Case Of Cyst Research Articles

A Case of a Primary Giant Adrenal Gland Hydatid Cyst—An Exceptional Location: A Case Report

Background and clinical presentation: The adrenal hydatidosis is an exceptional site location for the occurrence of hydatid cyst with an incidence of being 0.073%. We hereby report this rare case of adrenal hydatid cyst in a 38-year-old male who presented with a history of right flank pain and no other associated complaints. On non-contrast computed tomography/high-resolution computed tomography, the whole abdomen revealed the finding of an adrenal hydatid cyst. He underwent laparoscopic right adrenalectomy, which was further confirmed with the pathological examination. In an adjunct to this, he was put on anti-helminthic drug Albendazole. On one year of follow-up, there was no recurrence. Conclusion: The hydatid cyst rarely occurs in the adrenal glands and is an uncommon pathology. It should always be suspected in the case of any cystic tumour of the adrenal gland, especially in endemic countries. The clinical features are variable and non-specific in the majority of the cases. Ultrasonography and CT abdomen hold a significant sensitivity in the diagnosis of the hydatid cyst. Surgical excision is the main choice of treatment. Adjunctive medical treatment improves the outcome and decreases the recurrence rate.

Giant gallbladder cyst with acute cholecystitis: a case report

BackgroundGallbladder cysts are rare diseases with very few reported cases, and no clinical or histological definition has been established. Furthermore, cases of giant cysts outside the gallbladder wall are extremely rare. We report a rare case of giant gallbladder cyst with acute cholecystitis.Case presentationAn 85-year-old woman with appetite loss and right lower abdominal pain lasting 2 days presented to our hospital. At first, the patient’s abdominal pain was mild to moderate with no fever. Blood tests revealed a white blood cell count of 10,950/mm3, and the C-reactive protein (CRP) level was 14.35 mg/dl. A contrast-enhanced computed tomography (CT) scan of the abdomen revealed a grossly distended gallbladder (14.5 × 14.5 × 8.7 cm) with an incarcerated stone in the cystic duct. The patient was treated by percutaneous transhepatic gallbladder drainage (PTGBD) with 735 ml of drainage fluid. Oral contrast magnetic resonance cholangiopancreatography (MRCP) revealed that gallbladder swelling remained (14.0 × 6.5 cm) 3 days after PTGBD. We performed laparoscopic cholecystectomy 6 days after PTGBD. Because of the severe adhesion around the junction of the cystic and common bile ducts, we performed open cholecystectomy.The resected specimen was 14 × 11 cm in size and consisted of a gallbladder (6 × 7 cm) with a stone (2.4 × 1.8 cm) in the gallbladder and a large cystic lesion (18 × 18 cm) outside the gallbladder wall. The cystic lesion had a wall thickness of 6 to 12 mm and internal septal structures and contained hemorrhagic and necrotic tissue.Histological examination revealed that the specimens showed a mildly swollen gallbladder and a cystic lesion on the outside of the gallbladder wall, adjacent to the gallbladder wall, with wall thickening and inflammation. The cystic lesion suggested gallbladder duplication, gallbladder diverticulum or extension of the Rokitansky-Aschoff sinus (RAS). There was no malignancy. The patient’s postoperative course was uneventful, and she was discharged 5 days after the operation.ConclusionWe present a very rare case of giant gallbladder cyst with acute cholecystitis revealed by cholecystectomy.

An unusual cyst at an unusual site in an adult.

Bronchogenic cysts are usually seen in the intrathoracic region in children. The authors describe the cytologic features of a case of a bronchogenic cyst in the cervical region in an adult and discuss its differential diagnoses.

Presentation of a case of a dermoid cyst with a rare location

Dermoid cysts are choristoma that accumulate normal embryonic tissue in abnormal locations, making up 3% to 5% of congenital orbit conditions. They are found in various parts of the body, including the head and neck, frontal, periorbital, scalp, cervical, and nasoethmoidal regions. Nasoethmoidal dermoid cysts can compromise deep structures and may extend intracranially, with a frequency of 1% to 45%. They are usually diagnosed in the first 3 years of life, but some may go undetected until adulthood. Two theories explain the origin of nasal dermoids: the cranial origin theory and the superficial inclusion theory. Nasal dermoids can be pale, flesh-colored, pearly, or erythematous and may be accompanied by congenital anomalies. Different diagnoses include epidermal cysts, gliomas, meningoencephaloceles, tumors of vascular origin, fibromas, neurofibromas, osteomas, and lipomas. Imaging evaluations are necessary for diagnosis, determining the degree of involvement of neighboring structures, rule out associated malformations, and establish potential intracranial extension. The only curative treatment for nasoethmoidal dermoid cysts is surgical removal, as untreated lesions can cause nasal deformities, recurrent infections, and intracranial extension.

