Presence Of Cysts Research Articles

Posterior Fossa Arachnoid cysts (PFACs) in pediatric patients: a single-center retrospective study and proposal of a treatment flow-chart.

To investigate how different presentations of posterior fossa arachnoid cysts (PFACs) influence surgical indication and strategies and their impact on clinical and radiological outcome in children, proposing a treatment flow-chart. In this retrospective study, children < 14 years old with PFAC diagnosed at IRCCS Giannina Gaslini Hospital from 2008 to 2023 were identified Patients showing a mega cisterna magna (MCM), Dandy-Walker syndrome (DWS), Blake's pouch cyst (BPC), neuroenteric cysts or multiple cysts were excluded. Data regarding type of treatment, age at surgery, surgical complications were collected and analyzed. Clinical and radiological outcomes were considered at 1-, 3- and 5-years follow-up. A "wait and see" strategy in asymptomatic showed better clinical outcomes at 1-year follow-up (p = 0.047). No significant difference in clinical outcome or risk of re-surgery were observed between microsurgical fenestration, endoscopical fenestration or shunting were reported, while location of the cyst influenced surgical strategy (p = 0.015). Age < 12 months at surgery (p = 0.008), hydrocephalus (p = 0.001), especially when associated with macrocephaly (p = 0.004), and the placement of a shunt (p = 0.006) resulted as risk factors of re-surgery. An association between radiological and clinical outcomes was observed at 1-year follow-up. Treatment decision should be based on clinical presentation rather than radiological presentation. While a "wait and see" strategy is suggested in asymptomatic patients, when surgery is indicated, several factors should be considered, such as presence of hydrocephalus, location of the cyst and age of the patient, to improve clinical outcomes, reducing complications.

7817 A Rare Case of Intrathyroidal Thyroglossal Duct Cyst Presenting as a Rapidly Expanding Left Thyroid Goiter

Abstract Disclosure: C.M. Godar: None. A.J. Spiro: None. K.F. Brown: None. M.K. Shakir: None. T.D. Hoang: None. Introduction: Thyroglossal duct cysts are the most common congenital cyst in the head and neck, found during childhood as a midline neck mass. We present a rare case of a large intrathyroidal thyroglossal duct cyst with left lateral extension in an adult patient. Case Report: A 50-year-old man with family history of familial adenomatous polyposis presented for thyroid nodule evaluation. Thyroid ultrasound for screening of thyroid cancer showed a 4.8 x 4.5 x 2.5cm mixed cystic/solid hyperechoic thyroid nodule with smooth margins in the left lower thyroid lobe. He reported no compressive symptoms. FNA with standard 27G needle was insufficient for evaluation with Bethesda I result. Attempted syringe aspiration did not produce cystic fluid for analysis. The patient returned to clinic 8 weeks later due to visible enlargement of his anterior neck and new neck pressure with swallowing. Physical exam was significant for a new, firm palpable mass over the left thyroid isthmus. Bedside ultrasound noted expansion of the previously visualized mass now extending into the thyroid isthmus. FNA was reattempted with a 25G needle, and cytologic material was again inadequate. He elected to undergo left hemithyroidectomy. Histologic sections demonstrated a 3.4cm simple squamous, non-keratinizing cyst lining overlying a thickened fibrotic wall with mixed acute and chronic inflammation surrounded by benign thyroid tissue, consistent with an intrathyroidal thyroglossal duct cyst. Discussion: The thyroglossal duct derives from epithelial tissue during embryogenesis and atrophies during weeks 8-10 of gestation. A persistent duct may lead to cyst formation in the presence of remnant epithelial tissue secretions and local neck inflammation. A thyroglossal duct cyst is usually located midline in the anterior neck. This stands in comparison to a branchial cleft cyst, which arises due to failure of atrophy of the second branchial groove during embryogenesis and forms a cyst that is usually located in the upper lateral neck compartment. Other common neck masses include lipomas, dermoid cysts, or ectopic thyroid tissue. This case highlights the rarity of intrathyroidal thyroglossal duct cyst in an adult patient and the importance of definitive diagnosis and appropriate management. Presentation: 6/2/2024

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 Thyroglossal Cyst Presenting in an Elderly Man-A Rare Presentation

A Thyroglossal Cyst Presenting in an Elderly Man-A Rare Presentation

Soft tissue aneurysmal bone cyst presenting as an enlarging neck mass: Case report and review of the head and neck literature.

