Lymphatic Cyst Research Articles

Uterine cysts in mares

This work is aimed at studying the etiology, prevalence, diagnosis, treatment of uterine cysts and their difference from the embryo during ultrasound examination. Endometrial cysts are often the cause of infertility and indicate pathological changes in the uterus, occurring in older mares. There are two types of uterine cysts: endometrial glandular cysts and lymphatic lacunar cysts. Endometrial cysts are usually smaller than lymphatic cysts located in the endometrium and are composed of endometrial glands. Lymphatic cysts cause obstruction of the lymphatic channels and appear as single or multilobular structures. Cysts can result from chronic degenerative changes in the endometrium and their clinical significance varies. For example, in terms of fertility, their influence is related to size, conditioning, content and location in the uterus. The presence of small cysts often indicates matte structures. In addition, larger or more active cysts have an impact on the course of pregnancy. Single large or small cysts can lead to embryonic pregnancy failure, which is the most difficult recognition of maternal pregnancy. Careful testing methods can effectively monitor the mare's condition and ensure the prospects for a successful pregnancy. This pathology is diagnosed using rectal and ultrasound examinations. There are many treatment options: they can be removed by surgery, hysteroscopic biopsy forceps, snare, laser (diode, CO2 or Nd/YAG laser), electrocoagulation or injection of 70 % ethanol (sclerotherapy method). But unfortunately, many cysts are prone to relapse. Sometimes the presence of cysts can interfere with the diagnosis of pregnancy or lead to an erroneous diagnosis of “multiple pregnancy”, since cysts under ultrasound exposure appear as filling fluid structures in the endometrial lumen. For this reason, it is important to be able to diagnose, predict consequences and treatment options in the mare.

Para-aortic and pelvic lymphadenectomy in locally advanced cervical cancer with pelvic lymph node metastasis

ObjectiveThis study sought to explore the efficiency of para-aortic and pelvic lymphadenectomy in the treatment of locally advanced cervical cancer (LACC) with pelvic lymph node (PLN) metastasis.MethodsA total of 171 LACC patients with imaging-confirmed pelvic lymph node metastasis were included in this study. These patients were divided into two groups: the surgical staging group, comprising 58 patients who had received para-aortic and pelvic lymphadenectomy (surgical staging) along with concurrent chemoradiation therapy (CCRT), and the imaging staging group, comprising 113 patients who had received only CCRT. The two groups’ progression-free survival (PFS), overall survival (OS) and treatment-related complications were compared.ResultsThe surgical staging group started radiotherapy 10.2 days (range 9–12 days) later than the imaging staging group. The overall incidence of lymphatic cysts was 9.30%. In the surgical staging group, para-aortic lymph node metastasis was identified in 34.48% (20/58) of patients, while pathology-negative PLN was observed in 12.07% (7/58). Over a median follow-up period of 52 months, no significant differences in PFS and OS rates were found between the two groups (p > 0.05). Subgroup analysis of patients with lymph node diameters of ≥ 1.5 cm revealed a five-year PFS rate of 75.0% and an OS rate of 80.0% in the surgical staging group, compared to 41.5% and 50.1% in the imaging staging group, respectively, showing statistically significant differences (p = 0.022, HR:0.34 [0.13, 0.90] and p = 0.038, HR: 0.34 [0.12,0.94], respectively for PFS and OS). Additionally, in patients with two or more metastatic lymph nodes, the five-year PFS and OS rates were 69.2% and 73.1% in the surgical staging group, versus 41.0% and 48.4% in the imaging staging group, with these differences also being statistically significant (p = 0.025, HR: 0.41[0.19,0.93] and p = 0.046, HR: 0.42[0.18,0.98], respectively).ConclusionPerforming surgical staging before CCRT is safe and delivers accurate lymph node details crucial for tailoring radiotherapy. This approach merits further investigation, particularly in women with pelvic lymph nodes measuring 1.5 cm or more in diameter or patients with two or more imaging-positive PLNs.Graphical

