Location Of Cyst Research Articles

Evaluation of Renal Cyst on Ultrasound in Adults

Renal cysts are fluid-filled pockets that develop on or inside of the kidneys. Cysts were usual and incidental findings in routine sonographic examinations of kidneys. Objective: To evaluate the location and types of renal cyst using ultrasound. Material and Method: It is a cross-sectional study conducted in 5 months from November 2021 to March 2022. A sample size of 100 was calculated using previous published related study. All adults above 20 years were included and referred to an ultrasound scan of a kidney. After informed consent data was collected and analysed on SPSS version 20. Results: According to the current study renal cysts are most prevalent at the age group of 60 to 80 years having 35(35%) followed by 40 to 60 years 33(33%). The males were more prone to develop renal cysts 55(55%) as compared to females 45(45%). Unilateral cysts were more common 60(30%) as compared to bilateral cysts 40(20%). The occurrence of renal cyst was common in right kidney 65(32.5%) as compared to left kidney 35(17.5%). The renal cysts were commonly present at Cortex 70(70%) and the most common type was simple polycystic kidneys 60(60%). Conclusion: In conclusion, the prevalence of renal cyst is higher in old males specifically in the cortical region. Unilateral polycystic kidneys are most common.

Concomitant chronic subdural hematomas and arachnoid cysts in young adults.

Objective: This study aimed to evaluate the correlation between arachnoid cysts and chronic subdural hematomas in young adults. Methods: This retrospective study evaluated ten patients having concomitant chronic subdural hematomas and arachnoid cysts. Patients were evaluated with the data of age and gender, location of hematoma and arachnoid cyst, trauma history, symptoms at admission, maximum hematoma diameter, contiguity between arachnoid cyst and hematoma, and treatment methods. Results: We treated 285 patients who were diagnosed with cSDH between January 2013 and December 2019. 22 patients were under the age of 40 years. Ten of them had both cSDH and arachnoid cysts. The mean age of patients was 24.8±3.9 years. Patients with only chronic subdural hematoma had higher mean age than the patients with arachnoid cyst-related chronic subdural hematoma. In four patients, the onset of chronic subdural hematoma was reported after arachnoid cyst diagnosis. Four of the patients did not have causative trauma history, and two patients suffered minor sports-related traumas. All patients had headache, and only two patients had hemiparesis. The location of arachnoid cysts were in the middle fossa in eight patients. All patients had chronic subdural hematomas on the ipsilateral side of arachnoid cyst. Four patients who had smaller than 10 mm maximal cSDH diameter underwent conservative management. They were followed by serial neuroimaging studies and it was noted that the hematoma disappered and the size of the arachnoid cysts decreased over time without any neurological complication. In six cases, craniotomy was required, and all recovered completely. cSDH did not recur during 5-60 months of follow-up period (median 12 months). Conclusions: It seems that presence of an arachnoid cyst in young adults is a predisposing factor for the formation of chronic subdural hematoma. Coincidentally diagnosed arachnoid cyst patients may be followed up with periodical clinical examinations and neuroimaging studies.

Clinical and surgical evaluation of cyst hydatid cases in a training and research hospital in Şanlıurfa province

