Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “CYSTS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 883 records · Page 49Linked to original sources
PubMedDate not supplied

Laparoscopic management of paratubal and paraovarian cysts.

OBJECTIVES: To define the proportion, methods of diagnosis, and a simplified laparoscopic technique for treating paratubal and paraovarian cysts. METHODS: We conducted a prospective cross-sectional study in the Gynecologic Endoscopy Unit of Assiut University Hospital in Assiut, Egypt in 1853 patients undergoing video-assisted laparoscopy. Transvaginal ultrasonography (TVS) was performed to detect paratubal or paraovarian cysts. Tubal shape and patency were evaluated with hysterosalpingography (HSG) in the infertile group. Diagnostic laparoscopy was performed to confirm the diagnosis of paratubal or paraovarian cysts. Small cysts were punctured and coagulated, and larger cysts required cystectomy and extraction of the cysts by using bipolar electrosurgery. Cystectomy was preceded by endocystic visualization in all cases. The primary outcomes measured included (1) correlation of the preoperative TVS, HSG, or both of these, with the laparoscopic diagnosis; (2) estimation of the success of the laparoscopic management of paratubal cysts; (3) assessment of the value of endocystic visualization prior to cystectomy; and (4) evaluation of tubal patency after laparoscopic management. RESULTS: Laparoscopically, only 118 patients (15.7%) were proved to have paratubal or paraovarian cysts. Preoperatively, TVS confirmed paratubal or paraovarian cysts in 52 (44%) patients. Cysts less than 3 cm in size (34 cases) were treated with simple puncture and bipolar coagulation of the cyst wall, whereas larger cysts (84 cases) were treated by cystectomy. Endocystic visualization using the 4-mm rigid hysteroscope was performed in 84 (71%) patients with large cysts. Statistically significant improvement occurred in tubal patency after laparoscopic management. CONCLUSIONS: Sonographic diagnosis of not uncommon paratubal and paraovarian cysts is not always feasible and requires greater awareness and accuracy. The characteristic laparoscopic differentiation of ovarian cysts is the crossing of vessels over them. Endocystic-endoscopic visualization is a simple, valuable step prior to cystectomy. Bipolar coagulation or extraction of these cysts diagnosed at laparoscopy is easy, not time-consuming, and should be routinely performed in all cases following microsurgical laparoscopic principles.

Adult↗
PubMed2006

Adrenal cysts: an institutional experience.

INTRODUCTION: Adrenal cysts are rare clinical entities. We report our institutional experience with adrenal cysts and also assess various management options. MATERIAL AND METHODS: Over the past 15 years the Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India, has had seven cases of adrenal cysts, of which two were functional: one patient had Cushing's syndrome and the other patient had pheochromocytoma. The other five cases were incidentally detected. Ultrasound scan and computerized tomography (CT) scan were the imaging modalities. Four patients had a single cyst, two patients had two cysts, and one patient had multiple unilateral cysts. RESULTS: None of these cysts had foci of malignancy. Laparoscopic adrenalectomy was possible in three patients with no morbidity or mortality. DISCUSSION: The reported incidence in clinical series has been 5.4%. Pseudocysts, endothelial cysts, epithelial cysts, and hemorrhagic cysts have been commonly described. The management can be conservative or surgical. It is generally agreed that a hormonal work-up is necessary in all cases of adrenal cysts to rule out a sub-clinical disease. Adrenal neoplasms, including adrenocortical carcinomas, can be associated with cysts that are benign in appearance. Percutaneous aspiration has been suggested as an alternative treatment option if the cyst is not hormonally active and if there is no suspicion of malignancy. However, surgical excision provides a definite histopathological diagnosis and also removes the fear of future complications such as hemorrhage into the cyst and local pressure effects due to the tumor. CONCLUSIONS: Given that the adrenals are a vascular gland and taking into consideration the possibilities of bleeding and complications in the cyst, our treatment of choice is the elective excision of adrenal cysts.

Academies and Institutes↗
PubMed2003

Risk for laparoscopic fenestration of liver cysts.

