Cystic Neck Research Articles

Huge bony cyst of the glenoid neck after combined arthroscopic Bankart repair and open modified Bristow procedure

Huge bony cyst of the glenoid neck after combined arthroscopic Bankart repair and open modified Bristow procedure

Cystic lateral neck mass: Papillary thyroid carcinoma metastases with concomitant lymphangioma

The most common presentation of papillary carcinoma thyroid is a solitary thyroid nodule but it is also known to present as cystic metastatic deposits in the neck. It has an indolent course and good prognosis. Although ultrasound is a commonly used modality to detect thyroid nodules, it should be followed by Fine needle aspiration cytology (FNAC) of the thyroid, especially when they are associated with cystic lesions of the neck. We report a rare case of papillary thyroid carcinoma presenting as a cystic mass in the neck and associated with lymphangioma.

Clinical experience of thyroglossal cyst management

<p class="abstract"><strong>Background:</strong> Thyroglossal cyst is a cystic swelling arising from embryological remnant of thyroglossal cyst. Cyst is typically located in the midline of the anterior neck and moves upward with tongue protrusion. The gold standard management for thyroglossal cyst is the Sistrunk procedure.</p><p class="abstract"><strong>Methods:</strong> Total of 32 patients of all ages and both sexes operated at Sapthagiri Institute of Medical Science and Research Centre, Bangalore during the study duration were included a detailed history and thorough physical examination was done to arrive clinical diagnosis. Ultrasound studies and FNAC were done in all cases to confirm the clinical diagnosis of thyroglossal cyst. Management was mainly surgical and Sistrunk operation was done in all cases. </p><p class="abstract"><strong>Results:</strong> Thirty two patients of with the diagnosis of thyroglossal cyst were managed from 2011 to 2018 in the department of ENT, Sapthagiri Institute of Medical Science, Bangalore, 20 (62.5%) were females and 12 (37.5%) were males age ranged from 5 to 40 years; mean age was 16.5 years.</p><p class="abstract"><strong>Conclusions:</strong> Thyroglossal cyst presents most commonly in paediatric age as cystic painless midline neck swelling. Diagnosis is made on clinical examination complimented with ultrasound and FNAC. Sistrunk operation is the treatment of choice to prevent recurrence and histopathological examination of the surgical specimen is must to rule out malignant transformation in the cyst.</p>

A rare case of primary hydatid cyst of neck

<p class="abstract">Primary hydatid cyst swelling of neck is an uncommon occurrence even in regions where hydatidosis is common. We report a case of a 13 year old male patient who presented with a swelling in right side of neck since 4 years, which turned out to be a hydatid cyst. FNAC is a useful pre-operative investigation for diagnosis of hydatid cyst. Complete surgical excision followed by medical treatment (benzimidazole derivatives) is considered to be the treatment of choice. Hydatid cyst should always be considered in the differential diagnosis of neck swellings.</p>

Modern
 approaches to the diagnosis and treatment of femoral neck fractures.

Choice of surgical tactics in femur neckfractures is the actual problem of modern traumatology and orthopedics. The analysis of results of treatment of patients with femur neck fractures is carried out. It is taped that femur neck fractures happened in the place of the formed solitary cyst. Diagnostics of cysts of a femur neck is complicated, however at their detection, performance of an osteosynthesis of a femur neck can lead to development of a nearthrosis. Selection criteria ofpatients which were established the osteosynthesis of a neck of a femur or endoprosthesis replacement of a hip joint is shown. The received clinical and statistical results demonstrate that use of these criteria promotes decrease of quantity of auditing interventions and improvement of quality of life ofpatients.

