Management Of Cysts Research Articles

Different surgical options for the management of symptomatic intracranial arachnoid cysts: A systematic review

Different surgical options for the management of symptomatic intracranial arachnoid cysts: A systematic review

Enhancing Outcomes and Efficiency in Large Epidermal Cyst Management: Quality Improvement Approach in Primary Care

Background: Epidermal cysts are common benign lesions encountered in primary care, especially in minor surgery clinics. The management of large epidermal cysts (>5 cm in diameter) poses significant challenges, including surgical intervention requirements, potential for complications, and impacts on patient care and clinic workflow. The prevalence of these cysts underlines the need for optimised management strategies that are essential for enhancing patient outcomes and clinic efficiency. This quality improvement initiative sought to better manage large epidermal cysts in primary care settings. Patients and methods: The initiative utilised the Plan-Do-Study-Act (PDSA) cycle over three distinct phases, with an emphasis on improving surgical techniques and postoperative care, optimising clinic workflow, and enhancing patient education and involvement. Over the course of this eighteen-month study, 100 patients who required surgical excision of large epidermal cysts were included. The interventions focused on standardising surgical protocols, implementing a new scheduling system, and developing comprehensive educational materials for patients. Results: The programme contributed to major efficiency gains for surgeries: the average operative time was reduced from 45 min to 30. The postoperative complication rate decreased dramatically while patient and clinician satisfaction went up, as did clinic throughput. With patient education enhancements, follow-up adherence rose to 92% while the postoperative complication rate declined from 18% to 9% with the overall approach to patient engagement. Conclusions: The successful application of the PDSA cycles in this work demonstrates that quality improvement methodologies have a potential role in optimising management for large epidermal cysts in primary care settings. Developed interventions can therefore be put into routine care that will indeed improve patient outcome, clinician experience, and operational efficiency in minor surgery clinics.

Management of radicular cyst – A case report

Radicular cysts are common jaw lesions, typically asymptomatic, and often found near the tooth apices. Radiographically, they appear as oval or pear-shaped unilocular radiolucencies in the periapical region. This case report highlights the successful surgical management of a large infected radicular cyst through enucleation and apicoectomy. These procedures were crucial in removing the cyst and promoting healing, with no post-surgical complications. Surgical intervention is vital in managing extensive radicular cysts to prevent further infection and damage to adjacent structures.

Management and outcome of fetal abdominal cyst in first trimester: systematic review of the literature.

The detection of a fetal abdominal cyst at the first-trimester ultrasound scan is a rare event, for which the natural history and prognosis are often unknown and unpredictable, owing to various underlying etiologies. The aim of this study was to evaluate the outcome of fetal abdominal cysts detected in the first trimester to better understand their possible clinical significance and improve their clinical management. We present a case report of a fetal abdominal cyst detected in the first trimester, with subsequent diagnosis of congenital multiple arthrogryposis. We also performed a systematic review of the literature to determine the incidence and outcome of similar cases, which was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and registered with PROSPERO (CRD42023491729). PubMed, Web of Science and EMBASE were searched from inception to December 2023 to identify case reports and case series documenting an ultrasound diagnosis of a single fetal abdominal cyst in the first trimester. Our case presented at 12 + 6 weeks' gestation with an isolated fetal abdominal cyst, which underwent spontaneous resolution in the second trimester, when multiple congenital arthrogryposis was observed. Data on a total of 60 cases of fetal abdominal cyst detected in the first trimester were extracted from the literature. Of these, 35% were associated with concurrent or late-onset structural anomalies, as in our case, and 65% were isolated. In pregnancies with an isolated fetal abdominal cyst, 54% had a live birth with a normal outcome. A fetal abdominal cyst in the first trimester is usually an isolated finding with a moderate-to-good prognosis, but it could also be an early sign of other associated abnormalities, including arthrogryposis. Increased ultrasound surveillance and additional genetic testing to rule out possible associated anomalies are necessary to assess the risk of adverse pregnancy outcome and provide appropriate parental counseling. © 2024 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Management of Ovarian Cysts through Individualized Homoeopathic Medicine: A Case Series

