Unilateral Cysts Research Articles

Dermoid Cysts of the Auricle: A Review of the Literature.

Dermoid cysts are congenital anomalies that contain ectodermal elements such as teeth, bone, and nerves. The purpose of this study was to identify trends in the characteristics of dermoid cysts of the auricle and the demographics of the patient population they affect. A PubMed and EMBASE search for English-language publications that included cases of dermoid cyst(s) of the auricle from database inception to October 2022 was performed. A total of 38 cases of dermoid cysts of the auricle were identified from 20 publications. The age, sex, and Fitzpatrick skin type of the patients, locations of the dermoid cysts, associated anomalies, treatment methods, and postoperative outcomes were examined. Patients' ages ranged from 0 to 63 years, with 27.6% (8/29) in the 0-17 age range. 56.8% (21/37) were reported as male. Dermoid cysts were frequently present on the postauricular surface (18/24, 75.0%) and on light skin (Fitzpatrick types I-III; 18/22, 81.8%). Unilateral dermoid cysts were more commonly reported on the right ear (17/22, 77.3%); only one patient had bilateral cysts. Associated anomalies included microtia, prominent ears, foot polysyndactyly, hemifacial microsomia, and cryptotia. All auricular dermoid cysts were managed with complete surgical excision, and no postoperative complications or recurrences were reported. Dermoid cysts of the auricle are reported more frequently in individuals with lighter skin; however, this is likely due to reporting bias. Complete surgical excision can be used to treat patients successfully, with a very low risk of complications and no need for preoperative imaging.

8314 Masculinizing Hormone Therapy and Gynecological Neoplasm: a Single Institution Cohort

Abstract Disclosure: S. Korpaisarn: None. T. Ngaothepphurktharam: None. Y. Tingthanatikul: None. Background: Gynecological neoplasm/malignancy is one of the concerned areas among transgender men on masculinizing hormone therapy (MHT). Long-term MHT and gynecological neoplasm/malignancy remain unclear. Methods: A retrospective cohort chart review was done on all transgender men (TM) who underwent hysterectomy with or without oophorectomy between January 2014 and October 2022. Intraoperative findings and pathological results of genital organs, including the cervix, endometrium, myometrium, and fallopian tubes, were extracted. The pathological results were classified as benign, precancerous, and malignant. Descriptive statistical analysis was used to demonstrate the prevalence of gynecological neoplasm and malignancy. Results: A total of 30 TM underwent hysterectomy with oophorectomy. Twenty-eight (93%) had bilateral oophorectomy, and 7% had unilateral oophorectomy due to gynecological conditions. The mean age when TM underwent surgery was 32.1 ± 5.1 years, and the mean age of gender-affirming hormone initiation was 28.7± 5.1 years. The median duration of MHT before gynecological surgery was 32 months (IQR 22-59). Most TM (73%) used testosterone enanthate, 17% testosterone undecanoate, and 2 transgender men did not start MHT before genital surgery. All TM who used GHT became amenorrheic before surgery. The median preoperative testosterone level was 561.5 ng/dL (IQR 776-1189). Intraoperative findings revealed that most TM (86.7%) had unremarkable uterus size, and 13% showed enlarged uterus size. In the latter, all were from myoma uteri. Most intraoperative findings of ovaries showed 93% unremarkable. One TM had intraoperative polycystic ovarian morphology, and one showed a unilateral ovarian cyst. Cervical pathological reports showed unremarkable results in 67%. Five TM (17%) had chronic cervical inflammation. There was 1 TM (3%) who showed low-grade squamous intraepithelial lesion (LSIL) with squamous metaplasia. Regarding endometrial pathology, the mean endometrial thickness was 0.13 ± 0.08 cm. Most endometrial reports (66%) were in a proliferative phase, 27% were in an atrophic or inactive endometrium, and 7% were in the secretory phase. Regarding pathological reports of ovaries, 80% had cystic ovaries. None of the TM showed precancerous or malignant conditions of endometrium, ovaries, and fallopian tubes. PAP smear was available in 27 TM; all were negative for intraepithelial lesions or malignancy. Conclusion: Among a cohort of TM who received MHT for 32 months, there is no evidence of precancerous or malignant pathology of the endometrium, ovaries, and fallopian tubes. Most of them had thin endometrium with cystic ovaries. One TM showed LSIL with squamous metaplasia of the cervix. Healthcare providers should follow local gynecological cancer screening guidelines developed for cisgender women in their clinical practice. Presentation: 6/2/2024