Soft tissue aneurysmal bone cysts (STABCs) are rare neoplasms histopathologically identical to aneurysmal bone cysts. These benign lesions are characterized by thin, peripheral ossification and no skeletal continuity. STABC may be difficult to distinguish from myositis ossificans (MO) and malignant entities from imaging and fine needle aspiration, due to rarity and overlapping features. We present a case of a STABC occurring in the paraspinal cervical muscles. The imaging, histopathology, molecular analysis, and treatment are discussed. Four other published cases of STABC of the head and neck are reviewed.

Unraveling the Mystery of Rathke's Cleft Cyst Presenting with Hyponatremia: A Case Report with a Comprehensive Review of Literature

Abstract Background Rathke's cleft cyst (RCC) is a benign cystic lesion that is commonly discovered incidentally and remains asymptomatic in most cases. However, its association with the syndrome of inappropriate antidiuretic hormone (SIADH) secretion leading to hyponatremia (HN) is rare and has only been sporadically reported in the medical literature. In this article, we present a unique case of RCC manifesting with HN and discuss the diagnostic and management challenges encountered in a neurosurgical context. Additionally, we provide a comprehensive review of existing literature on RCC presenting with HN to enhance our understanding of this rare presentation. Case Description A 56-year-old woman with acute-onset blurry vision, headaches, and low fluid intake was diagnosed with euvolemic HN secondary to SIADH. Further evaluation revealed an intrasellar cystic lesion consistent with RCC, which was successfully resected through endoscopic transnasal transsphenoidal surgery, resulting in a complete recovery without the need for hormone replacement. Conclusion The most likely explanation for the HN due to SIADH in this case is the release of accumulated antidiuretic hormone (ADH) due to compression by the cyst and the irritating effect of inflammation at this location. Accurate evaluation and classification of HN are essential for proper diagnosis and management, considering the rarity of RCC presenting with HN. A multidisciplinary approach to treatment can lead to favorable functional outcomes; however, further research is necessary to better comprehend this unique clinical entity and optimize neurosurgical approaches.

Non-identical presentations of Intra-Articular Anterior Cruciate Ligament Ganglion Cysts: A report of two cases and review of literature

An uncommon cystic, tumor-like lesion of uncertain origin, an anterior cruciate ligament ganglion is encircled by dense connective tissue that is filled with a gelatinous fluid. Ganglion cysts and ACL mucoid degeneration may coexist. The size and location of the lesion determine how the lesion presents clinically. Two examples of ganglion cysts originating from the anterior cruciate ligament are presented here; one exhibits a painful restriction of flexion, while the other presents with chronic pain that is not related to motion restriction. With MRI, this uncommon clinical disease can be identified. It can be distinguished by magnetic resonance imaging (MRI) from pigmented villonodular synovitis, synovial sarcoma, mucoid degeneration of the ACL, and localized synovitis. It can be treated by arthroscopic cyst debridement or aspiration assisted by CT or USG. ACL damage must be prevented with caution. Following arthroscopic cyst debridement, both patients experienced a complete functional recovery. Conclusion: Although uncommon, ganglion cysts of the ACL should be considered a differential diagnosis for knee discomfort. Diagnosis is confirmed by MRI evaluation. Good clinical results can be achieved by arthroscopic debridement of cysts without causing ligament damage.