Echinococcus, which is a zoonotic agent, is endemic in our country and causes hydatid disease by localizing in various organs in the human intermediate host. This study aims to present the demographic and clinical characteristics of patients treated for hydatid cysts in our hospital, determine the methods used for treatment, and review the complications in detail. Cases reported to have a hydatid cyst in the surgical material pathology result in Şanlıurfa Training and Research Hospital were evaluated between March 2017 and December 2019. All patients were living in Turkey, which is endemic for hydatid cysts. The records of the patients who were operated on with the pre-diagnosis of cyst hydatid after the examinations and whose pathology results were reported as hydatid cysts were reviewed retrospectively. During the study dates, a total of 84 patients, 55 (65.4%) female and 29 (34.5%) male, were operated on for cyst hydatid in our hospital. The mean age of the patients was 28.6 (min: 2-max: 67). Seventeen (20%) of the patients were in the pediatric age group. When the patients were examined in terms of the number of cysts, 65 (77.3%) patients had a single cyst, while 19 (22.6%) patients had more than one cyst. When evaluated in terms of cyst location, liver localization was observed in 35 (41.6%) patients, liver and lung co-location in 4 (4.7%) patients, lung location in 19 (22.6%) patients, spleen location in 2 (2.3%) patients, and brain location in 2 (2.3%) patients. localization, adnexal localization in 6 (7.1%) patients, renal localization in 2 (2.3%) patients, and soft tissue localization in 14 (16.6%) patients. In the pediatric age group, cyst localization was 4 in the liver, 10 in the lung, 2 in the brain, and 1 in soft tissue. Preoperative serology test results of 42 patients were reported as positive (+) (1/320-1/2560). The average duration of hospitalization was 1-27 days. When the postoperative complications of the patients were examined, the biliary fistula was found in 4 (4.7%) patients, prolonged air leak in 2 (2.3%) patients, pneumothorax in 1 (1.1%) patient, empyema in 1 (1.1%) patient, who was operated for liver cyst hydatid and postoperative seroma was observed in 5 (5.9%) patients. The mean specimen diameter in the pathology results was 2-20 cm. Cyst hydatid disease caused by echinococcus is endemic in our country and often requires surgical intervention. Imaging methods and serology are used in the diagnosis, but a negative serology does not rule out this disease. Patients should be followed up for possible complications after surgery.

Hydatid cyst detection by liver ultrasonography in sheep: Impact of cyst abundance, viability and location

Cystic echinococcosis (CE) is a major zoonosis in Morocco, common in most livestock including sheep. The objectives of this study, performed in sheep of different ages in the Middle Atlas in Morocco, were (1) to compare CE detection, CE count and cysts classification into viable and calcified by ante-mortem hepatic ultrasound (US) scanning and post-mortem macroscopic hepatic inspection and (2) to investigate post-mortem the hydatid cysts present in the liver and lungs to determine in as far hepatic US scanning would fail to detect sheep with exclusive location of CE in the lungs that are not detected on ultrasound. Among 126 examined sheep, 106 were considered as infected by CE by US scanning, whereas 108 were detected at necropsy. Whatever the diagnostic method used; the total number of cysts increased significantly in function of age (p < 0.001). Differentiation capacity between viable and calcified cysts was similar for US scanning and necropsy. Sheep considered as negative by US scanning (n = 32) were confirmed negative by necropsy, leading to a specificity of US scanning of 100% (95% CI: 90–100%) and sensitivity of 98% (IC: 92–99%). Part 2 of the study evidenced that among 97 infected sheep, 78% (IC 95%: 72–83%) presented hepatics cysts, whereas 22% (IC 95%: 17–28%) presented exclusively pulmonary cysts. 56% (IC 95%: 54–59%) of total cysts were located in the liver. Animals showing exclusively pulmonary cysts were lightly infected in comparison to sheep with liver or with liver and pulmonary cysts. Under the conditions of the Middle Atlas sheep farm, the US scan was able to detect 98% of sheep with liver cysts. The US scan therefore allows easy monitoring of the progress of the control measures and provides data on the infestation of animals without the need for autopsy.

Concomitant chronic subdural hematomas and arachnoid cysts in young adults

Objective: This study aimed to evaluate the correlation between arachnoid cysts and chronic subdural hematomas in young adults. Methods: This retrospective study evaluated ten patients having concomitant chronic subdural hematomas and arachnoid cysts. Patients were evaluated with the data of age and gender, location of hematoma and arachnoid cyst, trauma history, symptoms at admission, maximum hematoma diameter, contiguity between arachnoid cyst and hematoma, and treatment methods. Results: We treated 285 patients who were diagnosed with cSDH between January 2013 and December 2019. 22 patients were under the age of 40 years. Ten of them had both cSDH and arachnoid cysts. The mean age of patients was 24.8±3.9 years. Patients with only chronic subdural hematoma had higher mean age than the patients with arachnoid cyst-related chronic subdural hematoma. In four patients, the onset of chronic subdural hematoma was reported after arachnoid cyst diagnosis. Four of the patients did not have causative trauma history, and two patients suffered minor sports-related traumas. All patients had headache, and only two patients had hemiparesis. The location of arachnoid cysts were in the middle fossa in eight patients. All patients had chronic subdural hematomas on the ipsilateral side of arachnoid cyst. Four patients who had smaller than 10 mm maximal cSDH diameter underwent conservative management. They were followed by serial neuroimaging studies and it was noted that the hematoma disappered and the size of the arachnoid cysts decreased over time without any neurological complication. In six cases, craniotomy was required, and all recovered completely. cSDH did not recur during 5–60 months of follow-up period (median 12 months). Conclusions: It seems that presence of an arachnoid cyst in young adults is a predisposing factor for the formation of chronic subdural hematoma. Coincidentally diagnosed arachnoid cyst patients may be followed up with periodical clinical examinations and neuroimaging studies.