BACKGROUND: Laparoscopic fenestration is considered the best treatment for symptomatic simple liver cysts. Conversely, the laparoscopic approach for the management of hydatid simple liver cysts is not widely accepted because of the risk for severe complications. Despite improvement in imaging techniques, the probability of preoperatively mistaking a hydatid liver cyst for a simple liver cyst remains about 5%. Therefore, laparoscopic fenestration, planned for a liver cyst could be performed unintentionally for an undiagnosed hydatid liver cyst. METHODS: From January 2000 to January 2001, 15 patients with a diagnosis of liver cyst underwent laparoscopy for fenestration. In all cases preoperative serologic and imaging assessment had excluded hydatid liver cyst. To further exclude hydatid liver cyst, preliminary aspiration of the cyst with assessment of cystic fluid characteristics was performed. RESULTS: In two patients with presumedly simple liver cyst, hydatid liver cyst was diagnosed instead at laparoscopy by aspiration of cystic fluid. The procedure was converted to laparotomy with subtotal pericystectomy. CONCLUSIONS: The risk of misdiagnosing a hydatid liver cyst for a simple liver cyst, especially in the presence of a solitary cyst, should be considered before laparoscopic fenestration is performed. Intraoperative aspiration of cyst fluid before fenestration can minimize this risk, thus avoiding severe intraoperative and late complications.

Adult↗
PubMed1995

Fluid characteristics of benign ovarian cysts: correlation with recurrence after puncture.

OBJECTIVE: To determine whether concentrations of gonadal steroids and fibrinolytic indices in fluid from benign ovarian cysts can discriminate between functional and neoplastic cysts and predict recurrence after ultrasound-guided puncture. METHODS: Concentrations of gonadal steroids and components of the plasminogen-activating system were measured in cyst fluid obtained at ultrasound-guided puncture of 96 ovarian cysts and were related to subsequent cyst recurrence. In 83 patients who had surgery for benign ovarian cysts, components of the plasminogen-activating system in the cyst fluid were correlated with the histopathologic diagnosis. RESULTS: Higher levels of plasminogen activators and lower levels of inhibitors were found in those 54 cysts that recurred after puncture and in cysts with low levels (below 2000 pmol/L) of estradiol (E2). This enzyme-inhibitor balance resulted in high fibrinolytic activity. In contrast, cysts with high E2 levels (above 2000 pmol/L) had lower levels of activators, higher levels of inhibitors, and virtually no fibrinolytic activity. A high E2 concentration in cyst fluid was the single best predictor of no recurrence after puncture. Sixteen of 18 cysts in postmenopausal women recurred, and all had low levels of E2. However, an index based on cyst fluid volume and concentrations of E2 and urokinase predicted recurrence even better. A high concentration of urokinase in the fluid correlated with neoplastic histology of the cysts obtained at laparotomy. CONCLUSION: The fluid content of ovarian steroids and plasminogen activators and inhibitors is related to histopathology and recurrence after puncture of benign ovarian cysts. Puncture and assay of these components may minimize surgery on functional cysts.

Estrogens↗
PubMed2002

Risk factors for postpartum ovarian cysts and their spontaneous recovery or persistence in lactating dairy cows.

