Asymptomatic Simple Cysts Research Articles

Renal Cysts: An Issue of Concern

Simple renal cysts are frequent benign conditions that rarely evolve to malignancy. Complications include rupture, hemorrhage, infection, and local compression effects. Benign cysts are most often asymptomatic and incidentally detected by imaging tests, which reveal that these changes can increase in size doubling their volume in a decade. The Bosniak classification is widely utilized as a useful guide for diagnosis and control, and the uncomplicated cysts usually do not need invasive procedures or interventions. An elderly female with asymptomatic simple cysts in the left kidney and antecedent of partial mastectomy and total thyroidectomy due to malignant tumors is here reported. The registered comparative abdominal images of a long-standing control are shown.

Asymptomatic Simple Ovarian Cyst in Postmenopausal Women: Syndrome of ‘Visible Ovary’

ABSTRACT Simple cysts of the ovary are quite common, with a prevalence of 5 to 17%. Advances in the technology of ultrasound and the increasing frequency of use of TVS has made it all the more important to have knowledge of the natural history of simple asymptomatic postmenopausal cysts. Previously, due to the paucity of data, postmenopausal women with asymptomatic simple cysts were managed much too aggressively. Current available data suggest a more conservative approach with serial ultrasounds, Doppler evaluation and CA-125 levels. Further studies are needed in order to have definitive guidelines for the gynecologic practitioner. How to cite this article Zalud I, Busse R, Kurjak BF. Asymptomatic Simple Ovarian Cyst in Postmenopausal Women: Syndrome of ‘Visible Ovary’. Donald School J Ultrasound Obstet Gynecol 2013;7(2):182-186.

The Auto-Amputated Adnexa: A Review of Findings in a Pediatric Population

Study ObjectiveTo quantify our experience and that of the literature with diagnosis and management of the auto-amputated adnexa in a pediatric population. DesignCase series and literature review. SettingTertiary care medical center. ParticipantsCase series of pediatric patients (<18 years of age) with surgically documented adnexal auto-amputation collected from our medical center and the literature. InterventionsNone. Main Outcome MeasureAuto-amputated adnexa. ResultsIn addition to the 3 cases discussed from our institution, 91 cases of auto-amputated adnexa were identified in the literature dating back to 1943, for a total of 94 cases. Forty-nine percent (46/94) of the cases involved girls in a pediatric population (<18 years of age). Of these, the majority (n = 26) were identified in a subgroup of girls who were diagnosed with an adnexal cyst by antenatal ultrasound. Most of these neonates were asymptomatic at birth or had a palpable abdominal mass (n = 6) and at the time of surgical exploration were found to have an auto-amputated adnexa. 34 out of 46 cases were analyzed in detail. The right adnexa were involved in 56% of the cases. The most common presenting complaint verbalized by the older girls was pain; however, 8 cases were identified in asymptomatic girls undergoing unrelated diagnostic testing. ConclusionThe auto-amputated adnexa is a rare finding in the pediatric population, but it must be considered as a possible explanation for the incidental finding of absence of the fallopian tube or ovary in the subgroup of patients who undergo surgery for any reason. Patients with an antecedent history of pelvic pain either chronic or intermittent in nature may be diagnosed with torsion or less frequently auto-amputation of the adnexa. A fetal “pelvic mass” or “ovarian cyst” may predispose the adnexa to torsion and subsequent auto-amputation either in-utero or post-delivery. Many of these antenatally diagnosed cysts and even subsequent auto-amputations are completely asymptomatic, however, and do not compromise fertility assuming the contralateral adnexa are normal. Thus expectant management is appropriate for small (less than 4 cm), asymptomatic simple cysts and even suspected auto-amputated adnexa in an asymptomatic patient.

Surgical management of cystic lesions in the liver

Liver cysts are common, occurring in up to 5% of the population. For many types of cysts, a variety of different treatment options exist and the preferred management is unclear. A Pubmed and Medline literature review using key words non-parasitic hepatic cysts, polycystic liver disease, echinococcus, hydatid cysts parasitic cysts, Caroli's disease, cystadenoma; liver abscess, surgery, aspiration and treatment was undertaken and papers pertaining to the diagnosis and management of cystic lesions within the liver were retrieved. Asymptomatic simple cysts in the liver require no treatment. Therapy for symptomatic cysts may incorporate aspiration with sclerotherapy or de-roofing. At present, insufficient evidence exists to recommend one over the other. Polycystic liver disease presents a unique management problem because of high morbidity and mortality rates from intervention and high rates of recurrence. Careful patient counselling and assessment of symptom index is essential before embarking on any treatment. New medical treatments may ameliorate symptoms. Acquired cystic lesions in the liver require a thorough work-up to fully characterize the abnormality and direct appropriate treatment. Hydatid cysts are best treated by chemotherapy followed by some form of surgical intervention (either aspiration and sclerotherapy or surgery). Liver abscesses can effectively be treated by aspiration or drainage. With improved antimicrobial efficacy, prolonged treatment with antibiotics may also be considered. All patients with cystic lesions in the liver require discussion at multi-disciplinary meetings to confirm and the diagnosis and determine the most appropriate method of treatment.

Simple Cyst of the Testis

We report 5 cases of simple cyst of the testis, the largest series to date, and review the literature. Included are 2 autopsy cases, a case of a multilocular simple cyst and 1 case treated nonoperatively. Based on our experience, simple cyst of the testis should be suspected particularly in an enlarged but otherwise palpably normal testis. High resolution real-time scrotal sonography revealing an anechoic mass in the testis with well defined walls, and enhanced posterior through transmission and edge shadowing is diagnostic for a simple cyst. An asymptomatic simple cyst of the testis may be treated with observation alone. The symptomatic simple cyst should be treated ideally with local parenchyma-sparing excision.