Buccal bifurcation cyst: A case series and review of the literature

IntroductionBuccal bifurcation cyst is an inflammatory odontogenic cyst and constitutes up to 5% of all odontogenic cysts. The aim of this study was to report a series of cases, review the recent literature, and facilitate recognition and proper treatment of this entity. MethodsWith institutional review board approval, the authors retrieved all archival cases of buccal bifurcation cyst from the oral pathology biopsy service from 1994 through 2018. Patient age and sex, cyst location, clinician’s impression, radiographic appearance, diagnosis, and treatment data were recorded. ResultsA total of 10 cases were identified. Average patient age was 9 years. A slight male predilection was observed (n = 6, 60%). One hundred percent of cases were in the mandible, including 3 (30%) bilateral cases. ConclusionsMandibular buccal bifurcation cyst is an important entity in pediatric patients but may be less likely to be recognized by clinicians not regularly treating children. The results of this study are mostly consistent with the literature. Treatment is typically via enucleation or even more conservative modalities, and extraction should be avoided if possible. Practical ImplicationsBuccal bifurcation cysts should be treated via enucleation or even more conservative methods. If possible, the affected teeth should be preserved.

Trends in the Surgical Incidence of Cystic Echinococcosis in Uzbekistan from 2011 to 2018.

Cystic echinococcosis (CE) is a zoonosis with a cosmopolitan distribution caused by Echinococcus granulosus sensu lato tapeworms. Although Uzbekistan and other countries in Central Asia are considered endemic, estimates of disease burden are lacking. We present data regarding surgically managed cases of CE obtained from Uzbekistan's national disease surveillance registry. These data are from medical centers in Uzbekistan authorized to treat the disease and reported to the Uzbek Center for Sanitation and Epidemiology from the period 2011 to 2018. Information included patient age class (children 14 years or younger versus adults 15 years and older), but no data regarding cyst location. Incidence rates were calculated using data from the national population registry, and the Cuzick nonparametric test for trends was used to test for differences in the incidence over time at the country and regional levels. A total of 7,309 CE cases were reported. Of these, 857 (11.73%) involved pediatric patients. The mean incidence rates were 4.4 per 100,000 population in 2011 and 2.3 per 100,000 population in 2018 (P = 0.016). One region (Republic of Karalpakistan) showed a nonstatistically significant increase (P = 0.824). All other regions except three showed a statistically significant decrease. We present data showing a decrease in the overall incidence of surgically treated CE in Uzbekistan from 2011 to 2018. However, the presence of cases involving children suggests ongoing parasite transmission. The absence of clinical information (starting with cyst stage and localization) needs to be addressed to improve the national surveillance system. Field studies are also needed to further explore the epidemiology of CE in the country.

Neurocysticercosis with convulsion, confusion, and hypomnesia

Neurocysticercosis (NCC), which is typically caused by the tapeworm Taenia solium after ingesting contaminated food or water, is one of the most common parasitic diseases of the nervous system (NS) in humans, and constitutes a major public health problem for most of the developing countries. The clinical manifestations of NCC can vary from completely asymptomatic infection to death, and largely depend on the number, type, size, location of cysts, and the host’s immune response against the parasite. The NS manifestations usually include seizures, headache, intracranial hypertension, focal neurological signs and mental disorder. NCC diagnosis is usually based on neuroimaging studies (computerized tomography, magnetic resonance) and immunological tests (antibody/antigen detection in the serum and the cerebrospinal fluid). Therapeutic approaches for NCC include symptomatic therapy, antiparasitic treatment and surgery. Keywords: neurocysticercosis; convulsion; confusion.

