Cystic Lesions Research Articles

Cystic lung in sarcoidosis: Clinico-radiologic characteristic and evolution.

Sarcoidosis can manifest with atypical findings on chest computed tomography (CT). Cysts are a rare manifestation of lung sarcoidosis. The aim of the study was to describe a series of patients with cystic sarcoidosis and their clinical-radiological characteristics and progression. In this retrospective, bicentric study we recruited all patients affected by sarcoidosis with lung cystic lesions at chest CT. We collected clinical characteristics, pulmonary tests and tracked number, distribution and size of the cysts at diagnosis and at the last evaluation. Twelve patients (6 males, median age 53 years) were identified (prevalence: 1.9%; 95% Confidence Interval: 0.8%-2.9%). All patients presented multiple cystic lesions (median number: 14 [range: 2-216]) with a bilateral distribution in 10/12, micronodules and nodules in 11/12 and fibrotic lesions in 4/12. Seven patients had normal lung function test, three had an obstructive syndrome, one had a restrictive syndrome and one had coexistence of both. During follow-up (median: 10 years [range 1-16 years]), an increase of the number of cysts was observed in four patients. At last evaluation, 3/12 patients experienced a decline of forced vital capacity >10% and 3/12 patients a decline of diffusing capacity for carbon monoxide (DLCO) >10%. A lower DLCO at diagnosis, and the presence of nodules or fibrotic lesions on CT were associated with an increase in the number of cysts. Cystic lung lesions are rare in patients with sarcoidosis and do not influence long term prognosis.

Recurrent symptomatic abdominopelvic cystic lesions of unknown etiology treated with image-guided sclerotherapy: A case report

This case report highlights the diagnostic approach and treatment for 30 cm bilateral multiloculated pelvic peritoneal cystic masses. The patient had a history of spina bifida with ventriculoperitoneal shunt placement and neurogenic bladder with partial cystectomy and ileal conduit diversion. The cysts were suspected to be peritoneal inclusion cysts. Due to prior failed surgical intervention, the patient was treated with image-guided sclerotherapy.

Fetal Brain MRI Abnormalities in Pyruvate Dehydrogenase Complex Deficiency.

Pyruvate dehydrogenase complex deficiency (PDCD) is a disorder of mitochondrial metabolism that is caused by pathogenic variants in multiple genes, including PDHA1. Typical neonatal brain imaging findings have been described, with a focus on malformative and encephaloclastic features. Fetal brain MRI in PDCD has not been comprehensively described. The aims of this study were (1) to further characterize the fetal brain MRI findings in PDCD using comprehensive fetal imaging and genetic testing and (2) to determine whether markers of diagnosis of PDCD could be identified on prenatal imaging. Fetuses with a diagnosis of PDCD related to a genetic etiology that had undergone fetal MRI were included. Fetuses were identified retrospectively from local databases of 4 fetal diagnostic clinics within tertiary pediatric health care centers. Electronic medical records were reviewed retrospectively: demographics, maternal and pregnancy history, fetal outcomes, and neonatal outcomes (if available) were reviewed and recorded. Fetal and neonatal imaging reports were reviewed; source fetal and neonatal brain MRI scans were reviewed by a single pediatric neuroradiologist (J.W.S.) for consistency. Genetic testing strategies and results including variant type, zygosity, inheritance pattern, and pathogenicity were recorded. Deidentified data were combined and reported descriptively. A total of 10 fetuses with a diagnosis of PDCD were included. 8 fetuses had corpus callosum dysgenesis, 6 had an abnormal gyration pattern, 10 had reduced brain volumes, and 9 had cystic lesions. 1 fetus had intraventricular hemorrhages. 1 fetus had a midbrain malformation with aqueductal stenosis and severe hydrocephalus. 6 fetuses imaged in the second trimester had cystic lesions involving the ganglionic eminences (GEs) while GE cysts were not present in the 4 fetuses imaged in the third trimester. Fetuses with PDCD have similar brain MRI findings to neonates described in the literature, although some of these findings are subtle early in pregnancy. Additional features, such as cystic lesions of the GEs, are noted in the second trimester in fetuses with PDCD. These may represent an early diagnostic marker of PDCD, although more data are needed to validate this association. Early diagnosis of PDCD using fetal MRI may inform genetic counseling, pregnancy decision making, and neonatal care planning.

