Cystic Mass Research Articles

Case report: A rare case of omental extrarenal rhabdoid tumor and review of the literature

Extrarenal rhabdoid tumor of the greater omentum is extremely rare, with only sporadic reports and limited documentation of its ultrasonographic findings. Here, we report a case of an extrarenal rhabdoid tumor of the greater omentum in a 16-year-old girl and review the relevant literature. It was found that the disease mainly occurred in female children and adolescents, and mainly manifested as lower abdominal pain and a large abdominal cystic or solid hemorrhagic mass. The clinical characteristics include a high degree of malignancy and mortality. Ultrasound shows some malignant features, but it is not specific; thus, it is easy to be misdiagnosed in the clinic.

A CASE REPORT OF COMPLETE ANDROGEN INSENSITIVITY SYNDROME RISING A CONCERN ABOUT THE TIME OF SURGERY AND THE ROLE OF PARENTS' BEHAVIOR

Purpose: This case study refers to a case of complete androgen insensitivity syndrome, which presented with amenorrhea back in the past. Case: After conformation of the diagnosis, parents decided not to reveal the condition’s specifics to the patient. At the age of 34 years, she attended our hospital with abdominal swelling, and the following CT scan showed an abdominal mass arising from the ovary of 13 cm x 14 cm size. A laparotomy was done, and a mixture of solid and cystic mass of 20 cm in diameter was found and removed with the ovary. Histopathology of the tumor showed features of testicular seminoma. Conclusion: The aim of this case report is to outline the difficulties in choosing whether and when to do the gonadectomy and whether and how to explain the condition to the patient.

Decisional Conflict Among Patients Newly Diagnosed With Clinical T1 Renal Masses.

Because multiple management options exist for clinical T1 renal masses, patients may experience a state of uncertainty about the course of action to pursue (ie, decisional conflict). To better support patients, we examined patient, clinical, and decision-making factors associated with decisional conflict among patients newly diagnosed with clinical T1 renal masses suspicious for kidney cancer. From a prospective clinical trial, participants completed the decisional conflict scale (DCS), scored 0 to 100 with < 25 associated with implementing decisions, at two timepoints during the initial decision-making period. The trial further characterized patient demographics, health status, tumor burden, and patient-centered communication while a sub-cohort completed additional questionnaires on decision-making. Associations of patient, clinical, and decision-making factors with DCS scores were evaluated using generalized estimating equations to account for repeated measures per patient. Of 274 enrollees, 250 completed a DCS survey; 74% had masses ≤ 4 cm in size while 11% had high complexity tumors. Model-based estimated mean DCS score across both timepoints was 17.6 (95% CI: 16.0-19.3) though 50% reported a DCS score ≥ 25 at least once. On multivariable analysis, DCS scores increased with age (+2.64, 95% CI 1.04-4.23), high vs low complexity tumors (+6.50, 95% CI 0.35-12.65), and cystic vs solid masses (+9.78, 95% CI 5.27-14.28). Among decision-making factors, DCS scores decreased with higher self-efficacy (-3.31, 95% CI -5.77 to -0.86]) and information-seeking behavior (-4.44, 95% CI -7.32 to -1.56). DCS scores decreased with higher patient-centered communication scores (-8.89, 95% CI -11.85 to -5.94). In addition to patient and clinical factors, decision-making factors and patient-centered communication relate with decisional conflict, highlighting potential avenues to better support patient decision-making for clinical T1 renal masses.

A Rare Case of Prenatal Diagnosis and Management of Fetal Oral Cystic Mass

AbstractCongenital fetal oral mass is a very rare entity. A correct ultrasound-based approach on the anatomic location, consistency, and vascularity will help us to narrow down the differentials antenatally but a confirmed diagnosis can be made by histopathological examination postnatally. We describe a case of a fetal oral cyst diagnosed antenatally at 20 weeks of gestation. On follow-up, fetal growth and amniotic fluid volume were normal with no changes in the size or the position of the cyst. The cyst was excised on the first neonatal day. Histopathology was consistent with a mucocele.

