before. Two patients had history of previous vaginal surgery. Five cases were diagnosed preoperatively by ultrasound. Cysts were located on the medial anterior vaginal wall (42%), suburethral (42%) and the vaginal apex (16%). The mean lesion size was 2.6 (SD 0.9) cm. Eleven percent of cases showed microbiological positivity. Most (89%) vaginal cysts were excised; 11% were fenestrated, biopsied and drained. Twenty-six percent of patients underwent outpatient procedures; for inpatient procedures, the median stay was 2.7 days. Postoperative hemorrhage with no transfusion requirement occurred in one patient. All lesions were benign. ConclusionsAnterior-compartment vaginal cysts can be found incidentally during pelvic organ prolapse assessment and surgery, as they can mimic anterior-vaginal-wall prolapse. In this cohort, all excised lesions were benign.

Anterior Cervical Corpectomy and Fusion with excision of recurrent long segmental midline anterior cervical arachnoid cyst

Anterior midline cervical arachnoid cysts are very rare, common in the thoracic region. The treatment of midline ventrally lying arachnoid cyst may be challenging via a posterior approach because of a lack of direct visualization of the entire cyst, in particular, its attachment to the cord, complete excision of the cyst wall through a posterior approach is not always possible. Incomplete excision at the first operation and the reaction caused by the epithelial secretion from the marsupialized cyst makes surgery for recurrence very difficult. So, Anterior cervical corpectomy and fusion (ACCF) with cyst excision may be the ideal approach for the anterior midline arachnoid cyst with complete removal and fewer chances of recurrence. Here we report a case of long segmental recurrent midline anterior arachnoid cyst which is completely excised using an anterior cervical corpectomy and fusion and the patient improved drastically neurologically.

Single piece flexible obturator for the management of complex maxillary defects: A clinical report

Cysts, a common occurrence in the jaws, are managed with different conservative and radical approaches. Although surgical excision is usually the treatment of choice, it can result in an open defect that compromises the oronasal seal and affects the patient’s quality of life by interfering with daily intake of nutrition. These defects vary in anatomic geometry and extent depending upon etiology and require a prosthodontic intervention in the intermediate phase until a definitive closure is executed. An unconventional obturator design with a helical spring incorporated into a flexible obturator is described to manage 2 patients with challenging anterior maxillary cysts.

Quiste aracnoidal cervical anterior en edad pediátrica

Los quistes aracnoidales espinales son lesiones poco comunes en la población pediátrica. La mayor parte de ellos, se ubican en los segmentos dorsales y la posición anterior respecto a la médula es rara en todos los casos. Si bien su patogenia no está aclarada, se han asociado a defectos del tubo neural y traumas previos. Clínicamente, pueden presentarse con síndrome medular que en ocasiones pueden empeorar con cambios posturales. El tratamiento, puede ser conservador o quirúrgico, el que está indicado en presencia de síntomas neurológicos secundarios a compresión medular, siendo el abordaje posterior el más frecuentemente utilizado. El propósito de la cirugía es la resección total o en su defecto, la fenestración del quiste para comunicarlo al espacio subaracnoídeo. Una potencial complicación de la vía posterior, es la herniación medular durante la durotomía, secundaria al efecto compresivo del quiste, la cual podría aumentar la morbilidad neurológica en el período postoperatorio. Se presentan 2 casos consecutivos en edad pediátrica con quistes intradurales espinales anteriores, el primero en la región cervico-dorsal cuya cirugía se vio dificultada por la presencia de herniación medular transdural y un segundo caso con un quiste exclusivamente cervical, en que mediante una punción lateral del quiste guiada por ecografía previo a la durotomía, se logró resecar la lesión sin esta complicación.

2317 Accidentally Discovered Cystic Echinococcosis of the Liver

INTRODUCTION: Cystic echinococcosis (CE) is a complex, chronic and neglected disease with a worldwide distribution. The liver is the most frequent location of parasitic cysts. In humans, its clinical spectrum ranges from asymptomatic infection to severe, potentially fatal disease. We are presenting a case report of a patient with incidentally discovered liver hydatid disease after he was found to have suspicious liver cystic liver on renal ultrasound. CASE DESCRIPTION/METHODS: A 57-years-old male with history of hypertension and penile pain was referred to the Gastroenterology clinic after he was found to have a possible cystic liver lesion on renal ultrasound. He was originally from Palestine and moved to US 10 years ago. He did not have abdominal pain, icterus, nausea, vomiting or history of recent travel or liver disease. Examination was only relevant for non-tender, non-pulsatile, hepatomegaly with no palpable masses. Labs showed normal liver enzymes. CT Abdomen followed by MRCP showed 11.7 × 10.6 × 9.7 cm cystic mass within the right hepatic lobe, demonstrating multiple non enhancing daughter cysts within in, suggestive of hydatid disease. His serology was positive for Echinococcus granulosus antibodies. After discussion with the patient, he agreed for total cystectomy due to large size of the cyst. During the surgery, once the large cyst was mobilized, daughter cysts were first suctioned through a little puncture hole on the top of the cyst, until the large cavity was totally empty. During excision of the cyst wall, it was found to be tightly adherent to the liver tissue allowing only for excision of anterior cyst wall and omentoplasty. Pathology showed numerous scolexes consistent with Echinococcus Granulosus. He was given Albendazole 2 weeks prior the surgery and 4 weeks after with absence of recurrence on repeated imaging. DISCUSSION: Cystic echinococcosis is often asymptomatic and diagnosed accidentally during radiographic examination, surgery, or during evaluation of other clinical diagnoses. Potential presentations may be due to the mechanical effect of a large cyst on surrounding tissues, rupture of a cyst causing an acute hypersensitivity reaction, or complications such as biliary obstruction. Surgery has long been considered the best, if not the only, option in the treatment. However, in the past two decades, medical treatment, percutaneous procedures, and a “watch and wait” approach have been successfully introduced and have replaced surgery as the treatment of choice in selected cases.