Cystic ovarian disease is a major cause of reproductive failure and economic loss for the dairy industry. Many cysts that develop during the early postpartum period regress spontaneously. However, it is difficult to decide at what point it would be more cost effective to treat ovarian cysts than to wait for spontaneous recovery. The objective of this study was to analyze risk factors for the development of the ovarian cystic condition during early and late postpartum, and for its persistence or recovery during the pre-service period in lactating dairy cows. Using multiple logistic regression, we analyzed data derived from 873 lactating dairy cows from a single herd. An ovarian cyst was diagnosed if it was possible to observe a single follicular structure with an antrum diameter > or = 25 mm in the absence of a corpus luteum in three sonograms performed at 7-day intervals. The cystic condition was denoted as early if the cyst was diagnosed 43-49 days postpartum, and late if detected 57-63-day postpartum. Spontaneous cyst regression before 60-day postpartum was regarded as early cystic recovery. For the early cystic group, there were no significant effects of lactation number, body condition score on prepartum Day 60, at parturition or on postpartum Day 30, or of body condition loss from parturition to 30-day postpartum. Cows calving in summer were 2.6 times more likely to develop ovarian cysts than those giving birth in winter. The risk of having a cyst was 1.9 times higher in cows with an abnormal puerperium. A 1-kg increase in milk yield raised the risk of cysts by a factor of 1.05. A 1-unit increase in body condition score (scale from 1 to 5) from prepartum Day 60 to parturition increased the risk of cyst development 8.4 times. Milk production and lactation number were negatively correlated with spontaneous early cyst recovery. A 1-kg decrease in milk production increased the probability of cyst recovery by a factor of 1.06, and a 1-unit drop in lactation number was associated with a 1.4-fold increased probability of cyst recovery. For the late cystic group, there were no significant effects of abnormal puerperium and body score data, except for a prepartum change in body score. Calving season (Odds ratio: 2.3), lactation number (Odds ratio: 1.36), increased milk production (Odds ratio: 1.05) and increased body condition score during the prepartum period (Odds ratio: 4.3) were all related to an increased risk of ovarian cysts. The probability of having a late cyst was 36.6 times greater in cows with early cysts. These findings suggest that it would be profitable to treat multiparous cows having cysts very early in the postpartum period, while treatment of primiparous cows should be delayed, at least until the end of the pre-service period, to provide the opportunity for spontaneous recovery.

Animals↗
PubMed1981

Management of adult choledochal cysts.

A review of the English literature reveals a total of 1,337 patients with choledochal cysts. Improved diagnostic techniques to visualize the biliary system are demonstrating an increasing number of unsuspected choledochal cysts in adult patients. Either choledochal cysts remain clinically silent until adulthood or may develop in later life. Experience is reported with adult patients having type I, II, III, and IV choledochal cysts. Type I cysts are preferably managed by excision but cyst anatomy may necessitate choledochoenteric drainage. Type II cysts are treated by excision except for those located within the pancreatic portion of the common bile duct. These are best managed by transduodenal cystoduodenostomy. The type III cyst (choledochocele) should be excised carefully, identifying and preserving the common bile and pancreatic ducts. Type IV cysts include a combination of any one of the first three types of cyst plus the presence of intrahepatic cyst or cysts. Treatment of these cysts is dictated by the type and location of the extrahepatic cyst. Since choledochal cysts are being recognized with increased frequency in adults, surgeons need to be aware of the diagnostic and treatment modalities available for each type of biliary cyst.

Adult↗
PubMed1991

Non-neoplastic ovarian cysts with ectopic pregnancy.

Thirty non-neoplastic ovarian cysts, discovered at laparotomy in association with 27 cases of tubal ectopic pregnancy, were examined to document changes seen in early pregnancy and possibly to identify precursor lesions to the luteinized cysts of later pregnancy. The ages of the patients ranged from 16 to 40 years, and length of gestation varied between 5 and 11 weeks. Of the 30 cysts, 12 were corpus luteum cysts; 10 were called lutein cysts, nonspecific, and had a lining of luteinized cells of a single cell type; three cysts were luteinized follicles; four cysts were unlined or lined by a single layer of cells. The origin of these four was not obvious, and they were called "simple cysts." The last was a granulosa-theca lutein cyst. Corpus luteum cysts are assumed to arise from the corpus luteum, and simple cysts appear to arise from both corpus luteum cysts and other follicular structures. The nonspecific lutein cysts appeared to arise from structures other than the corpus luteum or corpus luteum cysts; these nonspecific lutein cysts may be precursors to the so-called large solitary luteinized follicle cyst of pregnancy.

Adolescent↗
PubMed2000

A theory on the natural history of colloid cysts of the third ventricle.

