Subcutaneous Cystic Lesions Research Articles

Craniosynostosis, inner ear, and renal anomalies in a child with complete loss of SPRY1 (sprouty homolog 1) function

IntroductionSPRY1 encodes protein sprouty homolog 1 (Spry-1), a negative regulator of receptor tyrosine kinase signalling. Null mutant mice display kidney/urinary tract abnormalities and altered size of the skull; complete loss-of-function...

Oil Cyst Formation after Lower Blepharoplasty with Fat Grafts.

Fat grafting is increasingly used as an adjuvant surgery to blepharoplasty to refill the volume loss of an aged face and promote cellular regeneration. Complications, such as hematoma, infection, seroma, and palpable mass, may occur. We collected the patients that underwent lower blepharoplasty combined with fat graft to evaluate the incidence of oil cyst formation in the lower eyelid and to identify risk factors. A retrospective review was performed of all patients who underwent lower or total blepharoplasty combined with fat graft at the authors' institution between January 2018 and June 2020. Complication rates were observed, and associations between preoperative variables and outcomes were assessed. A total of 119 patients were included in the series (all bilateral, 238 eyelids). The average patient age was 54.88 ± 11.94 years, and the average grafted fat was 1.88 ± 1.0 mL. On a per-eyelid basis for all patients, the complication rate of oil cyst formation was 6.72% (16 of 238 eyelids). The occurrence of oil cyst formation was associated with hypertension (P = 0.012; adjusted odds ratio, 9.27; 95% confidence interval, 1.62-52.99) and diabetes mellitus (P = 0.005; adjusted odds ratio, 14.02; 95% confidence interval, 2.22-88.45), but not associated with anticoagulants use (P = 0.931), age (P = 0.784), sex (P = 0.317), or fat volume (P = 0.215). The mean interval between the fat graft procedure and oil cyst noted was 236.5 ± 118.9 days. Oil cyst in lower eyelid can be defined as a palpable, firm, and persistent subcutaneous cystic lesion found postoperatively in any size during physical examination. The complication rate of oil cyst formation occurring after lower blepharoplasty with autologous fat grafting is 6.72%. Hypertension and diabetes mellitus maybe are risk factors of oil cyst formation. Steroid injection, needle capsulotomy, liposuction, and excision are safe and effective treatments. Reduce surgical trauma by diminishing anterior lamina trauma and capsulopalpebral fascia repair might decrease the complication rate of oil cyst formation.Transconjunctival lower blepharoplasty with fat graft or 2-stage surgery may be a choice to prevent oil cyst formation.

Musculoskeletal Echinococcus infection as a rare first presentation of hydatid disease: case report

BackgroundHydatid disease (HD) is a cosmopolitan parasitosis caused by Echinococcus granulosus that can potentially affect any part of the human body. Liver and lungs are the most frequent localizations. Primary musculoskeletal hydatidosis are seldom reported in literature and their incidence is unknown.Case presentationWe deem interesting to report a case of a primary hydatid cyst in a 25-year-old patient who presented with a painful swelling of the right elbow. Meticulous examination and preoperative imaging did not reveal other localizations. Patient was admitted for surgery where total excision of cyst was done without intraoperative spillage and a cutaneous skin flap was subsequently required to make up for soft tissue loss.ConclusionPrimary hydatid cysts are sometimes difficult to diagnose preoperatively. It should be considered in the differential diagnosis of subcutaneous cystic lesions in regions where hydatid cysts are endemic. Currently, surgical excision is deemed first choice treatment for solitary cysts and antihelminthic treatment should be initiated preoperatively in the case of risk of rupture or in the event of complications.

A solitary primary subcutaneous hydatid cyst in the thigh: a case report

Hydatid disease is a parasitic infestation caused by Echinococcusgranulosus. It occurs frequently in liver and lung. Hydatid disease of the soft tissue is uncommon. In this paper, we report a case of a primary subcutaneous hydatid cyst in the thigh. We report a case of a 45-year-old female who presented to our hospital with a painless subcutaneous mass in the medial aspect of the right thigh for one year. Computed tomography scan demonstrated a subcutaneous cystic lesion close to adductor magnus muscle. The diagnosis of hydatid cyst was suspected peroperatively, complete surgical excision of the mass was done and the patient had an uneventful post-operative recovery. The suspected diagnosis was confirmed by histopathological examination. This case shows that hydatid cyst should be considered in the differential diagnosis of any cystic mass at different anatomical sites, especially in endemic regions. Total excision of the cyst with an intact wall remains the mainstay of treatment.

Subcutaneous Fungal Cyst Masquerading as Benign Lesions - A Series of Eight Cases.

Subcutaneous fungal infections are caused by penetration of the causative fungi into the subcutaneous layer and are usually localised. We present a series of eight cases with subcutaneous fungal cystic lesions masquerading as benign lesions. A retrospective study was conducted on subcutaneous fungal infections seen between January 2007 to July 2014 in the Department of Pathology. Eight patients with biopsy proven subcutaneous fungal infection were included. We collected and analysed their demographic, clinical and histopathological details. Among eight patients, six were male and two were female. The mean age was 47 years (Range: 21-70). All the eight patients presented with non-tender cystic swelling. The size of the swellings varied from a minimum of 3x3 cm to maximum of 10x4 cm. Out of eight, hand was involved in three, forearm in one, elbow in two, leg in one and foot in one. On H&E staining, all the cases showed fibro collagenous cyst wall, lined by histiocytes, granulomatous reaction, foreign body type of giant cells with acute and chronic inflammatory infiltrate containing fungal elements. Six were identified as hyalohyphomycosis and two were identified as phaeohyphomycotic cysts based on pigmentation of hyphae. Fungal infection should be suspected in all subcutaneous cystic lesions. Excised tissue should always be sent for culture and histopathology.

