Resolution Of Cyst Research Articles

Management of Ovarian Cysts through Individualized Homoeopathic Medicine: A Case Series

AbstractOvarian cysts are common gynecological problems encountered by gynecologists in their day-to-day practice. They are benign growths arising from the ovary and occur in the reproductive age group. Conventional system of medicine usually opts for surgical procedures in such cases. Homoeopathic system of medicine is a specialized system that believes in individualization. This article reports five cases of suffering from ovarian cysts, who reported at Dr. D.P. Rastogi Central Research Institute, Noida, Uttar Pradesh, India. All the five cases were treated successfully with individualized homoeopathic medicines. Each patient received individualized homoeopathic medicine selected on the basis of the totality of symptoms using synthesis repertory with the help of RADAR software. Pre and post treatment ultrasongraphy USG reports were kept as evidence. The assessment of causal attribution of homeopathic treatment effect was performed using the Modified Naranjo Criteria for Homeopathy (MONARCH). Marked improvement was observed in all five cases, with complete resolution of the cysts along with symptomatic relief, which was evident by USG reports. The MONARCH scores were +9/13, +7/13, +8/13, +9/13, and +7/13, which indicate a positive causal attribution of homeopathy in relieving the symptoms. This case series suggests a significant role of individualized homeopathic medicines in the resolution of ovarian cysts and associated symptoms. The results obtained from this case series are encouraging.

Persistence of Labral Tears and Resolution of Paralabral Cysts with 2-year MRI analysis after Periacetabular Osteotomy (PAO) for Hip Dysplasia

To evaluate the labrum status and paralabral cysts on preoperative and postoperative magnetic resonance imaging (MRI) in patients with developmental dysplasia of the hip (DDH) who underwent periacetabular osteotomy (PAO). A retrospective review was conducted using prospectively collected data from patients who had undergone primary PAO between June 1, 2021 and May 30, 2022. Inclusion criteria were an age range of 16 to 55 years and a minimum follow-up of two years. MRI was utilized to evaluate the preoperative and postoperative conditions of the labrum and the presence of paralabral cysts. Furthermore, the correlations between the presence of paralabral cysts and demographic and radiographic variables were investigated. Additionally, patient-reported outcomes (PROs), minimal clinically important difference (MCID), and complications were reported during the final follow-up evaluation. A total of 23 patients were included in the final analysis, with an average follow-up of 26.6 ± 3.4 months (range, 24-32 months). All patients diagnosed with symptomatic DDH exhibited labrum tears. MRI scans revealed paralabral cysts in ten out of twenty-four (41.6%) patients, with a significant correlation noted between the presence of cysts and preoperative LCEA (ρ=-0.649; P=0.001), ACEA (ρ=-0.637; P=0.001), Tönnis angle (ρ=0.593; P=0.002) and age (ρ=-0.444; P=0.034). Postoperative MRI scans at one year showed resolution of all paralabral cysts, while labral tears were found to persist. At the end of the follow-up period, most patients improved considerably in PROs compared to preoperative values. The probabilities of achieving the MCID were 91.3% on the HOS-ADL, 78.2% on the HOS-SSS, 91.3% on the mHHS, 73.9% on the iHOT-12, and 69.6% on the VAS pain scale. All symptomatic patients with DDH had labral tears and a high prevalence of paralabral cysts, which were corrected with reduced acetabular coverage. After PAO surgery, patients experienced notable enhancements in PROs, with resolution of paralabral cysts but persistence of labral tears.

An osmolarity dependent mechanism partially ameliorates retinal cysts and rescues cone function in a mouse model of X-linked retinoschisis.