Current Practice of Laparoscopic Surgery for Choledochal Cyst in Children -a Survey on Opinion and Experience Among IPEG Members

PurposeLaparoscopic resection of choledochal cyst (CC) has become a popular approach. As the discussion about optimal treatment and technical strategies continues, we aimed to investigate perspectives of IPEG members. MethodsAn online survey was conducted in 2023 on behalf of the IPEG Research Committee. IPEG members were asked to complete an anonymous questionnaire that included 36 items on the management of CC. Result148 members responded to the survey (North America:49/Asia:44/Europe:23/South America:21/Others:11) and 116 completed all questions. Most surgeons (92.5%) operate on less than 5 cases annually. Diagnostic tools of choice were Magnetic Resonance Imaging (MRI, 95.9%) and ultrasonography (US, 74.5%). Regarding fusiform-type CC, operative indications were cyst size greater than 10 mm (68.9%), typical symptoms (78.5%), or anomalous pancreatico-biliary junction (63.8%). In unilateral intrahepatic biliary cysts (type IVa) cases, 81.3% of respondents do not perform a simultaneous liver resection with the initial cyst resection. While 22.0% resect the CC at diagnosis, even if asymptomatic, a larger group of surgeons (41%; 49/118) wait until the infant reaches six months. Intraoperative cholangiography and choledochoscopy are performed routinely by 38.9% and 13.7%, respectively. The majority (52.5%) ligates the common bile duct stump just below the CC. Laparoscopic reconstructions are performed by retrocolic hepatico-jejunostomy (48.3%) or hepatico-duodenostomy (45.8%) at similar rates, but when done open, 71.2% of respondents prefer retrocolic hepatico-jejunostomy. For the laparoscopic anastomosis, interrupted sutures with intracorporeal knot tying were most often utilized (48.3%). ConclusionInidividual pediatric surgeons treat a small number of patients with CC each year. Laparosopic and open reconstruction techniques vary, likely due to technical challenges. Level of EvidenceIII.

Transcorneal aspiration for management of primary iris cysts in the standing horse.

Equine primary iris cysts are usually incidental findings but, if associated with clinical signs, may require intervention. The use of laser (Nd:Yag or diode) has been reported but requires specialised equipment. Transcorneal aspiration has not been previously evaluated in the standing horse. To review outcomes of standing transcorneal aspiration of primary iris cysts (STAPIC) in horses. Horses were identified from electronic patient records from 2018 to 2024 across four collaborating centres. Clinical presentation and outcomes were identified and reported using descriptive statistics. Eighteen horses were identified. Behavioural signs reported included 'spooking' and changes in rideability often associated with jumping. Single large unilateral cysts were present in 11 horses, bilateral cysts in three horses and multiple unilateral cysts in four horses. Following treatment, one horse developed uveitis and fibrin in the anterior chamber associated with needle contact with the iris stroma due to movement, and a second horse developed fibrin within the anterior chamber. Both conditions resolved with anti-inflammatory medication and administration of tissue plasminogen activator. No other adverse effects were reported. Follow-up was available from all horses (median: 6months, interquartile range [IQR]: 4-11months) with no recurrence, although one horse developed an iris cyst in the contralateral eye after 3years. All owners reported improvement in clinical signs, with 61% reporting no further signs. STAPIC is an effective and easily accessible alternative for treating iris cysts in horses rarely associated with complications.

