Hematic Cyst Research Articles

An Unusual Case of Post-traumatic Intramuscular Organised Haematoma of the Left Hand

An organised haematoma is a benign cystic lesion in which the haematoma is enclosed by a superficial fibrotic capsule. It is also referred to as chronic expanding haematoma or hematic cyst. Organised haematoma can be observed in various sites, but it is extremely rare to find it in an intramuscular location. This is a rare case of organised haematoma in the palm of the left hand of a 75- year-old female, which occurred after an accidental injury from broken bangles fifteen years ago. The swelling gradually increased in size and became painful over the years. A pre-operative Magnetic Resonance Image (MRI) revealed a well-defined, large soft tissue density lesion located in the subcutaneous plane of the interdigital space between the left thumb and index finger, extending into the volar and dorsal aspects of the hand. An incision was made on the skin over the swelling, followed by excision. The patient was discharged with a good post-operative outcome.

Removal of Traumatic Hematic Cyst of the Orbit Through Sub-Brow Approach

Orbital hematic cyst is characterized by cystic accumulation of hematogenous debris surrounded by a wall of fibrous tissue without an epithelial lining. It is a relatively uncommon benign cyst and occurs secondary to blunt trauma in most cases. We experienced a case of 53-year-old male who presented with proptosis of the left eye. A cystic lesion was found at the superolateral orbital rim of the patient. We report a case of orbital hematic cyst that was resected completely through the sub-brow approach.

1806 Tricky and Inexpensive Way to Aspirate Large Hemoperitoneum

Video Objective show a inexpensive, safe and fast way to aspirate large hemoperitoneum during a laparoscopy Setting large amounts of blood in the abdominal cavity delays a lot during a laparoscopy for ectopic pregnancy or an hematic ovarian cyst, using a regular 5mm aspirator Interventions make a small, inexpensive, reversible and safe modification in a regular aspirator hose with scissors Conclusion this reversible and fast modification improve the operation time without harm for the patient during aspiration of large hemoperitoneum

Clinical, radiological and histopathological characteristics of surgically removed orbital hematic cysts: A case series

BackgroundHematic cyst is a rare orbital condition that has a wide range of clinical presentation and is characterized pathologically by lack of endothelial lining. PurposeTo correlate clinical and radiological features of hematic cysts, to tissue diagnosis, and investigate the possible etiology behind this condition, its relation to trauma and other interesting histopathological findings. MethodsRetrospective case series at King Khaled Eye Specialist Hospital (KKESH) and King Abdulaziz University Hospital (KAUH) of all orbital lesions with tissue findings supporting the clinical and/or radiological diagnosis of hematic cyst. ResultsA series of 13cases was studied, 8 males and 5 females. Age ranged from 2 to 84 years with a median of 54. Most cases presented with proptosis (76.9%) and limitation of eye movements (69.2%). History of trauma was confirmed in only 2/13. The clinical diagnosis of hematic cyst was made prior to surgery in 38.4%. MagneticResonance Imaging (MRI) confirmedthe presence of blood in the orbit in 7/7. Surgical intervention was the mainstay of treatment.Histopathologically, these lesions demonstrated variable constituents including blood break-down products (hemosiderin), macrophages, mononuclear inflammatory cells, hemorrhage, absent endothelial lining, reactive fibrosis and capsule-like formation.Cholesterol clefts with typical granulomas and multinucleated giant cells were present in 2 cases. A clue to an underlying vascular lesion was found histopathologically in 30.8%. None of the patients developed recurrence or long-term complications with an average follow up period of 1 year. ConclusionHematic cyst is a challenging clinical diagnosis that can be aided by radiological examination and histopathological confirmation. Trauma does not seem to play a major role while presence of a pre-existing vascular lesion with spontaneous hemorrhage may be an etiologic factor. Associated cholesterol granuloma is an interesting controversial finding. Surgical intervention is curative with possible persisting motility disturbance and/or the eye deviation and worse prognosis in post-traumatic cases.

Hematic cyst around orbital floor implant masquerading as choroidal mass.

Hematic cyst around orbital floor implant masquerading as choroidal mass.

Hematic Cyst in a Barrier-Covered Porous Polyethylene/Titanium Mesh Orbital Floor Implant

Hematic cyst formation after placement of nonporous alloplastic orbital floor implants is well described. A benefit of porous polyethylene is fibrovascular ingrowth without capsular formation. This ingrowth inhibits hematic cyst formation. In the case presented here, a hematic cyst developed on a screw-fixated porous polyethylene/titanium mesh implant (Medpor Titan B-T-M, Porex Surgical, Newnan, GA, U.S.A.). The risk factor for this patient was the nonporous barrier surface of the implant and inadequate fracture reduction. Proper surgical technique, including implant sizing, placement, and fixation, are factors reported to prevent hematic cyst formation. This patient's symptoms resolved after removal of the implant and cyst and replacement of the orbital implant.