X-linked retinoschisis (XLRS) is a vitreoretinal dystrophy caused by RS1 gene mutations which disrupt retinoschisin-1 (RS1) function. Vital for retinal architecture, the absence of functional RS1 leads to the development of intraretinal cysts. Intravitreal injection of a gene therapy for treating XLRS caused ocular inflammation in high dose groups in a phase I/II clinical trial. This study investigates a low dose subretinal gene therapy in Rs1 knockout (Rs1-KO) mice compared to injection of buffer alone. Observation of an unexpected therapeutic effect following the subretinal injection of the hypertonic buffer led to novel findings in XLRS. Rs1-KO mice were subretinally injected with an AAV2/4 vector (n = 10) containing the RS1 gene driven by an Ef1α promoter, a hypertonic buffer (n = 15) (180 mM NaCl 0.001% F68/PBS (pH 7.4)), or isotonic buffer (n = 7) (155.2 mM NaCl 0.001% F68/PBS, pH 7.0). A sham puncture group was also included (n = 6). Endpoints included electroretinogram (ERG), optical coherence tomography (OCT), a visually guided swim assay (VGSA), and immunohistochemistry. Unexpectedly, hypertonic buffer-injected eyes had reduced cyst severity at 1-month post-injection (MPI) (p < 0.0001), higher amplitudes in cone-dominant ERGs persisting to 5 MPI (5 Hz flicker; p < 0.0001; 3.0 flash; p = 0.0033) and a trend for improved navigational vision in the light compared to untreated Rs1-KO eyes. To investigate the role of tonicity on this effect, an isotonic buffer-injected cohort was created (155.2 mM NaCl 0.001% F68/PBS, pH 7.0) (n = 7). Surprisingly, hypertonic buffer-injected eyes exhibited a greater reduction in cyst severity and demonstrated improved cone-dominant ERG metrics over isotonic buffer-injected and sham puncture eyes. An immunohistochemistry assay demonstrated greater cone density in hypertonic buffer-injected eyes than untreated Rs1-KO eyes at 5-6 MPI (p = 0.0198), suggesting a possible cone preservation mechanism. Moreover, our findings reveal a negative correlation between the peak severity of cysts and long-term ERG amplitudes in cone-dominant pathways, implying that effectively managing cysts could yield enduring benefits for cone function. This study presents evidence that cyst resolution can be triggered through an osmolarity-dependent pathway, and early cyst resolution has long-term effects on cone signaling and survival, offering potential insights for the development of novel treatments for XLRS patients.

7426 Tamoxifen-Induced Ovarian Hyperstimulation in a Pre-Menopausal Patient with Breast Cancer History: Spontaneous Resolution with Conservative Management

Abstract Disclosure: S. Gondi: None. M. Contento: None. A. Leiter: None. Background: Tamoxifen is a selective estrogen receptor modulator (SERM) that competitively binds to estrogen receptors (ER) on tumors and inhibits the effect of estrogen, which is used in the treatment and prevention of ER-positive breast cancer. Tamoxifen therapy has been reported to increase serum estrogens and cause ovarian hyperstimulation in premenopausal women, but knowledge on how to manage these conditions is limited. Clinical Case: A 36-year-old pre-menopausal female with history of malignant neoplasm of the right breast (ER positive) who completed neoadjuvant chemotherapy, lumpectomy, and radiation, on tamoxifen for seven years presented with new-onset oligomenorrhea. Laboratory testing done by the patient’s gynecologist revealed total estrogen 2,723 pg/mL (reference range [RR] 34-501), testosterone 132 ng/dL (RR 8-60), anti-Mullerian hormone 12.7 ng/mL (RR for age 0.66-8.75), ovulation-phase follicle stimulating hormone 11.5 mIU/mL (RR 4.7-21.5) and luteinizing hormone (LH) 63.3 mIU/mL (RR 14-95.6). Further workup revealed that ovarian tumor markers alpha-fetoprotein and serum human chorionic gonadotropin and other labs including dehydroepiandrosterone sulfate, progesterone 17-OH, lactate dehydrogenase, prolactin, and thyroid stimulating hormone were normal. Transvaginal ultrasound (TVUS) showed a new 2.8 x 1.9 x 2.3 cm complex left ovarian cyst, which, along with the elevated estrogen level, was concerning for ovarian hyperstimulation. Treatment with LH-releasing hormone (LHRH) agonists, surgical consultation, and discontinuation of tamoxifen were offered as potential management strategies, but the patient opted for observation and continued tamoxifen. Two months later, estradiol was 989 pg/mL (RR 85-498), and then three months later decreased to 152 pg/mL with repeat TVUS showing resolution of the left ovarian cyst. The patient’s oligomenorrhea resolved with resumption of regular menstrual cycles. Conclusion: While it is well-known that tamoxifen causes elevated serum estrogen levels and can lead to ovarian hyperstimulation, there is limited research on the management of these side effects. Treatment strategies in past cases have included oophorectomy or medical management with LHRH agonists or gonadotropin-RH agonists. However, this case demonstrates that a tamoxifen-induced ovarian cyst and high estrogen levels can resolve on its own with continued tamoxifen treatment. Conservative management with monitoring via imaging and repeat estrogen levels may be sufficient in management of pre-menopausal women with tamoxifen-induced ovarian hyperstimulation. Presentation: 6/1/2024