Young patient with a giant gastric bronchogenic cyst: A case report and review of literature

BACKGROUND Gastric bronchogenic cysts (BCs) are extremely rare cystic masses caused by abnormal development of the respiratory system during the embryonic period. Gastric bronchial cysts are rare lesions that were first reported in 1956; as of 2023, only 33 cases are available in the PubMed online database. BCs usually have no clinical symptoms in the early stage, and imaging findings also lack specificity. Therefore, they are difficult to diagnose before histopathological examination. CASE SUMMARY A 34-year-old woman with respiratory distress presented at our hospital. Endoscopic ultrasound revealed an anechoic mass between the spleen, left kidney and gastric fundus, with hyperechogenic and soft elastography textures and with a size of approximately 6.5 cm × 4.0 cm. Furthermore, a computed tomography scan demonstrated high density between the posterior stomach and the spleen and the left kidney, with uniform internal density and a small amount of calcification. The maximum cross section was approximately 10.1 cm × 6.1 cm, and the possibility of a cyst was high. Because the imaging findings did not suggest a malignancy and because the patient required complete resection, she underwent laparotomy surgery. Intraoperatively, this cystic lesion was found to be located in the posterior wall of the large curvature of the fundus and was approximately 8 cm × 6 cm in size. Finally, the pathologists verified that the cyst in the fundus was a gastric BC. The patient recovered well, her symptoms of chest tightness disappeared, and the abdominal drain was removed on postoperative day 6, after which she was discharged on day 7 for 6 months of follow-up. She had no tumor recurrence or postoperative complications during the follow-up. CONCLUSION This is a valuable report as it describes an extremely rare case of gastric BC. Moreover, this was a very young patient with a large BC in the stomach.

Perioperative management of a patient with unexpectedly detected early-stage ovarian mucinous carcinoma combined with progressive bulbar paralysis: a case report and literature review

BackgroundGiant ovarian cysts (GOCs)complicated with progressive bulbar paralysis (PBP) are very rare, and no such literature about these cases have been reported. Through the diagnosis and treatment of this case, the perioperative related treatment of such patients was analyzed in detail, and early-stage ovarian mucinous carcinoma was unexpectedly found during the treatment, which provided reference for clinical diagnosis and treatment of this kind of diseases.Case presentationIn this article, we reported a 38-year-old female patient. The patient was diagnosed with PBP 2 years ago. Examination revealed a large fluid-dominated cystic solid mass in the pelvis measuring approximately 28.6×14.2×8.0 cm. Carbohydrate antigen19-9(CA19-9) 29.20 IU/mL and no other significant abnormalities were observed. The patient eventually underwent transabdominal right adnexal resection under regional anesthesia, epidural block. Postoperative pathology showed mucinous carcinoma in some areas of the right ovary. The patient was staged as stage IA, and surveillance was chosen. With postoperative follow-up 1 month later, her CA19-9 decreased to 14.50 IU/ml.ConclusionsGOCs combined with PBP patients require a multi-disciplinary treatment. Preoperative evaluation of the patient's PBP progression, selection of the surgical approach in relation to the patient's fertility requirements, the nature of the ovarian cyst and systemic condition are required. Early mucinous ovarian cancer accidentally discovered after operation and needs individualized treatment according to the guidelines and the patient's situation. The patient's dysphagia and respiratory function should be closely monitored during the perioperative period. In addition, moral support from the family is also very important.