Acute spontaneous extraconal hematic cyst of the orbit

A 49 year old man presented with one day history of mild right eye pain and proptosis. There was no definite history of trauma. On examination there was limitation of movement in all directions of gaze and 6 mm proptosis of his right eye. CT scan showed extraconal lesion compressing the optic nerve and inferior rectus muscle. Right inferior conjunctival fornix based approach was performed with lateral canthotomy and inferior cantholysis and exploration revealed a cyst containing blood which was removed.

Cause of Hematic Cysts of the Orbit: Increased Fibrinolysis and Immunohistologic Expression of Tissue Plasminogen Activator

Hematic cysts of the orbit are relatively uncommon. These cysts expand gradually, leading to progressive orbital symptoms. To clarify the cause of hematic cyst, especially the mechanisms leading to its gradual expansion, we investigated the immunohistologic expression of tissue-type plasminogen activator (tPA), a key enzyme of fibrinolysis, in cases of hematic cysts. Retrospective small case series. Three patients with hematic cyst of the orbit were studied. Three surgically removed hematic cysts were studied from a histologic perspective, including immunohistochemistry for tPA. The cyst content was also analyzed chemically. The pathologic features of hematic cyst of the orbit, expression of tPA in the cyst wall, and coagulation-fibrinolytic factors in the content of the cyst. The cyst wall was composed of dense collagen fibers lacking an epithelial lining and contained many fine capillary- or venule-like vessels. Hemosiderin-laden macrophages were observed among the collagen fibers. Strong immunoreactivity for tPA was revealed in the endothelial cells of the vessels in the cyst wall. Chemical analysis of the cyst content revealed a marked delay in the activated partial thromboplastin time and prothrombin time, a low fibrinogen concentration, and high concentrations of the D-dimer and tPA-plasminogen activator inhibitor-1 complex. Our findings indicate that blood coagulation and hemostasis occur first and that fibrinolysis occurs second in hematic cysts. Gradual expansion of the cyst may be due to hyperfibrinolysis resulting from oversecretion of tPA from the endothelial cells in the cyst wall, thus impairing normal hemostasis. Hemorrhage may then recur, resulting in enlargement of the hematic cyst. These mechanisms are similar to those occurring in chronic subdural hematomas. The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Clinical controversy in orbitary cholesteatoma

Cholesterol granulomas are tumor-like lesions very rarely encountered in the orbital, frontal sinus, and maxillary sinus sites but with higher frequency in the middle-ear and petrous apex. Theoretically, cholesterol granulomas develop as a reaction to localized hemorrhages, often occurring in bony sites with no blood and blood products drainage. We present 5 cases with exophthalmoses, namely, 3 cases with granuloma and 2 cases with cholesteatoma, all being characterized by the presence of cholesterol spikes at the histologic examination. Henderson (Orbital tumors. 3rd ed. New York: Raven Press; 1994) reports cholesterol spikes in medical literature as structures with different histologic names as hematic cyst, intraorbital hematoma, subperiostal hemorrhages, chocolate cyst, and xanthomatosis reactive lesions of bone. In fact, cholesterol granuloma is the term for the pocket of hematogenous debris found in the frontal bone at surgery. We try to review the spectrum of clinical-pathological and radiographic features that characterize cholesterol granuloma but with the same surgical way management.

Spontaneous onset corneoscleral hematic cyst

Corneoscleral cysts are a rare entity. We report a case of spontaneous corneoscleral hematic cyst, which was treated by cyst excision and lamellar corneal patch graft. No recurrence of cyst was noticed during the 6 years of followup.

Chronic hematic cyst of the temporomandibular joint: MRI features and dynamic magnetic resonance imaging

Hematic cyst refers to accumulation of blood or blood breakdown products in a non epithelium-lined fibrous tissue capsule. Hematic cyst is a term often used for deeply placed, incompletely resorbed hematoma (hemorrhagic cyst), which may remain unchanged and unidentified for long periods of time. Trauma is the major causative factor, although it is often vague or totally unrecalled by the patient. Chronic hematic cysts are uncommon lesions those can present diagnostic challenge. In this article we reported, to our knowledge, the first case of a chronic hematic cyst of the temporomandibular joint (TMJ) with magnetic resonance imaging (MRI) features and dynamic MRI application of the lesion.

Chronic orbital hematic cyst

A rare case of chronic orbital hematic cyst is reported. A 40-year-old male presented with a mass which displaced the eye downward. The initial symptoms, progression of the disease, the difficulty in clinical and radiological diagnosis are presented and discussed together with treatment.

Surgical pathology of primary cardiac and pericardial tumors.