Treatment of sacral Tarlov cysts by cyst neck sealing with free-fat graft

Objective To introduce the operative technique of cyst neck sealing with free-fat graft for sacral Tarlov cyst and to observe its clinical therapeutic effect. Methods This retrospective study included 59 cases of symptomatic sacral Tarlov cysts treated by cyst neck sealing with free-fat graft from January 2010 to February 2016 at Neurosurgical Department of Army General Hospital of PLA (42 cases), Tsinghua University Yuquan Hospital (14 cases) and Fengning Hospital of Hebei Province (3 cases). The key points of operation were cutting cystic wall, identifying the nerve root and opening of cyst neck within cyst, cutting the cyst neck open and suturing the wound with free-fat graft in it to reconstruct root sheath in order to avoid cerebrospinal fluid leakage and root compression. The pain severity was assessed according to visual analog scale (VAS). Results The VAS score was 7.5±1.8 before operation and decreased to 2.7±0.6 and 2.3±0.5 at 6 and 18 months post operation, respectively. The difference was statistically significant (P=0.008). There was no complication relevant to operation. During the 10-18 (average: 15.0±3.7) months after operation, MRI follow-up was conducted. The latest MRI results showed complete obliteration of cysts in 54 cases and a little hydrops ex vacuo in lower place of original cyst cavity in 5 cases without cyst and symptom relapses. Conclusion Cyst neck sealing with free-fat graft for treatment of sacral Tarlov cysts is safe and may have better long-term effects. Key words: Tarlov cysts; Microsurgery; Sacral; Fat

DYNAMICS IN CHANGES OF FREE-RADIAL OXIDATION PROTEINS, REGENERATOR PROCESSES, MICROBIAL DISTRIBUTION AND NON-SPECIFIC IMMUNITY IN THE HOMOGENATES OF SCAR TISSUES AT DIFFERENT STAGES OF THE POSTOPERATIVE PERIOD

The problem of excessive scar formation deserves a particular attention, primarily in the open areas of the human body, because the biochemical mechanisms of the regulation of collagenosynthesis processes after planned surgical interventions of the skin are not well-substantiated. The aim of the study was to optimize the prevention of pathological scars after surgical treatment of congenital neck cysts by determination of the dynamics of changes in biochemical parameters occurring in the neck skin at various stages of healing. It was proved that the combined use of PRF-clot at the intraoperative stage of prophylaxis and ceruloplasmin at the post-operative, in contrast to monotherapy with fibrin membranes, obtained from platelets-rich plasma caused a better functional and aesthetic result, which significantly improved the quality of life of patients in the early and late postoperative periods.

Invasive primary papillary carcinoma in a thyroglossal duct cyst: A case report and review of the literature

PatientFemale, 46. Clinical procedureSistrunk's procedure, Total Thyroidectomy and excision of the cervical lymph nodes. BackgroundThyroglossal duct cyst is the commonest congenital anomaly of the thyroid gland. Occurrence of malignancy in a thyroglossal duct cyst is considered a rare condition, forming 1% of all cases of thyroglossal duct cyst. Here in the current report we presented a rare case of primary papillary carcinoma which arise in a thyroglossal duct cyst and a review of the literature. Case reportOur case is a 46-year-old female patient who presented with a painless cystic mass in front of the neck. After initial physical examination we have performed fine needle aspiration cytology (FNAC) of the cyst which revealed a papillary neoplasm. The patient underwent total thyroidectomy with excision of the cervical lymph nodes and surgical excision of the thyroglossal duct cyst (the Sistrunk's procedure). Histopathology of the specimen revealed a thyroglossal duct cyst which contains a primary invasive papillary carcinoma that infiltrated the cyst wall. The thyroid gland was normal, most of the cervical lymph node was positive for PTC. ConclusionsPrimary papillary carcinoma of thyroglossal duct cyst is a rare condition that should be considered in patients with cystic midline neck masses. Surgery and radical excision is the optimal patient management to improve survival.

Varied Presentation of Venous Ectasia Head and Neck: Case Series and Review of Literature.

Jugular venous ectasia in head and neck region is a rare entity. They may present as asymptomatic neck masses and should be considered in the differential diagnosis of cystic neck masses. Management is individualised based on the patient and includes conservative or surgical management. We hereby report three cases of venous ectasia (2-external jugular and 1-facial vein) managed at our institute.