Non-gynecological cystic pelvic masses

Non-gynecological cystic pelvic masses

MR Imaging of Typical Ovarian Hemangioma: A Case Report

MR Imaging of Typical Ovarian Hemangioma: A Case Report

Giant intraperitoneal non-pancreatic pseudocyst: a case report

IntroductionNon-pancreatic pseudocysts are rare lesions that typically form from the omentum and mesentery. These cysts have a thick fibrotic wall made up of fibrous tissue and may show signs of calcifications and inflammatory changes. The fluid inside them can vary, ranging from hemorrhage and pus to serous or sometimes chylous content. In most cases, these cysts appear as a result of trauma, surgery, or infection.Case presentationA 35-year-old male patient from Ethiopia presented with swelling in his lower abdomen that had been present for 2 years. Initially, the swelling was small but gradually increased in size. The patient experienced frequent urination but no pain or difficulty during urination, urgency, intermittent urination, or blood in the urine. The swelling was initially painless but became painful 2 months prior to his presentation. Abdominal computed tomography scans revealed a well-defined, lobulated peritoneal lesion measuring 16 × 12 × 10 cm, consisting primarily of fluid-filled cysts with a thick, enhancing wall and septa. Additionally, there was a large, heterogeneous enhancing soft tissue component measuring 8 × 6 cm. As a result, the cystic mass was surgically removed in its entirety with partial removal of the bladder wall, and the patient was discharged in an improved condition.ConclusionPrimary non-pancreatic pseudocysts are extremely rare lesions that must be differentiated from other possible causes of cystic lesions within the peritoneal or retroperitoneal regions. Surgeons should be aware of the potential occurrence of these lesions, which may have an unknown origin.

True pylorus duplication: a case report

True pylorus duplication cysts are particularly rare, the literature describes only a small number of cases. They account for nearly 2.2% of all alimentary tract duplications. Most of the gastric duplications presents at an age younger than one year with one-third diagnosed in the neonatal period. However, they are not limited to that period. We report a case of a true pyloric duplication cyst in a 3-year-old girl who had been experiencing frequent vomiting with occasional abdominal pain for about 15 days prior to her presentation. The patient had an abdominal ultrasound that showed an epigastric cystic mass. CT of the abdomen demonstrated a 3.8×3.8 cm mass with a claw sign proximal to the first part duodenum. The diagnosis of pyloric duplication cyst was confirmed during the operation and with the histopathological examination following the resection. The patient is doing well with an appropriate weight gain at the follow-up appointments. The patient is doing well with an appropriate weight gain at the follow-up appointments. In summary, this is an an unusual case of gastric outlet obstruction that presented outside the usual age period caused by a pyloric duplication cyst. Imaging studies including US and CT are useful aids in the diagnoses of gastrointestinal duplication cysts.

Modified supraauricular approach in recurrent preauricular sinus: A case report

The preauricular sinus (PAS) also known as the fossa fistula sac or depression is located near the external auricle at the posterior end of the stalk of the ascending helix. Most cases of PAS are asymptomatic and do not require treatment. Surgery is performed if there are signs of infection or recurrence. Incomplete PAS resection is the most common cause of recurrence. The real problem with surgical resection of PAS is the high recurrence rate after sinusectomy. We report the case of a 22-year-old woman who complained of a mass in her left ear that was enlarging for the past 3 months. The patient had previously undergone two operations at the same site but they were recurrent. Physical examination revealed a non-hyperemic painful cystic mass. A few days after the operation the patient recovered and the pain in front of his left ear disappeared. The patient can close his eyes and lift his forehead symmetrically and show no signs of infection. A follow-up examination 1-2 weeks after surgery in the Department of Ear Nose Throat Head and Neck Surgery (ENT-HNS) showed that the general condition of the patient was good and there were no signs of infection. After 6 months the patients ears returned to normal and there was no recurrence 6 months after surgery. There is a scar along the leading edge of the helix. The patient was diagnosed with a recurrent PAS complicated by a preauricular cyst and treated with sinusectomy using a modified supraauricular approach and resection of the preauricular cyst. Sinusectomy with a modified supraauricular approach is an effective technique and is superior to simple sinusectomy due to its low recurrence rate with minimal complications and superior aesthetic appearance. This modified supraauricular approach achieved excellent functional and aesthetic results in this patient.