Role of ultrasound‑guided fine‑needle aspiration cytology combined with thyroid peroxidase and thyroglobulin antibodies in evaluating cervical lymph node metastasis in thyroid cancer.

The present study was designed to explore the role of ultrasound-guided fine-needle aspiration (FNA) cytology combined with thyroid peroxidase antibody (TPO-Ab) and thyroglobulin antibody (Tg-Ab) in evaluating cervical lymph node metastasis in thyroid cancer. The aim was to propose more effective diagnostic strategies for cervical lymph node metastasis in patients with thyroid cancer. Firstly, the present retrospective case-control study selected 294 patients with thyroid cancer treated at Changzhou Second People's Hospital (Changzhou, China). High-resolution ultrasound equipment was used for ultrasound and FNA examinations. Additionally, a retrospective analysis of the patient's comprehensive thyroid function tests, including TPO-Ab and Tg-Ab levels, was conducted. Subsequently, univariate and multivariate logistic regression models were employed to analyze the association between various factors and cervical lymph node metastasis. The overall diagnostic accuracy of the model was evaluated using the receiver operating characteristic curve and its area under the curve. Finally, the performance of the diagnostic model was quantitatively assessed through calculating sensitivity, specificity, positive predictive and negative predictive values. According to the experimental results, sex, tumor stage and the levels of thyroid autoantibodies were associated with the risk of cervical lymph node metastasis in thyroid cancer. Moreover, ultrasound features, such as cystic lesions, loss of hilum of the lymph nodes, abundant vascular supply, heterogeneous echo and microcalcification were also closely related to cervical lymph node metastasis. Logistic regression analysis also showed that tumor stage, serum levels of TPO-Ab and Tg-Ab, and cystic lesions were independent predictors of cervical lymph node metastasis. Furthermore, the combined use of ultrasound, FNA, TPO-Ab and Tg-Ab significantly improved diagnostic sensitivity and specificity. Overall, ultrasound-guided FNA combined with TPO-Ab and Tg-Ab may have a significant role in the evaluation of cervical lymph node metastasis in thyroid cancer. This combined diagnostic approach could significantly enhance diagnostic accuracy, providing a more effective strategy for the clinical management of cervical lymph node metastasis in thyroid cancer.

Rehabilitation of a neonate with persistent caput succedaneum using cranial remoulding orthosis (helmet): a case report

A second-born male child to nonconsanguineous parents was delivered by normal vaginal delivery following a difficult extraction at term and had a normal transition to postnatal life. At 40 days of life, the baby presented with a soft, boggy swelling in the posterior occipital region, which had been noticed since birth but was increasing in size gradually, and he was born through a difficult normal vaginal delivery. The preliminary diagnosis considered at admission was probable caput succedaneum, with a differential diagnosis of spontaneous CSF leak. Cranial ultrasound reports showed a cystic lesion measuring 37×28 mm in the right parietooccipital region, suggestive of caput succedaneum. So, the baby was aided by our rehabilitation team experts, who provided the cranial remolding orthosis (helmet) to the neonate, which would provide adequate soft, consistent compression. At 3 and a half months of age, the caput subsided, and the baby was doing clinically well with normal developmental milestones and a normal head circumference, appropriate for the age. Thus, the use of the helmet resulted in a significant improvement in the baby's condition, demonstrating the effectiveness of this intervention for treating persistent caput succedaneum. Therefore, this article highlights the importance of early intervention and specialized care in managing cranial deformities in neonates.