OBJECTIVE: Patients with third ventricular colloid cysts typically are diagnosed when they develop symptoms related to cerebrospinal fluid (CSF) obstruction at the foramen of Monro. However, the clinical and neuroimaging characteristics related to symptom development are poorly understood. METHODS: From January 1974 to June 1998, 155 patients with newly diagnosed colloid cysts were managed at our center. Eighty-seven patients (56%) were thought to have tumor-related symptoms, and they underwent surgery (resection, n = 74; ventriculoperitoneal shunting, n = 11; stereotactic aspiration, n = 2). Sixty-eight patients (44%) had colloid cysts thought to be asymptomatic, and observation with serial neuroimaging was recommended. Recursive partitioning was used to examine the association of patient and tumor characteristics with the development of cyst-related symptoms. RESULTS: Univariate analysis comparing symptomatic and asymptomatic patients revealed four factors associated with cyst-related symptoms: 1) younger patient age (44 yr versus 57 yr; P < 0.001); 2) cyst size (13 mm versus 8 mm; P < 0.001); 3) ventricular dilation (83% versus 31%; P < 0.001); and 4) increased signal on T2-weighted magnetic resonance images (44% versus 8%; P = 0.001). All four variables remained significant in a multivariate logistic regression model: patient age (P = 0.04; odds ratio, 1.0); cyst size (P = 0.04; odds ratio, 1.2); ventricular dilation (P = 0.02, odds ratio, 7.2); and increased signal on T2-weighted magnetic resonance images (P = 0.04; odds ratio, 2.7). The most significant variable was ventriculomegaly (yes versus no). Patients with normal-sized ventricles (n = 62) were further categorized by cyst size (< or = 10 mm versus > 10 mm). For patients with enlarged ventricles (n = 93), patient age (< or = 50 yr versus > 50 yr) was the most important variable. Patients older than 50 years also were split with respect to cyst size; patients aged 50 years or younger with enlarged ventricles were not affected by cyst size. The percentage of patients with cyst-related symptoms was 12, 50, and 85% in the three final patient classes, respectively. Multivariate analysis including the patient classes resulted in removal of the other significant variables from the model, whereas the patient classes remained significant (P < 0.0001; odds ratio, 6.3) for predicting patients with cyst-related symptoms. CONCLUSION: The patient and neuroimaging characteristics of the different patient classes support a theory on the natural history of colloid cysts. Patients with third ventricular colloid cysts become symptomatic when the tumor enlarges rapidly, causing CSF obstruction, ventriculomegaly, and increased intracranial pressure. Some cysts enlarge more gradually, however, allowing the patient to accommodate the enlarging mass without disruption of CSF flow, and the patient remains asymptomatic. In these cases, if the cyst stops growing, the patient can maintain a steady state between CSF production and absorption and may not require neurosurgical intervention.

Adult↗
PubMed2001

Symptomatic spinal intradural arachnoid cysts in the pediatric age group: description of three new cases and review of the literature.

Spinal arachnoid cysts are a relatively uncommon lesion that may be either intra- or extradural, and intradural spinal arachnoid cysts are even less common. These cysts are usually asymptomatic but may produce symptoms by compressing the spinal cord or nerve roots suddenly or progressively. We present three cases in the pediatric age group with spinal intradural arachnoid cysts without a preceding history of trauma. Three patients with symptomatic intradural arachnoid cysts were investigated with conventional T1- and T2-weighted magnetic resonance imaging (MRI). The MRI scans demonstrated the intradural arachnoid cysts with slightly lower CSF signal intensity on the gradient echo images and slightly higher signal intensity on T1-weighted images. The first cyst was located at the level T12-L1 and compressed the conus medullaris, with neurogenic bladder and cauda equina syndrome for 2 months. The second was located at the level C5-T1 ventrally, with spastic gait and neurogenic bladder for 4 years. The other was located at T2-3 ventrally, with sudden onset of quadriplegia after jumping rope. The combined treatment of total resection and wide fenestration in our three patients produced an excellent return of neurologic function in each one, except for residual urinary disturbance in case 2. Intradural spinal arachnoid cysts appear to result from an alteration of the arachnoid trabeculae; some such cysts are ascribed anecdotally to previous trauma or arachnoiditis, whereas the majority are idiopathic and congenital. The majority of intradural spinal arachnoid cysts occur in the thoracic region and most are dorsal to the neural elements. Only 10 cases have been reported in which the intradural arachnoid cysts were located anterior to the cervical spinal cord, of which 8 were in the pediatric age group, like our case 2. Myelography, postcontrast CT myelography and MRI have been demonstrated as useful for the diagnosis of intradural arachnoid cysts. MRI is the imaging modality of choice, and the extent, size and nature of the lesion in our cases were well demonstrated by MRI. Surgical treatment is necessary if progressive neurological dysfunction appears in the course of spinal cord compression. Complete surgical excision of the cysts is the best choice of treatment, and wide fenestration and shunting of the cyst to the peritoneum, pleural cavity or right atrium were the modalities of choice. MRI offers a noninvasive and effective means to make the diagnosis of arachnoid cysts easier. Intradural arachnoid cysts may cause progressive myelopathy; however, the postoperative prognosis is good if the operation is performed prior to neurologic deficits.