Аnalysis of dynamics of clinical changes in cicatricially-changed tissues after surgical treatment of branchiogenic cysts in chronological aspect

Objective. Studying of processes of the cicatrices development after surgical treatment of the neck cysts of embryonal origin in chronological aspect.
 Маterials and methods. Experience of surgical treatment of 60 patients, suffering branchiogenic cysts, was analyzed. Retrospective analysis of the treatment results, including those performed in accordance to own elaborated procedures, was conducted.
 Results. Clinical changes in cicatricially-changed tissues depends upon the kind of intra- and postoperative prophylaxis of the cutaneous pathological cicatrices in surgical treatment of the neck cysts of embryological origin. Intraoperative application of the fibrin clot, enhanced by thrombocytes (PRF - clot), аnd postoperatively - of biocerrulin preparation, promotes a mostly expressed lowering of the course intensity for the free-radical oxidation in cicatricially-changed tissues of postoperative wound and prognosis for the pathological cutaneous cicatrices development, comparing with solely application of PRF-clot, аnd with operative intervention in accordance to classical method as well. 
 Conclusion. Application of PRF-clot and biocerullin preparation improves significantly the healing processes in postoperative wound after surgical treatment of the neck cysts of embryonal origin, and this lead to lowering of possibility for development of pathological cutaneous cicatrices.

Down Syndrome as an indicator for pediatric otolaryngologic procedures

ObjectiveDown Syndrome (DS) is the most common chromosome abnormality in humans. Due to the phenotype associated with DS, there are many disease states that require otolaryngologic procedures. Our goal is to use national data to study otolaryngologic procedures, their association with DS, and the degree of difference in risk profiles encountered with DS. MethodsData was obtained from the 2012–2015 American College of Surgeons' National Surgical Quality Improvement Program-Pediatric public use files. ENT procedure CPT codes were used to query the database and DS patients were identified using ICD-9 code 758.0. The ENT procedures were grouped into 18 categories and their frequency in DS patients as well as outcomes were analyzed. Postoperative outcomes were measured by complication rates, readmission rates, operation time, anesthesia time, and total length of stay. ResultsResults showed that DS patients are significantly (p < 0.05) over-represented in the following categories: Tracheostomy, Endoscopy, Laryngoscopy, Tracheoplasty, Myringoplasty, Tympanoplasty with Mastoidectomy, and Tympanoplasty without Mastoidectomy. DS patients are under-represented in the following categories: Abscess, Palatoplasty, Excision of Congenital Neck Cyst, and Cochlear Implantation. Logistic regression analysis showed that DS patients were significantly (p < 0.05) more likely to undergo procedures in the over-represented categories and were significantly (p < 0.05) less likely to undergo procedures in the under-represented categories as listed above. Outcomes analysis yielded no pattern of significance. ConclusionOur data showed that DS may predispose patients to require certain procedures over others.

Evaluation of Multimodality Management of Adenoid Cystic Carcinoma of the Head and Neck.

Adenoid cystic carcinoma is a relatively rare tumour arising from salivary glands of head and neck region. Surgery and radiotherapy form standard treatment modalities in the management of this tumor. In this analysis we present results of multimodality treatment in our cohort of patient. This retrospective analysis evaluated results of treatment in forty patients diagnosed with adenoid cystic carcinoma ofthe head and neck. Evaluation was done to identify prognostic factors affecting the disease free survival. A median disease free survival of 34 ± 2.42 (Median ± SE) versus 10 ± 5.45months was seen in patients undergoing surgery followed by post operative radiotherapy versus radiotherapy alone (P = 0.01). A radiotherapy dose more than 60Gy was associated with a better disease free survival compared with patients receiving less than 60Gy (P = 0.01). Positive surgical margins and perineural invasion were associated with a poor treatment outcome (P = 0.02) Patients with c-kit positive status showed a poor local control rate (P = 0.05).

Doppler ultrasound appearance of neck tumors.