The Study on Lymphatic Cysts Caused by Lymphadenectomy

<i>Background</i>: Traumatic lymphatic cyst, also known as cystic lymphangioma, is a multidisciplinary disease, with congenital lymphatic cysts being more common. Lymphatic cysts lack specific clinical manifestations, and the vast majority of cases are incidentally discovered during auxiliary examinations or surgeries, making diagnosis challenging. Surgery is the most effective treatment for this condition, with a favorable prognosis. Lymphatic cysts caused by lymphatic injury are clinically rare. This study theoretically analyzes the clinical characteristics of lymphatic cysts resulting from lymphatic injury. <i>Objective</i>: To explore the mechanisms by which lymphatic injury leads to lymphatic cyst formation and provide guidance for clinical treatment measures. <i>Methods</i>: The study involves analyzing the principles of lymphatic injury and examining the process of lymphatic cystic transformation and cyst formation. <i>Results</i>: The causes of lymphatic injury include mechanical cutting, thermal energy conduction from electrocautery, needle puncture, and trauma. <i>Conclusion</i>: There are various mechanisms and causes of lymphatic injury, and lymphatic injury is common during surgery. When lymphatic vessels are identified during surgery, they should be managed similarly to blood vessel ligation and disconnection. Lymphatic cysts are prone to recurrence, and complete resection is an effective treatment for this condition. Puncture and subtotal resection have a high recurrence rate.

Diagnostic spectrum of cysts of head and neck: Case series and review of literature

One of the foremost problems that brings patients to Otorhinolaryngology clinics are cystic swellings in the head and neck region. We aimed to study the presentation, configuration of cystic swellings of head and neck for diagnosis and management. A retrospective study of 30 patients belonging to diverse age group and presenting with complaints of swelling in the craniofacial domain to the otorhinolaryngology outpatient department was conducted. Based on the characterization of cystic swellings of head and neck, most turned out to be usually benign. The most common cyst was epidermoid cyst (56%), followed by second arch branchial cyst (26%). A single case each of nasopalatine cyst and intra-parotid lymphatic cyst was also reported. Swellings in the head and neck can have various presentations. Cytologic examination of head and neck cysts along with pre-operative clinical examination and imaging offer imperative information concerning the nature of the cystic lesions, and may rarely lead to any misdiagnosis.

Retroperitoneal Mullerian Cyst of Renal Origin in a Cat - A Case report

Extreme rarely reported mullerian cysts of the retroperitoneum are considered to be a subtype of urogenital cysts. Retroperitoneal cysts can be categorized into lymphatic cysts, mesothelial cysts, enteric cysts and urogenital cysts based on embryological origin and histogenesis. The present case is an rare encounter and the successful management of the same is herewith discussed. A twelve months old intact female domestic short hair cat was presented with a history of progressive abdominal distension, anorexia, lethargy and oliguria. On abdominal palpation, an extensive globular mass was palpable in the cranial abdomen a survey radiography of the abdomen and thorax revealed a soft tissue contour at the cranial abdomen at the left renal position, thoracic radiography revealed absence of any abnormalities. Renal functional status was ascertained with intravenous pyelography which revealed unilateral cystic dysgenesis of left kidney and agenesis of left ureter. Hematobiochemical profiles and preoperative assessment were done to rule out general organ health. Following routine and special diagnostic procedures, an exploratory laparotomy confirmed the cystic renal distension that was excised through an unilateral nephrectomy and the cat was observed on periodic reviews to confirm any abnormalities if any which was absent and the animal had an uneventful recovery,.

Mesenteric and Omental Lymphatic Cysts in Children: A 23-Year Retrospective Descriptive Study from Central India