Clinical characteristics and management of gonadotropin-independent precocious puberty in McCune–Albright syndrome in children – A case series from a tertiary care center, Sri Lanka

McCune–Albright syndrome (MAS) is characterized by the triad of monostotic/polyostotic fibrous dysplasia (FD), café-au-lait spots, and precocious puberty. Gonadotropin-independent precocious puberty (GIPP) is frequently the presenting feature among many hyperfunctioning endocrinopathies seen in MAS. We report the clinical profile and management of four cases of MAS who were being followed up in a children’s hospital in Sri Lanka. Patient 1 presented with GIPP along with growth hormone excess at the age of 7 years and was started on spironolactone. Patient 2 presented at the age of 4 years but developed GIPP after 2 years and was started on letrozole. Patient 3 initially presented with thyrotoxicosis and hypophosphatemic rickets at 2 years of age and, after 9 months, developed GIPP and a unilateral ovarian cyst and was started on letrozole. Patient 4 presented at the age of 3 years with GIPP with a unilateral ovarian cyst, and letrozole was started. MAS is a clinically heterogeneous entity with various clinical manifestations, with GIPP being one of the most common presentations. Management options are varied with aromatase inhibitors showing promising results. However, long-term studies are needed to comment on the final heights of children with MAS with GIPP.

Prospects for Using 3D Modeling and Biomarkers in Differential Diagnosis of Endometrioid Ovarian Cysts

Background. Ovarian heterotopias are quite successfully diagnosed with ultrasound examinations. Considering the high risk of spread of the disease, as well as reproductive consequences (infertility, pelvic adhesive processes, chronic pelvic pain syndrome, dysmenorrhea), early differential diagnosis of endometrioid cysts and, accordingly, early initiation of treatment are of particular importance.Objective: to combine ultrasound criteria using 3D visualization and the content of biomarkers to verify stage 1–2 endometrioid ovarian cysts.Material and methods. In 59 infertile women with endometrioid ovarian cysts, in the dynamics of the menstrual cycle, ultrasound examinations were performed using Acuson S2000 (Siemens, Germany) and Voluson E8 (General Electric, USA) with the possibility of Doppler measurements and three-dimensional reconstruction of tissue images. Also, in laboratories “Invitro”, “Hemotest”, “Nauka” (Samara, Russia) the biomarkers were determined: interleukins IL-1β, IL-6, cancer antigen 125 (CA-125), human epididymis protein 4 (HE4) and the index by Risk of Ovarian Malignancy Algorithm (ROMA). The control group included 195 fertile women of reproductive age. In patients with endometrioid cysts, the diagnosis was subsequently confirmed morphologically.Results. Small unilateral and bilateral ovarian cysts corresponding to stage 1–2 endometriosis by revised American Fertility Society classification (rAFS) were clearly differentiated in 56 (94.9%) patients, in 3 (5.4%) of them the ultrasound result was questionable. In 48 (81.4%) women the lesion was unilateral and in 11 (18.6%) it was bilateral. The structure of cystic formations in all cases was hypoechoic, heterogeneous, in 36 (61.0%) cases it was finely cellular, without blood flow.Conclusion. Ovarian endometriomas in “gray scale” are round formations of reduced echogenicity and fine suspension, with an even, clear contour, not fused with the surrounding tissues, avascular, changing size depending on menstrual cycle phase. An ovarian mass may have a capsule with locus signals on Doppler. The sensitivity of ultrasound examination in “gray scale” in the presence of an endometrioid cyst is 94.6%.

Zinner syndrome in pediatric age: Clinical image

Zinner Syndrome (ZS) is a rare genitourinary malformation characterized by the triad of unilateral seminal vesicle cyst (QVS), ipsilateral Multicystic Displastic Kidney (MCDK), and obstruction of the ejaculatory duct. This condition is rare in pediatric age and both diagnosis and treatment are challenging.

Iris cyst with precipitate in the anterior chamber: A case report

Iris cyst is a common condition that can manifest with various presentations. We describe an atypical presentation with precipitate formation in the anterior chamber. The patient presented with glaucoma and precipitate in the chamber due to a unilateral iris cyst.