Arachnoid Cysts↗
PubMed1993

Lung cysts associated with Pneumocystis carinii pneumonia: radiographic characteristics, natural history, and complications.

OBJECTIVE: The purpose of our study was to characterize the radiographic features of thin-walled air-filled structures (cysts) related to Pneumocystis carinii pneumonia in a large series of patients, determine the natural history of the cysts, and test the hypothesis that the cysts are associated with an increased risk of pneumothorax. MATERIALS AND METHODS: Of 100 patients with proved pneumocystis pneumonia, 34 (34%) had cysts shown on chest radiographs. The size, number, and location of the cysts and their natural history and association with pneumothorax were determined. A control group consisting of a random sample of 30 patients was selected from the 66 patients who had pneumocystis pneumonia but no cysts to assess the frequency of pneumothorax in this population. RESULTS: Of 34 patients with cysts, 32 (94%) had multiple cysts that were 1.0-5.0 cm in diameter. Most cysts were in the upper part of the lungs. Most patients had complete or partial resolution of the cysts after the acute episode of pneumonia. Pneumothoraces occurred in 12 (35%) of the 34 patients with cysts, but in only two (7%) of the 30 who did not have cysts (p = .007). CONCLUSION: Cysts related to pneumocystis pneumonia are usually multiple, occur most often in the upper parts of the lungs, and tend to decrease in size or resolve after the acute stage of the infection. In patients with pneumocystis pneumonia, the prevalence of pneumothorax is significantly higher in those who have cysts than in those who do not. The cysts are similar to pneumatoceles and the high prevalence of pneumothorax may be due to the subpleural location of some cysts.

Adult↗
PubMed2000

MR imaging and MR arthrography of paraglenoid labral cysts.

OBJECTIVE: We investigated the pathophysiology of paraglenoid labral cysts on the basis of MR imaging, MR arthrography, and cyst aspiration. MATERIALS AND METHODS: From 2211 MR imaging examinations, 51 (2.3%) cysts in 46 patients were identified. MR arthrography (n = 5), cystography (n = 1), arthroscopy (n = 17), percutaneous needle aspiration (n = 4), and medical records were also reviewed (n = 46). RESULTS: On MR imaging and arthrography, cysts were best viewed on T2-weighted images. Mean cyst diameter and volume were 2.2 cm and 2.8 cm3, respectively. Fifty-seven percent of cysts were located adjacent to the posterior labrum. On MR imaging and arthroscopy, a labral tear was identified in 27 (53%) and 15 (88%) patients, respectively. Eight cysts that caused compression neuropathy were large (mean size, 3.1 cm; p = 0.04) and located next to the posterior or inferior labrum. In four of five patients, MR arthrograms showed no intraarticular contrast material in the cyst. Cystograms showed no communication with the glenohumeral joint space, and cyst aspiration resulted in temporary symptom relief; however, cysts recurred in three of four patients. CONCLUSION: Most paralabral cysts are associated with labral tears. Paralabral cysts may be difficult to identify on MR arthrography unless a T2-weighted sequence is performed. Direct communication between a cyst and joint space rarely occurs. A posterior or inferior cyst may cause compression neuropathy of the suprascapular or axillary nerve, respectively. Cyst aspiration may result in temporary relief of symptoms, but an untreated labral tear should be suspected if cysts recur.