Giant intracranial arachnoid cyst in an outstanding soldier.

This article reports a case of a large intracranial arachnoid cyst in a soldier who had performed well. This is a very marvelous and interesting case. Although the cyst pressed the entire brain into the contralateral cranial cavity, the patient did not show any significant clinical symptoms and had excellent motor and cognitive abilities, reflecting the excellent plasticity of the brain tissue.

Dentigerous cyst of inflammatory origin: a case report

To document a case of a dentigerous cyst of inflammatory origin which developed due to periapical infection from a grossly carious deciduous tooth. An 11-year-old male patient presented with a 4-month history of swelling within the right mandible. Radiological examination showed a cystic lesion in association with an impacted, displaced tooth 44 with an overlying carious 85. Marked expansion of the buccal bone was noted.

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.

A rare case of multiple gastric duplication cysts in an adult

Intestinal duplications are rare developmental anomalies that can occur anywhere along the gastrointestinal tract. Gastric duplication cysts are uncommon congenital anomalies and are rarely diagnosed in adults. However, diagnosis of the condition in an adult can be difficult as it is usually asymptomatic, or the symptoms are nonspecific. Here we report a rare case of symptomatic gastric duplication cysts in an adult who was treated successfully with surgical resection.

Diagnostic Dilemmas in Fetal Scalp Cystic Lesions: A Case Series

AbstractFetal Scalp cystic lesions are occasionally encountered during the routine mid trimester scan. Some may be benign scalp cysts like an epidermal or dermal cyst, and some may contain neural tissue with associated calvarial defects like meningocele or encephalocele. Prenatally, differentiating them and arriving at an exact diagnosis is challenging. This case study describes seven cases diagnosed with fetal scalp cysts and normal intracranial anatomy. Seven cases with normal intracranial anatomy were included. Out of seven cases, four turned out to be scalp cysts, two turned out to be meningocele, and one was atretic encephalocele. Of four cases of scalp cysts, three regressed spontaneously and one required surgical excision. All instances of meningocele and encephalocele required surgical correction. In the case of fetal scalp cystic lesions, the presence of normal intracranial anatomy and head circumference, the absence of other associated anomalies, and the use of high frequency ultrasound transducers to rule out calvarial defects can aid in delineating the diagnosis of benign fetal scalp cysts.

Immense potential for self-healing with conservative management of a large radicular cyst associated with pulpectomized primary tooth: A 40-month follow-up

Radicular cysts are one of the most common cysts of inflammatory origin involving the maxillofacial region that arise from the remnants of Herwig’s epithelial root sheath. These are often diagnosed as incidental findings on radiographs, which are seldom symptomatic and are slowly progressive. Decompression could be used as a conservative treatment approach for the management of large radicular cysts in children to have satisfactory healing and minimum damage to adjacent vital structures, simultaneously allowing the eruption of succedaneous tooth. This paper discusses the management of a large radicular cyst in a 12 year old, causing displacement of the mandibular canal and developing tooth germ using decompression that resulted in bony healing and spontaneous eruption of displaced succedaneous premolar, with a periodic follow-up for 40 months. Although decompression is a well-known approach, the present case with long-term follow-up emphasizes the potential of spontaneous healing in pediatric radicular cyst cases restoring the anatomy to normal without any functional impairment. This paper also highlights the importance of periodic clinical and radiographic follow-up in pulpally treated nonvital primary teeth.

An Arachnoid Cyst Incidentally Found in a Young Man Who Died of Sudden Cardiac Death

An arachnoid cyst is a rare cerebrospinal fluid–filled non-neoplastic cystic lesion. Most arachnoid cysts are asymptomatic; however, depending on their location and size, they may show various clinical symptoms and rarely can cause serious complications. We report a case of an arachnoid cyst incidentally found in a 25-year-old male soldier, which was not the cause of death. A 2.3×1.7 cm unilocular cystic lesion filled with colorless serous fluid was observed near the interpeduncular fossa of the brain. Microscopy revealed the cyst membrane to be lined by a single layer of meningothelial cells with no edema or inflammatory reaction in the surrounding structures. Considering the medical history, circumstances of death, and autopsy findings, the cause of death was determined to be sudden cardiac death, and the cyst found in the brain was consistent with an arachnoid cyst. Reviewing this case and related literature would help to determine the cause and manner of death if an arachnoid cyst is incidentally found during an autopsy.