Decline in measured glomerular filtration rate is associated with simple renal cyst in Chinese patients with type 2 diabetes.

Simple renal cysts (SRC) are associated with age, hypertension and hyperuricemia, which are risk factors of renal impairment. This study aimed to investigate the prevalence of SRC and its association with measured glomerular filtration rate (mGFR) in patients with type 2 diabetes mellitus in China. A total of 3,552 patients with type 2 diabetes mellitus admitted to Shanghai Sixth People's Hospital from January 2012 to December 2016 were investigated. All participants were diagnosed as SRC by color Doppler, and all participants were measured for GFR by using dynamic renal scintigraphy with technetium-99m-diethylene triamine peta-acetic acid. The prevalence of SRC was 17.4% (619 cases). Participants with SRC had significantly lower mGFR values than those without SRC (86.16 ± 26.20 vs 94.88 ± 23.98 mL/min/1.73 m2 , P < 0.001). In 478 participants with unilateral renal cyst, the mGFR of the kidney affected by SRC was significantly lower than that of the unaffected kidney (43.32 ± 13.74 vs 44.18 ± 13.34 mL/min/1.73 m2 , P = 0.014). The participants were divided into four groups according to the quartiles of mGFR level (≥109.50, 93.80-109.49, 76.90-93.79 and <76.90 mL/min/1.73 m2 ). The prevalence of SRC gradually increased with decreasing mGFR level (12.9, 13.9, 16.6 and 27.8%, respectively; P trend <0.01). After adjusting for age, sex, duration of diabetes, hypertension and other potential confounders, the logistic regression showed that SRC was an independent risk factor for impaired GFR (<60 mL/min/1.73 m2 ; odds ratio 1.656; 95% confidence interval 1.451-1.890, P < 0.001). SRC is an independent risk factor for the decrease of mGFR in Chinese diabetes patients, and could affect the renal GFR measured by dynamic renal scintigraphy on the SRC side.

Our Experience at Tertiary Medical College: Excision with Sublabial Approach Versus Marsupialization with Transnasal Endoscopic Approach in Patients with Nasolabial Cyst.

Rare non-odontogenic cysts of the soft tissue of the midface that form between the nasal vestibule and upper lip are known as nasolabial cysts. Treatment can be accomplished by surgical removal, injection of sclerosing material into the cyst, and endoscopic marsupialization. The aim of this study is to compare the effectiveness of Excision with sublabial approach versus Marsupialization with Transnasal Endoscopic approach in patients with Nasolabial cyst in terms of operating time, recurrence rate, postoperative pain and complications. Our study was Duration based prospective observational study with a Duration of four years from August 2018 till July 2022 with study population inclusive of 30 patients aged between 20 and 70years who were diagnosed with a unilateral nasolabial cyst on the basis of clinical presentation, anatomical location, and computed tomography (CT) findings at ENT Department of our Tertiary Institution. The study used a randomized, single blind, parallel design with a total of 30 patients, which were randomly allocated to undergo Excision with sublabial approach (group A) in 15 patients (15 nasolabial cysts) and Marsupialization with Transnasal Endoscopic approach (Group B) in 15 patients (15 Nasolabial cysts). In the sublabial approach group, the mean operating time was 91.28 ± 3.1min, whereas in the transnasal marsupialization group, it was 29.7 ± 3.2min. These differences were statistically significant (P = 0.003). In the excision with sublabial approach and transnasal endoscopic marsupialization groups, the visual analogue scale (VAS) for postoperative pain was 5.9 ± 1.4 and 3.2 ± 0.6, respectively (P = 0.001). Ten patients in the sublabial approach group and five patients in the transnasal marsupialization group had one or more problems during the follow-up period which disappeared spontaneously within 4weeks without long lasting issues. There were no recurrence lesions or obstructions of the marsupialized cyst opening in either group, according to physical, endoscopic and computed tomography examinations. Nasolabial cysts can be marsupialized transnasally, which offers many advantages over the more traditional sublabial excision method. Transnasal endoscopic marsupialization has the benefits of a shorter operating time, less postoperative pain, and a low complication rate. Therefore, we propose that Transnasal Endoscopic marsupialization be the treatment of choice for nasolabial cyst, replacing the conventional Excision with sublabial approach.