Adult↗
PubMed2001

[Epidemiology of apparently benign ovarian cysts].

The incidence of ovarian cysts in the general population is difficult to estimate. Certain cysts are functional and generally not operated, except in case of complications. Others are organic cysts which are usually, but not always operated. Data is available only from surgical series or pathology reports. An analysis of the literature shows that for operated cysts, approximately 75% are organic, 25% are function and 1 to 4% of the supposed benign cysts are found to be malignant. In France, the PMSI database on public and private institutions is available on the net (www.le-pmsi.fr). The number of hospital stays for benign ovarian tumors or ovarian cysts was to the order of 45,000 in 1998 and 1999. Twenty-one percent of these patients were discharged without surgery. Most had a functional cyst of the ovary. This leaves 32,000 women who underwent surgery annually for an ovarian cyst. Nearly 7000 women were hospitalized for follicular or yellow body cysts, i.e. 15%, with an incidence of 29/100,000 women over the age of 15 years. The abstention rate for hospitalized women with a follicular cyst or a yellow body cyst was 30 to 40%. For endometrioma, there were 5218 hospitalizations in 1999 (2137 in the public hospitals and 3081 in private clinics) (11% of the hospitalizations). The rate of abstention was 11% (15% in the public hospitals and 8% in private clinics). Approximately 4100 women thus underwent surgery, including 13% for ovarian cysts. According to data in the literature, serous and mucinous cysts account for 20 to 30% of the operated cysts and dermoid cysts for 10 to 20%. The type of cyst cannot be identified with the international WHO classification used in the PMSI.

Female↗
PubMed2002

[Endoscopic endonasal sinus surgery for post-operative maxillary cysts].

Surgical treatment for postoperative maxillary cysts uses a Caldwell-Luc or endonasal approach. Endoscopic endonasal surgery has become the treatment of choice in postoperative maxillary cyst, and many postoperative maxillary cysts have been classified. Due to the importance of cyst medial wall sites, we classified cysts into 4 types by location. Those whose, medial wall was close to the middle meatus, inferior meatus, or nasal lateral wall, we termed middle meatus, inferior meatus, and nasal lateral wall types. When the lateral cyst was not close to the nasal cavity but to another cyst, we termed the cyst continuous. We opened all nasal cavity cysts as far as possible. For continuous types, we determined location of the lateral cyst 3-dimensionally before surgery. We first opened medial cysts and opened the lateral cyst through the medial cyst. The tube was placed the lateral cyst to the nasal cavity. We opened all 45 cysts in 29 patients to the nasal cavity. As of this writing, no cysts connected to the nasal cavity have recurred.

Adult↗
PubMed2004

Fine needle aspiration of unilocular ovarian cysts--a cytohistological correlation.

OBJECTIVE: To assess the diagnostic efficacy of Fine Needle Aspiration Cytology in differentiating neoplastic and non-neoplastic dysfunctional ovarian cysts--cytological findings to be verified with histology of excised cyst. METHODS: In this prospective study fifty-three cases with unilocular nonseptate ovarian cystic masses,detected on ultrasound examination were subjected to ultrasound guided fine needle aspiration of the cyst contents at Department of Pathology, Allama Iqbal Medical College Lahore, from January 1999 - January 2000. Aspirated fluid was examined cytologicaly using Giemsa stain on the smears prepared from centrifuged deposit. The same cyst removed surgically was examined histologicaly and cytohistological correlation was carried out. RESULTS: In this series of 53 cases, histologically confirmed break up of various types of cysts was follicular cysts (n=25), leuteal cysts (n=6), serous cysts (n=15), mucous cysts (N=4) and Endometriotic cysts (n=3). Non-diagnostic fine needle aspirate was obtained in 19/53 cases, majority being the follicular cysts. The cytohistological correlation revealed no false positive but 40% false negative results for follicular cysts on cytological examination of the aspirate. Hence the specificity and sensitivity for cytological diagnosis of follicular cyst was 100% and 60% respectively. For leuteal cysts, false positive and false negative results on cytological examination were 0% and 16.6% respectively with a specificity and sensitivity value of 100% and 83% respectively. For neoplastic serous cysts cytologically false positive and false negative diagnosis was 0% and 46.6% respectively with specificity and sensitivity of 100% and 53%. For mucinous cystadenomas sensitivity and specificity of cytological diagnosis was 100%. For endometriotic cysts a sensitivity of 67% and specificity of 100% was procured with cytological evaluation. CONCLUSION: Guided fine needle aspiration cytology may prove to be one of the most valuable and acceptable tools in the differential diagnosis of ovarian cystic lesions.