A splenic hydatid cyst in young female: a case report

Splenic hydatid disease is a rare kind of hydatid disease, accounting for less than 8% of cases in humans. Here we present a case of 23 years old female patient came to hospital with chief complaints of pain radiating to left quadrant in the last 2 years and cough with sputum and nausea and admitted in the hospital for further evaluation. CT chest shows cystic mass in the left hypochondrium lateral to the stomach compressing the stomach, later did CT abdomen which clearly indicates the spleen is enlarged in size with well-defined hypodense non enhancing unilocular cystic lesion measuring 13×13×11 cm (CC×AP×TR) in the upper and mid poles.

Imaging manifestations of papillary glioneuronal tumors

To analyse the imaging findings of papillary glioneuronal tumors (PGNTs), in order to improve the accuracy of preoperative diagnosis of this tumor. The clinical and imaging manifestations of 36 cases of PGNT confirmed by pathology were analyzed retrospectively. A total of 17 males and 19 females, averaging 22.47 (± 11.23) years. Initial symptoms included epilepsy in ten, headache in seven, and others in 19 cases. 97.2% (35/36) of the lesions were located in the supratentorial area, and 80.5% (29/36) in the intraventricular or deep white matter adjacent to the lateral ventricles. Twenty-four of the lesions (66.7%) were mixed cystic and solid, four (11.1%) were cystic with mural nodules, four (11.1%) were cystic, and four (11.1%) were solid. Four cases of PGNT of cystic imaging showed a “T2-FLAIR mismatch” sign. 69.4% (25/36) had septations. Nine lesions (25%) were accompanied by edema, and 9 (25%) of the mixed cystic and solid lesions were accompanied by hemorrhage. Among the 18 patients who underwent computed tomography (CT) or susceptibility-weighted imaging (SWI), nine had lesions with calcification. PGNTs mostly manifest as cystic mass with mural nodules or mixed cystic and solid mass in the white matter around the supratentorial ventricle, and the cystic part of the lesion is mostly accompanied by septations. Pure cystic lesions may exhibit the sign of “T2-FLAIR mismatch”. PGNT is rarely accompanied by edema but sometimes by calcification and hemorrhage. Patients often present with seizures, headaches, and mass effect symptoms.

Malignancy and "Violated Neck" Rates in Consecutive Cohort of 79 Adult Patients With Solitary Cystic Neck Mass-Lessons Learned and Recommendations for Clinical Practice Guidelines.

The neck region is a common site for solitary cystic neck mass (SCNM) of various etiologies, including congenital, inflammatory, and neoplastic. In adults, the primary focus is excluding malignancy. The objective of this study was to retrospectively analyze the accuracy of available diagnostic technologies for the differentiation of benign and malignant SCNM in adult patients. The study aimed to develop new clinical practice guidelines for evaluating and managing SCNM. The primary predictive variables were the diagnostic utilities of fine-needle aspiration cytology (FNAC), ultrasound (U/S), multislice computed tomography, and magnetic resonance imaging. The study's endpoint was the overall diagnostic accuracy in differentiating between benign and malignant SCNM. The final diagnosis was based on histopathology. The study included 79 adult patients: 55 (69.62%) male and 24 (30.38%) female (P<0.05). The mean age at presentation was 42.1 years (range: 18-84 years). Solitary cystic neck mass was distributed in the anterior neck region in 30 (37.97%) patients and the posterolateral neck regions in 49 (62.03%) patients (P<0.05). The posterolateral neck regions had a significantly higher rate of malignant SCNM than the anterior neck region [19/49 (38.78%) versus 1/30 (3.33%)] (P<0.05). There was no statistically significant difference between the U/S+FNAC and U/S+FNAC+multislice computed tomography and/or magnetic resonance imaging groups in differentiating benign and malignant SCNM (40/42 versus 36/37, P>0.05). "Violated neck" was recorded in 2 cases. A systematic investigation protocol should be applied to evaluate adult patients with SCNM.