Giant pancreatic cyst with extension to spleen managed by laparoscopy

To review the etiology, clinical presentation, diagnostic evaluation, management, and prognosis of giant pancreatic cysts. Giant pancreatic cysts, defined as cysts exceeding 5 cm in diameter, include a diverse group of lesions such as pseudocysts, serous cystadenomas, mucinous cystic neoplasms (MCNs), and intraductal papillary mucinous neoplasms (IPMNs). Their clinical significance stems from potential complications and the necessity to differentiate benign from malignant cysts. A comprehensive review of the literature was conducted, focusing on the pathophysiology, symptomatology, diagnostic modalities, treatment options, and outcomes associated with giant pancreatic cysts. The etiology of giant pancreatic cysts varies from benign conditions like pseudocysts and serous cystadenomas to potentially malignant or malignant neoplasms such as MCNs and IPMNs. Clinical presentation ranges from asymptomatic cases to severe abdominal symptoms and complications. Diagnostic evaluation includes imaging modalities like ultrasound, CT, MRI/MRCP, and endoscopic ultrasound (EUS) with fine-needle aspiration (FNA) for cytology and biochemical analysis. Management strategies depend on the type and characteristics of the cyst, with options including observation, endoscopic drainage, surgical resection, and percutaneous drainage. The prognosis varies, with benign cysts generally having a favorable outcome, while cysts with malignant potential require timely surgical intervention to improve survival rates. Giant pancreatic cysts pose a diagnostic and therapeutic challenge due to their varied etiologies and potential complications. Accurate diagnosis through advanced imaging and fluid analysis is crucial. Management should be tailored based on the cyst type, symptoms, and malignancy risk, involving a multidisciplinary approach to optimize patient outcomes. Further advancements in diagnostic and therapeutic techniques are anticipated to enhance the management of these complex lesions.

Colloid Cyst Presenting as CSF Rhinorrhea: Case Report

Colloid Cyst Presenting as CSF Rhinorrhea: Case Report

Multiple Synchronous Thoracoabdominal Duplication Cysts With Ectopic Gastric Mucosa Detected on 99mTc-Pertechnetate Scintigraphy and SPECT/CT.

Thoracoabdominal duplication cysts are a congenital malformation of the posterior primitive foregut with synchronous thoracic and abdominal duplication cysts being found in up to 15% of cases. The presentation of duplication cysts depends on their location, size, and other factors, like the presence of ectopic functioning gastric mucosa, which is reported in 20%-30% of duplication cysts. 99mTc-pertechnetate scintigraphy along with SPECT/CT helps in the preoperative localization of ectopic functioning gastric mucosa in these duplication cysts. We report the scintigraphic and SPECT/CT findings of one such case, which helped in the final diagnosis and management of the patient.

Cerebellopontine angle epidermoid cyst presenting with only trigeminal neuralgia: A retrospective study at the single-center in Vietnam

ObjectiveTo assess the influence of clinical and imaging characteristics on the outcome of microsurgery treatment for cerebellopontine angle (CPA) epidermoid cyst (EC) presenting only with trigeminal neuralgia (TN). MethodsA retrospective observational study describing 42 cases of CPA epidermoid cyst presenting only with TN n CPA for 10 years from 2011 to 2021 with the mean follow-up period was 37 months (range, 6–60 months). This study is the largest research with a long follow-up period reported so far worldwide for ECs with only TN symptom. We analyzed the clinical-radiological records of all the patients who met the rigorous requirements to find the distinct features of these tumors. ResultsThe mean age was 40.1 ± 4.7 years. The time from symptom onset to surgery was 8.6 ± 3.9 months. Symptoms of multiple branches of the 5th nerve appeared in 71.4 %, the most common was V2V3 accounting for 42.9 %. Most of the tumors were located limited in the CPA, accounting for 66.7 %. Total resection reached 90.5 %. The effectiveness of pain relief of microsurgery reached 97.6 %, Barrow Neurological Institute (BNI) score I reached 73.8 % and pain relief was 23.8 %. The postoperative neurologic deficit was 14.3 %. ConclusionCPA epidermoid cysts presenting with TN as the sole symptom have favorable characteristics for total removing the tumor compared with other tumors in the remaining group. Total removing the tumor with the support of continuous intraoperative electromyography monitoring and decompressing the 5th nerve was ideal; it will not only increase the symptom improvement but also have a low rate of postoperative complications.

Adult ileal duplication cyst acting as lead point of ileo-caecal intussusception a rare case of complete bowel obstruction in adults

Enteric duplication cyst presenting as intussusception in adult and causing complete small bowel obstruction is a rare phenomenon. A 19 year old female presented with complaints of abdominal pain, bilious vomiting, abdomen distension and constipation for 2 days. Patient had similar episodes in the past. Computed tomography of abdomen showed dilated small bowels with “Target Sign” suggestive of Ileo caecal intussusception. Patients was taken for surgery and intraoperatively it was noted to have thick walled cystic swelling in the terminall ileum. Segmental resection done along with cyst and primary anastamosis was done. Histopathological confirmation was done as Duplication cyst.

