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PubMedDate not supplied

Treatment of unicameral calcaneal bone cysts in children: review of literature and results using a cannulated screw for continuous decompression of the cyst.

Nine unicameral bone cysts of the calcaneus in children were managed surgically using the technique of continuous decompression with titanium cannulated cancellous screws. The average age of the patients at surgery was 12.8 years. At follow-up a minimum of 2 years after surgery, eight cysts showed complete healing; one patient showed healing with residuals. Irritation at the screw insertion site necessitated early removal of the screw in one patient; implant-related problems were not observed in the other patients. Patients were allowed to bear weight after surgery. Implant extraction was performed after full consolidation of the cyst and was uneventful in all patients. A review of the literature and the different treatment modalities used for managing calcaneal cysts is also presented.

Adolescent↗

PubMed2004

[Total cyst excision with ultrasonic scalpel under the laparoscope for choledochal cyst].

OBJECTIVE: To discuss the technique and its advantage on application of ultrasonic scalpel in laproscopic cyst excision with Roux-en-Y hepatoenterostomy. METHODS: Forty-five cases were undergone laparoscopic cyst excision with Roux-en-Y hepatoenterostomy by ultrasonic scalpel. After intraoperative cholangiogram, the gallbladder and the dilated bile duct were completely excised by ultrasonic scalpel. Roux-en-Y hepatoenterostomy was performed extracorporeally through umbilical incision, then an end-to-side anastomosis was carried out intracorporeally. RESULTS: All 45 cases were completely accomplished under laparoscope combined with ultrasonic scalpel. Median duration of operation was 4.2 h (3.5-6.0 h). Intraoperative bleeding was between 10-50 ml (median 15 ml). No complication were found during operation. All children were discharged in 3-9 d (median 5.5 d) after operation. Thirty-eight cases were followed up 1-18 months. No stenosis or ileus occurred. Liver functions were in normal level. CONCLUSIONS: Total cyst excision with Roux-en-Y hepatoenterostomy by ultrasonic scalpel under the laparoscope was effective and safe for choledochal cyst. The most excellence was that clearly viewing during operation, less bleeding and injury, free of pain postoperation, microincision and scar.

Anastomosis, Roux-en-Y↗

PubMed1989

Eruptive vellus hair cysts. A follicular cyst of the sebaceous duct (sometimes)

The eruptive vellus hair cyst is an uncommon, yet distinct, clinical and pathological entity that may be acquired in a sporadic or hereditary form. This descriptive term gives no indication of the type of epithelium lining this cyst. A case report of eruptive vellus hair cyst is reported herein in which the epithelial lining differentiated toward the sebaceous duct. We propose that eruptive vellus hair cysts should be more accurately diagnosed by characterizing the type of epithelial lining.

Adult↗

PubMed1989

Suprasellar arachnoid cysts: management by cyst wall resection.

Five children with ventricular dilatation (4 boys, 1 girl) had features seen on computer tomographic scan that were consistent with suprasellar arachnoid cysts. All children were investigated with a CT ventriculogram and/or CT cisternogram, and no communication with the cyst was demonstrated. Three children were seen in the 1st year of life and the remaining 2 children were between 1 and 5 years of age. Hydrocephalus and developmental delay were the most common presenting features, followed by visual disturbance, squint, or ataxia. Direct surgical decompression was performed in all 5 patients to avoid long-term placement of a ventriculoperitoneal shunt. A temporary shunt was placed in 2 children because of high intracranial pressure. Direct partial excision of the cyst wall to allow long-term drainage into the basal cisterns or ventricular system was successful in all children. The presence of subdural collections postoperatively required temporary shunting in 2 children. After follow-up for between 10 and 22 months no clinical endocrinological sequelae have been detected, but 2 children have raised serum prolactin levels. Three children are developmentally delayed; one of these has regained some skills since surgery. Direct surgical decompression of suprasellar arachnoid cysts to avoid long-term shunt placement is the preferred method of surgical treatment for this condition.

Arachnoid↗

PubMed1981

[Retrocerebellar cysts and cysts of the tentorial hiatus in children (author's transl)].

A series of 11 children is reported with retrocerebellar cysts or cysts of the tentorial hiatus. The principal symptom is hydrocephalus of early onset (before 3 months of age in 6/11 cases). Neuroradiological examination usually shows only an expansive lesion of the posterior fossa, and occasionally the cyst itself. These classically called arachnoid cysts are probably glio-ependymal in origin.