Analisis gambaran radiologis suspek ameloblastoma tipe solid pada radiograf CBCT 3D

Objectives: The aim of this case report is to provide further information on the radiological features of a solid type ameloblastoma suspected on a 3D CBCT radiograph.&#x0D; Case Report: A patient came referred by a dentist for CBCT 3D radiography with suspected clinical diagnosis of a maxillary anterior dentigerous cyst. The results of the CBCT 3D radiographic examination showed a radiointermediate with a clear border on the anterior maxilla and in the right maxillary sinus accompanied by the impact of two supernumerary teeth. Radiological features of ameloblastoma generally show a multilocular radiolucent picture and have a radiopaque septa bone internal structure such as a soap bubble appearance or honey combed appearance. This case showed a clearly demarcated radiointermediate image because a solid type ameloblastoma contains tissue that is histologically formed from cells hat are follicular or plexiform and derived from the results of a degenerative process at the center of the Langerhans islands. &#x0D; Conclusion: Radiographic examination with high modality such as CBCT 3D is very important in helping to establish a diagnosis, especially for cases that sometimes show differences in the radiographs.

Calcium signals act through histone deacetylase to mediate pronephric kidney morphogenesis.

Autosomal dominant polycystic kidney disease is the most common monogenetic kidney disorder and is linked to mutations in PKD1 and PKD2. PKD2, a Ca2+ -conducting TRP channel enriched in ciliated cells and gated by extracellular signals, is necessary to activate the multifunctional Ca2+/ calmodulin-dependent protein kinase type 2 (CaMK-II), enabling kidney morphogenesis and cilia stability. In this study, antisense morpholino oligonucleotides and pharmacological compounds were employed to investigate the roles of class II HDAC family members (HDAC 4, 5, and 6) in Zebrafish kidney development. While all three class II HDAC genes were expressed throughout the embryo during early development, HDAC5-morphant embryos exhibited anterior cysts and destabilized cloacal cilia, similar to PKD2 and CaMK-II morphants. In contrast, HDAC4-morphant embryos exhibited elongated cloacal cilia and lacked anterior kidney defects. Suppression of HDAC4 partially reversed the cilia shortening and anterior convolution defects caused by CaMK-II deficiency, whereas HDAC5 loss exacerbated these defects. EGFP-HDAC4, but not EGFP-HDAC5, translocated into the nucleus upon CaMK-II suppression in pronephric kidney cells. These results support a model by which activated CaMK-II sequesters HDAC4 in the cytosol to enable primary cilia formation and kidney morphogenesis. Developmental Dynamics 247:807-817, 2018. © 2018 Wiley Periodicals, Inc.

Synergistic Osteogenic Potential of Human Mesenchymal Dental Pulp Stem Cells and Platelet-Rich Plasma on Repair of Anterior Maxillary Bone Defect

Purpose: The aim of the present study was to evaluate synergistic osteogenic potential of human dental pulp mesenchymalstem cells (hDMSCs) and platelet-rich plasma (PRP) in enhancement of bone regeneration in anterior maxillary bone defects.Patients and methods: Eighteen patients (10 males and 8 females), were selected and divided equally into three groups. Group I included patients (4 male and 2 female ) having anterior maxillary cyst and impacted or supernumerary teeth in another place indicated for surgical removal for production of mesenchymal dental pulp stem cells, group II and III included patients (3 male and 3 female in each) having anterior maxillary cyst. The cyst was enucleated and the space left were filled by hDMSCs with PRP in group I. in group II the cavity was filled by PRP only. In group III the cystic cavity left with no filling material and considered as control group. Cone Beam Computed Tomography (CBCT) was performed preoperatively, one month and six months postoperatively for comparison of bone density intra group and inter groups. Results: Comparison of bone density between the three groups at one month post-operative period showed that group II recorded highest and significant bone density. At six months post-operative period the three groups showed significant increase in bone density However group I (hDMSCs with PRP) showed highest mean increase in bone density. Conclusions: hDMSCs can provide an osteogenic cell source for new bone formation and the PRP improves and retains their differentiation capacity due to possible synergisticosteogenic potential between PRP and stem cells.

A rare case of a lingual mass in a neonate

A large lingual cyst was noted on the 22-week antenatal ultrasound, which grew in proportion to the foetus on serial imaging. An elective c-section was performed in view of possible airway obstruction, and the neonate initially required oxygen to maintain saturations. Aged 1 month, the baby developed significant breastfeeding difficulties secondary to rapid cyst and secondary tongue enlargement, completely filling the oral cavity. Fifteen millilitres of fluid were aspirated in clinic, resulting in reduction of tongue size and immediate improvement in feeding. The patient subsequently underwent surgical excision of the cyst, which filled most of the anterior two-thirds of the tongue up to the foramen caecum. Histology supported the diagnosis of lingual thyroglossal duct cyst. A rare variant of thyroglossal duct cysts, these cysts can be potentially difficult to manage. More commonly located in the tongue base, we present an even rarer variant, that of an anterior tongue cyst.