Epididymal Cyst Lesions Are Not Associated With Impaired Semen Parameters Among Men Presenting for Fertility Evaluation.

Epididymal cyst lesions (ECLs) include both spermatoceles and epididymal cysts and are often incidentally found on physical exam or scrotal US (SUS). We aimed to determine the association of ECLs and semen parameters among men presenting for fertility evaluation. We reviewed men at our institution who had at least 1 semen analysis and SUS available for review between 2002 and 2022. SUS data included testicular measurements, presence or absence of subclinical varicocele, and size and laterality of ECL, if present. Demographic and clinical information including serum testosterone and follicle-stimulating hormone and semen parameters were compared between men with and without ECLs. Among 861 men, 164 (19%) had unilateral right ECL (median 4 mm, interquartile range 3-8 mm), 189 (22%) had unilateral left ECL (median 4 mm, interquartile range 3-9 mm), and 113 (13%) had bilateral ECL. Patients with ECLs were significantly older than men without ECLs at the time of evaluation but had no statistically significant difference in semen volume, sperm concentration, sperm motility, sperm morphology, total motile sperm count, or serum hormonal values. Analysis of men with unilateral and bilateral ECLs showed that ECL size and laterality did not significantly correlate with any semen parameter evaluated. We found no association between ECLs and semen parameters. Patients should be counseled toward conservative management with observation for asymptomatic ECLs in the setting of fertility evaluation.

MR imaging of benign vulvar lesions: a pictorial essay.

Benign vulvar lesions can be difficult to differentiate with few publications on their imaging appearances. While many vulvar lesions may be clinically diagnosed and treated, more are being detected incidentally with the increasing prevalence of magnetic resonance imaging (MRI) of the pelvis. In addition, clinicians may find imaging of benign vulvar lesions helpful for greater anatomical correlation. After reviewing the important MRI sequences for vulvar imaging and the anatomy of the vulva on MRI, this pictorial essay illustrates variety of cystic and solid benign vulvar lesions to familiarize radiologists with their common MRI appearances. Other miscellaneous pelvic lesions that can affect the vulva are also described.

Simultaneous lesions of complex odontoma associated with dentigerous cyst: case report and critical review in CBCT

Objectives: To our knowledge, there is limited evidence reporting cystic lesions associated with odontoma. Therefore, this case report aims to describe the clinical, histological, and particularly the characteristic cone beam computed tomography (CBCT) diagnostic features . Case Report: A 20-year-old male patient presented with a complaint of a lump in the upper right jaw. There was no history of systemic disease. A panoramic radiograph showed a solid radio-opaque mass surrounded by an osteolytic lesion with a radio-opaque margin causing impaction of the maxillary canine. Given the limitations of panoramic radiography in assessing lesion extent, a CBCT examination was performed. Multiplanar reconstruction revealed a well-defined unilocular hyperdense lesion with a hypodense encapsulation and corticated margin, measuring 31.5 x 32 mm, expanding the buccal cortical plate and pushing the upper right canine tooth into the maxillary sinus cavity. The extensive expansion of the lesion required histopathological analysis to confirm the final diagnosis. The histopathological examination concluded a dentigerous cyst. Conclusion: Several reports in the literature discuss the development of cysts and tumors in the jaw, but some cases are very difficult to identify. The variability of lesions can complicate pattern identification, leading to misinterpretation of conventional radiographs, thus requiring additional CBCT evaluation.

Mucinous Carcinoma of Ovary in a 15-Year-Old Girl, A Rare Case Report and Literature Review.