Introduction: Lymphatic cystic malformations occur in the mesentery of the small and large bowel, omentum and retroperitoneal area and are rare, benign, intra-abdominal cystic lesions. Aim: To review the demographics, clinical presentation and surgical outcomes of children’s mesenteric and omental lymphatic cystic lesions. Materials and Methods: A single-institution, retrospective descriptive study was conducted in the Department of Paediatric Surgery, Gandhi Medical College and Associated Hospitals, Bhopal, India, from January 1, 2000, to December 31, 2023. It included cases of lymphatic cystic lesions in infants and children below 12 years of age involving the mesentery of the small and large bowel and omentum. The details collected from the case records were the age, sex, clinical presentation, radiological investigations carried out, operative findings and the outcome of the operative intervention executed for mesenteric and omental lymphatic cysts in children. The results obtained from the present study are expressed in numbers and percentages. Results: The present study analysed 18 children aged ≤12 years who underwent surgery for lymphatic cysts of the mesentery of the small bowel (n=14), large bowel/mesocolon (n=1) and omentum (n=3) during the study period. There were 11 boys and 7 girls. More than four-fifths (n=15) of the children were ≤5 years old at the time of diagnosis and operative therapy provided. One-third (n=7) of the cases clinically presented with the clinical features of intestinal obstruction. The cysts involved the mesentery of the small bowel in three-fourths (n=14) of the cases. The complete excision of the lymphatic cysts was possible in three-fourths (n=14) of the cases. In 10 children, resection of the adjacent/involved small bowel segment was also required during the operative procedures. Fifty percentage of the cases revealed volvulus of the small bowel caused by mesenteric cysts involving the small bowel. More than half of the cases required resection of the adjacent/involved segment of the small bowel along with excision of the mesenteric cysts. Conclusion: Mesenteric cysts are rare abdominal pathology with diverse clinical presentations ranging from vague abdominal pain and lump to an acute abdomen. Early referral to higher centres, diagnosis and prompt surgical excision of the mesenteric cysts can prevent volvulus, one of the most common complications and requirements of an emergency surgical procedure.

Cytological and Biochemical Analyses of Lymphatic Fluid from Patients with Lymphatic Malformations.

Background: Intracystic hemorrhage from lymphangiomas is a common phenomenon in lymphatic malformations (LMs); however, little is known about the associated compositional changes in the lymphatic fluid. Materials and Methods: We prospectively collected lymphatic fluid from children with LMs. Lymphatic fluid was divided depending on the bleeding status into the bleeding and nonbleeding groups. The fluid was subjected to cytological and biochemical analyses to determine protein and cytokine levels. The Mann-Whitney U test was used to compare the two groups. Results: There were significant differences in the levels of interleukin (IL)-6, IL-10, and glucose, and the percentage of white blood cells between the bleeding and nonbleeding groups. There was no significant difference in chlorine and protein content; white blood cell count; and IL-2, IL-4, tumor necrosis factor α, and interferon γ levels between the two groups. Conclusion: Lymphatic fluid is less stable in bleeding LMs than in non-bleeding LMs and is prone to inflammatory reactions. The inflammatory reaction in lymphatic fluid does not stimulate the cytokine storm in blood. The inflammatory reaction due to LMs does not affect the contents of protein and chlorine in lymphatic cyst fluid.

Stability and safety of transbronchial dye mixture for preoperative localization in a porcine model.

For thoracoscopy, the usefulness of a dye mixture of indigo carmine and Lipiodol for localizing lung lesions has been reported. However, little is known about the stability and safety of this dye mixture injected on the visceral pleura through a bronchoscope. Porcine models were divided into three groups according to the detection time of the dye mixture: group A with a detection time of 4h; group B, 8h; and group C, 24 h. A dye mixture of indigo carmine and Lipiodol (0.5mL each) was sprayed onto the visceral pleura both in the ventral and dorsal regions via a spray catheter. Twelve markings were created on the visceral pleura of the porcine lung (six ventral and six dorsal) in the six porcine models. At predetermined detection times, all 12 dye markings (100%) were visible on the visceral pleura. The mean longest diameter of the dye marking in the ventral and dorsal regions was 18.8 mm and 24.3 mm, respectively. In groups B and C, pathological changes in the lymphatic system, such as lymphatic dilatations, were found; minimal changes were found in group B, however, these changes with oval-shaped lymphatic cysts and Lipiodol accumulation, were more evident in group C. The dye mixture of indigo carmine and Lipiodol had reliable stability and visibility. In terms of safety, it may be necessary to check the dye mixture on the lung surface within 8h.