Sonographic Identification of Klippel-Trenaunay-Weber Syndrome

Klippel-Trenaunay-Weber syndrome is a rare cutaneous vascular disorder characterized by the presence of multiple hemangiomata, arteriovenous fistulas, and limb hypertrophy. We report the prenatal sonographic findings in a case of Klippel-Trenaunay-Weber (KTW) syndrome including fetal limb hypertrophy and large subcutaneous cystic lesions. Prenatal diagnosis is possible by ultrasound examination and recognition important for prevention of complications and future management.

Facial wrigglies: live extralymphatic filarial infestation in subcutaneous tissues of the head and neck

We report a rare case of a 32-year-old male with live extralymphatic filarial infestation presenting as a facial subcutaneous soft-tissue swelling. To the best of our knowledge these imaging findings have not been previously reported in the head and neck region in the existing English language literature. Real-time high-resolution ultrasonography revealed a solitary well-defined subcutaneous cystic lesion over the right zygomatic arch. It showed multiple linear, echogenic, undulating structures exhibiting a persistent twirling motion during the examination. This typical ultrasonographic appearance was consistent with the filarial dance sign (FDS) of live adult filarial worms. Subsequent MRI confirmed the cystic and solitary nature of the lesion. Complete excision of the cyst was performed, which revealed intracystic straw-coloured fluid and multiple white-coloured adult worms within the lesion. Histopathological examination confirmed multiple adult filarial worms with surrounding reactive inflammatory changes. In an endemic region, identification of the FDS in any normal anatomical structure or abnormal swelling, however remote or unusual the location within the body, should strongly suggest the diagnosis of live active filarial infestation. In view of the increasing migratory trends in the global population, it is imperative for radiologists in all countries to be aware of the typical imaging findings of this disease to arrive at the correct diagnosis.

Subcutaneous hydatid cysts occurring in the palm and the thigh: two case reports

IntroductionHydatid cyst disease is common in some regions of the world and is usually located in the liver and lungs. This report presents two cases of primary hydatid cysts located subcutaneously: one in the medial thigh and one in the left palm between the index and middle fingers.Case presentationsA 64-year-old male farmer visited our hospital because a swelling on the right medial thigh had grown during the last year. Superficial ultrasound and computed tomography revealed a lesion resembling a hydatid cyst. A germinative membrane was encountered during surgical excision. Pathological examination was compatible with a hydatid cyst. The second case involved a 67-year-old male farmer who complained of a swelling that had grown in his left palm in the last year. The preliminary diagnosis was a lipoma. However, a hydatid cyst was diagnosed during surgical excision and after the pathological examination. The patient did not have a history of hydatid cyst disease and hydatid cysts were not detected in other organs. There has been no disease recurrence after following both patients for 3 years.ConclusionA hydatid cyst should be considered in the differential diagnosis of subcutaneous cystic lesions in regions where hydatid cysts are endemic, and should be excised totally, with an intact wall, to avoid recurrence.

Prenatal sonographic findings of Klippel‐Trénaunay‐Weber syndrome

We describe the prenatal sonographic findings in a case of Klippel-Trénaunay-Weber syndrome including fetal ascites and subcutaneous cystic lesions associated with a relatively low level of maternal serum alpha-fetoprotein and a relatively high level of maternal serum beta-human chorionic gonadotrophin. Klippel-Trénaunay-Weber syndrome may present prenatally with fetal ascites and an abnormal maternal serum screening result in addition to fetal limb hypertrophy and subcutaneous cystic lesions.

Juxta-articular myxoma of the shoulder presenting as a cyst of the acromioclavicular joint: A case report

Treatment of patients with subcutaneous cystic lesions of the acromioclavicular joint has yielded unpredictable results unless the underlying pathologic process producing the cyst is addressed.4,9 Three causes of this lesion have been reported in the literature: true ganglion,9,2 mechanical irritation of a degenerated acromioclavicular joint by direct contact with the humeral head through a rotator cuff defect,8 and up-welling of glenohumeral joint fluid through a rotator cuff defect (“geyser” sign).3,4 We report a case of juxta-articular myxoma of the shoulder involving both the acromioclavicular joint and the glenohumeral joint in the presence of a large rotator cuff tear as an additional cause of acromioclavicular cyst. The aggressive behavior of this lesion compared with other known causes warrants the attention of surgeons who evaluate and treat this condition. CASE REPORT A 68-year-old right-hand-dominant man had a soft tissue mass over the superior surface of his right acromioclavicular joint compatible with subcutaneous acromioclavicular cyst. The lesion was excised by a general surgeon in the patient’s home district but recurred 5 weeks later. The cyst was reexcised, and a pathologic diagnosis of juxta-articular myxoma was confirmed by the Armed Forces Institute of Pathology. Two months later recurrence in the same location prompted referral to our facility for evaluation and further treatment. Physical examination showed a 2.5-cm marble-sized soft tissue mass superior to the right acromioclavicular joint with marked erythema, shiny skin edges at the previous scar, and dense induration and firm attachment to the underlying acromion. Glenohumeral range of motion was unrestricted; no pain was elicited on motion examination. After routine radiography was performed, computed tomography scan indicated erosion of the acromioclavicular joint and apparent cystic change in the humeral head. Magnetic resonance imaging evaluation of the shoulder with the 1.5-Tesla Siemens Magnetom System suggested a chronic rotator cuff tear, subdeltoid fluid, a synovial or gan