Spontaneous resolution of synovial lumbar cyst presented with severe symptoms: a case report

IntroductionSpinal cysts have traditionally been treated with surgery since it was first described in 1950. However, there have been rare instances where these cysts have resolved on their own without the need for surgical intervention. Here, we discuss the 27th reported case of such spontaneous resolution in the medical literature and delve into the details of this unique case.Case presentationThis report details a rare case of a 58-year-old Middle Eastern female who suffered from severe radicular and lumbar pain. Radiological study showed the presence of a cyst in the lumbar column. Noninvasive treatment was chosen after ensuring that there were no other symptoms requiring surgery. The patient showed gradual improvement over the course of 12 months, after which the pain completely disappeared.DiscussionThe surgical approach is currently the main treatment for spinal cysts, but spontaneous resolution, despite its rarity, may be worth considering as a preferred therapeutic approach in the future. This avenue has not been thoroughly explored or studied. Due to the etiology of these cysts and their location within mobile joints, a longer period of conservative management including rest and physical therapy may play a pivotal role in promoting natural resolution.ConclusionConservative treatment of cysts should continue for at least 8 months, using painkillers and physical therapy without lumbar bracing. Surgery remains the most effective means of treatment to date. Further research is needed to validate and establish standardized treatment protocols.

Variables Associated With Resolution and Persistence of Ovarian Cysts

Variables Associated With Resolution and Persistence of Ovarian Cysts

Variables Associated With Resolution and Persistence of Ovarian Cysts: Correction.

Variables Associated With Resolution and Persistence of Ovarian Cysts: Correction.

Simultaneous resolution of arachnoid cyst and chronic subdural hematoma after middle meningeal artery embolization: illustrative case.

Arachnoid cysts are cerebrospinal fluid-filled spaces that are typically congenital and treated conservatively or with fenestration when symptomatic. Chronic subdural hematomas (cSDHs) can arise in the presence of arachnoid cysts due to fragile leptomeningeal vessels or veins within the cyst wall or cyst lumen, leading to bleeding and subsequent hematoma formation. Middle meningeal artery (MMA) embolization is regularly used for the treatment of cSDH as an alternative to craniotomy and evacuation. Here, the authors present the first known report of the simultaneous resolution of an arachnoid cyst and cSDH following MMA embolization in an adult. A 24-year-old male presented to the emergency department with 1 month of worsening headaches. Imaging revealed the presence of a cSDH and ipsilateral arachnoid cyst. The cSDH was treated with MMA embolization using coils exclusively. Follow-up imaging 4 months after embolization demonstrated simultaneous resolution of both the hematoma and the arachnoid cyst. MMA embolization has been used for the treatment of cSDH. In cases in which the hematoma is related to an arachnoid cyst, MMA embolization can also lead to the concurrent resolution of both pathologies. https://thejns.org/doi/10.3171/CASE24192.

Development of a tibial intraneural ganglion cyst after surgery on a peroneal intraneural ganglion in a pediatric patient: further support for the articular origin of intraneural ganglion cysts. Illustrative case.