AbstractOvarian cysts are common gynecological problems encountered by gynecologists in their day-to-day practice. They are benign growths arising from the ovary and occur in the reproductive age group. Conventional system of medicine usually opts for surgical procedures in such cases. Homoeopathic system of medicine is a specialized system that believes in individualization. This article reports five cases of suffering from ovarian cysts, who reported at Dr. D.P. Rastogi Central Research Institute, Noida, Uttar Pradesh, India. All the five cases were treated successfully with individualized homoeopathic medicines. Each patient received individualized homoeopathic medicine selected on the basis of the totality of symptoms using synthesis repertory with the help of RADAR software. Pre and post treatment ultrasongraphy USG reports were kept as evidence. The assessment of causal attribution of homeopathic treatment effect was performed using the Modified Naranjo Criteria for Homeopathy (MONARCH). Marked improvement was observed in all five cases, with complete resolution of the cysts along with symptomatic relief, which was evident by USG reports. The MONARCH scores were +9/13, +7/13, +8/13, +9/13, and +7/13, which indicate a positive causal attribution of homeopathy in relieving the symptoms. This case series suggests a significant role of individualized homeopathic medicines in the resolution of ovarian cysts and associated symptoms. The results obtained from this case series are encouraging.

Bilateral Dermoid Ovarian Cysts in a Young Woman - A Case Report and Literature Review.

Ovarian tumors are a common type of neoplasm in women, with mature cystic teratomas being the most frequent variant. These tumors occur bilaterally in approximately 10% of cases. However, bilateral and multiple occurrences are rarely reported. A 22-year-old nulliparous woman presented with amenorrhea and sudden, generalized, dull lower abdominal pain. Diagnostic imaging, including ultrasound and computed tomography (CT) scans, revealed large solid-cystic lesions in both ovaries, with internal hyperechoic foci consistent with fat and calcification, along with thin internal septations. A laparoscopic cystectomy was successfully performed, preserving ovarian function. Histopathological examination confirmed the presence of stratified keratinized squamous epithelium, sebaceous glands, hair follicles, mature adipose tissue, blood vessels, and lymphatic vessels within the resected cysts, with no evidence of malignancy. This unique case provides valuable insights into the understanding and management of bilateral dermoid cysts, highlighting the importance of preserving ovarian function in young women.

Comparative analysis of Roux-en-Y cystojejunostomy versus conservative surgical strategies for giant hepatic hydatid cysts: A retrospective study

BackgroundThis retrospective study addressed the challenge of postoperative biliary fistula, a common complication observed after surgical management of giant hepatic hydatid cysts. The primary objective was to compare the efficacy and safety of conservative surgical techniques versus prophylactic Roux-en-Y cystojejunostomy (R-en-Y CJ) in addressing residual cavity. MethodsRetrospective analysis was conducted on patients who underwent surgical intervention for giant hepatic hydatid cysts with cysto-biliary communication from July 2021 to Jan 2024. Preoperative laboratory tests, imaging studies, surgical procedures, and postoperative outcomes were reviewed from medical records. Results32 patients who underwent surgery for giant hepatic hydatid cysts were included. There were 19 (59.38%) female patients, with a mean age of cohort was 39.13 years. The patients were divided into two groups with respect to the treatment modality: Group A (n = 14), treated with conservative surgical techniques and R-en-Y CJ, and Group B (n = 18), treated with conservative surgical methods. The overall cavity-related complications occurred in 9/18 (50%) in Group B, whereas 2/14 patients (14.29%) in Group A during the follow-up period (p < 0.05). ConclusionR-en-Y CJ is an effective and safe surgical procedure for tackling residual cavities in giant hepatic hydatid cysts with cysto-biliary communication.

Management of pediatric thyroglossal duct cyst: A case report

Introduction: Thyroglossal duct cysts are common congenital neck anomalies in children, diagnosed through clinical assessment and ultrasound, and treated with the Sistrunk procedure to prevent complications like infection and malignancy. Case Description: We present a case of a 4-year-old male patient with a progressively enlarging neck mass for three months. The mass was asymptomatic, did not cause any eating difficulties, and moved upwards during swallowing and tongue protrusion. Upon physical examination, a soft, mobile, cystic mass approximately 3 cm in diameter was identified beneath the hyoid bone. Supporting examinations, including ultrasound and fine-needle aspiration cytology, led to the diagnosis of a thyroglossal duct cyst. The patient underwent a successful Sistrunk procedure, which involved the excision of the cyst along with a portion of the hyoid bone. Postoperative management included administration of intravenous antibiotics and paracetamol, culminating in a full recovery without any signs of infection. The patient exhibited complete wound healing within two weeks. There was no evidence of cyst recurrence during a follow-up examination six months later. Conclusion: Despite being common, thyroglossal duct cysts require thorough evaluation to avoid misdiagnosis, and are typically identified by a slowly growing midline neck mass that moves with swallowing and tongue protrusion, often near the hyoid bone.

