Cystic Benign Tumors Research Articles

Differential Diagnosis Difficulty between Biliary Cystadenoma and Cystaadenocarcinoma of the Liver: A Case Report

Biliary cystadenoma is a multilocular cystic benign tumor which arises in the intrahepatic biliary system. Diagnosis is often difficult and based on imaging, however histology remains the only argument for diagnosis certainty. We report a case of biliary cystadenoma in a 69-year-old female. Observation: it was a 69-year-old female with history of RHUPUS syndrome (Lupus + Rheumatoid arthritis) under low-dose corticosteroid therapy. She presented with pain in the right hypochondrium with permanent moderate intensity for 3 months associated to altered performance status. Physical examination showed a hepatomegaly, cervical subluxation, and pulmonary condensation syndrome. Hepatobiliary ultrasound showed presence of multiple septate cystic formations occupying segments 1, 7, 8, 5 of the left liver. Abdominal CT scan and hepatic MRI were in favor of biliary cystadenoma but could not rule out biliary cystadenocarcinoma with certainty. Conclusion: biliary cystadenoma is a benign cystic tumor of the liver. The differential diagnosis with cystadenocarcinoma is most often difficult and usually requires histological analysis for diagnostic certainty.

Diagnostic and Surgical Outcomes of Mediastinal Tumors in Adults: What Place for Conventional Surgery in Resource-Limited Countries?

Abstract Introduction: Mediastinum tumors are a heterogeneous group of tumors with diverse and varied presentations. We reviewed our experience with mediastinal tumors and the role of conventional surgery in their management in countries with limited resources. Materials and Methods: We retrospectively reviewed the medical records of patients with mediastinal tumors who underwent surgery at our Thoracic Surgery Department, University Hospital Center, Fez, Morocco, from January 2009 to December 2017. Results: A total of 56 patients underwent surgical resection for mediastinal tumors during the 9-year study period. Chest computed tomography imaging was obtained in all patients, and magnetic resonance imaging and technetium 99 (99-m Tc-methoxy-isobutyl-isomitril) scintigraphy were required in select patients. Sternotomy was the most frequently used surgical approach. Histopathology of the resected surgical specimens were 9 neurogenic tumors, 9 cystic benign tumors, 7 ectopic parathyroid adenomas, 8 teratomas, and 23 epithelial tumors of the thymus. Postoperative morbidity and mortality were 5.3% and 5.3%, respectively. All deaths were in patients with thymus epithelial tumors. Conclusion: Conventional surgery has acceptable morbidity and mortality and remains a viable therapeutic approach despite the advent of minimally invasive techniques like video-assisted surgery in recent decades.

A Case of Cystic Struma Ovarii: A Rare Ovarian Tumor

ABSTRACTBackgroundStruma ovarii is a rare ovarian neoplasm, which contains thyroid tissue. It accounts for less than 5% of ovarian teratomas. These are mostly benign, occurring between 40 years and 60 years of age. Clinical and radiological features are inconclusive and mostly it is diagnosed by histopathology. About 5–8% cases have hyperthyroidism. Cystic struma ovarii is very rare with only 25 cases reported till now. It creates confusion in diagnosis, as even in histopathology, the cells are mostly like those resembling other cystic ovarian tumors with minimal thyroid follicles.Case descriptionA 20-year-old girl came with complaints of abdominal discomfort and difficulty in squatting and lying supine. Clinically, a 28-week-size cystic tumor was palpated. Ultrasound showed features of a cystic benign tumor. Tumor markers were normal. Laparoscopic cystectomy was done. Histopathology showed cystic struma ovarii. At 6-month follow-up, the patient has been doing well.ConclusionCystic struma ovarii is a rare diagnosis. Clinical, biochemical, and radiological features do not help. A careful and keen pathological examination is necessary so that thyroid follicles are not left while viewing. There is no clear consensus on follow-up of these patients, but benign tumors usually do not need extensive follow-up.Clinical significanceIt is a rare tumor and a good histopathological diagnosis is needed. Cystic tumors should be carefully examined. A proper correlation between clinical, biochemical, radiological, intraoperative, and histopathological findings may help us to consider this diagnosis when we get similar cases.How to cite this articleGautam H, Kathar K, Goswami P,et al. A Case of Cystic Struma Ovarii: A Rare Ovarian Tumor. J South Asian Feder Obst Gynae 2020;12(5):320–322.

Pancreatic mucinous cystadenoma doubly complicated by acute pancreatitis and retroperitoneal rupture

Mucinous cystadenomas are the most frequent cystic benign tumors of the pancreas. They are characterized by a malignant potential. Acute pancreatitis is their most common complication. This manuscript reports a unique complication of mucinous cystadenomas of the pancreas: retroperitoneal rupture associated to acute pancreatitis. After resuscitation, the patient underwent surgery. A cystic mass of the pancreas tail with retroperitoneal rupture was found. Splenopancreatectomy was performed. Outcomes were straightforward. After 3 years of follow-up, no signs of recurrence are highlighted.

Current status of multi-detector row helical CT in imaging of adult acquired pancreatic diseases and assessing surgical neoplastic resectability

BackgroundIt is usually hard to detect pancreatic lesions early as the pancreas lays retro peritoneum so it cannot be assessed during a routine physical exam. By the time a person has symptoms, the disease has already established morphological imaging CT changes. ObjectiveThe objective of our study was to clarify the role of multidetector computerized tomography (MDCT) in different adult acquired pancreatic diseases and assess the efficacy of surgical pancreatic tumors resectability preoperative. Materials & methodsThe study included thirty adult patients suspected to have pancreatic diseases (18 males and 12 females); their age range was 45–90years with a mean age of 68years. All patients underwent triple-phase multi-detector row CT using a 16-slice machine. The presence of inflammation, masses, and vascular invasion was evaluated and interpreted images were obtained during each phase. Results were compared with surgery, histopathology or follow-up. ResultsOf 30 patients, 15 had pancreatic malignancies (14 adenocarcinoma of which 6 were resectable and 8 were irresectable, 1 distant metastasis) proven at biopsy and/or surgery, 11 patients had pancreatitis (acute and chronic), three patients had cystic benign tumors (2 mucinous cystadenoma, 1 serous cystadenoma), and one patient had neuroendocrine tumor (insulinoma). ConclusionContrast enhanced multiphase pancreatic imaging by MDCT with its post processing techniques represents the imaging modality of choice for the diagnosis of different adult acquired pancreatic diseases.

Preoperative cytological diagnosis of papillary cystic variant of acinic cell carcinoma: A key consideration in patient management

Preoperative diagnosis of malignant salivary gland tumors is difficult as radiological imaging procedures have low sensitivity rate for detecting malignancy in parotid gland tumors. With careful and detailed analysis of cytological features, guided fine needle aspiration cytology can prove to be a reliable diagnostic modality that can help in differential diagnosis of cystic parotid malignancies from cystic benign tumors and non-neoplastic lesions. Papillary cystic variant of acinic cell carcinoma is a rare, cystic, primary neoplasm of salivary gland that occurs commonly in parotid. The tumor shows high local recurrence rate and has poorer prognosis compared to classic acinic cell carcinoma. Preoperative cytological diagnosis of papillary cystic variant of acinic cell carcinoma of parotid, in the case described here was the basis for adequate and timely surgical management with good results.