Kidney Cysts in Hypophosphatemic Rickets With Hypercalciuria: A Case Series

Rationale & ObjectiveHereditary hypophosphatemic rickets with hypercalciuria (HHRH) is a rare monogenic disorder caused by SLC34A3 pathogenic variants. HHRH is characterized by kidney phosphate wasting, hypophosphatemia, hypercalciuria, an elevated 1,25-dihydroxyvitamin D level, nephrocalcinosis, and urinary stone disease. Previously, we reported a 100% prevalence of kidney cysts in the related CYP24A1 deficiency. Thus, in the current study, we characterized cysts’ presence in HHRH, another monogenic cause of hypercalciuria, nephrocalcinosis, and urinary stone disease.Study DesignCase series.Setting & ParticipantsMedical records from the Mayo Clinic and the Rare Kidney Stone Consortium monogenic stone disease database were queried for patients with a genetically confirmed HHRH diagnosis. The number, sizes, and locations of kidney cysts in each patient were recorded.ResultsTwelve patients with SLC34A3 pathogenic variants were identified (7 monoallelic, 5 biallelic). Of these, 5 (42%) were males, and the median (Q1, Q3) ages were 16 years (13, 35 years) at clinical presentation and 42 years (20, 57 years) at genetic confirmation. Kidney cysts were present in 9 of 12 (75%) patients, and the median (Q1, Q3) age at first cyst detection was 41 years (13, 50 years). The median number of cysts per patient was 2.0 (0.5, 3.5). Fifty percent of adult patients had a cyst number that exceeded the 97.5th percentile of an age- and sex-matched control population. All children had at least 2 or more total cysts. None had a family history of cystic kidney disease.LimitationsRetrospective study, possible selection bias, single-center experience.ConclusionsA strong association between HHRH and kidney cysts was observed. Similarities in the biochemical profiles of HHRH and CYP24A1 deficiency suggest elevated active vitamin D and hypercalciuria may be potential cystogenic factors. Further studies are needed to understand how genetic changes in SLC34A3 favor cyst formation.

Successful Sclerotherapy for Cervicofacial Macrocystic Lymphatic Malformations Using Polidocanol and Pingyangmycin Combined Foam Sclerosants.

Background: Sclerotherapy is the first-line therapeutic method for lymphatic malformations (LMs). This retrospective cohort study evaluated the effectiveness and safety of a novel combined foam sclerosant: polidocanol and pingyangmycin foam (PPF), for treating cervicofacial macrocystic LMs. Methods and Results: From July 2018 to October 2020, 51 patients with cervicofacial macrocystic LMs were enrolled in this study. All patients received intralesional 3% polidocanol or PPF injections. The outcome was evaluated regarding demographic and clinical characteristics, degree of treatment response, and post-treatment complications. Overall, 16 patients (31.4%) underwent PPF sclerotherapy. All these patients (100%) showed remarkable reduction in lesion size within three sessions. Excellent responses were shown in 88.5% of these patients within three sessions, which is higher than single polidocanol sclerotherapy (80%). The average sessions (duration) of PPF sclerotherapy were 2.5, which was significantly shorter than the single foam sclerotherapy (p < 0.05). Treatment duration was significantly associated with age, lesion location, lesion size, and number of cysts (p < 0.05). No severe complications were noted in this study. Local or systemic complications, such as swelling and mild fever occurred but subsided without any specific treatment. Conclusions: PPF is a safe, and effective combined foam sclerosant for the treatment of cervicofacial macrocystic LMs. This combined foam can improve treatment response and reduce treatment duration compared with a single sclerosant. It can be broadly used if further large-scale clinical trials verify its efficacy and safety.

