Fluid-filled Mass Research Articles

Papillary Cystadenocarcinoma in a Budgerigar (Melopsittacus undulatus)

Budgerigar (Melopsittacus undulatus) is a tiny colorful parrot and one of the most popular pets worldwide. This study was performed on a 5-year-old male budgerigar with a large and fluid-filled mass in the anterior part of the neck. Fine needle aspiration was accomplished to determine tumor origin, and the tumor content was cultured on blood and MacConkey agars (aerobic and anaerobic conditions). Besides, tumor ultrasonography and whole-body radiographs were done in the lateral and ventrodorsal positions. Finally, the tumor was removed, fixed in 10% neutral buffered formalin, and stained with hematoxylin and eosin (H & E). The radiology and ultrasonography results showed that the tumor (5.2×4×3.7 cm) had a homogenous structure filled with echogenic fluid content. The tumor content culture revealed no bacterial growth. Histopathologically, the mass was composed of cystic spaces with invagination of the lining epithelial cells, forming intraluminal papillae. The tumor was diagnosed as a papillary cystadenocarcinoma.

Ovarian mucinous adenocarcinoma and false negative frozen pathology: A case report and review of the literature

Introduction: In this case report we discuss the presentation and management of a woman with a large adnexal mass. Case Report: This report describes a 32-year-old year healthy woman who presented with four months of increasing abdominal fullness. Computed tomography (CT) imaging showed a 34 cm fluid-filled left adnexal mass with few thin septations. Tumor markers were within normal limits. She strongly desired minimally invasive surgery in the setting of low concern for malignancy. A mini-laparotomy was performed, purse string sutures were placed through the cyst wall, and fluid was aspirated with minimal spillage. Her left tube and ovary were resected laparoscopically. Intraoperative frozen pathology returned as mucinous cystadenoma with some areas of atypia. Final pathology resulted with Grade 2 mucinous adenocarcinoma and she was taken back to the operating room for a surgical staging procedure. Pathology from her laparoscopic staging surgery was benign. She underwent chemotherapy with carboplatin/paclitaxel for Stage 1C1, Grade 2 mucinous adenocarcinoma of the ovary based on intra-operative spillage. Conclusion: Despite reassuring imaging and tumor markers, particularly in the setting of frozen pathology with low concern for malignancy, final pathology may indicate carcinoma. Although the accuracy of intra-operative frozen pathology is generally high, both gynecologic oncologists and non-oncologic gynecologists should be aware of the limitations of the test and counsel patients that the final pathology may be discordant. Appropriate counseling about the risk of intra-operative spillage and subsequent upstaging is of particular importance.

Hepatic Abscess in Adults: Integrated Approach and Surgical Considerations

Hepatic abscesses are suppurated cavities caused by the invasion and multiplication of microorganisms within the liver parenchyma. This condition is relatively uncommon, with an estimated incidence of 2.3 to 3.6 cases per 100,000 people yearly. However, the incidence is higher in specific populations, such as patients with underlying liver disease, diabetes, or other immune-compromising conditions. The most common cause of liver abscesses is the spread of infection from other parts of the body, such as the biliary tract or gastrointestinal tract. Other causes include trauma to the liver, such as from a penetrating injury or surgery or the presence of a foreign body in the liver. Liver abscesses are broadly divided into two types: amoebic and pyogenic. The clinical presentation might vary, including fever, abdominal pain, nausea and vomiting, jaundice, and weight loss. In some cases, there may be no symptoms. Diagnosis typically involves an ultrasound or CT scan, which can show the presence of a fluid-filled mass in the liver. CT is the standard modality for diagnosis. Blood tests may also evaluate liver function and identify any underlying infections. Treatment typically involves a combination of antibiotics to target the underlying infection and drainage of the abscess. Supportive measures like hydration and pain management may also be necessary. In addition, close monitoring and follow-up are essential to ensure that the abscess has resolved and there are no complications. In some cases, surgical intervention may be necessary to remove the abscess or repair any damage to the liver. Liver abscess drainage is typically indicated in patients with significant, symptomatic abscesses or those who do not respond to medical treatment with antibiotics. In addition, abscesses at risk of rupturing or located close to vital structures, such as major blood vessels, may require drainage to prevent serious complications. Two drainage methods are presently available: non-surgical options, such as percutaneous needle aspiration or percutaneous catheter drainage, and surgical options, such as open drainage or laparoscopic drainage. This review identifies when these alternatives should be used, taking adverse effects, symptoms, and comorbidities into account.

What is your diagnosis? Perineal swelling in a dog.