The articular origin of intraneural cysts has been previously described and well supported. Intraneural ganglion cysts most commonly occur in adults and in the common peroneal nerve arising from the anterior aspect of the superior tibiofibular joint (STFJ). The authors report a pediatric patient who developed a tibial intraneural cyst arising from the posterior aspect of the STFJ within months after surgical treatment of a peroneal intraneural cyst from the anterior aspect of the same joint. Surgery consisted of disconnecting the articular branch of the peroneal nerve and decompression of the cyst. Three-month postoperative magnetic resonance imaging showed resolution of the peroneal intraneural cyst and anterior compartment denervation but demonstrated a clinically occult small tibial intraneural ganglion cyst arising from the STFJ with popliteus muscle atrophy. This case underscores the importance of addressing the underlying etiology (articular synovitis) or the communication pathways (articular branches) whenever feasible to mitigate intraneural cyst recurrence. Furthermore, this report reinforces the validity of the articular theory. https://thejns.org/doi/10.3171/CASE24277.

Ayurvedic Management of Endometriosis – A Case Study

Introduction: Endometriosis is a benign gynaecological disorder defined by presence of endometrial glands and stroma outside the lining of uterine cavity. This ectopic endometrial tissue behaves as normal endometrial tissue and bleeds every month. This blood may become encysted and form endometrioma. The exact prevalence is not known but estimates range from 10-15% within the woman reproductive age group. Materials and methods: A 26-year-old married patient came to the OPD of Prasutitantra evam Streeroga on 10 September 2023 with the complains of failure to conceive since four and half years along with early and scanty menses since 3 years. A chocolate cyst of size 18*21*13mm in right ovary and a haemorrhagic cyst of size 42*36*41mm in left ovary was detected by USG. She was given Virechana Karma in first cycle, followed by Matra Basti with Dashamoola Trivruta Taila for 7 days in next consecutive cycle and orally Saptasara Kashayam along with Purana Guggulu Choorna as Prakshepa and Goghruta as Anupana. Result: After treatment her USG on 31/11/2023 relieved complete resolution of the chocolate cyst. The follow-up was done for 1 month which showed no recurrence of the cyst. Discussion: Virechana eliminates the Doshas and normalizes the ovarian functions. Dashamoola Trivruta Taila Matra Basti helps in Vaatanulomana and does Tridosha Shamana, in Saptasara Kashayam most of the ingredients are having digestive, carminative, analgesic, anti-inflammatory, Stroto Shodhana, Vatakaphashamana, laxative, and blood purifier properties. Guggulu when given with Saptasar Kashayam will increase the efficiency of the formulation by its Yogavahi property thus helping in breaking the pathogenesis.

Albendazole and praziquantel combination versus albendazole alone in children with multiple neurocysticercosis: An open labelled randomized controlled trial.

The efficacy of the combination of albendazole and praziquantel has not been thoroughly studied in multiple neurocysticercosis in children. To compare the efficacy and safety of albendazole and praziquantel combination versus albendazole alone in the treatment of children with multiple neurocysticercosis in terms of proportion of cysts undergoing complete resolution or calcification at 6-month follow-up. A total of 52 children, aged 1-14 years, with newly diagnosed two or more active neurocysticercosis were randomized to either group A or B. Group A (n = 26) received albendazole plus praziquantel, and Group B (n = 26) received albendazole alone. At the end of 6 months, a repeat MRI brain was performed to see for the resolution of cysts and was classified as complete resolution, calcified, or persistence of viable and noncalcified cysts. The proportion of cysts undergoing complete resolution was higher in Group A (23/60 [38.33%]) than in Group B (19/65 [29.23%]), but the difference was not statistically significant. The proportion of cysts undergoing calcification was also comparable in Group A (20/60 [33.33%]) and Group B (20/65 [30.77%]). Both groups had comparable safety profiles. Albendazole and praziquantel combination therapy is as effective as albendazole alone in terms of complete resolution of viable cysts and calcification of cysts.Trial registration: CTRI/2021/12/038492.