Brain Diseases↗

PubMedDate not supplied

[Statistical study of the colloid cyst of the 3rd ventricle (so-called cyst of the paraphysis). Clinico-anatomical series of 75 cases].

Known as the paraphysis cyst, or the colloid cyst of the third ventricle, the lesion described in this study continues to have an unprecise etiology in spite of a great number of investigations. This series of 75 anatomo-clinical cases with this lesion provides sufficient material for a valuable statistical analysis. After enumerating the different cerebral symptoms of this disease, the author makes a macroscopic and microscopic morphological analysis and compares his own results with those found in literature. The embryologic investigations mentioned and the hypotheses to which they lead do not shed light on the origin of these cysts. The mathematical analysis indicates a difference in frequency between both sexes, with a far greater frequency in males. Referring to the grey commissure's agenesia, mentioned by Morel as statistically more frequent in men than in women, the author concludes that the colloid cysts of the third ventricle are also to be considered as a cerebral anomaly related to sex.

Adult↗

PubMed1993

[Treatment using laparoscopic surgery of dermoid cysts. Apropos of a series of 33 cysts].

Laparoscopy is a surgical method which is now widely used for the treatment of ovarian cysts. The authors wish to present their experience concerning the management and treatment of dermoid cysts or dysembryomas since these lesions embody all the problems persisting in this field. They report 33 cases exclusively treated by laparoscopic surgery in a series of 407 adnexal cysts treated over a 4-year period (April 1988 to April 1992). As regards diagnosis, the principal difficulty is not to miss the odd malignant lesion (1 to 2%) encountered mainly in older women. Technically, the most delicate stage in the operation is extraction of the cyst, especially when it is large and has an important solid component. Provided all precautions are taken in the diagnosis and the operative technique, this new method seems to be quite acceptable as it enables women who carry these lesions, which require excision, to benefit from the well-known advantages of laparoscopic surgery.

Adnexal Diseases↗

PubMedDate not supplied

Frontal arachnoid cyst. A case of bilateral frontal arachnoid cyst without clinical signs.

The purpose of this study is to report a case of a very large arachnoid cyst in a patient having spent a very active life and who had never presented any neurological or psychiatric symptomatology beside a dementia in the last years of her life. The gross examination of the brain revealed the presence of a voluminous frontal bilateral cyst, located in the midline and displacing laterally the frontal lobes, so they displayed a foliated aspect. Microscopically, the examination of the cyst walls confirmed its arachnoid origin and the cerebral cortex contained lesions typical for senile dementia. This case exemplifies the histological nature and the pathogeny of arachnoid cysts, in particular of congenital origin. This also shows that the very early occurrence of such a malformation does not prevent the development of functional neuronal pathways, owing to the important plasticity of the central nervous system.

Aged↗

PubMed1997

Expression of mucin-like carcinoma-associated antigen in the cyst fluid differentiates mucinous from nonmucinous pancreatic cysts.

OBJECTIVES: Differential diagnosis of pancreatic cystic lesions may be difficult: the main problem is to distinguish mucinous neoplasms from nonmucinous cysts. We evaluated the usefulness of the mucin-like carcinoma-associated antigen (MCA) in the fluid of pancreatic cysts for detecting mucinous neoplasms. Results were compared with those of CA 15-3, carcinoembryonic antigen (CEA), and CA 72-4 fluid content, and cytology. METHODS: Twenty-four pancreatic cyst fluids were collected from 10 pseudocysts, eight mucinous cystic tumors, and six serous cystadenomas. RESULTS: MCA was elevated in seven of eight mucinous tumors (sensitivity 87.5%, specificity 100%). A significant difference was found between MCA levels in mucinous neoplasms versus pseudocysts (p = 0.0003) and serous cystadenomas (p = 0.001). Mean MCA levels were higher (133.7 U/ml) in mucinous cystadenocarcinomas than in cystadenomas (37.5 U/ml). The sensitivity of CA 15-3, CEA, and CA 72-4 in detecting mucinous neoplasms was 50, 87.5, and 87.5%, respectively, with a specificity of 94%, 44%, and 94%, respectively. Cytology showed mucinous epithelial cells in only four of eight mucinous neoplasms, with a specificity of 100%. CONCLUSIONS: These data suggest that MCA determination in the cyst fluid is a promising new tumor marker for the preoperative diagnosis of mucinous cystic neoplasms of the pancreas.

Antigens, Neoplasm↗

PubMed2001

Water relations during desiccation of cysts of the potato-cyst nematode Globodera rostochiensis.