Retrospective study of surgical pathology experience on cardiac and pericardial tumors at the University of Padua in the era of immunohistochemistry and endomyocardial biopsy. In the period 1970-1995, we studied 125 bioptic primary neoplasms: specimens were obtained from surgical resection in 116 cases, heart transplantation in 3, pericardiectomy in 3, endomyocardial biopsy in 2 and thoracoscopic biopsy in 1. Tumor histotype was established by light microscopy and more recently by immuno-histochemistry, using a large panel of antibodies, through avidin-biotin peroxidase method, against factor VIII-related antigen, ulex-europaeus, desmin, myoglobin, muscle-specific actin, smooth muscle-specific actin, vimentin, cytokeratins, leukocytic common antigen, neurofilaments and S100-protein. One hundred and thirteen were benign neoplasms: myxoma was the most frequent (87 cases) followed by pericardial cyst (8), endocardial papilloma (5), fibroma (3), rhabdomyoma (3), hematic cyst (2), teratoma (2), hemangioma (1), celothelioma (1) and lipoma (1). Malignancy was diagnosed in 12 cases, and consisted of pericardial mesothelioma (3), myxosarcoma (3), angiosarcoma (2), fibrosarcoma (2) and leiomyosarcoma (2); 4 of them were intracavitary atrial masses and were supposed to be atrial myxoma on the clinical ground. Differential diagnosis included endocardial thrombosis (10), metastasis of concealed extracardiac tumors (5), echinococcosis (3), and Loeffler's fibroplastic endocarditis (3). In 4 cases, cardiac mass histotype was defined without thoracotomy, through endomyocardial (3) and thoracoscopic (1) biopsy. A large spectrum of cardiac tumors is observed in the surgical pathology practice. Although the diagnosis of cardiac masses is easily attainable by routine imaging techniques, differential diagnosis between primary and secondary tumors, malignant and benign forms, and non neoplastic masses, is achievable only by a thorough microscopic study of surgical resections. The role of the cardiac pathologist is becoming crucial as in other fields of oncology.

Orbital Hematic Cyst: Case Report and Clarification of Terms

We present a case of a hematic cyst and review the literature in order to clarify nomenclature discrepancies regarding terms used to describe cysts containing blood and blood breakdown products in and around the orbit. We believe orbital cysts containing blood and blood breakdown products should be separated into two major categories depending on the presence or absence of an epithelial or endothelial lining. A hemorrhage into a preexisting lesion such as a dermoid, on lymphangioma, which contains blood breakdown products lined by an endothelial or epithelial lining, should be referred to as an acute or chronic hematoma in a dermoid or lymphangioma. In contrast, a hematic cyst contains blood breakdown products and has no epithelial or endothelial lining but rather a fibrous pseudocapsule.

Plasmacytoma Manifesting as Recurrent Cellulitis and Hematic Cyst of the Orbit

To describe a patient with recurrent periorbital cellulitis and orbital blood cyst as the initial manifestation of primary extramedullary plasmacytoma. The chart, imaging studies, and histopathologic examination results and literature on the subject were reviewed. Orbital surgery disclosed a hematic cyst along with a solitary plasma cell tumor. Periorbital cellulitis and pain can be a manifestation of a plasma cell tumor. Bleeding may occur within a necrotic orbital tumor.

Hematic cyst of the orbit : Loeffler M. Arch Ophthalmol 108:886, 1990

Hematic cyst of the orbit : Loeffler M. Arch Ophthalmol 108:886, 1990

Spontaneous Hematic Cysts of the Orbit Presenting with Acute Proptosis A Report of Three Cases

Three cases of spontaneous hematic cyst of the orbit are described. All cases presented with acute onset of proptosis, conjunctival chemosis, choroidal folds, restricted ocular movement, and optic nerve compression syndrome with very poor vision. A computed tomography scan demonstrated a cystic lesion situated in the upper part of the orbit. Exploration revealed a cyst containing chocolate-colored fluid. Visual recovery was complete in two of three cases. There was no definite history of trauma in all three cases. Chronic hematic cysts have been described recently, but cases with acute onset such as ours have not to our knowledge been described clearly.

Hematic Cyst of the Orbit

Hematic Cyst of the Orbit

POSTSURGICAL HEMATIC CYST SIMULATING A CONJUNCTIVAL MELANOMA

A 75-year-old man had undergone bilateral intracapsular cataract extraction and then a scleral buckling procedure for an aphakic retinal detachment in the right eye. He presented 15 years later with a dark brown mass in the superior fornix of his right eye. On the basis of the clinical findings, the diagnosis of a conjunctival melanoma was considered. The lesion was surgically excised and found to be a chronic hematic cyst that arose adjacent to a episcleral sponge placed at the time of retinal detachment surgery. Hematic cysts should be included in the differential diagnosis of pigmented conjunctival lesions.

Chronic Hematic Cyst of the Orbit

Chronic Hematic Cyst of the Orbit