Variables Associated With Resolution and Persistence of Ovarian Cysts

(Abstracted from Obstet Gynecol 2023;142:1293–1301 Approximately 15%–20% of women develop ovarian cysts, and roughly 85% resolve within 5 years. However, ovarian cysts do carry a very low potential for malignancy and can be distressing.

Variables Associated With Resolution and Persistence of Ovarian Cysts.

Variables Associated With Resolution and Persistence of Ovarian Cysts.

Symptomatic lumbar Tarlov cyst resolution after computed tomography-guided percutaneous trans-sacral fibrin glue intracystic injection: A case report and literature review

Symptomatic lumbar Tarlov cyst resolution after computed tomography-guided percutaneous trans-sacral fibrin glue intracystic injection: A case report and literature review

Variables Associated With Resolution and Persistence of Ovarian Cysts.

Variables Associated With Resolution and Persistence of Ovarian Cysts.

Endoscopic Ultrasound-Guided Ablation of Premalignant Pancreatic Cysts and Pancreatic Cancer.

Pancreatic cancer is on the rise and expected to become the second leading cause of cancer-related death by 2030. Up to a one-fifth of pancreatic cancers may arise from mucinous pancreatic cysts, which are frequently present in the general population. Currently, surgical resection is the only curative approach for pancreatic cancer and its cystic precursors. However, only a dismal proportion of patients are eligible for surgery. Therefore, novel treatment approaches to treat pancreatic cancer and precancerous pancreatic cysts are needed. Endoscopic ultrasound (EUS)-guided ablation is an emerging minimally invasive method to treat pancreatic cancer and premalignant pancreatic cysts. Different ablative modalities have been used including alcohol, chemotherapy agents, and radiofrequency ablation. Cumulative data over the past two decades have shown that endoscopic ablation of mucinous pancreatic cysts can lead to cyst resolution in a significant proportion of the treated cysts. Furthermore, novel data are emerging about the ability to endoscopically ablate early and locally advanced pancreatic cancer. In this review, we aim to summarize the available data on the efficacy and safety of the different EUS-ablation modalities for the management of premalignant pancreatic cysts and pancreatic cancer.

Resolution of arachnoid cyst after development of chronic subdural hematoma and burr hole surgery - a case report

&lt;p&gt;蜘蛛膜囊腫是先天性且通常無症狀的顱內病灶，自行消失的案例非常罕見，已知有此病灶的病人較一般人於輕微頭部創傷後引發後續的慢性硬腦膜下血腫，若造成腦部壓迫之症狀，臨床上通常會進行顱骨鑽孔引流手術，只引流血水並不會去特別處理囊腫，但在極少數情況下，囊腫會在術後追蹤時被發現慢慢消失。我們報告一例蜘蛛膜囊腫在接受硬性硬腦膜下出血手術後消退的案例，探討其可能的病生理機轉和相關文獻回顧。&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;&lt;p&gt;Arachnoid cyst (AC) is usually asymptomatic, incidentally-found, and a well-known risk factor of developing chronic subdural hematoma (CSDH) after minor head injury in young patients. Spontaneous remission or rupture of arachnoid cyst is very rare. When chronic subdural hematoma occurs, burr hole drainage is indicated if mass effect presenting. Only the hematoma is drained, where the cyst is left untouched. Although the chance of an arachnoid cyst to disappear is low, here we presents a case where the AC disappears after burr hole operation. We subsequently discuss the possible pathophysiological mechanisms and the relevant literatures.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Treatment of Polycystic Ovarian Syndrome through Individualised Homoeopathic Medicine: Two Case Reports

AbstractPolycystic ovarian syndrome (PCOS) is one of the most common metabolic and reproductive disorders among women of reproductive age. Women suffering from PCOS present with menstrual dysfunction and androgen excess. Two patients aged 16 and 19 years suffering from PCOS were treated successfully with individualised homoeopathic medicine. These two cases of PCOS were treated with marked improvement within 1.5 years by individualised homoeopathic medicine with change in potency and repetition as per requirement. Modified Naranjo Criteria for Homeopathy (MONARCH) was used as a tool for attributing a causal relationship between the homoeopathic intervention and outcome. Visual analogue scale was used as a tool for assessing pain during menses (dysmenorrhoea). The improvement is evident from the regularity of the menstrual cycle, along with the resolution of cysts in ovaries as evidenced by ultrasonography reports which indicate a positive response of homoeopathy in relieving the symptoms as well as pathology associated with PCOS.