Extradural spinal arachnoid cysts: Management and outcome in five children

Abstract Background: Spinal extradural arachnoid cysts (SEACs) are rare lesions, which may become symptomatic due to mass effect or nerve root compression. They are discrete pockets of cerebrospinal fluid (CSF) communicating with subarachnoid space. These cysts may be single or multiple. Multiple cysts in the pediatric population are very rare, of which a few are reported to date. Materials and Methods: Here, we present a case series of five pediatric patients diagnosed with symptomatic SEACs and operated in our institute between the period of October 2017 and January 2021. The patients underwent surgery for excision of the cysts and closure of dural defects. The results were analyzed in terms of the clinical symptoms, location of cyst, surgical procedure performed, and outcome after surgery. Result: The mean age of presentation was 12 years. Common presenting complaints were lower limb weakness, pain, and bladder involvement. The median duration of symptoms before surgery was 7.8 months (mean 3 ± 12 months). Excision of cyst wall with closure of dural defect was done in all cases except one, in which the dural defect was not found. All cases gained near-normal muscle strength of lower extremities over a variable period of time after surgery. Conclusion: Pathogenesis of SEAC is not completely understood. Intraoperative localization and closure of the dural defect is the single most important step for excellent outcome.

Occurrence and genetic characterization of Echinococcus granulosus sensu lato from domestic animals in Central Iran

BackgroundThe species complex of Echinococcus granulosus sensu lato (s.l.) causes cystic echinococcosis distributed worldwide. There is no genotype information from hydatid cysts in the intermediate hosts in Central Iran. Therefore, in this study, we analyzed the hydatid cysts in livestock slaughtered in an abattoir in this region. Six hundred fifty-seven hydatid cysts were isolated from 97 animals, including sheep, cattle, camels, and goats slaughtered in Yazd abattoir from September 2018 to January 2020. The demographic data was collected as well as cyst location, fertility, and viability. Out of 657 samples, 164 samples were genotyped. Then, phylogenetic analysis was performed using MEGAX. Statistical analyses were done using SPSS version 16.0 by chi-square with a significant difference of less than 0.05.ResultsOut of 164 samples, the G1-G3 complex genotype had the most frequency in samples, with 135 cases recognized. The G6/G7 was observed in 19 isolates and G5 was reported in nine samples. One sample was detected as Taenia hydatigena.ConclusionsThis study showed that G1-G3 and G6/G7 genotypes were presented in all animals, but G5 was reported only in cattle, goats, and camels. It is the first molecular identification of cystic echinococcosis in Central Iran. Hence, reporting G5 in livestock in this area should be considered due to transmission to humans.

Bone and Intramuscular Hydatid Cysts: A Rare Association

<i>Background:</i> Hydatidosis is a parasitic disease linked to the development of Echinococcus Granulosus larval form in humans. This anthropozoonosis is characterized by many topographical and evolutionary aspects. Musculoskeletal hydatidosis is rare, it represents only 0.9 to 2.5% of all locations. <i>Objective:</i> the aim of this manuscript is to report a rare case of bone and muscle location of hydatid cyst and show the imaging contribution in its positive diagnosis and pre-therapeutic assessment. <i>Method:</i> We report the observation of a 61-year-old man admitted to our training for a right thigh mass, revealing a muscular hydatid cyst with a concomitant iliac bone location. <i>Result:</i> Ultrasound examination shows an intra muscular cystic lesion, of the Sartorius and rectus femoris muscles, with hydatid membranes inside. A simultaneous bone location, at the ipsilateral iliac bone, was fortuitously discovered on CT scan and MRI exploration, which show a multicystic lytic lesion with cystic signal and round daughter cysts on MRI examination. A complementary X-ray of the pelvis shows the classic "honeycomb" appearance of the right iliac bone. A positive hydatid serology confirmed the diagnosis. No concomitant hepatic or pulmonary localization was demonstrated on abdominal ultrasound and chest CT scan. An anthelminthic therapy (Albendazole) was started, and the patient was a candidate for further surgical treatment. <i>Conclusion:</i> Musculoskeletal hydatid cyst location is rare. The Hydatid osteopathy is usually infiltrative, slow and progressive, which makes diagnosis late and compromises the quality of treatment. So, despite its rarity; musculoskeletal hydatid cyst should always be considered in the differential diagnosis of cystic lesions in endemic areas.