What is your diagnosis? Perineal swelling in a dog.

Nasopharyngeal Presentation of a Pharyngeal Cleft Cyst in a Dog.

A 2 yr old castrated male shih tzu was presented for assessment of worsening chronic snoring since first detected at 3 mo of age. An upper respiratory endoscopic examination and a computed tomographic scan showed a well-circumscribed, fluid-filled nasopharyngeal mass located in the median plane on the nasal side of the soft palate. This lesion was removed using a ventral approach to the nasopharynx by blunt-sharp dissection from the submucosal tissues of the soft palate. Histopathology revealed a cystic lesion lined by a single layer of a pseudostratified columnar ciliated epithelium, characteristic of a pharyngeal cyst. Follow-up 5 mo after surgery revealed complete resolution of the clinical signs with no evidence of local recurrence. Pharyngeal cysts are developmental abnormalities of the branchial apparatus. Most derive from the second branchial arch and cause cysts, sinuses, and fistulae to develop in the neck region. In our case, the lesion was located in the nasopharynx, leading to snoring and exercise intolerance. This condition should be included in the differential diagnosis of suspected nasopharyngeal obstruction.

Vibration Energy Regeneration System Using Piezoelectric Sensor for Wideband Application

This paper presents a method for widening bandwidth by using non-uniform mass which use the concept of center of gravity. Piezoelectric acts as a tool to convert vibration energy to electrical energy. The displacement from the liquid movement plays a role to enhance the bandwidth as the beam bends. The bandwidth is widened 2 times higher compared without tip mass and 1.6 times increased than that of solid tip-mass. High viscosity and density will give a greater effect on the bandwidth at low volume compared to low properties of fluid. Rectangular container can resist the tension of liquid due to high viscosity and volume. The fluid-filled mass technique widened the bandwidth without reducing the harvested power.

Teaching NeuroImage: Prenatal Diagnosis of Limited Dorsal Myeloschisis.

The fetus of a 34-year-old primigravida with gestational diabetes but no folate deficiency was found to have a posterior sacral cystic lesion at 21-week ultrasound. Fetal MRI at 22 weeks revealed a 2.3 × 1.1 × 2.2 cm hyperintense cystic lesion, resembling a meningocele without bony or intracranial abnormalities (Figure 1). Postnatally, a midline fluid-filled sacral mass with squamous epithelial covering was seen (Figure 2A).1 Neurologic examination was normal. Postnatal MRI confirmed the diagnosis of limited dorsal myeloschisis (LDM) and also detected Chiari I malformation (Figure 1). LDM should be considered in posterior sacral cystic lesions without bony abnormalities and has a better prognosis than meningoceles.2

Arthroscopic treatment of massive acromioclavicular joint ganglion cysts with color-aided visualization: a case series of 4 patients

Acromioclavicular joint ganglion cysts are rare lesions that mainly arise from the degeneration of the acromioclavicular joint in elderly patients. Although surgical management may be required because of their high recurrence rate after aspiration, few reports have described arthroscopic surgical procedures to treat acromioclavicular ganglion cysts. We report the surgical results of arthroscopic ganglionectomy with color-aided visualization for massive acromioclavicular ganglion joint cysts. This retrospective case series examined patients identified with massive ganglion cysts that were localized above the acromioclavicular joint. All patients underwent an arthroscopic removal of subacromial synovium and subsequent injection of indigo carmine into the ganglion. The distal end of the clavicle was excised arthroscopically from the inferior surface, and the ganglion stalk was confirmed using indigo carmine for enhanced visualization and magnification. A ganglion portal was created, and the ganglion cyst was resected with the aid of the dye. Four female patients, aged 78-90 years, were identified with a massive acromioclavicular joint ganglion cyst. Plain radiography showed joint degeneration in the acromioclavicular joint, and magnetic resonance imaging scans showed fluid-filled mass formation. Although all patients initially underwent multiple aspirations of the ganglion cyst, we opted for surgical intervention because of its persistent recurrence. Three patients exhibited concurrent rotator cuff tears, and one patient had a prior history of cuff repair with no retear. After arthroscopic ganglionectomy with color-aided visualization for massive acromioclavicular ganglion joint cysts, none of the patients have shown recurrences at 2 years postoperatively. Novel aspects of this case series include the use of indigo carmine to provide a better visualization and identification of the ganglion stalk under arthroscopy. Furthermore, a ganglion portal is useful for achieving complete resection of the indigo carmine-stained ganglion cyst. Color-aided visualization using indigo carmine and the construction of a ganglion portal were useful techniques for performing arthroscopic ganglionectomy in patients with a massive acromioclavicular joint ganglion cyst.