The loss during desiccation of osmotically active water (OAW), which freezes during cooling to -45 degrees C, and osmotically inactive water (OIW), which remains unfrozen, from the cysts of the potato cyst nematode, Globodera rostochiensis, was determined using differential scanning calorimetry. Exotherms and endotherms associated with non-egg compartments were not detected after 5 min desiccation at 50% relative humidity and 20 degrees C. The pattern of water loss from the cysts indicates that water is lost from compartments outside the eggs first, that nearly all the non-egg water is OAW and that the OIW content of the cyst is contained within the eggs. Water is lost from the eggs only after the OAW content outside the eggs falls below that within the eggs. Both OAW and OIW are lost from the eggs during desiccation but the eggs retain a small amount of OIW. Other animals which survive some desiccation but which are not anhydrobiotic will tolerate the loss of OAW but not the loss of their OIW. Anhydrobiotic animals can survive the loss of both their OAW and a substantial proportion of their OIW.

Adaptation, Physiological↗

PubMed1993

Hygroma renale: pararenal lymphatic cysts associated with renin-dependent hypertension (Page kidney). Case report on bilateral cysts and successful therapy by marsupialization.

A total of 42 cases of large symptomatic parapelvic or pararenal lymphatic cysts has been reported since 1890, of which 54% were associated with hypertension and 14% were bilateral. We report on a patient in whom during a 3-month period abdominal pain and distention developed successively on both sides associated with hypertension. Initially, ultrasound and computerized tomography revealed a large multicystic pararenal lymphatic mass on the right side and small parapelvic hilus lesions on the left side. Two months after resection and marsupialization of the large cyst on the right side the small hilus lesions on the left side developed into large pararenal cysts requiring the same therapeutic measures. Hypertension was reversible after surgery in both instances; at the second operation high preoperative and lower postoperative renin activity, active renin, total renin, aldosterone and atrial natriuretic factor in plasma were noted. Immunoreactive active and total renin levels in the lymph fluid were elevated, a finding that may be explained by the renal origin of the lymph. Marsupialization is a kidney preserving measure that reverses all symptoms of large pararenal cysts, including Page kidney hypertension.

Adult↗

PubMed2006

Oral immunization of BALB/c mice by intragastric delivery of Streptococcus gordonii-expressing Giardia cyst wall protein 2 decreases cyst shedding in challenged mice.

Giardia lamblia (Giardia duodenalis or Giardia intestinalis) is a protozoan parasite of vertebrates with broad host specificity. Specific antibodies directed against cyst antigens can interfere with the cyst wall-building process. In this study, we engineered Streptococcus gordonii to express a 26 kDa fragment of cyst wall protein 2 (CWP2), containing a relevant B cell epitope, on the cell surface. This is the first report of S. gordonii expressing a protein of parasite origin. As S. gordonii was intended for intestinal delivery of CWP2, it was determined that this oral commensal bacterium is able to persist in the murine intestine for 30 days. Immunization with recombinant streptococci expressing the 26 kDa fragment resulted in higher antibody levels. Specific anti-CWP2 IgA antibodies were detected in fecal samples and anti-CWP2 IgG antibodies were detected in serum demonstrating the efficacy of S. gordonii for intragastric antigen delivery. In a pilot challenge experiment, immunized mice demonstrated a significant 70% reduction in cyst output.

Administration, Oral↗

PubMed1997

Pituitary-directed leukemia inhibitory factor transgene forms Rathke's cleft cysts and impairs adult pituitary function. A model for human pituitary Rathke's cysts.

Leukemia inhibitory factor (LIF) and LIF receptors are expressed in adenohypophyseal cells and LIF regulates pituitary hormone transcription and cell replication in vitro. Therefore, transgenic mice expressing pituitary-directed LIF driven by the rat growth hormone (GH) promoter were generated to evaluate the impact of LIF on pituitary development. Three founders were established with diminished linear growth and body weight (57-65% of wild type [WT]), and intense anterior pituitary LIF immunoreactivity. Cystic cavities observed in pituitary anterior lobes were lined by cuboidal, ciliated epithelial cells, focally immunopositive for cytokeratin and S-100 protein and immunonegative for adenohypophyseal hormones. Transgenic pituitaries showed decreased GH (40%) and prolactin (PRL) (26%) cells, and decreased GH and PRL mRNAs by in situ hybridization. ACTH cells increased 2.2-fold, whereas gonadotrophs and thyrotrophs were unchanged. Serum GH was undetectable (< 0.78 ng/ml), PRL levels were one third of WT (P < 0.05), IGF-I levels were 30% of WT (P < 0. 001), and T4 was normal. 10 human pituitary Rathke's cysts studied all showed conclusive LIF immunoreactivity in cyst-lining cells. Thus, intrapituitary murine LIF overexpression causes cystic invaginations from the anterior wall of Rathke's cleft, suggesting failed differentiation of Rathke's epithelium to hormone-secreting cells. Arrested murine pituitary maturation with formation of pituitary Rathke's cleft cysts, GH deficiency, and short stature provide a model to study human Rathke's cyst pathogenesis.