SURGICAL TREATMENT OF ECHINOCOCCOSIS OF THE LIVER AND ITS COMPLICATIONS

The aim: To analyze the frequency of complications of echinococcal cysts of the liver, the causes of recurrence and the results of surgical treatment of patients with echinococcal liver disease. Materials and methods: The results of surgical treatment of 79 patients who were hospitalized from January 2011 to JANUARY 2022 with liver echinococcosis and its complications were analyzed. Among them there were 11 men (13,9%) and 68 women (86,1%), with average age 47,5 ± 2,3 years. Complications of echinococcal cysts developed in 17 (21,5%) patients. Results: The choice of surgical intervention method was determined individually, taking into account the location of echinococcal cysts, their size, depth, proximity of important anatomical structures. 53 (67,1%) patients underwent total or subtotal pericystectomy, 8 (10,1%) patients underwent liver segment resection, 5 (6,3%) patients underwent cyst dissection with removal and treatment its cavity, PAIR method was applied in 1 (1,3%) patient. Echinococcectomy was performed laparoscopically in 12 (15,2%) patients. The use of laparoscopic surgery for echinococcosis of the liver reduced intraoperative blood loss, duration of operation, hospital stay. We did not have recurrences of the disease after radical surgery. After palliative surgery, recurrence occurred in 2 (2,63%) patients. Conclusions: Surgical interventions for urgent indications in patients with complicated echinococcal cysts of the liver increase the risk of recurrence of the disease. Pericystectomy was performed in 53 (67,1%) patients, is a radical and efficient operation for complete recovery and does not lead to recurrence of the disease. The efficiency of laparoscopic echinococcectomy has been demonstrated.

Pathomorphological and histochemical parameters in the internal organs of carp infested Cariophyllaeus brachycollis

Pathomorphological and morphohistochemical changes were performed in the intestine of carp at the location of cysts of Cariophyllaeus brachycollis and other organs that do not have direct contact, primarily such as liver, kidneys, spleen, heart. A pathological autopsy of intensively infected carp with C. brachicollis cystism showed a slightly enlarged clay-yellowish liver; the gallbladder is often overflowing with bile. The kidneys are in most cases flabby and surrounded by a jelly-like mass, the spleen is also partially enlarged, and its edges are rounded, indicating dystrophic changes in these organs. The results of morphohistochemical studies have shown that granular dystrophy is observed in carp cells during cariophilic invasion in liver parenchyma cells. The content of α-amino acids and acid phosphatase activity in dystrophically altered hepatocytes increases significantly. The content of CHIC-positive substances increases in and around the veins and sinusoidal capillaries. These processes coincide with the destruction of individual liver beams. At a karyophilosis in kidneys of carp expansion of distal departments of tortuous tubules and a granular dystrophy is observed. In addition, a decrease in the content of neutral glycoproteins, alkaline phosphatase activity with a simultaneous increase in protein and acid phosphatase activity is observed in the brush border of nephrocytes. The appearance of pyroninophilic cells, decrease in the content of CHIC-positive substances, decrease in alkaline activity and increase in acid phosphatase activity were detected in the renal corpuscle. In the endothelium of blood vessels and capillaries, an increase in protein content, a decrease in alkaline phosphatase activity and an increase in acid phosphatase activity were found. Morphohistochemical studies in the capsule of the carp spleen indicate an increase in such indicators as pyroninophilia, CHIC-positive reaction, the presence of α-amino acids, acid phosphatase activity and decreased alkaline phosphatase activity. At the same time in the walls of blood vessels, there is an increase in the CHIC reaction and α-amino acids, a decrease in alkaline phosphatase, and an increase in acid phosphatase activity. Around the vessels in the reticular tissue of the spleen and between the cells of the pancreas significantly increases the accumulation of reticulocytes with increased acid phosphatase, bright pyroninophilic lymphocytes, and hemosiderocytes with an enhanced CHIC response. Morphohistochemical studies of the heart of fish are accompanied by dilation and overflow of blood cavities and vessels of the heart, small hemorrhages, and locally – pyknosis of muscle cell nuclei and granular dystrophy in the myocardium. At the same time in the endocardium – an increase in the number of lymphocytes and plasma cells with high content of DNA and RNA, as well as a marked increase in α-amino acids in connective tissue elastic fibers and squamous epithelial cells of the atrial and ventricular epicardium, alkaline and acid phosphatase. The amount of CHIC-positive substances is reduced in the striated muscle cells of the myocardium and the walls of the blood vessels of the epicardium. Thus, morphological and histochemical studies indicate profound and local changes in karyophilosis in the intestines of carp. In organs that are not directly related to the invasive onset, moderate histopathological and histochemical changes are observed, indicating a moderate severity of functional impairment.