Cyst of the canal of Nuck (female hydrocele)

We here report the case of a 06-year old girl treated for Kawasaki disease admitted with right tender and painful inguinal swelling. Ultrasound images suggested cystic lymphangioma. TDM showed fluid-filled mass in the right iliac fossa (RIF) in contact with the external iliac vessels, the sigmoid colon and a few small bowel loops extending downward from a dehiscence of the inguinal canal into the large lip. It had localized thickening of the wall measuring 5 mm in thickness at the level of the inguinal orifice. The diagnosis of cyst of the canal of Nück (female hydrocele) was retained and surgically confirmed (Figure 1). The cyst of the canal of Nück is caused by incomplete closure of the canal, resulting in fibrous vestigial structure of the peritoneal-vaginal duct which connects the peritoneal cavity with the large lip. This usually closes at birth or during the first month of life, with resultant formation of a cystic lesion bordered by mesothelium, which is predominantly flattened and sometimes hyperplastic, located in the anterosuperior portion of the large lips and/or the inguinal canal. Surgical treatment for cyst of the canal of Nück is the same as for hernia.

Vertical Strabismus and Positive Bielschowsky Head-Tilt Test: Atypical Presentation of a Maxillary Mucocele

AbstractTest of skew has become a cornerstone in the approach of a patient with vestibular symptoms but a detected vertical misalignment may be caused by an oculomotor disturbance and not a skew deviation. We report the case of an elderly patient with a 1-month history of dizziness and visual disturbance that revealed on bedside examination a spontaneous left head-tilt and a pathologic alternate cover test, with right eye hypertropia and excyclotorsion, worse with right head-tilt. Dizziness was assumed to have a visual origin with unrecognized binocular diplopia, caused by an acquired right eye superior oblique muscle palsy. However, imaging revealed a right maxillary mucocele that eroded the orbit floor into the orbit. The change of the intraorbital component of the maxillary fluid-filled mass with head-tilt through a dehiscent orbital floor may explain the findings of vertical strabismus and positive Bielschowsky head-tilt test in this case. Endoscopic treatment improved symptoms and findings.

Coherence-Based Beamforming Increases the Diagnostic Certainty of Distinguishing Fluid from Solid Masses in Breast Ultrasound Exams

Ultrasound is often used as a supplement for mammography to detect breast cancer. However, one known limitation is the high false-positive rates associated with breast ultrasound. We investigated the use of coherence-based beamforming (which directly displays spatial coherence) as a supplement to standard ultrasound B-mode images in 25 patients recommended for biopsy (26 masses in total), with the eventual goal of decreasing false-positive rates. Because of the coherent signal present within solid masses, coherence-based beamforming methods allow solid and fluid-filled masses to appear significantly different (p < 0.001). When presented to five board-certified radiologists, the inclusion of robust short-lag spatial coherence (R-SLSC) images in the diagnostic pipeline reduced the uncertainty of fluid-filled mass contents from 47.5% to 15.8% and reduced the percentage of fluid-filled masses unnecessarily recommended for biopsy from 43.3% to 13.3%. These results are promising for the potential introduction of R-SLSC (and related coherence-based beamforming methods) into the breast clinic to improve diagnostic certainty and reduce the number of unnecessary biopsies.

Surgical removal of a thyroglossal duct cyst in a geriatric dog

A 12-year-old, body condition score (BCS) 9, female, Poodle mix dog was presented for coughing, gasping sounds and exercise intolerance. The symptoms started 2 months prior to the presentation. Clinical...

Muscular angiomatosis in a dog

A 12-year- 4 month- old male neutered crossbreed small dog was presented for moderate lameness and a swelling in the tibio-tarso-metatarsal area of the left hindlimb. Clinical examination revealed a...

Case 267.