Possibilities of aggressive oncosurgery in treatment of IIA–IIIB stages of cervical cancer

Introduction. Arming gynecological oncology with modern chemotherapy schemes, elements of aggressive oncosurgery, it is possible to achieve an increase in the number of cured patients with locally advanced forms of cervical cancer (CC), providing an improvement in the immediate and long-term results of treatment. The proposed method of surgical treatment is the method of choice for the surgical treatment of patients with locally advanced forms of cervical cancer (stages IIA–IIIB).Purpose of the study. Introduction into clinical practice of the method of surgical treatment of IIA–IIIB stages of cervical cancer.Material and methods. Long-term results of treatment of 155 patients with morphologically verified stage IIA–IIIB cervical cancer were studied. The patients underwent neoadjuvant chemotherapy (NACT) (n = 110) and chemoradiotherapy (CRT) (n = 45). When resectability was achieved, the patients underwent surgical treatment using a new technique. Overall survival (OS) and progression-free survival (PFS) outcomes were assessed.Results. In the period from 2017 to 2020, 155 patients with stage IIA–IIIB cervical cancer after NACT (n = 110) and CRT (n = 45) underwent combinedextended extirpation of the uterus with appendages according to our patented method. The most frequent postoperative complications were urination disorders in 106 (67 [60.9%] and 19 [42.2%]) patients, lymphatic cysts in 30 (20 [18.2%] and 10 [22.2%]) patients and vesicovaginal fistula in 7 patients (5 [4.6%] and 2 [4.4%]), respectively. According to the results of a pathomorphological study, the most frequent tumor response to NACT was III degree of therapeutic pathomorphosis (TP) in 44 (40.0%) patients of group 1 and in 21 patients – IV-degree TP, amounting to 46.6%. The median follow-up was 28.7 (from 3.6 to 51.1) months. During this time, 30 patients died in both groups (17 [15.5%] and 13 [28.9%]) (p = 0.047). Disease progression occurred in 16 (10.3%) patients (6 [5.5%] and 10 [22.2%]) (p = 0.004), respectively. The 3-year OS was 83.8 ± 3.7 and 71.0 ± 6.8 (p = 0.131), PFS – 93.5 ± 2.6 and 77.7 ± 6.6 (p = 0.006).Conclusions. The proposed method of surgical treatment of IIA–IIIB stages of cervical cancer has a novelty and can be used in practical medicine for the surgical treatment of oncology diseases in cervical cancer

Calcium channel blocker and risk of postoperation lymphatic-related complications among gynecologic malignances.

This study was performed to assess the association of calcium channel blockers (CCB) and other potential factors with postoperative lymphatic-related morbidity in patients with cervical cancer and endometrial carcinoma. Patients diagnosed with cervical cancer or endometrial carcinoma with pelvic lymphadenectomy between January 2017 and January 2022 were enrolled. Postoperative lymphatic-related morbidity was evaluated by calculating the lymph cyst occurrence within 3 months after surgery and the duration of pelvic drainage. Univariate analyses evaluating the risk factors for lymphatic-related morbidity were performed. Of a total of 251 patients, 52 patients were diagnosed with lymphatic cysts by B-ultrasound or computed tomography, and the duration of drainage from 110 patients exceeded the average number of days. Univariable analysis revealed that hypertension, CCB, and lymph node metastasis were independent predictors of postoperative complications. This study demonstrated that CCB may be a factor associated with the incidence of postoperation lymph cysts, and CCB usage prolongs the duration of pelvic drainage.

Clinical application of greater omentum plasty and fixation to prevent lymphocysts after lymphadenectomy in early-stage cervical cancer

To explore the clinical effects of omentum plasty and fixation in the preventing the formation of lymphcysts and lower limb edema after lymphatic dissection of cervical cancer. The method we adopted is, a retrospective analysis was performed based on the clinicopathological data of patients with early cervical cancer who underwent extensive total hysterectomy, with pelvic lymph node dissection and omentum shaping and fixation at the Jiaxing Maternity and Child Health Care Hospital from January 2019 to January 2021. Greater omentum plasty and fixation was performed in 7 early-stage cervical cancer patients. The mean operation time was (210.71 ± 14.56) min, and had a recorded blood loss of 258.57 ± 39.77 mL, 18.14 ± 3.58 resected lymph nodes, 273.14 ± 34.50 mL postoperative abdominal drainage volume and 36.55 ± 2.12 g/L postoperative serum albumin. No lymphocysts were found on B-scan ultrasound reexamination one month after the surgery. However, 6 months post surgery asymptomatic Lymphatic cyst was identified via B-ultrasound in one patient but had no signs of lower extremity edema and intestinal obstruction. We found that Omentum shaping and fixation could reduce the risk of postoperative lymphatic cyst occurrence and infection pelvic lymphatic cyst and lower limb edema by absorbing the leaking lymph through the omentum. The operation was found to be safe and feasible in short-term follow-up, but long-term complications should be further explored to validate the clinical reliability of this procedure.