Rectal duplication cyst presenting with change in bowel habits and rectal bleeding: A case report and literature review

We present a rare case of rectal duplication cyst (RDC) in an adult patient who presented with chronic fluctuating bowel habits and rectal bleeding. A faecal immunochemical test (FIT) and a faecal Calprotectin level showed negative results, and no previous abdomen-pelvis CT scan or MRI was identified. A Colonoscopy was performed, showing a benign rectal lesion causing colonic intraluminal compression leading to rectal ulceration and prolapse, and solitary rectal ulcer syndrome was suspected. A Transanal Minimally Invasive surgery (TAMIS) was performed to excise the lesion, with histopathology findings consistent with a rectal duplication cyst. The patient had no intraoperative complications and made an uneventful recovery. A systematic literature review showed 30 30 adult Rectal supplication cyst case reports. In conclusion, The most common presentation of RDC is anal pain and rectal bleeding. The diagnosis of RDC is challenging, and it requires Surgical resection to confirm the diagnosis.

Epidermoid Cyst Presenting as a Large Palpable Breast Mass.

Epidermoid Cyst Presenting as a Large Palpable Breast Mass.

Variable arachnoid cyst presentations in variable age groups; a comparative single center study

Introduction. Arachnoid cysts are an intracranial spaces that are filled with cerebrospinal fluid (CSF) and lined with arachnoid membranes. They may be asymptomatic or present with focal epilepsy, headache and other neurological symptoms. Purpose. This study shows the different presentation of brain arachnoid cysts in relation to their locations in variable age groups. Methods. This is a retrospective analytic cohort comparative study that enrolled 168 patients was done in the Middle Euphrates Neuroscience Center and Al-Sadder Medical City, from the first of February 2020 to the first of February 2023. The collected data of patients include patient’s age, gender, presentation, location of the cyst in the brain and its dimension. Each patient was assessed a full general and neurological examination. The data were analyzed according to presentation and location of cyst in the brain via MRI. Results. The mean age of group one is 10 years (4-18 years) and for group two is 35 years (19-70 years). Regarding the gender, the male gender was more in group one, while the female gender was more in group two than in group one. Regarding the presentation, the most common presentation is focal epilepsy in about 47.61% in both groups and more in group one (about 68.11%). Regarding the MRI location of arachnoid cyst, the most common site was the temporal lobe. The overall percentage of arachnoid cyst is 57.14% in temporal lobe and 13.09% in occipital lobe in total patients Conclusion. The arachnoid cysts of brain are variable in both their presentations and their locations in different ages. The most common presentation is focal epilepsy in patient 18 years old and less, while the headache in patient older than 18 years. The most common site of cyst is temporal lobe.

Presentation and Management of Thyroid Hydatid Cyst: A Comprehensive Systematic Review of the Literature

Introduction Hydatid cysts of the thyroid gland, though rare, pose a diagnostic and therapeutic challenge. This systematic review summarizes current knowledge on the presentation, diagnosis, and management. Methods A systematic review of the published studies of thyroid hydatid cysts was conducted. The included studies of thyroid hydatid cysts had the following properties: 1) The thyroid infection was confirmed by diagnostic modalities, surgical findings, or histopathology. 2) The case presentation was provided in the study. 3) The cyst(s) were originally located or adhered to the thyroid and did not rupture into it from the other adjacent structures or organs. Results Overall, 39 studies were compatible with the inclusion criteria. Turkey had the highest case occurrence (36%). Female predominance (59%) and a mean age of 38.33 years were observed. Mass (79.5%) was the most common symptom, followed by hoarseness of voice (4%). Serology (18.75% positive) and ultrasound (77.5%) were primarily used for diagnosis. Surgery was the mainstay of treatment (96%), with total thyroidectomy (32.6%) and left hemithyroidectomy (16%) being the most common approaches. No recurrence was reported in the follow-up period (0%). Conclusion This review highlights the rarity, clinical presentation, diagnosis, and successful surgical management of thyroid hydatid cysts. Further research is needed to optimize diagnostic methods and explore alternative treatment options.

Pediatric Intraabdominal Cysts-A Case Series from a Single Tertiary Center Experience.