Ovarian epithelial tumors are common in adults, and the median patient age at presentation is 55 years. In children, epithelial tumors are rare and mostly benign. Mucinous cystadenocarcinoma is reported in only 11 cases less than 15 years old. This report describes the case of a 15-year-old postmenarchal Omani girl with ovarian mucinous carcinoma. She was admitted with severe epigastric pain and abdomen distension. CT scan showed a huge cystic lesion arising from the left adnexa filling the entire abdominal and pelvic cavity. The patient underwent laparotomy with left ovarian cystectomy and omental biopsy which revealed a 35 x 30 cm left ovarian cyst filled with turbid straw color fluid. Histopathology was reported as mucinous carcinoma. The patient later underwent cytoreductive surgery with left salpingo-oophorectomy, omentectomy, appendicectomy, and lymph node dissection that were negative for malignancy or metastatic disease. During follow-up, she developed a lymphocele in the pelvic cavity that was drained. There were no other significant issues during follow-up, as well as no evidence of recurrence or metastasis. Epithelial tumors of the ovary are rare in young girls, with malignant tumors being exceedingly rare. Fertility-sparing surgery is adopted over radical surgery in these patients, even though the recurrence rates with this treatment protocol are high. All cases should be under follow-up to look for recurrence and timely management.

Preoperative diagnosis of cervical cystic lesions using magnetic resonance imaging: a retrospective study

BackgroundWe conducted this study to clarify the magnetic resonance imaging (MRI) characteristics of lobular endocervical glandular hyperplasia (LEGH) and Nabothian cysts.MethodsThis study included 48 patients who underwent hysterectomy at our institution between 2016 and 2020 for suspected LEGH. Histopathological studies confirmed the presence of 25 Nabothian cysts and 23 cases of LEGH. We retrospectively analyzed five characteristic MRI findings: (1) located at the upper cervical canal, (2) positioned within the cervical stroma, (3) not circumscribing the cervical canal, (4) low- to iso-intensity on T1-weighted images (T1WI), and (5) “cosmos” or “microcystic” pattern. We compared the diagnostic accuracy of these findings for LEGH and Nabothian cysts using sensitivity, specificity, and predictive values. Combinations of findings were also calculated.ResultsThe characteristics “cosmos” or “microcystic” pattern, lesion not circumscribing the cervical canal, and low/iso-intensity on T1WI had a sensitivity and specificity greater than 50%. The sensitivity was 73.9% and specificity 84.0% when a combination of “cosmos” or “microcystic” pattern and lesion not circumscribing the cervical canal was present.ConclusionThe coexistence of a “cosmos” or “microcystic” pattern and not circumscribing the cervical canal was the most characteristic finding that distinguished LEGH from Nabothian cysts. When neither of these findings is present, Nabothian cyst can be suspected.

An aggressive Cushing's syndrome originating from a rare thymic neuroendocrine tumor, controlled successfully with fluconazole and octreotide therapy before surgery.

Cushing's syndromes (CSs) due to the thymic neuroendocrine tumors are rarely seen. Here, a case of ectopic CS originating from an atypical neuroendocrine tumor has been presented. A 49-year-old woman was hospitalized with symptoms of fatigue, chest pressure, dyspnea, muscle weakness, and resistant hypertension. There was marked hyperpigmentation in the whole-body surface suggestive of adrenocorticotropic hormone (ACTH) excess and there were physical features of CS. There was deep hypokalemia. Basal hormone profile, dexamethasone suppression tests, midnight cortisol, and 24-hour urine cortisol levels were suggestive of ectopic CS. The pituitary magnetic resonance imaging revealed a 5 mm cystic lesion and the patient refused inferior petrosal sinus sampling. Thorax computerized tomography showed an anterior mediastinal mass. A fluorodeoxyglucose-positron emission tomography showed the same mediastinal lesion (suvmax: 11.4), and no other tumor focus was detected. There was an aggressive cortisol excess causing acute respiratory distress syndrome, making it difficult to perform the surgery. We immediately started fluconazole and octreotide therapy and were successful in lowering the cortisol level. Then a complete resection of the tumor had been able to be surgically performed and tumor cells showed strong cytoplasmic immunopositivity with ACTH. A definitive diagnosis of "ACTH secreting atypical thymic carcinoid tumor" was rendered based on the histopathological and immunohistochemical features. There was only surrounding vessel invasion, and no lymphoid or other organ metastases were detected. As there were surrounding vessel invasions, a two-cycle regimen cisplatin-etoposide chemotherapy and radiotherapy were employed. After surgical and medical therapy, the cortisol and ACTH levels turned to normal. The patient is in biochemical and clinical remission and has no tumor recurrence yet. Ectopic ACTH-producing thymic carcinoids are rare but life-threatening tumors because of the underlying malignancy and severe hypercortisolemia. It is important to consider this disease and perform appropriate treatment at the right time. Today, surgery is the standard therapeutic modality if it is possible to perform, but there is not a clear and constant recommendation for nonsurgical therapeutic modalities. Further studies are needed for the optimal treatment strategies.