Concomitant chronic subdural hematomas and arachnoid cysts in young adults

Objective: This study aimed to evaluate the correlation between arachnoid cysts and chronic subdural hematomas in young adults. Methods: This retrospective study evaluated ten patients having concomitant chronic subdural hematomas and arachnoid cysts. Patients were evaluated with the data of age and gender, location of hematoma and arachnoid cyst, trauma history, symptoms at admission, maximum hematoma diameter, contiguity between arachnoid cyst and hematoma, and treatment methods. Results: We treated 285 patients who were diagnosed with cSDH between January 2013 and December 2019. 22 patients were under the age of 40 years. Ten of them had both cSDH and arachnoid cysts. The mean age of patients was 24.8±3.9 years. Patients with only chronic subdural hematoma had higher mean age than the patients with arachnoid cyst-related chronic subdural hematoma. In four patients, the onset of chronic subdural hematoma was reported after arachnoid cyst diagnosis. Four of the patients did not have causative trauma history, and two patients suffered minor sports-related traumas. All patients had headache, and only two patients had hemiparesis. The location of arachnoid cysts were in the middle fossa in eight patients. All patients had chronic subdural hematomas on the ipsilateral side of arachnoid cyst. Four patients who had smaller than 10 mm maximal cSDH diameter underwent conservative management. They were followed by serial neuroimaging studies and it was noted that the hematoma disappered and the size of the arachnoid cysts decreased over time without any neurological complication. In six cases, craniotomy was required, and all recovered completely. cSDH did not recur during 5–60 months of follow-up period (median 12 months). Conclusions: It seems that presence of an arachnoid cyst in young adults is a predisposing factor for the formation of chronic subdural hematoma. Coincidentally diagnosed arachnoid cyst patients may be followed up with periodical clinical examinations and neuroimaging studies.

Gambaran Kista Dentigerous Gigi Premolar Rahang Atas pada Radiograf CBCT : Laporan Kasus

Background: Dentigerous cyst is a cyst that forms around the crown of an unerupted tooth. It begins when fluid accumulates in the layers of reduced enamel epithelium or between the epithelium and the crown of the unerupted tooth. Dentigerous cysts attach to the cementoenamel junction. Some dentigerous cysts are eccentric, developing from the lateral aspect of the follicle so that they occupy an area beside the crown instead of above the crown. In the case of dentigerous cysts with supernumerary, lesions appear to develop in the lateral aspect, so proper imaging is needed to see the expansion of the lesion. A modality that can be used to see the location and expansion of dentigerous cysts is by using a CBCT radiograph. Objective: Identification and interpretation of dentigerous cysts with supernumerary using CBCT radiography. Case Report: 12-year-old male came to the RSGM FKG Unpad bring a referral letter for CBCT photos. From the history it is known that the patient has a complaint of teeth that have not grown with swelling in the right maxilla. Case Management: Using CBCT, there were supernumerary and dentigerous cysts at 14,13. Sagittal, coronal and axial CBCT features show the position and condition of supernumerary, and give information about the location and expansion of dentigerous cyst at 14,13. Conclusion: CBCT provides a description of dentigerous cysts about location, lesion expansion, and involvement with surrounding tissue. CBCT provides an overview of lesions in sagittal, coronal and axial

Morbidity and Mortality Risk Factors for Lung Hydatidosis Surgery: Over 30 Years’ Experience Review