An Unusual Cystic Lesion in Ovary

Introduction: Hydatid disease is a zoonosis caused by the larval stages or the adult of tapeworm Echinococcus granulosus or less commonly Echinococcus multilocularis. It is prevalent in the areas where livestock is raised in association with the dogs. Humans are accidental intermediate host. Primary ovarian hydatid cyst is extremely rare and often mistaken as cystic tumors of the ovary. Case report: We present a rare case of a 38 years old woman who presented with intermittent dull aching pain in the lower abdomen since 6 months. Ultrasonography of whole abdomen revealed the evidence of a left adnexal cystic lesion. Exploratory laparotomy was performed and a left ovarian cystic mass was identified. The cyst was removed intact. Histopathological examination confirmed it to be a hydatid cyst. Conclusion: Removal and proper treatment of the infected animals, interrupting the cycle of transmission of hydatid cyst, help to eliminate the disease. The implementation of public awareness of the disease and proper sanitation are needed to prevent this disease. Primary ovarian hydatid cyst is rare and requires proper intraoperative management to avoid spillage and thereby recurrences. Then the patients are treated with anthelmintics. Keywords: Echinococcosis, Hydatidosis, Echinococcus granulosus, Echinococcus multilocularis, hydatid cyst, laparotomy, ovary, surgery

An unusual cystic presentation of pelvic skeletal Ewing sarcoma: a case series.

Ewing sarcoma (ES) is the second mostcommon primarymalignant bone tumour in children and adolescents. About 14.5% of primary malignancies develop in pelvic bones, wherethey typically have worse prognoses than extremity or acral sarcomas. It usually presents with aggressive features onradiology scans, but may also present with different radiological characteristics. In this series, we describe rare appearancesof pelvic skeletal Ewing sarcoma, with large extraosseous cystic component on imaging, defined by the presence of fluid-filledspaces in the extraosseous tumour lesion, which distinguishes it from the solid nature of conventional ES. We report3 cases of cystic presentation of ES, with imaging features supporting diagnosis of a primary malignant bone tumourarising from the superior pubic ramus with associated massive intrapelvic solid and cystic mass. CT-guided biopsy provideddiagnosis of ES, with large intrapelvic soft tissue and cystic component. These patients underwent neo-adjuvantchemotherapy and proton beam therapy with significant reduction in size of the solid components, while the cysticcomponents remained relatively unchanged. Two patients underwent surgical resection of the tumour (navigated P3internal hemipelvectomy and hemipelvis P2/P3 resection, respectively), and one patient died while on treatment. In both whounderwent surgery, histology showed ES with margins clear and more than 99% of treatment-induced necrosis. To theauthors' knowledge, this unusual presentation of pelvic ES is described for the first time in the literature as a case series,with particular reference to atypical extraosseous cystic changes, along with the clinical and radiological characteristics,and their treatment.

Intra-Abdominal Cysts Not Originating from Liver, Spleen, or Kidney in Children: Assessment of the Diagnostic Value of Ultrasound Features