Case series multilocular cystic hemangioma of the liver: Three cases and literature review.

Multilocular cystic hemangioma is a rare benign tumor classified as an atypical hemangioma. Currently, there are limited imaging reports available, and the imaging characteristics can be challenging to distinguish from other malignant multilocular cystic liver diseases such as cystadenocarcinoma, necessitating confirmation through pathological diagnosis. Here, we discuss the imaging features of 3 cases of multilocular cystic hemangiomas. Case 1 was a 24-year-old young female, and Case 2 involved a 60-year-old elderly male. Both patients were asymptomatic and physical examination revealed hepatic space-occupying lesions. Imaging findings revealed multilocular cystic lesions in the left liver with septa, calcification, a high diffusion-weighted magnetic resonance imaging (DWI) signal at the edge of the lesion, and progressive enhancement of the cyst wall and septa. Case 3 involved a 50-year-old male patient with epigastric distending pain for 1 month and sudden severe abdominal pain for 14 hours. Imaging results revealed a multilocular cystic lesion in the left liver with septa and tumor bleeding, a high DWI signal, and an enhanced cyst wall and septa. The pathological diagnosis confirmed a hepatic hemangioma. All 3 patients underwent liver tumor resection. All 3 patients recovered successfully without any intraoperative or postoperative complications during the follow-up periods of 5 years, 6 months, and 5 months. There were no signs of recurrence. Liver imaging revealed multilocular cystic lesions with features, such as compartmentalization, calcification, or bleeding. Multilocular cystic hemangiomas should be considered in imaging diagnosis. Enhancing our understanding of multilocular cystic hemangiomas can aid in improving the differential diagnosis of other malignant multilocular cystic liver diseases, ultimately reducing unnecessary liver resection.

Effectiveness of marsupialization on the reduction of cystic jaw lesions in children: A scoping review

Effectiveness of marsupialization on the reduction of cystic jaw lesions in children: A scoping review

Effect of deep learning reconstruction on the assessment of pancreatic cystic lesions using computed tomography.

This study aimed to compare the image quality and detection performance of pancreatic cystic lesions between computed tomography (CT) images reconstructed by deep learning reconstruction (DLR) and filtered back projection (FBP). This retrospective study included 54 patients (mean age: 67.7 ± 13.1) who underwent contrast-enhanced CT from May 2023 to August 2023. Among eligible patients, 30 and 24 were positive and negative for pancreatic cystic lesions, respectively. DLR and FBP were used to reconstruct portal venous phase images. Objective image quality analyses calculated quantitative image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) using regions of interest on the abdominal aorta, pancreatic lesion, and pancreatic parenchyma. Three blinded radiologists performed subjective image quality assessment and lesion detection tests. Lesion depiction, normal structure illustration, subjective image noise, and overall image quality were utilized as subjective image quality indicators. DLR significantly reduced quantitative image noise compared with FBP (p < 0.001). SNR and CNR were significantly improved in DLR compared with FBP (p < 0.001). Three radiologists rated significantly higher scores for DLR in all subjective image quality indicators (p ≤ 0.029). Performance of DLR and FBP were comparable in lesion detection, with no statistically significant differences in the area under the receiver operating characteristic curve, sensitivity, specificity and accuracy. DLR reduced image noise and improved image quality with a clearer depiction of pancreatic structures. These improvements may have a positive effect on evaluating pancreatic cystic lesions, which can contribute to appropriate management of these lesions.