History A 28-year-old man presented with lifelong anejaculation, which had become an issue because of family planning. The patient had a history of normal erections and experienced the sensation of orgasm without ever ejaculating. On physical examination, both testes were present in the scrotum, with normal dimensions and a normal epididymis bilaterally. The patient had a slightly tender left testicle, and digital rectal examination findings were normal. The patient underwent further investigation for the possibility of retrograde ejaculation with urine cytology, the results of which were negative. Genetic testing was performed to exclude Y chromosome microdeletions. Serum-luteinizing and follicle-stimulating hormone levels were normal, with a borderline low level of testosterone (7.6 nmol/L; normal range, 8.0-29.0 nmol/L). All other pertinent laboratory results were noncontributory. Pelvic MRI was requested to exclude an anatomic cause of anejaculation. MRI was performed in accordance with the standard clinical prostate protocol, with a dynamic contrast material-enhanced study ( Figs 1 - 3 ). CT of the upper abdomen was also performed ( Fig 4 ). The patient subsequently underwent cystoscopy, which revealed an intravesicular fluid-filled mass near the left ureteric orifice ( Fig 5 ). Figure 1a: (a) Coronal and (b, c) axial fast spin-echo T2-weighted MR images of the pelvis, with b being superior to c. Figure 1b: (a) Coronal and (b, c) axial fast spin-echo T2-weighted MR images of the pelvis, with b being superior to c. Figure 1c: (a) Coronal and (b, c) axial fast spin-echo T2-weighted MR images of the pelvis, with b being superior to c. Figure 2a: (a) Coronal T2-weighted (repetition time msec/echo time msec, 4574/86.5) MR image of the pelvis. (b) Axial T2-weighted (3000/85.4) MR image of the pelvis. Figure 2b: (a) Coronal T2-weighted (repetition time msec/echo time msec, 4574/86.5) MR image of the pelvis. (b) Axial T2-weighted (3000/85.4) MR image of the pelvis. Figure 3: Unenhanced axial fat-saturated T1-weighted (6.2/3.1) MR images. Figure 4: Coronal CT urogram. Figure 5: Image obtained at cystoscopy.

Frequency band widening technique for cantilever-based vibration energy harvesters through dynamics of fluid motion

Vibration energy harvesting has evoked great interests for a wide variety of self-powered microsystems. Vibration energy harvesters typically have a narrow bandwidth, which causes infeasibility for real-life applications. This issue has been addressed by incorporating frequency band widening technique with the help of fluid filled tip mass. It is based on the principle of center of gravity shifts due to the mass change caused by the dynamic motion of the fluid. This concept has been validated through simulations and experimentation carried out for piezoelectric patches from MIDE™, MEAS™ and our fabricated device. Performance evaluation of piezoelectric energy harvester has been carried with solid, and fluid filled tip mass. Open circuit electric potential of 7.4 V with 10 Hz bandwidth has been recorded for fluid (honey-motor oil mixture) tip mass in contrast with 4 Hz bandwidth for solid tip mass. It is found that fluid-filled tip mass has broadened frequency band by 250% without affecting harvested power.

Diagnosis and Treatment of Sialectasis in a Domestic Rabbit (Oryctolagus cuniculus)

An approximately 10-year-old female spayed rabbit (Oryctolagus cuniculus) was presented with a subcutaneous mass of the ventral submandibular and cervical region. Initial culture results from fine-needle aspirates revealed Gram-positive cocci; cultures following antibiotic therapy identified Cryptococcus spp. (not Cryptococcus neoformans), Actinomyces spp., unidentified yeast, and alpha-hemolytic Streptococcus spp. The mass did not resolve following antibiotic treatment and the rabbit was referred for further evaluation. A computed tomography scan revealed a large (9 × 5 × 5cm3) fluid-filled rim-enhancing mass in the left submandibular and intermandibular region that extended caudally into the cervical region. The mass and attached skin were surgically excised, and the tissue was submitted for histopathology and culture. The histopathologic diagnosis of the mass was severe, cystic, heterophilic, lymphoplasmacytic dochitis, and cellulitis consistent with sialectasis. Enrichment broth culture grew Candida albicans. The rabbit made a rapid postoperative recovery. No signs of recurrence were noted at multiple examinations until 1 year following the surgical procedure, when a small (0.5 × 0.5 × 0.5cm3) mass was identified at the previous location and contained fluid consistent with saliva. Culture of this fluid was negative. About 1 year following the initial surgery, computed tomography images were consistent with mild fluid dilation of the remaining tract of the salivary duct; surgical exploration and complete excision of the duct and salivary gland were recommended but declined by the owner.

Experiences of Parents Caring for Infants with Rare Scalp Mass as Identified through a Disease-Specific Blog.