Surgical Management of Thoracic Spinal Extradural Arachnoid Cysts: A Case Report

Spinal extradural arachnoid cysts (SEACs) are exceptionally rare and require advanced imaging for an accurate diagnosis and surgical planning. Magnetic resonance imaging and computed tomography myelography play a pivotal role in delineating cyst characteristics and guiding effective interventions. Laminectomy, coupled with laminoplasty, has emerged as a strategic approach to decompress the spinal cord while preserving spinal alignment. This technique mitigates the risk of postoperative complications and facilitates reoperations if recurrence takes place. The integration of a detailed radiological assessment with meticulous surgical planning is crucial for managing SEACs and optimizing outcomes. This paper presents a case of a 33-year-old man with multiple SEACs at the thoracic level who was successfully treated with a surgical intervention, exemplifying the discussed approach.

Reversal of Denervation Changes in Infraspinatus Muscle After Operative Management of Paralabral Cysts: An MRI-Based Study.

Paralabral cysts at the spinoglenoid notch are rare disorders that can potentially lead to compressive suprascapular neuropathy. Given their infrequency, a standard treatment protocol has not yet been established. This study aimed to assess changes in the infraspinatus muscle using magnetic resonance imaging (MRI) and to compare the outcomes of 2 different surgical methods. It was hypothesized that surgical intervention could alleviate compressive neuropathy, with comparable outcomes between the 2 surgical approaches. Cohort study; Level of evidence, 3. This retrospective review encompassed 43 patients undergoing arthroscopic labral repair for a paralabral cyst at the spinoglenoid notch, with cyst decompression (27 patients; labral repair with cyst decompression [LRCD] group) or without cyst decompression (16 patients; labral repair only [LRO] group). Preoperative MRI focused on evaluating the condition of the infraspinatus and teres minor muscles. Electromyography (EMG) was conducted on 36 patients (21 in LRCD and 15 in LRO) to assess suprascapular nerve function. Postoperative evaluations were performed in 35 patients at postoperative 1 year, excluding those lost to follow-up. Postoperative MRI findings (24 patients in LRCD and 11 patients in LRO) and functional outcome scores including recovery of external rotation power were compared with preoperative status in both groups. Preoperative MRI revealed denervation changes or atrophy of the infraspinatus in 26 of the 43 patients (60.4%). Among the 36 patients who underwent preoperative EMG, 21 patients (58.3%; 13 patients in LRCD and 8 patients in LRO) showed evidence of suprascapular neuropathy. A discrepancy between EMG and MRI findings was noted in 10 patients, with 5 patients showing suprascapular neuropathy according to EMG despite normal muscle status on MRI scans, and the remaining 5 vice versa. Notable atrophy of the infraspinatus was seen in 6 patients and teres minor hypertrophy in 5 patients, all of whom exhibited concurrent infraspinatus atrophy. Postoperatively, cyst disappearance was observed in all cases in both LRCD (24 patients) and LRO (11 patients) groups. Denervation changes in the infraspinatus were resolved in all patients. In patients with infraspinatus atrophy, some improvement was noted. Teres minor hypertrophy persisted in 2 of 4 patients. Improvements were similar in both groups (all P > .05). External rotation power improved postoperatively in both groups (from 39.1 ± 18.6 to 50.6 ± 17.7 N in LRCD, P < .001; from 45.1 ± 16.0 to 54.2 ± 10.7 N in LRO, P = .025). Both LRCD and LRO surgical approaches appear to be effective for paralabral cysts at the spinoglenoid notch. Suprascapular neuropathy can be successfully addressed by both methods. However, conditions with severe infraspinatus atrophy and teres minor hypertrophy warrant further investigation in larger series.

Surgical Management of Epidermoid Cysts of Scalp: A Case Report

Surgical Management of Epidermoid Cysts of Scalp: A Case Report

Diagnostic dilemmas and multidisciplinary management of glandular odontogenic cyst: A case report

Glandular odontogenic cyst (GOC) is a rare odontogenic cyst typically found in the anterior mandible and, in rare cases, the anterior maxilla, characterized by asymptomatic, slow-growing swelling. It mimics other odontogenic cysts and tumors, complicating the diagnosis. Histologically, GOC features mucus-producing cells and gland-like structures, initially suggesting a salivary gland origin. However, the absence of salivary gland markers and the presence of hybrid lesions with other odontogenic tumors confirm its odontogenic nature. Known for its aggressive behavior, GOC can cause significant growth and bone perforation, leading to high recurrence rates. This case report discusses a 34-year-old male with a recurrent cystic lesion initially misdiagnosed as a periapical abscess. Accurate diagnosis and successful management involved root canal treatment and surgical intervention, highlighting the importance of precise diagnosis and prompt treatment.