Spontaneous resolution of spinoglenoid ganglion cyst: a case series

BackgroundSpontaneous resolution of a spinoglenoid notch ganglion cyst (SGC) without surgical treatment has been rarely reported; however, we have encountered this phenomenon occasionally. Therefore, we aimed to describe a case series of consecutive patients with SGC in whom it spontaneously resolved without surgical treatment. MethodsWe retrospectively reviewed 12 patients with magnetic resonance imaging (MRI)-confirmed SGC in whom it resolved without surgical treatment between January 2011 and March 2023. We included patients without abnormally increased signal intensity or muscle atrophy due to denervation from suprascapular neuropathy on MRI. Resolution of the SGC was confirmed via MRI or ultrasound at the follow-up visit, and suprascapular neuropathy was assessed using electromyography and nerve conduction studies when needed. For functional assessments, the visual analog scale (VAS) for pain and active range of motion of the shoulder were used to compare pre- and post-resolution follow-ups. ResultsEleven men and one woman with a median age of 54.0 years (interquartile range [IQR] 37.0–65.3) were included in this study. The SGCs resolved spontaneously at a median of 13.2 months with an IQR of 8.2–23.0 after initial evaluation using MRI. The SGCs were multiloculated cysts with superior labrum anterior and posterior (SLAP) II–IX lesions, with a median diameter of 2.5 cm (IQR 2.0–2.8). The median VAS for pain (pre-resolution 5.0 [IQR 4.0–7.0] vs. post-resolution 1.0 [IQR 0.0–1.0], P = 0.002) and internal rotation at the back (pre-resolution 8.0 [IQR 7.0–10.3] vs. post-resolution 7.5 [IQR 7.0–8.0], P = 0.034) were significantly improved after the resolution. ConclusionsSurgical treatment may not be necessary in all cases of SGC. Nonsurgical treatment may be a viable option in the absence of suprascapular nerve involvement or SLAP-related physical findings.

Safety and efficacy of the EndoRotor device for the treatment of walled-off pancreatic necrosis after EUS-guided cystenterostomy: A systematic review and meta-analysis.

Debridement of infected walled-off pancreatic necrosis is indicated to treat and prevent sepsis-related multiorgan failure. The aim of this study was to evaluate the efficacy and safety of the EndoRotor-powered endoscopic debridement system to remove solid debris under direct endoscopic visualization. Search strategies were developed for PubMed, EMBASE, and Cochrane Library databases from inception to June 2022, in accordance with Preferred Reporting items for Systematic Reviews and Meta-Analyses and Meta-Analysis of Observational Studies in Epidemiology guidelines. Outcomes of interest included technical success defined as successful use of device for debridement, clinical success defined as complete debridement and cyst resolution, and procedure-related adverse events. A random-effects model was used for analysis, and results were expressed as odds ratio along with 95% confidence interval. A total of 7 studies (n = 79 patients) were included. The mean walled-off pancreatic necrosis size was 154.6 ± 34.0 mm, whereas the mean procedure time was 71.4 minutes. The mean number of necrosectomy sessions required was 2.2 (range, 1-7). The pooled rate of clinical success was 96% (95% confidence interval, 91%-100%; I 2 = 0%) with a pooled technical success rate of 96% (91%-100%; I 2 = 0%). The pooled procedure-related adverse event rate was 8% (2%-14%; I 2 = 6%), which included procedure-associated bleeding, pneumoperitoneum, peritonitis, pleural effusion, and dislodgement of lumen-apposing metal stents. Our study shows that the novel EndoRotor device seems to be safe and effective for treating pancreatic necrosis. Patients undergoing endoscopic necrosectomy with the EndoRotor seem to require less debridement sessions when compared with studies using conventional instruments.