Delayed subaponeurotic fluid collection (DSFC) is a self-limited disorder of unknown etiology characterized by a benign, fluid-filled mass in the subaponeurotic layer of an infant's scalp. While a few case series describe DSFC, the experiences of families whose infants develop this condition have not previously been reported. We used a disease-specific blog to evaluate the experiences of 69 families affected by DSFC. We identified self-reported clinical features of DSFC and qualitatively analyzed the families' experiences with obtaining a diagnosis and care for their infants. Infants presented in several clinical settings, and multiple diagnostic procedures were administered, including ultrasound (46%), computed tomography (30%), and head radiography (22%). Qualitative themes emerged: lack of provider awareness of DSFC, concern about potentially harmful diagnostic procedures, suspicion of child abuse, and the importance of the website in providing support to families. Though DSFC can be diagnosed clinically and its natural history is benign, its presence can be emotionally draining for parents. Physicians should be aware of this clinical entity to rapidly allay parental distress and avoid unnecessary procedures. Disease-specific blogs can help providers learn about rare diseases, contain useful clinical information for research, and can benefit patient care by providing social support for families.

Management of afferent loop obstruction: Reoperation or endoscopic and percutaneous interventions?

Afferent loop obstruction is a purely mechanical complication that infrequently occurs following construction of a gastrojejunostomy. The operations most commonly associated with this complication are gastrectomy with Billroth II or Roux-en-Y reconstruction, and pancreaticoduodenectomy with conventional loop or Roux-en-Y reconstruction. Etiology of afferent loop obstruction includes: (1) entrapment, compression and kinking by postoperative adhesions; (2) internal herniation, volvulus and intussusception; (3) stenosis due to ulceration at the gastrojejunostomy site and radiation enteritis of the afferent loop; (4) cancer recurrence; and (5) enteroliths, bezoars and foreign bodies. Acute afferent loop obstruction is associated with complete obstruction of the afferent loop and represents a surgical emergency, whereas chronic afferent loop obstruction is associated with partial obstruction. Abdominal multiple detector computed tomography is the diagnostic study of choice. CT appearance of the obstructed afferent loop consists of a C-shaped, fluid-filled tubular mass located in the midline between the abdominal aorta and the superior mesenteric artery with valvulae conniventes projecting into the lumen. The cornerstone of treatment is surgery. Surgery includes: (1) adhesiolysis and reconstruction for benign causes; and (2) by-pass or excision and reconstruction for malignant causes. However, endoscopic enteral stenting, transhepatic percutaneous enteral stenting and direct percutaneous tube enterostomy have the principal role in management of malignant and radiation-induced obstruction. Nevertheless, considerable limitations exist as a former Roux-en-Y reconstruction limits endoscopic access to the afferent loop and percutaneous approaches for enteral stenting and tube enterostomy have only been reported in the literature as isolated cases.

Popliteal cysts: a current review.

Baker's cyst, or popliteal cyst, is a fluid-filled mass that is a distention of a preexisting bursa in the popliteal fossa, most commonly the gastrocnemio-semimembranosus bursa. This bursa is unique in that it communicates with the knee joint, unlike other periarticular bursae, via an opening in the joint capsule posterior to the medial femoral condyle. Many have theorized that this opening creates a valve-like mechanism in the presence of effusion that contributes to the formation of these cysts in adults. Popliteal cysts rarely manifest alone and are most often found in conjunction with other intra-articular pathologies and inflammatory conditions, such as osteoarthritis, meniscus tears, and rheumatoid arthritis. In children, popliteal cysts are only occasionally associated with these conditions and are more often an incidental finding discovered during a routine physical examination. Popliteal cysts may present as either a chronically persistent or relapsing condition or as an acute and dramatic condition that can occur in the case of cyst rupture presenting as pseudothrombophlebitis. Ultrasound and magnetic resonance imaging have proven to be consistent and accurate in the confirmation of popliteal cysts, with magnetic resonance imaging becoming the modern imaging modality of choice. This review discusses the anatomy and etiology of popliteal cysts, describes the common clinical presentations, reviews the differential diagnoses, and provides guidance for proper diagnostic imaging. It also provides a comparison of current conservative, minimally invasive, and invasive treatment options, along with a discussion of results. Postoperative rehabilitation depends largely on the condition associated with the popliteal cyst.

Percutaneous Sclerotherapy for Treatment of Tumoral Calcinosis

Massive tumoral calcinosis developed in a 29-year-old woman with type 1 diabetes and failed pancreas and kidney transplant on peritoneal dialysis. The patient had a symptomatic calcified, fluid-filled posterior thigh mass. After percutaneous drainage of 260 mL of milky fluid, she had rapid recurrence of the collection. She underwent catheter-based sclerotherapy first with 110 mL of povidone-iodine followed 2 days later by 40 mL of 3% sodium tetradecyl sulfate foam. At 5.5 months after the procedure, the patient remained asymptomatic, and computed tomography imaging showed complete resolution of the collection.