Rare presentation of Omental Cyst in Inguinal Hernia

Introduction: Inguinal hernia is one of the most frequent surgery performed by pediatric surgeons and majority of the hernias are indirect inguinal hernia. Mostly the sac is empty or might contain omentun , small bowel , ovaries , fallopian tubes etc. Rarely we see patients in which sac contains huge cystic lesion. We present a case report of patient who presented to us with swelling in left inguinal region and a preiminalry diagnosis of Left inguinal hernia was made later on it was found that the hernia sac contains a huge omental cyst which remained un-diagnosed till the time of surgey. Omental cyst is one of the rarest types of intraabdominal cystic lesions in pediatric age group.

Endoscopic Transsphenoidal Drainage for Rathke Cleft Cyst With Sellar Xanthogranuloma - Successful Cyst Drainage and Prevention of Postoperative Cerebrospinal Fluid Leakage: 2-Dimensional Operative Video.

The etiology of sellar xanthogranuloma (SXG) remains unclear,1-5 and the surgical strategy for treating SXG is debatable. In this study, we present the surgical case of a symptomatic SXG associated with Rathke cleft cyst. The intraoperative decision to prevent postoperative cerebrospinal fluid (CSF) leakage and secure the drainage route is discussed. A 72-year-old woman presented with severe headaches, visual loss, and gradual enlargement of a cystic lesion on magnetic resonance imaging. The cyst compressed the chiasm upward. The cyst wall was partially thickened and contained a solid mass that was weakly enhanced after gadolinium administration. The endoscopic transsphenoidal cyst was drained, the solid tumor was partially removed for histological diagnosis, and the wide drainage orifice was secured. Intraoperatively, the cyst wall was widely open, but CSF leaked during manipulation of the solid tumor. The sellar floor was partially reconstructed by a multilayer technique to prevent postoperative CSF leakage. The wide cyst drainage route to the sphenoid sinus was also secured. Histologic diagnosis revealed SXG with ciliated columnar epithelium. No postoperative CSF leakage occurred, and the cyst continued to shrink. The patient's visual acuity improved, and pituitary function was preserved. If a CSF leak is identified intraoperatively in a case of secondary SXG associated with Rathke cleft cyst, a cystic fenestration with partial sellar reconstruction may reduce the likelihood of postoperative CSF leakage and ensure continuous drainage. Institutional Review Board approval was not required; The patient consented to the surgery and the publication of her images and surgical video.

Osseous cyst‐like lesions in an unusual location in the equine distal phalanx

SummaryOsseous cyst‐like lesions (OCLLs) of the distal phalanx commonly occur around midline. The dorsopalmar location can be challenging to identify radiographically; however, advanced imaging has shown they are typically located in the central and palmar thirds of the bone. This study reports unusually located OCLLs in the dorsal, axial aspect of the palmar processes of the distal phalanx in three horses, with communication with the distal interphalangeal (DIP) joint confirmed by contrast arthrography in two horses. All horses were lame and had lameness localised to the distal limb with diagnostic anaesthesia. A rounded radiolucency with a surrounding rim of increased opacity was identified in the dorsal aspect of a palmar process on radiographs, with the palmaroproximal–palmarodistal oblique (PaPrPaDiO) view being most useful. On magnetic resonance imaging (MRI), the lesions were seen as hyperintense structure on T2*, T2 FSE and STIR sequences; a thin rim of intermediate signal surrounding a low signal centre was seen on T1 images. A rim of low T1/T2 FSE signal was seen in the surrounding bone in all cases, consistent with sclerosis, and mildly increased STIR signal was present in the surrounding trabecular bone in two cases. Two horses underwent standing cone‐beam computed tomography (CT) examination of the affected foot, revealing a well‐defined hypoattenuating region within the dorsal, axial aspect of the palmar process of the distal phalanx, with surrounding rim of increased attenuation. Contrast arthrography was performed in two cases, one using radiographs and the other CT, and confirmed communication of the cystic lesion with the DIP joint in both cases. Although advanced imaging provided further information and allowed other possible causes of lameness to be identified, careful assessment of radiographs allowed these unusually located OCLLs to be identified in all cases.