A retrospective analysis of robot-assisted total hysterectomy by transvaginal natural orifice transluminal endoscopic surgery

ObjectiveThe present study aimed to explore the feasibility and safety of robot-assisted total hysterectomy by transvaginal natural orifice transluminal endoscopic surgery (vNOTES). MethodsIn this study, the clinical data of 37 patients who underwent da Vinci robot-assisted total hysterectomy by vNOTES between September 1, 2019 and March 31, 2022 at the Department of Gynecology, the First Affiliated Hospital of Zhengzhou University, China were retrospectively analyzed. Clinical characteristics, operative postoperative complications, surgical outcomes, and postoperative pain scores were collected and analyzed. ResultsThe average age of the patients included in the study was 47.43 ± 4.44 years. The body mass index (BMI) was calculated using the formula BMI = body weight (kg)/height2 (m2). The average BMI was 23.16 ± 2.72 kg/m2. Among the 37 patients, 30 patients underwent total hysterectomy and bilateral salpingectomy, of which 11 patients underwent ovarian cystectomy simultaneously. Among these 11 patients, three had bilateral ovarian cysts and eight had unilateral ovarian cysts, with the largest cyst diameter measuring 8 cm. The remaining seven patients underwent total hysterectomy and bilateral salpingo-oophorectomy. The average operative time was 86.19 ± 17.83 min, and the estimated intraoperative blood loss was 24.46 ± 15.40 mL, with no intraoperative complications reported. The time to the first postoperative exhaust was 18.51 ± 6.63 h, and the average postoperative length of hospital stay was 3.81 ± 1.05 days. The postoperative visual analog scale (VAS) pain scores were 5.30 ± 0.91 at 24 h after surgery, 3.30 ± 0.70 at 36 h after surgery, and 1.14 ± 0.92 at 48 h after surgery. Only one patient experienced a fever exceeding 38.5 °C, which resolved after receiving antibiotic treatment. ConclusionThe use of the da Vinci robot-assisted total hysterectomy by vNOTES demonstrated safety and offers several advantages. These include reduced surgical trauma, an aesthetic incision, decreased pain, and shorter duration of postoperative exhaust time and hospital stay. These benefits contribute to accelerated postoperative rehabilitation.

A Rare Case of Vitreous Cyst

A patient with a unilateral congenital vitreous cyst attached to the posterior lens capsule is now described, with its photographic appearance.

The Difference Between Post-Laparoscopic Cystectomy Anti-Mullerian Hormone Levels In Endometrioma And Non-Endometrioma Cysts Patients

Background: Endometrioma is a complex gynecological disease with increasing global prevalence. Laparoscopic cystectomy remains to be the primary choice of modality. Several studies, however, have revealed that laparoscopic cystectomy in endometriomas can cause ovarian damage and reduction in ovarian reserve. They demonstrated a decrease in serum AMH levels in endometrioma patients following laparoscopic cystectomyObjective: To identify the difference between the mean post-laparoscopic cystectomy AMH levels in endometrioma and non-endometrioma cysts patientsMethods: A prospective cohort study with 40 selected patients undergoing laparoscopic cystectomy in Kariadi General Hospital Semarang. They were divided into 2 groups of endometrioma and non-endometrioma cysts. AMH levels were measured before and after laparoscopic cystectomy surgery in both groupsResults: The mean age of endometrioma and non-endometrioma group were 32.40 ± 6.26 and 30.6 ± 3.69 years consecutively. The most common cysts were unilateral cysts with a diameter of &gt; 4 cm which were dominated by endometrioma cysts. The group of subjects with endometrial cysts had lower AMH levels, both before (9.47 + 5.26 ng/mL) and after laparoscopic cystectomy (7.80 + 4.27 ng/mL). AMH levels before and after laparoscopic cystectomy in the endometrioma group showed a significant difference (p=0.004). In contrast, there was no significant difference in delta AMH between the non-endometrioma group (-1.63 + 4.12; p=0.685) and the endometrioma group (-1.74 + 2.37 ng/mL; p=0.685)Conclusion: Both endometrioma and non-endometrioma groups showed a decrease in AMH levels after laparoscopic cystectomy but they did not show a significant difference.