Possibilities of aggressive oncosurgery in the treatment of IIA – IIIB stages of cervical cancer

Arming gynecological oncology with modern chemotherapy schemes, elements of aggressive oncosurgery, it is possible to achieve an increase in the number of cured patients with locally advanced forms of cervical cancer (CC), providing an improvement in the immediate and longterm results of treatment. The proposed method of surgical treatment is the method of choice for the surgical treatment of patients with locally advanced forms of cervical cancer (stages IIA – IIIB). Purpose. Introduction into clinical practice of the method of surgical treatment of IIA – IIIB stages of cervical cancer. Material and methods. Long-term results of treatment of 155 patients with morphologically verified stage IIA – IIIB cervical cancer were studied. The patients underwent neoadjuvant chemotherapy (NACT) (n=110) and chemoradiotherapy (CRT) (n=45). When resectability was achieved, the patients underwent surgical treatment using a new technique. Overall survival (OS) and progression-free survival (PFS) outcomes were assessed. Results. In the period from 2017 to 2020, 155 patients with stage IIA – IIIB cervical cancer after NACT (n=110) and CRT (n=45) underwent combinedextended extirpation of the uterus with appendages according to our patented method. The most frequent postoperative complications were urination disorders in 106 (67 – 60.9 % and 19 – 42.2 %) patients, lymphatic cysts in 30 (20 – 18.2 % – and 10 – 22.2 %) patients and vesicovaginal fistula in 7 patients (5 – 4.6 % and 2 – 4.4 %), respectively. According to the results of a pathomorphological study, the most frequent tumor response to NACT was III degree of therapeutic pathomorphosis (TP) in 44 patients (40 %) of group 1 and in 21 patients – IV degree TP, amounting to 46.6 %. The median follow-up was 28.7 months. (from 3.6 to 51.1 months). During this time, 30 patients died in both groups (17 – 15.5 % – and 13 – 28.9 %) (p=0.047). Disease progression occurred in 16 (10.3 %) patients (6 – 5.5 % – and 10 – 22.2 %) (p = 0.004) respectively. The 3-year OS was 83.8 ± 3.7 and 71.0±6.8 (p=0.131), PFS – 93.5±2.6 and 77.7±6.6 (p=0.006). Conclusion. The proposed method of surgical treatment of IIA – IIIB stages of cervical cancer has a novelty and can be used in practical medicine for the surgical treatment of oncology diseases in cervical cancer.

Gastric lymphangioma: a case report and review of literature

BackgroundGastric lymphangioma is one of the highly rare benign tumors characterized by multilocular or unilocular lymphatic spaces. Herein, we report a case of lymphangioma in the gastric antrum.Case presentationA 77-year-old male patient who had been experiencing epigastric discomfort for a year was presented to our hospital. A gastric subepithelial lesion was diagnosed by upper endoscopy and was entirely excised via diatal subtotal gastrectomy. Endoscopic ultrasonography revealed an echoless homogenous echo pattern in the third wall layer. A lymphangioma was diagnosed by pathologic investigation of the resected specimen. The PubMed, Embase and Web of Science databases were reviewed for literature in English while using the keywords of “gastric lymphangioma” or “lymphangioma of stomach” or “gastric lymphatic cyst” or “lymphatic cyst of stomach” and the results were discussed.ConclusionGastric lymphangioma is a rarely occurring submucosal tumor that should be considered when diagnosing subepithelial lesions in the stomach.

Idiopathic lymphatic mesenteric cyst of the proximal jejunum: A case report of an unusual clinical presentation.