Aim: The purpose of this study was the evaluation of the sonographic appearance of neck tumors and determining the features useful in differential diagnosis. Material and method: The studied group consisted of 57 patients: 16 patients with carotid body tumors, 9 patients with neurogenic tumors, 8 patients with venous anomalies, 12 patients with neck cysts, 6 patients with lipomas, 5 patients with extracranial carotid artery aneurysms and 1 with a laryngocele. Results: All carotid paragangliomas were located within the carotid bifurcation and demonstrated rich low-resistance vascular flow, with higher maximum velocity and lower flow resistance parameters registered in the ipsilateral external carotid artery. In 7 out of 9 cases, neurogenic tumors were homogeneous, and in the remaining 2 cases – heterogeneous. Four schwannomas were hypervascular or showed moderate vascularity, and the rest of neurogenic tumors were hypovascular or avascular, with symmetrical maximum velocity and resistance values of carotid blood flow. Apart from one branchial cleft cyst with multiple fine internal acoustic reflexes, all other neck cysts were anechoic and avascular, and presented with posterior acoustic enhancement. The laryngocele presented as a well-demarcated, hypoechoic, homogeneous lesion located in the immediate proximity of the larynx, without signs of internal vascular flow. Lipomas were well-demarcated, homogeneous, hypoechoic tumors with regular margins, without signs of internal vascular flow. Venous malformations presented as irregular, hypoechoic spaces with venous blood flow, easily compressed by the probe. Extracranial carotid artery aneurysms were hypoechoic, well-defined spaces, which presented with slow internal, turbulent flow on Doppler study, and showed continuity with the carotid artery. Conclusions: Doppler ultrasound allows to visualize features characteristic for certain neck tumors. Solid or cystic structure, echogenicity, localization, as well as internal flow signals and vascularity pattern create a combination of ultrasound findings helpful in the differential diagnosis of lesions such as paragangliomas, venous malformations, neurogenic tumors, aneurysms, cysts and laryngoceles.

Trisomy 9 presenting in the first trimester as a fetal lateral neck cyst and increased nuchal translucency

Abstract Background Fetal lateral neck cysts are transient fluid accumulations that result from abnormal lymphatic formations. In the first trimester, fetal lateral neck cysts accompanied by an increased nuchal translucency have been associated with aneuploidy, single-gene disorders and other malformations. Highlights We describe a case in which a lateral neck cyst, which measured 6.7 × 4 × 6.2 mm, was detected by ultrasonography in the first trimester with the additional finding of increased nuchal translucency (3.7 mm; &gt;95th percentile). No other abnormalities were detected at that time. Standard cell-free DNA screening resulted in no aneuploidy detected for chromosomes 21, 18, 13 and the sex chromosomes. The patient declined diagnostic testing with chorionic villus sampling. A repeat ultrasound at 16 weeks’ gestation demonstrated a normally grown fetus with persistence of the cyst, which measured 4.9 × 5 × 8.4 mm, as well as a pericardial effusion with a single outflow tract overriding the ventricular septum and vermian hypoplasia. The diagnosis of trisomy 9, 47,XX,+9, was made by amniocentesis and the patient opted for termination of the pregnancy. Conclusions This report illustrates the importance of identifying additional abnormalities in a fetus with lateral neck cysts, documenting the size of the cysts and obtaining diagnostic genetic testing.

External Laryngocoele or Anterior Jugular Vein Aneurysm (A Rare Clinical Entity): A Paradox Solved by A Few Simple Non-Invasive Radiological Tests

Introduction&#x0D; &#x0D; &#x0D; The differential diagnosis of a cystic upper neck mass that becomes prominent on coughing, straining, breath holding, or Valsalva manoeuvre includes mediastinal tumours and cysts, external laryngeal diverticula, and jugular venous aneurysms. Jugular venous aneurysms, while extremely rare, must be considered. We report the fifth case of anterior jugular aneurysm in an adult patient.&#x0D; &#x0D; Case Report&#x0D; &#x0D; A 55 year old female patient presented with a swelling in the upper part of right side of neck near the greater cornu of hyoid bone. The swelling increased with Valsalva, straining and while stooping forward. Clinically it was thought to be an external laryngocoele. However Colour Doppler Ultra-sonography and C.T angiogram of neck established it as of anterior jugular venous aneurysm by distinguishing from external laryngocoele.&#x0D; &#x0D; Discussion&#x0D; &#x0D; Patient presenting with unilateral cystic swelling in upper neck at upper border of thyroid cartilage which clinically bears the common provisional diagnosis of external laryngocele must be differentiated radiologically from anterior jugular venous aneurysm, (though rare in occurrence) to avoid a catastrophic incident during surgery.