(031) Bartholin Cysts Can Be Treatable Causes of Female Sexual Dysfunction: Four Year Review of Diagnosis and Treatment Principles

Abstract Introduction Bartholin glands are major vestibular androgen dependent glands that release mucus secretions during sexual arousal through a 2.5 cm duct that drains at the 5 o'clock and 7 o'clock positions of the vestibule. Bartholin's glands are innervated by a branch of the pudendal nerve; mucous secretion is activated by the efferent pelvic nerve. Unilateral or bilateral obstruction of the Bartholin's ducts may occur (e.g. from trauma, infection, surgery, or idiopathic), however as long as innervation is intact, Bartholin glands continue to produce mucus despite outlet ductal occlusion. This leads to dilation of the duct with subsequent cyst formation that can result in Bartholin cyst-associated sexual dysfunction symptoms. Objectives To review patient records of women presenting to a sexual medicine clinic over a four-year period diagnosed with and surgically treated for Bartholin cyst-associated sexual dysfunction. Methods Grayscale ultrasound was performed (see figure) using the Aixplorer and cyst dimensions were measured after visual sexual stimulation in the office. Vulvoscopy was performed with the Wallach Zoomscope. Bartholin cyst anesthesia testing was performed using benzocaine 20%, lidocaine 8% and tetracaine 6%. Marsupialization surgery was performed as an out-patient. Results We identified 11 patients (mean age 26 +/− 6 years) diagnosed with Bartholin cyst-associated sexual dysfunction between January 2019 and November. 2010 who met inclusion criteria and were surgically treated by marsupialization for unilateral (4) and bilateral (7) Bartholin cysts. Their symptoms of Bartholin cyst-associated sexual dysfunction included dryness with sexual arousal (73%), pain with sexual arousal (82%), pain with orgasm (36%), spontaneous drainage (18%), and a mass at the introitus interfering with penetration (45%). 55% had been treated previously at other facilities unsuccessfully, including cyst aspiration, Word catheter placement, and marsupialization. The mean cyst size on ultrasound was 2.9 +/− 1.5 cm. Bartholin cyst anesthesia testing was positive in all (4/4) that underwent this test. Surgical principles to encourage post-op mucin drainage through the Bartholin duct included visualization of the duct at surgery (see figure) and direct anastomosis of the duct to the inferior portion of the incision at 5 and/or 7 o’clock locations (see figure). Post-operative daily arousal was encouraged and mucin secretion through the marsupialized ducts was documented by placement of gauze in the introitus and observing the mucous (see figure). At the time of this review, with an average follow-up of 8 months, 15 of 18 (83%) cysts are still draining and 9/11 patients are somewhat better, much better and very much better with resolution of Bartholin cyst-associated sexual dysfunction symptoms. Conclusions Bartholin cysts are a sexual dysfunction that can be successfully treated. Diagnosis involves an ultrasound after sexual arousal and a positive Bartholin cyst anesthesia test. Treatment involves marsupialization with visualization and anastomosis of the Bartholin duct to the inferior portion of the incision at the 5:00 and 7:00 locations. Post-operative daily arousal is encouraged with documentation of mucinous drainage detected. Disclosure No.