Endodontic and surgical management of traumatic radicular cyst: A case report

A radicular cyst is most common among all cystic lesions of the jaw. It is mostly associated with apical and lateral exits of an infected root canal. Radicular cysts are usually asymptomatic and often discovered accidentally on routine radiographic examination. This article presents a case of 18 years old male patient with the chief complaint of palatal swelling for a month and history of trauma. Based on clinical, radiological and cytological examination, a provisional diagnosis of infected radicular cyst was made. The treatment plan included root canal therapy followed by surgical enucleation of cystic lesion and apicectomy of the involved tooth. Patient remained asymptomatic in follow up period and 18 months follow up radiographs showed complete resolution of periapical radiolucency and new bone formation at the site of cystic lesion.

Management of Ovarian Endometrioma: A Detailed Case Analysis

Women play an integral role in the society, there health and well-being are vital in such journey, certain health conditions like endometriomas often affect the quality of life of many women. These endometriomas are cystic lesions that stem from endometriosis. And are most commonly found in the ovaries. Ovarian endometrioma is the most common form of endometriosis, with its prevalence ranging between 17% and 44%. The clinical challenges include persistent pain, dysmenorrhea, and infertility, all of which adversely affect women's quality of life and their ability to reproduce. In Ayurveda, this condition is comparable to Udavartini Yonivyapad, a known gynecological disorder. It has a significant prevalence among women, reflecting its widespread impact on female reproductive health. Methods: Case study of a 30-year-old married woman came with severe pain during menstruation along with prolonged bleeding during cycles in the last 4 years and the patient was initially diagnosed with an ovarian endometrioma through sonography before she approached us. Based on the Lakshanas and Nidana Panchaka it was diagnosed as Udavartini Yonivyapad. This case was effectively managed using Shodhana therapy combined with internal medications. Results: Following Shodhana her condition exhibited signs of improvement, and there was noticeable reduction in the size of endometrioma. Conclusion: This case is an example to explain the Ayurveda’s role in managing such disease conditions by demonstrating the improvement in the pain and size of the endometrioma which was confirmed by a sonography before and after the treatment

The impact of cystic lesions on the postoperative prognosis of non-small cell lung cancer: a comparative study

Due to the rarity of lung cancer with cystic imaging manifestations, we explore the clinical features and survival prognosis of such tumors. Imaging characteristics were used to categorize 3,556 patients who underwent surgery for isolated primary lung cancer into one of three groups: those with cystic lung cancer (149), solid lung cancer (1,399), and ground-glass lung cancer (1,160). Propensity score matching by sex and age was performed to analyze the differences in clinical characteristics of lung cancer among the three groups and the correlation between clinical characteristics of cystic lesions and progression-free survival (PFS). The three groups of patients differed in various aspects, including pathological type, smoking history, tumor stage, type of surgery, histological grading, and PFS (P < 0.05). The results of the multifactorial analysis indicated that lung cancer type, pathological type, lymph node metastasis, tumor stage, and histologic grading were independent prognostic factors for lung cancer (P < 0.05). After comparison, there was a difference in prognosis between cystic lung cancer and ground-glass lung cancer (P < 0.05). The clinical features of cystic lung cancer are significantly different from those of ground-glass lung cancer and solid lung cancer. Cystic lesions are independent influencing factors affecting lung cancer, and the prognosis of cystic lung cancer is worse than that of ground-glass lung cancer.