Isolated Hydatid Cyst: A Misleading Diagnosis

Cystic hydatid disease is an endemic disease caused by the larval form of Echinococcus granulosis. It is especially evident in the liver, lungs, and kidney. Testicular hydatidosis is extremely rare. A case of a hydatid cyst of the testis is reported that was misdiagnosed clinically as a testicular hydrocele. Echinococcosis should be considered in the differential diagnosis of testicular masses especially in endemic countries. Treatment is mainly surgical and, with proper diagnosis and treatment, the prognosis is good.

A rare case of an aggressive dentigerous cyst associated with a supernumerary tooth

A rare case of an aggressive dentigerous cyst associated with a supernumerary tooth

Tubal mesosalpinx cysts combined with adnexal torsion in adolescents: a report of two cases and review of the literature

BackgroundTubal mesosalpinx cysts are paratubal cysts, that account for approximately 10% of adnexal masses, and the presence of these cysts combined with adnexal torsion is a rare acute abdominal condition, with few cases reported in the literature. We reported two cases of adolescent tubal mesosalpinx cysts combined with adnexal torsion and reviewed the literature to help improve the diagnosis of the disease.Case reportsThe first patient was an 11-year-old girl with left lower abdominal pain for 5 days and fever with nausea and vomiting for 3 days, who was found to have a cystic pelvic mass on preoperative imaging and was diagnosed intraoperatively and postoperatively on pathology as having a left tubal mesosalpinx cyst combined with adnexal torsion. The second patient was a 13-year-old girl with right lower abdominal pain for 16 h and a palpable mass in the lower and middle abdomen on examination, which was hard and tender to palpate. Preoperative imaging revealed a large cystic mass in the right adnexal region, and intraoperative and postoperative pathology revealed a right tubal mesosalpinx cyst combined with adnexal torsion.ConclusionsTubal mesosalpinx cysts combined with adnexal torsion are rare causes of acute lower abdominal pain. Early diagnosis and timely surgery are necessary to ensure ovarian and tubal function. Accurate preoperative imaging diagnosis is challenging, and MRI is a beneficial supplement to ultrasound and CT examinations, providing more objective imaging information and reducing the incidence of adverse outcomes.

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.

Lower abdominal cyst complicated with suspected infection following INFIX internal fixation for pelvic fracture: a report of two rare cases

BackgroundThe Internal Fixator (INFIX) is a popular method, known for its minimal invasiveness and short operation time, for treating anterior pelvic ring fractures. Studies have shown that postoperative complications may occur, including anterolateral femoral cutaneous nerve injury, the femoral nerve paralysis, and delayed fracture healing. These complications are believed to be related to surgical stimulation, an excessively long lateral end of the connecting rod, a small distance between the screw and bone surface, insufficient pre-bending of the connecting rod, and difficulties in fracture reduction.Case presentationWe report two unique cases of lower abdominal pseudocyst complicated with suspected infection after INFIX treatment of pelvic fractures at our trauma center. Following surgical removal of the internal fixation, resolution of the cysts was observed in both patients, and subsequent postoperative follow-up revealed the absence of any residual sequelae. These cases have not been reported in previous literature reviews.DiscussionThe lower abdominal cysts, potentially arising from the dead space created during intraoperative placement of the INFIX rod, may increase infection risk. The etiology remains uncertain, despite the presence of abnormal inflammation markers in both cases, and staphylococcus aureus found in one. These cysts were confined to the lower abdomen, not involving the internal fixation, and hence, only the INFIX was removed. Postoperative oral cefazolin treatment was successful, with resolved pseudocysts and no subsequent discomfort.ConclusionWe report two unprecedented cases of post-INFIX abdominal cysts, with a suspected link to intraoperative dead space. Despite uncertain etiology, successful management involved INFIX removal and oral cefixime therapy. These findings necessitate further exploration into the causes and management of such complications.

Current Practice of Laparoscopic Surgery for Choledochal Cyst in Children -a Survey on Opinion and Experience Among IPEG Members