A case of third branchial cleft cyst

Branchial cyst or congenital cystic lesions of neck originate from branchial clefts, the 2nd branchial cleft cyst being the most common and 3rd and 4th being missed. Hence, they are often misdiagnosed as lymph nodal masses, cold abscess. We are reporting a case of 3rd Branchial cleft cyst, of a 12-year-old boy who presented with left sided recurrent painful cystic mass at the level of hyoid bone going down to the level of pyriform fossa. All the tests for tuberculosis were negative. USG neck revealed loculated thick walled cyst from SCM to lateral part of pharynx. CECT revealed a thick-walled cyst extending from the anterior border of the sternocleidomastoid going down obliquely below the level of thyrohyoid membrane to pyriform fossa. Exploration revealed a thick walled infected cyst, pushing left upper pole of thyroid medially and anterior to left sided superior laryngeal nerve. The cyst was going downwards medially below the level of thyrohyoid membrane. The cyst was excised completely. Histopathology revealed the findings of squamous epithelial lining of cyst wall and cholesterol crystals within. Detailed anatomy on CECT, surgery and histopathology confirmed 3rd arch Branchial cyst.

What are the prevalence, characteristics and significance of fetal lateral neck cysts detected in an early anatomical scan?

This study evaluated the association of fetal lateral neck cysts (FLNC) with adverse pregnancy outcomes, in relation to specific sonographic characteristics and co-existing findings. Pregnancies in which FLNC were detected by a single examiner in early anatomical scans (14-16weeks) were included. Data regarding the pregnancy and its outcome were retrieved from telephone-based questionnaires, patient charts and from the examiner's reports. 654 cases of FLNC were detected among 9446 early anatomical scans (6.9%). Complete data regarding 219 pregnancies were available. FLNC were significantly more prevalent in males (65.2%). The prevalence of heart malformations was 3.2% [all were non-isolated cases or with abnormal nuchal translucency (NT) and/or nuchal fold (NF)]. Amniocentesis performed in 165 pregnancies was abnormal in 1.2%. Among 206 children born from this cohort, adverse medical outcomes were reported in 5.3%. The likelihood of adverse pregnancy outcomes was significantly higher in non-isolated cases and in cases with abnormal NT or NF. Sonographic characteristics such as cyst size and bilateral findings were not linked to adverse pregnancy outcomes. Isolated FLNC are benign findings which do not require additional work up. FLNC with additional sonographic abnormalities are associated with a significantly increased risk for adverse pregnancy outcomes.

Lateral cervical thymic cyst in a child: a case report

BackgroundCervical thymic cysts are uncommon lesions, rarely considered in the differential diagnosis of neck cysts in children.Case presentationWe report a rare case of multiloculated thymic cyst in an 8-year-old boy on the right side of the neck. Perioperative diagnosis was a cystic hygroma. Macroscopic examination showed a cystic mass measuring 6.5 cm in total length. Histopathology of the excised specimen revealed thymic tissue with prominent Hassall’s corpuscles associated with multiloculated cyst. The cyst wall is bordered by a flattened or multilayered epithelium, often abraded.ConclusionThis case is presented here for its rarity and should be included in the differential diagnosis of neck masses in children. So, it’s a lesion to be well aware of, particularly by pathologists.

Giant neck cyst not only a surgical concern

Epidermoid cysts are slow-growing, usually benign lesions that derive from an abnormally located ectodermal tissue. Epidermoid cysts can appear anywhere on the body; they are usually small and frequently asymptomatic. Giant cysts are rare, with few cases ever described. We report a case of a 66-year-old male, with a giant mass in the neck that developed over the last 10 years. Due to geographic limitations and lack of access to health care, he allowed the mass to grow to giant proportions. Surgical treatment was decided, and the patient underwent full recovery. Giant epidermoid neck cyst was the final diagnosis.

Primary hydatid cyst of neck: case report

Primary hydatid cyst of neck: case report