BackgroundLung hydatidosis (LH) is still an endemic pathology. Different published surgical series have reported variable numbers of patients, but few have studied the morbidity- and mortality-associated risk factors. MethodsThrough a retrospective with a descriptive and analytical aim study, performed from January 1987 to December 2020, we reported all patients who underwent operations for LH, regardless of the cyst locations, numbers, and aspects. We excluded patients who were not operated on, patients with extrapulmonary hydatidosis, and those with a cystic pathology other than LH. ResultsOperations for LH were performed in 1169 patients, with a total of 1288 interventions and a median age of 20 years (semi-interquartile range [SIQR],11.5; 2-89 years). There were a total of 1951 cysts, with a median of 1 cyst (SIQR,0; 1-37 cysts) and a median size of 60 mm (SIQR,20; 10-250 mm). Forty percent were complicated. Conservative surgery was performed on most patients, and anatomical resection was required in 23 patients (1.8%). The median number of bronchial fistulas was 3 (SIQR,1; 0-16 fistulas). Decortication was necessary for 94 patients (7.3%). The morbidity rate was 25%, and mortality was 0.4%. Fever, pleural effusion, and associated decortication were correlated morbidity and mortality risk factors. Other morbidity factors were identified, including nonprotection of the surgical field, a cyst size ≥55 mm, and ≥3 bronchial fistulas. Mortality factors were determined, such as postoperative occurrence of septic shock, hemorrhage, and respiratory distress. ConclusionsThe earlier we operate on LH patients (before complications set in) and identify the different associated risk factors, the better the prognosis of curative surgery is

Congenital Conjunctival Cysts of the Orbit.

To evaluate the clinical presentation, anatomical location, and histological features of congenital conjunctival cysts of the orbit. The location and the histological features of inflammation in these patients were compared with those for 293 orbital dermoid cysts. Retrospective review of the clinical details, imaging, and histopathology for patients who had excision of conjunctival cysts from their orbit between 1992 and 2020; patients with a history of trauma or surgery were omitted. Twelve patients (7 male; 58%) with congenital conjunctival cysts were identified, the patients presenting at an average age of 16 years (median 26; range 1-61) with a symptoms for a mean duration of 20 months (median 24; range 6-36). The commonest symptoms were peribulbar lump (6/12 patients; 50%), and eyelid swelling and blepharoptosis (6/12 patients; 50%). An orbitaxl mass was palpable in 10 patients (83%), 3 patients (25%) had mild proptosis (1-3 mm), and the cysts were most commonly located superiorly (6/12 patients; 50%) or superonasally (3/12; 25%) in the anterior half of the orbit. Imaging was performed in 7 cases, this showing an intimate relation to the common sheath of the superior rectus/levator complex in 3 patients (25%) and to the trochlea in 1 (8%). All cysts were excised completely, and no patient had postoperative complications or recurrence. Chronic mild and nonspecific inflammation was evident within the cyst wall in 7 cases (54%), but-unlike 55% of the 293 dermoid cysts-none showed granuloma formation. Congenital conjunctival cysts are rare and usually present with a palpable mass in the upper eyelid sulcus. A significant proportion of these cysts have an intimate relationship with the trochlea, or the superior rectus, levator palpebrae or superior oblique muscles and, to minimize the risk of postoperative diplopia or ptosis, particular care must be exercised during surgery.

Association of Location of Cyst with the family history and Mutated Gene among patients of Myelomeningocele

Aim: To determine association of location of cyst with the family history and mutated gene among patients of myelomeningocele. Methodology: This cross sectional study consists of fifty diagnosed cases of myelomeningocele and ten healthy individuals taken as controls. The cases were collected from Jinnah Postgraduate Medical Center (JPMC) for a period of six months. The research was conducted in Dow Diagnostic and Research Laboratory (DDRL) (DUHS). Majority of the patients included in the study were neonates. Patients were examined for the presence and site of the cyst. Family history of the patients was also recorded. After taken informed consent from the patient’s attendants, blood was drawn by a trained phlebotomist. DNA was extracted from whole blood followed by PCR amplification of VANGL1 gene. Results: We found that among fifty individuals five patients showed mutation in VANGL1 gene. Mutation was absent entirely from the controls. The cyst was mostly (92%) present in the lumbar region. Only 2% patients showed positive family history. The association between site of the cyst and family history was statistically significant. Conclusion: It is concluded that all mutation of VANGL1 gene was present at lumbar region.There was a strong relation between location of cyst and family history. Keywords: Myelomeningocele, cyst, VANGL1 gene, PCR, mutation.