We aimed to analyze the clinical presentation, imaging, histopathology, and surgical management of pediatric intraabdominal cysts, which are relatively common but diverse lesions that pose diagnostic challenges. We conducted a retrospective analysis of pediatric intraabdominal cysts from 2010 to 2021 in a single tertiary center. We collected data on demographics, symptoms, radiological findings, surgical approaches, and histopathological diagnoses and compared them with the current literature. A total of 36 cases were included. There were 30 females and 6 males, aged 1 to 16 years. Abdominal pain was the most common symptom, followed by tenderness and distention. Diarrhea and vomiting were also reported in some cases. The cysts varied in size, location, and origin and were diagnosed as lymphangioma, mucinous cystadenoma, paratubal cyst, lowgrade mucinous neoplasm, mature cystic teratoma, duplication cyst, mesothelial cyst, pseudocyst, serous cystadenoma, and simple hepatic cyst. The surgical management depended on the type and location of the cysts and involved excision, oophorectomy, appendectomy, or resection. Pediatric intraabdominal cysts are heterogeneous lesions that require timely diagnosis and surgical resection. They may present with various symptoms and complications, depending on their size and location. Radiological and histopathological evaluation is essential for accurate diagnosis and optimal treatment.

Leczenie wrodzonej torbieli worka łzowego z użyciem technik endoskopowych – opis przypadku

Congenital lacrimal sac mucocele occurs in approximately 3% of infants with congenital lacrimal duct obstruction. Lacrimal sac mucocele is sometimes associated with a intranasal nasolacrimal duct cyst presenting as an intranasal cystic mass, which needs the involvement of an ophthalmologist and otolaryngologist in diagnosis and management. Bilateral cysts may cause in the early neonatal varying degrees of nasal obstruction, sleep disturbance, feeding difficulty and even respiratory distress. We present a case of bilateral dacryocystocoele with intranasal extension presenting as respiratory distress in a 7-day-old male newborn. The diagnosis was confirmed clinically and by computed tomography scan.

Management of a recurrent spinal arachnoid cyst presenting as arachnoiditis in the setting of spontaneous spinal subarachnoid hemorrhage: illustrative case.

Spontaneous spinal subarachnoid hemorrhage is a rare pathological entity with a variety of presentations depending on the underlying etiology, which often remains cryptogenic. The literature is sparse regarding the most efficacious treatment or management option, and there is no consensus on follow-up time or modalities. Additionally, there are very few reports that include operative videos, which is provided herein. The authors present a case of spontaneous spinal subarachnoid hemorrhage without an underlying etiology in a patient with progressive myelopathy, back pain, and lower-extremity paresthesias. She presented to our institution, and because of progressive worsening of her symptoms and the development of compressive arachnoid cysts, she underwent thoracic laminectomies for evacuation of subdural fluid, fenestration of the arachnoid cysts, and lysis of significant arachnoid adhesions. Her clinical course was further complicated by the recurrence of worsening myelopathy and the development of a large compressive arachnoid cyst with further arachnoiditis. The patient underwent repeat surgical intervention for cyst decompression with an improvement in symptoms. This case highlights the importance of long-term follow-up for these complicated cases with an emphasis on repeat magnetic resonance imaging. Unfortunately, surgical intervention is associated with short-term relief of the symptoms and no significant nonoperative management is available for these patients.

Unusual Clinicopathological Presentations of Mature Cystic Teratoma: A case series

Mature cystic teratomas also known as dermoid cyst are one of the most common benign tumors of the ovary.It is usually seen in young women in the reproductive age group. It comprises of mature elements derived fromall the three germ layers. In this case series we reported a series of 4 cases of mature cystic teratoma of the ovarywith uncommon clinicopathological presentations. First case was a rare entity of melanocytic nevus arising froma mature cystic teratoma. Second case was adipocyte rich teratoma, an uncommon lipomatous lesion of the ovary.Third case was rupture of dermoid cyst presenting as acute abdomen. Fourth case was mature cystic teratoma ina post-menopausal woman. To conclude, though dermoid cysts after surgical removal have an uneventful clinicalcourse, extensive sampling of the specimen for histopathological study should be done to identify rare pathologieswhich bears a clinical significance.