Background: Cystic abdominal masses are relatively prevalent in the pediatric population. Ultrasound (US) often serves as the initial imaging modality for evaluating these lesions, assisting in diagnosis, and guiding clinical decisions. Objectives: This study aimed to delineate the characteristic US features of intra-abdominal cystic lesions not arising from the liver, spleen, or kidney in children and to assess their diagnostic value for providing definitive diagnoses. Methods: Conducted in the radiology department of pediatric hospitals affiliated with Mashhad University of Medical Sciences from 2019 to 2022, this cross-sectional study examined 104 children with cystic abdominal lesions. Patient demographic data and US characteristics were documented. Definitive diagnoses were established through histopathological reports, surgical outcomes, or clinical follow-up. The accuracy of US findings was evaluated against these definitive diagnoses, with the sensitivity and specificity of US features for various intra-abdominal cystic lesions being calculated. Results: The most frequent cystic lesions identified were perinatal ovarian torsion (22.1%) and duplication cysts (18.2%). Ultrasound achieved a sensitivity and specificity of 82.61% (95% CI = 0.6 - 0.94) and 100% (95% CI = 0.94 - 1), respectively, in diagnosing perinatal ovarian torsion and 89.47% (95% CI = 0.65 - 0.98) and 94.11% (95% CI = 0.86 - 0.97) in diagnosing duplication cysts. In 80.8% of the cases, the initial US diagnosis corresponded with the final diagnosis. Conclusions: Ultrasound exhibits commendable sensitivity and specificity in identifying intra-abdominal cysts not originating from the liver, spleen, or kidneys in children, demonstrating its effectiveness in the diagnostic evaluation of these lesions.

Holy Cyst! Solitary Pulmonary Cystic Mass Presenting as Diffuse Large B Cell Lymphoma

Holy Cyst! Solitary Pulmonary Cystic Mass Presenting as Diffuse Large B Cell Lymphoma

Esophageal bronchogenic cyst treated with submucosal tunneling endoscopic resection: two case reports

IntroductionAlthough esophageal bronchogenic cysts are benign diseases, they may be accompanied by serious complications and have the possibility of recurrence. Therefore, once confirmed, it is necessary to treat the esophagobronchial cyst when the contraindication is excluded. Endoscopic treatment is usually used for lesions with small diameter and shallow origin, and has the advantages of small surgical trauma and risk, which can reduce the psychological burden of patients to a certain extent, help them to recover quickly, and lower hospital costs.Case presentationCase 1 is a 54-year-old Han Chinese man admitted to our hospital who complained of difficulty swallowing in the past 6 months. Case 2 is a 41-year-old Han Chinese man who was hospitalized in the past 3 months due to chest discomfort. Endoscopic ultrasound revealed a hypoechoic cystic lesion arising from the muscularis propria. Submucosal tunneling endoscopic resection was performed using a dual knife, and a cystic mass was observed between the mucosa and the muscular layers of the esophagus. On locating the cyst, an incision was made on the oral side of the lesion for evacuation. The cyst wall was excised using endoscopic argon plasma coagulation. We successfully removed the esophageal bronchogenic cyst lesion in the intrinsic muscle layer using submucosal tunneling endoscopic resection.ConclusionEsophageal bronchogenic cysts are rare in clinical practice and lack specificity in clinical manifestations. Multiple methods can be used to determine the location and nature of the lesion and ultimately determine the treatment plan. Surgical resection and endoscopic treatment are two different treatment methods, and appropriate treatment plans need to be selected on the basis of the origin layer, size, and relationship with the esophagus of the lesion to reduce complications and improve prognosis.

Neoplasias quísticas hepatobiliares productoras de mucina: claves diagnósticas para radiólogos

Mucin-producing cystic hepatobiliary neoplasms are rare neoplasms which include mucinous cystic neoplasms of the liver and intraductal papillary mucinous neoplasms of the bile duct.Mucinous cystic neoplasms of the liver are characterised by the presence of ovarian-like stroma, and are usually benign. They present as large, multiloculated, cystic masses without biliary communication and are more common among middle-aged women.Intraductal papillary mucinous neoplasms of the bile duct are premalignant lesions originating in the bile duct and presenting with biliary communication. There are 3 growth patterns: cystic, duct-ectatic and mass-forming. They tend to appear between the ages of 50 and 70, with no gender predilection. There is a high probability of malignancy, so segment-oriented hepatic resection is the treatment of choice.Both entities have overlapping and distinctive features, and it is important for the radiologist to be aware of these and be able to distinguish between them, as they have different prognoses and require different management approaches.