Tubarial Salivary Gland – The New Member of Nasopharynx

Tubarial Salivary Gland – The New Member of Nasopharynx

Elastic Intramedullary Nail Drainage in the Treatment of Long Bone Cyst with Pathological Fracture in Children

Background: Unilateral bone cyst (UBC) is a common lesion in children. Currently, the commonly used treatment methods for UBC have the defects of large surgical trauma and high recurrence rate. Objective: To investigate the effect of elastic intramedullary nail in the treatment of long bone cyst in children with pathological fracture. Methods: 11 patients with pathological fracture long bone cyst were treated with elastic intramedullary nail. There are 7 men and 4 women. The age ranged from 6 to 12 years, with a mean age of 7.6 years. There were 3 cases of proximal humerus, 2 cases of middle humerus, 1 case of whole humerus, 2 cases of proximal femur, 1 case of middle femur, and 2 cases of middle tibia. Results: t test was performed on the remaining static penetration area of the cyst measured at two adjacent time points using SPSS25 statistical software. P < 0.05 was considered statistically significant. Results All the 11 patients were followed up for 4 to 24 months, with an average of 12 months. The cyst healed in 4 cases (36.3%), the defect healed in 4 cases (36.3%), the healing rate was 72.7%, and 3 cases were sustained (1 case was followed up for 4 months). Discussion: Minimally invasive elastic nail fixation is effective in the treatment of bone cyst. However, the limitations of this study are influenced by the duration of follow-up, which is still ongoing for some UBC children. Long-term elastic titanium intramedullary nail implantation in the treatment of long bone cyst has the characteristics of single intervention, small injury, good stability and prevention of pathological fracture.

A Ganglion Cyst in the Anterior Cruciate Ligament of a 13-Year-Old Boy

Intra-articular ganglion cysts of the knee are a rare occurrence in pediatric patients, particularly involving the anterior cruciate ligament (ACL). Only a handful of case reports have been documented in the medical literature, highlighting the rarity of this condition. Patients with intra-articular cysts often experience knee discomfort and mechanical symptoms like locking of the knee. We present the case of a 13-year-old boy who had a unilateral intra-articular ganglion cyst of the ACL in his left knee. To diagnose and treat the cyst, we conducted radiographs and MRIs, and arthroscopic drainage was performed, resulting in a successful cyst decompression. Our case report provides an overview of the pathogenesis, diagnostic methods, treatment options, and complications of treatment for intra-articular cysts of the ACL. It highlights the rarity of this condition in pediatric patients and underscores the importance of prompt diagnosis and appropriate management.

Macrophthalmos mimics microphthalmos in an 8-month-old Great Swiss Mountain Dog

An 8-month-old Great Swiss Mountain dog was presented with a suspected right-sided microphthalmos, malformed and blind globe which was present since birth. On magnetic resonance imaging an ellipsoid macrophthalmos with absence of the normal retrobulbar tissue was detected. Histology revealed a dysplastic uvea with unilateral cyst formation associated with mild lymphohistiocytic inflammation. The ciliary body covered the posterior side of the lens unilaterally and showed focal metaplastic bone formation. Slight cataract formation as well as diffuse panretinal atrophy and intravitreal retinal detachment was evident. Preoperative diagnostic imaging procedure is recommended in eyes that clinically demonstrate as microphthalmos and are planned to be enucleated. As described in this case report the bulbus may be macrophthalmic which potentially complicates the enucleation. The performance of such a procedure at a site with ophthalmologic and soft tissue expertise is advisable. To the authors' knowledge this is the first report of a macrophthalmos with multiple ocular defects in a dog.