IntroductionMesenteric cysts are rare lesions of the abdominal cavity or retroperitoneum. The exact etiopathogenesis is still undefined. Clinical manifestation can vary from asymptomatic patients to symptoms of an acute abdomen, making diagnosis very challenging.Case presentationWe present a case of a 47-year-old male with new ongoing polyuria and nocturia as well as episodes of slight abdominal pain. An abdominal ultrasound showed ascites and the computer tomography (CT) scan raised suspicion of an internal hernia. We performed a diagnostic laparoscopy and open resection of a cystic lesion of the small bowel mesentery. The histological examination revealed a lymphatic mesenteric cyst.DiscussionMesenteric cysts represent rare intra-abdominal tumors that physicians should consider as a differential diagnosis in patients with abdominal pain and an intra-abdominal mass.ConclusionSurgery should be advised to prevent the development of complications and to confirm the histopathological diagnosis.

Ethiodised Oil Lymphangiography in the Management of Chyluria

Chyluria is clinical condition in which there is excretion of chyle in urine. The most common cause of chyluria is lymphatic filariasis. This case report describes imaging findings of non filarial chyluria due to retroperitoneal lymphatic cyst and its successful management by minimally invasive percutaneous lymphangiography procedure. The patient presented with complaints of passing milky white urine which was confirmed to be chyluria. After a non successful trial of conservative approach in form of highprotein and low-fat diet, percutaneous ethiodised oil lymphangiography was performed, which resulted in immediate symptomatic improvement and no recurrence on follow-up.

O-BN07 Transesophageal Endoscopic Resection of Mediastinal Cysts

Abstract Background Primary mediastinal cysts are infrequent lesions derived from a variety of mediastinal organs or structures. Complete surgical resection is the treatment of choice even in asymptomatic patients to prevent severe adverse events (AEs) and establish the diagnosis. Transesophageal endoscopic resection of benign mediastinal tumors has been proven feasible. The aim of this study is to evaluate the feasibility, safety and efficacy of transesophageal endoscopic surgery for mediastinal cysts. Methods From January 2016 to May 2021, patients with mediastinal cysts who underwent transesophageal endoscopic resection were retrospectively included. Clinicopathological characteristics, procedure-related parameters, AEs, and follow-up outcomes were analyzed. Results A total of 10 patients with mediastinal cysts were included in this study. The mean cyst size was 3.3±1.3 cm. Histopathology revealed 3 bronchogenic cysts (30.0%), 4 esophageal duplication cysts (40.0%), 2 gastroenteric cysts (20.0%), and 1 lymphatic cyst (10.0%). All procedures were performed uneventfully. En bloc resection was achieved in 6 patients (60.0%). Aggressive resection was avoided to prevent damage to the surrounding vital organs. Mean procedure time was 63.4±36.5 min. No major pneumothorax, bleeding, mucosal injury or fistula occurred. One patient had a transient febrile episode (>38.5 °C). Mean postoperative hospital stay was 2.7±0.9 days. No residual or recurrent lesions were observed in any patient during a mean follow-up period of 29.8±19.5 months. Conclusions Transesophageal endoscopic surgery appears to be a feasible, safe, effective and much less invasive approach for mediastinal cyst resection. Larger prospective studies are required to fully assess the efficacy and safety of this novel technique.

Transesophageal endoscopic resection of mediastinal cysts (with video)

Primary mediastinal cysts are infrequent lesions derived from a variety of mediastinal organs or structures. Complete surgical resection is the treatment of choice even in asymptomatic patients to prevent severe adverse events (AEs) and to establish the diagnosis. Transesophageal endoscopic resection of benign mediastinal tumors has been proven feasible. The aim of this study was to evaluate the feasibility, safety, and efficacy of transesophageal endoscopic surgery for mediastinal cysts. From January 2016 to May 2021, patients with mediastinal cysts who underwent transesophageal endoscopic resection were retrospectively included. Clinicopathologic characteristics, procedure-related parameters, AEs, and follow-up outcomes were analyzed. Ten patients with mediastinal cysts were included in this study. The mean cyst size was 3.3 ± 1.3 cm. Histopathology revealed 3 bronchogenic cysts (30.0%), 4 esophageal duplication cysts (40.0%), 2 gastroenteric cysts (20.0%), and 1 lymphatic cyst (10.0%). All procedures were performed uneventfully without conversion to traditional surgery. En-bloc resection was achieved in 6 patients (60.0%). Aggressive resection was avoided to prevent damage to the surrounding vital organs. Mean resection time and suture time were 58.0 ± 36.4 minutes and 5.4 ± 1.0 minutes, respectively. No major pneumothorax, bleeding, mucosal injury, or fistula occurred. One patient had a transient febrile episode (>38.5°C). Mean postoperative hospital stay was 2.7 ± .9 days. No residual or recurrent lesions were observed in any patient during a mean follow-up period of 29.8 ± 19.5 months. Transesophageal endoscopic surgery appears to be a feasible, safe, effective, and much less invasive approach for mediastinal cyst resection. Larger prospective studies are required to fully assess the efficacy and safety of this novel technique.