PurposeLaparoscopic resection of choledochal cyst (CC) has become a popular approach. As the discussion about optimal treatment and technical strategies continues, we aimed to investigate perspectives of IPEG members. MethodsAn online survey was conducted in 2023 on behalf of the IPEG Research Committee. IPEG members were asked to complete an anonymous questionnaire that included 36 items on the management of CC. Result148 members responded to the survey (North America:49/Asia:44/Europe:23/South America:21/Others:11) and 116 completed all questions. Most surgeons (92.5%) operate on less than 5 cases annually. Diagnostic tools of choice were Magnetic Resonance Imaging (MRI, 95.9%) and ultrasonography (US, 74.5%). Regarding fusiform-type CC, operative indications were cyst size greater than 10 mm (68.9%), typical symptoms (78.5%), or anomalous pancreatico-biliary junction (63.8%). In unilateral intrahepatic biliary cysts (type IVa) cases, 81.3% of respondents do not perform a simultaneous liver resection with the initial cyst resection. While 22.0% resect the CC at diagnosis, even if asymptomatic, a larger group of surgeons (41%; 49/118) wait until the infant reaches six months. Intraoperative cholangiography and choledochoscopy are performed routinely by 38.9% and 13.7%, respectively. The majority (52.5%) ligates the common bile duct stump just below the CC. Laparoscopic reconstructions are performed by retrocolic hepatico-jejunostomy (48.3%) or hepatico-duodenostomy (45.8%) at similar rates, but when done open, 71.2% of respondents prefer retrocolic hepatico-jejunostomy. For the laparoscopic anastomosis, interrupted sutures with intracorporeal knot tying were most often utilized (48.3%). ConclusionInidividual pediatric surgeons treat a small number of patients with CC each year. Laparosopic and open reconstruction techniques vary, likely due to technical challenges. Level of EvidenceIII.

Sleeve Gastrectomy And Liver Cyst Unroofing In Morbid Obesity With Multiple Liver Cysts: A Case Report

Background: Obesity has become a major global health issue which leads to various complications, including hepatic diseases. However, we found a rare case of morbid obesity and symptomatic multiple liver cysts. Aim: This article aims to represent a rare case of morbid obesity and multiple liver cysts surgically managed by sleeve gastrectomy and liver cyst unroofing which were performed in a single surgery. Case report: 41-year-old female presented with morbid obesity and blunt intermittent abdominal pain in the right upper quadrant. Stage II hypertension, tenderness on the right upper quadrant of the abdomen and epigastrium were found in clinical assessment. Lipid profiles were shown to be elevated. Abdominal CT revealed fatty liver and multiple cystic lesions in all hepatic segments. Discussion: Non-parasitic liver cysts affect 2-18% of the global population, with a higher prevalence in females possibly due to hormonal factors. Obesity is associated with hormonal alterations, potentially leading to increased secretion of FSH and LH. Conclusion: Sleeve gastrectomy and liver cyst unroofing may be considered as a treatment strategy for patients with morbid obesity and multiple liver cysts.

Hepatic Hydatid cyst in children: An experience from East of Turkey

İntoduction: Hydatid cyst is a parasitic disease caused by the infection of Echinococcus granulosus and rarely Echinococcus alveolaris eggs, which are endemic in our country. Current treatment options for liver hydatid cysts; They can be listed as medical treatment, surgical treatment, percutaneous drainage and clinical follow-up only. In this study, the effectiveness of the WHO-IWGE protocol in terms of diagnosis and treatment strategies in our pediatric cases of liver hydatid cyst in a health institution in eastern Turkey was evaluated in the light of the literature. Material Method: Pediatric patients between the ages of 0-16 who were diagnosed with KcKH and followed up and treated were evaluated retrospectively. In pre-operative evaluation, lung radiography, abdominal ultrasonography, serological tests, hemogram and liver function tests were routinely performed. Results: 250 child patients between the ages of 0 and 16, whose data were fully available, were included in the study. 118 of the cases were girls and 132 were boys. The average age was 11.2 years. Most of the KcKH patients were admitted to the hospital for another reason and the cyst was detected incidentally. Of the 65 patients requiring surgery, 17 were patients who initially underwent primary intervention with PAIR. Patients who underwent PAIR were observed for one night and discharged in an average of 18 hours. Patients with free drainage were discharged in 2-4 days. The average length of stay for patients who underwent open surgery was found to be 9 days. In conclusion; The Gharbi classification updated by WHO is effective and reliable in determining the KcKH treatment strategy. In cases who are receiving chemotherapy and an intervention decision is made, a final USG is performed just before the procedure; It can provide both a change in treatment management and more patients benefiting from medical treatment.

A GIANT HEPATIC HYDATID CYST: CASE REPORT

Hydatid cyst is a general health problem that can be seen in every country, with a higher prevalence in some certain areas. Liver is the most involved organ. The disease is usually asymptomatic. The cyst may enlarge and lead to compressive symptoms or complications through opening to THE biliary system. Although medical agents and surgical interventions have long been used in the treatment of hydatid cyst, minimally invasive percutaneous interventions and laparoscopic surgical interventions are also safely applied in selected patients. In this paper, we presented a case of a giant hepatic hydatid cyst for which we preferred open surgery.