Minimally invasive management of a spinal arachnoid cyst with ultrasound-assisted catheter placement: illustrative case.

Spinal arachnoid cysts are cerebrospinal fluid-filled sacs that are frequently located within the thoracic spine and can lead to symptoms due to direct compression of the thoracic spinal cord. These lesions are typically treated with laminectomy and fenestration of the cyst, with or without shunting. However, with recurrence, treatment is often more complex and sometimes requires re-exposure and fenestration or shunting. Here, the authors describe a 57-year-old female with a thoracic intradural arachnoid cyst that recurred despite extensive and initially successful fenestration. Given the failure of fenestration, the authors instead attempted to place a cystoperitoneal shunt. Given how extensive her laminectomy was, the authors elected to perform the procedure under ultrasonic guidance to avoid the large incision required for open shunt placement. The procedure was successful, with gradual improvement in the size of the arachnoid cyst as well as symptomatic improvement. Here, the authors present a unique minimally invasive technique to treat recurrent spinal arachnoid cysts. They successfully demonstrated the feasibility and safety of this approach in shunting the cyst while avoiding the extensive re-exposure often required in such complex cases. https://thejns.org/doi/10.3171/CASE24461.

Management of cyst by laparoscopic splenectomy in a tertiary hospital: case report

Management of cyst by laparoscopic splenectomy in a tertiary hospital: case report

S213 A Systematic Approach to Pancreatic Cysts: An Investigation of the Impact of Standardized Radiology Report Templates on the Management of New Pancreatic Cysts

S213 A Systematic Approach to Pancreatic Cysts: An Investigation of the Impact of Standardized Radiology Report Templates on the Management of New Pancreatic Cysts

Management of an Inflammatory Dentigerous Cyst in Pediatric Patient

Management of an Inflammatory Dentigerous Cyst in Pediatric Patient

Conservative management of dentigerous cyst and therapeutic approach

Conservative management of dentigerous cyst and therapeutic approach

300 - Overcoming Challenges in Sacral Meningeal Cyst Management: A Journey from Aspiration Failure to Successful Surgical Intervention

300 - Overcoming Challenges in Sacral Meningeal Cyst Management: A Journey from Aspiration Failure to Successful Surgical Intervention

Pancreatic Cysts in the Geriatric Sphere: A Call for Close Consideration of Patient Characteristics in Pancreatic Cyst Management

Pancreatic Cysts in the Geriatric Sphere: A Call for Close Consideration of Patient Characteristics in Pancreatic Cyst Management

Outcomes of Traditional Excisional Management of Breast Cysts with Ultrasonographical Guidance

Background: Surgery for breast cysts may be necessary for symptom relief or to rule out malignancy. Compared to palpation alone, ultrasound guidance provides better accuracy and outcomes. Objectives: This study aimed to assess the efficacy of conventional excisional therapy of breast cysts under ultrasonographic supervision. Ultrasound-guided excision allows precise localization of the lesion, potentially leading to better results than palpation-guided methods. Methodology: A prospective study was conducted from January 2023 to May 2024 on 40 patients undergoing excisional management of benign breast cysts. Patients were divided into two groups: Group A (n=20) underwent ultrasound-guided excision, while Group B (n=20) had palpation-guided excision. Outcomes measured included recurrence rates, cosmetic satisfaction, and post-operative complications. Statistical analysis was performed using SPSS version 28.0, employing independent t-tests for continuous variables and chi-square tests for categorical data. p ≤0.05 was considered statistically significant. Results: The recurrence rate was 5% in the ultrasound-guided group, compared to 20% in the palpation-guided group (p = 0.03). Cosmetic satisfaction was significantly higher in the ultrasound-guided group, with 85% reporting good to excellent outcomes, compared to 55% in the palpation group (p = 0.02). Post-operative complications, including hematoma and infection, were lower in the ultrasound-guided group. Conclusion: Ultrasound-guided excision of breast cysts is less invasive, with increased accuracy, lower recurrence, and improved cosmetic outcomes compared to palpation-guided excision. It should be considered the first-line treatment for benign breast cyst excision.