Large retroperitoneal mass in a 56-year old female

Purpose: Müllerian ductal cysts are rare congenital abnormalities of Müllerian system regression, typically located in the pelvis . Their presence in retroperitoneum is extremely rare, as the incidence of retroperitoneal cysts, even of diverse morphology and etiology, is approximately 1 in 100,000 adult admissions. Moreover, they can be classified into lymphatic, mesothelial, enteric, and urogenital cysts. Urogenital cysts are further categorized into pronephric, mesonephric, metanephric, and Müllerian types. However, in both sexes the most common location of the Müllerian cyst is in the pelvis; in men they reside mostly near the prostatic utricle and the appendix of the testis. In women, they may be often confused with primary ovarian or tubal cysts.
 Case Report: In this case report, we present a case of a benign retroperitoneal cyst of the Müllerian type in a 56- year old female.

Lymphadenectomy for oncogynecological pathology: evaluation of lymph cyst formation and detection of metastases depending on the number of lymph nodes removed

Introduction. Lymphadenectomy in gynecological oncology allows performing adequate surgical staging, determining the need for adjuvant therapy, and reducing the risk of disease recurrence. An increase in the volume of lymphadenectomy leads to an increase in the incidence of postoperative complications — the formation of lymphatic cysts. There are no clear recommendations on the required number of removed lymph nodes in order to identify their metastatic lesions. The aim of the study was to study the possible dependence of the number of removed lymph nodes and the formation of lymphatic cysts. Materials and methods. A retrospective study of 219 patients after surgical treatment from 2020 to 2021 was carried out on the basis of GBUZ Chelyabinsk Regional Center of Oncology and Nuclear Medicine. The study included cases of stage I-IV uterine cancer of all histological types, which underwent radical hysterectomy with bilateral pelvic or bilateral pelvic and paraaortic lymphadenectomy; cases of cervical cancer stage IA1-IIA disease after radical hysterectomy II-III type according to the classification of M.S. Piver, F. Rutledge (1974) with performing bilateral pelvic lymphadectomy. Statistical processing of the results was carried out. Results. The percentage of complications (lymphatic cysts) in the cervical cancer group was 2.06% (N = 2), in the uterine body cancer group 1.72 (N = 2). There was no statistically significant relationship between the removed lymph nodes and their metastatic lesions. Removing more than 27 lymph nodes is a risk factor for developing lymphatic cysts. Discussion. Lymphadenectomy allows for adequate surgical staging and reduces the risk of disease recurrence. Complicated lymphatic cysts occur in 0.9-34% of cases, which was reflected in our study, but the percentage of these complications is quite low. Conclusion. The increase in the volume of lymphadenectomy (removal of more lymph nodes) is justified by the desire for accuracy in the surgical staging of the tumor process. Despite this, there is a risk of complications after lymphadenectomy — the formation of lymphatic cysts that occurs when 27 or more lymph nodes are removed.

Endometrial Cancer Lymphadenectomy Trial (ECLAT) (pelvic and para-aortic lymphadenectomy in patients with stage I or II endometrial cancer with high risk of recurrence; AGO-OP.6)

BackgroundThe impact of comprehensive pelvic and para-aortic lymphadenectomy on survival in patients with stage I or II endometrial cancer with a high risk of recurrence is not reliably documented. The...