Effect of laparoscopic ovarian cystectomy on ovarian reserve and the outcomes of in vitro fertilization patients with benign ovarian cysts

Objective: To investigate the effect of laparoscopic ovarian cystectomy on anti-Mullerian hormone (AMH) level, ovarian response to gonadotropin stimulation and pregnancy rate for in vitro fertilization (IVF) patients with benign ovarian cysts. Methods: Patients with benign ovarian cysts who were admitted for cystectomy and had undergone IVF treatment were enrolled in the study. There were 373 participants with ovarian cysts underwent laparoscopic ovarian cystectomy in the experimental group. According to duration of post-surgery, there were four sub-groups: 1 year post-surgery (1Y POST), 2 years post-surgery (2Y POST), 4 years post-surgery (4Y POST) and ≥5 years post-surgery (≥5Y POST) in the experimental group. According to histopathologic types of ovarian cysts, there were two sub-groups: ovarian endometriotic cysts and ovarian non-endometriotic cysts. Two hundreds and three patients with no history of ovarian cysts and ovarian surgery were in the control group. The level of AMH and basic concentrations of follicle stimulating hormone (FSH), luteinizing hormone (LH), progesterone (P), estradiol (E2) were measured. Antral follicle counts (AFC) were calculated. There were other study variables: total dose of gonadotropins, duration of ovarian stimulation, the number of oocyte retrieved, the number of embryo obtained, blastocyst transfer rate and pregnancy rate. Results: The control group was matched as closely as possible to the experimental group, including age, body mass index and menstrual cycle (all P>0.05). Compared to the women in control group, the women in ovarian endometriotic cystectomy sub-group had significantly higher levels of basal FSH and basal P, lower level of AMH (all P<0.05); the women in ovarian endometriotic cysts sub-group had significantly higher dose of gonadotropins (all P<0.05); the women in ovarian endometriotic cysts ≥5Y POST sub-group had significantly lower number of oocyte retrieved, lower number of embryo obtained, lower blastocyst transfer rate, and lower pregnancy rate (all P<0.05). Compared to the women in control group, the women in ovarian non-endometriotic cysts sub-group had a significantly higher level of basal FSH and basal P (all P<0.05). The women in ovarian non-endometriotic cysts sub-group had lower level of AMH, higher dose of gonadotropins, lower number of oocyte retrieved, lower number of embryo obtained, lower rate of blastocyst transfer and lower rate of pregnancy than the control group but there were no statistically significant differences among them (all P>0.05). The women with unilateral ovarian endometriotic cysts had significantly lower number of oocyte retrieved on the side of surgery than another side (P<0.05). Conclusions: In short term laparoscopic ovarian cystectomy has no significant effect on ovarian reserve. But with long-term follow-up ovarian reserve, ovarian response to gonadotropin stimulation and pregnancy rate are decreased. The effect of laparoscopic ovarian cystectomy in benign cysts on ovarian is associated with whether or not it is the surgical side.

Short-term outcome of adrenal radiofrequency ablation of adrenal cysts: a single-center experience

Percutaneous thermal ablation is a minimally invasive treatment for liver, kidney, lung, bone, and thyroid tumors. This treatment also has been used to treat adrenal tumors in patients, but there is no evidence for the efficacy of thermal ablation of adrenal cysts. The present study was performed to analyze the experience of a single center with percutaneous radiofrequency ablation (RFA) of adrenal cysts and to evaluate its efficacy. The present study enrolled all patients who underwent percutaneous RFA for unilateral adrenal cysts from 2019 to 2021. All patients underwent USG-guided percutaneous aspiration of cystic fluid, followed by RFA. A total nine patients with adrenal cysts were included in this study. All of them underwent technically successful percutaneous RFA, with no immediate complication. Follow-up CT 3 months after RFA showed that six of the nine adrenal cysts showed good responses, with reductions in cyst volume ranging from 86.4 to 97.9%. One patient had poor response in the cyst size (volume reduction rate 11.2%). She underwent secondary RFA with resulting that the cyst volume reduced by 91.1%. After a median follow-up period of 17.2 months, eight patients showed no evidence of regrowth. The patient, who showed evidence of regrowth, declined any other treatment and has been under regular surveillance. None of the nine patients developed adrenal insufficiency during the follow-up period. In conclusion, percutaneous RFA is a safe and effective minimally invasive treatment for adrenal cysts, suggesting that percutaneous RFA may be a good alternative option in selected patients.