Adrenocorticotropic Hormone↗

PubMed2003

A large cerebral hydatid cyst associated with liver cyst.

Hydatid disease in childhood is a serious health problem in Turkey and other places where the parasite is endemic. An 8-year-old girl from a rural area was admitted with headache, recurrent abdominal pain, abdominal distension and hypo-aesthesia and paresis of the right arm. Computerised tomography (CT) scans demonstrated a large intracranial hydatid cyst. A hydatid cyst was detected in the liver also. Her mother had been treated previously for disseminated hydatid disease. The cerebral cyst was removed but only subtotal excision of the hepatic cyst was possible. She was treated with albendazole, has fully recovered and, after 12 months of follow-up, there is no sign of recurrence.

Brain Diseases↗

PubMed2001

Production of monoclonal antibody against Scrippsiella trochoidea cysts and its application to analysis during cyst formation and enzyme-linked immunosorbent assay.

A monoclonal antibody was produced by the fusion of mouse myeloma cells with spleen cells from a mouse immunized with the cysts of Scrippsiella trochoidea, marine phytoplankton. Immunofluorescence microscopic observation showed that the antibody reacted with the spines on the cyst but not with the vegetative cells and cyst walls. An enzyme-linked immunosorbent assay could be used to measure the cysts in muddy bottom sediments using the purified antibody conjugated with horseradish peroxidase.

Animals↗

PubMed1989

Symptomatic Rathke's cleft cyst simulating arachnoid cyst--case report.

A case of symptomatic Rathke's cleft cyst simulating an arachnoid cyst is presented. Although computed tomography and magnetic resonance imaging showed that the cyst content was identical to cerebrospinal fluid, there was faint contrast enhancement in part of the wall. Histological observation suggested that the somewhat vascular connective tissue associated with nests of pituitary cells might have contributed to the enhancement. This type of Rathke's cleft cyst requires further clinical and neuroradiological studies.

Arachnoid↗

PubMed1994

Significance of simple renal cysts and percutaneous cyst puncture on renal function.

Renal function was investigated in 17 patients with simple renal cysts. Single kidney glomerular filtration rate was estimated by gamma camera renography with 99mTc-DTPA before, 5 days and 6 months after percutaneous puncture and evacuation of the cysts. Prior to the puncture and evacuation, the only negative effects on renal function noted were signs of moderate obstruction of the renal outflow in 2 patients. Percutaneous puncture with evacuation of the cystic fluid did not change the renal function significantly. It was concluded that simple renal cysts do not have any functional consequences nor does percutaneous puncture and evacuation of the cysts.

Aged↗

PubMed1999

Echinococcal liver cysts: treatment with echo-guided percutaneous puncture PAIR for echinococcal liver cysts.

In spite of recent progress, treatment for liver echinococcal cysts is still far from satisfying. In recent years, percutaneous drainage has been increasingly used for this purpose and it has been shown to be an effective alternative to surgery and chemotherapy alone. This technique is known as PAIR, from Puncture, Aspiration, Injection (of a scolecidal agent), Reaspiration: here we present our experience and the state of the art of PAIR. Patients from Italy and Turkana (Kenya), harbouring 233 Gharbi type I, II and III echinococcal cysts were successfully treated with PAIR: it was performed according to protocols established at the Division of Infectious and Tropical Diseases, IRCCS--Policlinico S. Matteo, University of Pavia. In Italy, one relapse was recorded, four years after the procedure; the patient was treated again with PAIR; no cases of anaphylactic shock or peritoneal dissemination were observed in a follow-up of 10 years; only 10 minor complications (biliary fistula, urticarioid reaction, abscessualization of the cyst, anaphylactoid reactions) were reported. Long-term results indicate that in Gharbi type I, II and III echinococcal cysts, and in developing countries, in particular, PAIR is a first choice method for the treatment of abdominal localizations of this disease.

Adolescent↗