Adult↗
PubMed1982

[Therapy of thyroid cysts with fine needle aspiration].

In a study extending over a period of 4 years, therapeutic fine-needle aspirations were carried out in 194 thyroid patients with thyroid cysts. The cyst contents of 3-130 ml cyst fluid were completely removed by suction in 2-3 month intervals by 1-17 fine-needle aspirations on an outpatient basis. Malignancy was ruled out in all patients by repeated cytological tests. Complete emptying of the cyst, verified by twice-repeated check at 3-month intervals, was achieved in 86 patients (44.3%). A reduction of the cyst fluid to less than 30% was achieved in 13 patients (6.7%). In 17 patients (8.8%) the cyst fluid diminished to 31-50%. In 44 patients (22.7%) there was no diminution in the cyst fluid or a reduction of less than 50%. There was an increase in cyst fluid compared with the first puncture in 34 patients (17.5%). The success of puncture cannot be predicted, although cysts with brown cyst fluids can be emptied significantly more frequently than cysts with yellow cyst fluids (63% as compared with 43.5%, p less than 0.005). Cyst fluid volume, T3- and T4-contents of the cyst fluid, age and sex had no influence on therapeutic effect. Up to the 5th puncture the prospects of success are approximately constant, but even in cases of more frequent punctures emptying still takes place. Thyroid hormone therapy with 50-100 micrograms 1-T4 daily (n = 134), and a single intracystic injection of 40 mg methylprednisolone-crystal suspension (n = 42) or of 0.02 g hydroxypolyaethoxydodecan 1% (n = 11) did not show better results than the single aspiration. There were no complications except for 2 cases of afterbleeding in the cysts immediately after puncture, and these were easily dealt with. Fine-needle aspiration is a simple, effective and cost-saving method for the elimination of the frequent cosmetically disturbing thyroid cysts in half of patients, thus avoiding surgery.

Cysts↗
PubMedDate not supplied

Surgical strategy for patients with anomalous pancreaticobiliary ductal junction without choledochal cyst.

Anomalous pancreaticobiliary ductal junction (APBDJ) induces various pancreatobiliary diseases. Because of the high incidence of biliary tract carcinoma, excision of the gallbladder and choledochal cyst is now recognized to be the treatment of choice for patients with choledochal cyst. However, surgical strategy for patients with APBDJ without cyst is not well evaluated. Forty-five consecutive patients with APBDJ (33 with cyst, 12 without cyst) treated over a 20-years period were divided into two groups based on the presence or absence of choledochal cyst and associated pancreatobiliary diseases were examined to evaluate the surgical strategy for patients without cyst. Mean age of patients without cyst was older (p < 0.01) than that of patients with cyst. Female/male ratio was 1.0 in patients without cyst while it was 4.5 when cyst was present. Carcinoma of the gallbladder or bile duct was found in 12% and pancreatitis in 21% of patients with cyst, while 33% of patients without cyst had gallbladder carcinoma or pancreatitis. Chronic calcifying pancreatitis was present in 17% of patients without cyst but not in patients with cyst. We conclude that a significantly higher incidence of gallbladder carcinoma necessitates cholecystectomy in patients with APBDJ without choledochal cyst. Excision of the extrahepatic bile duct is recommended for these patients at an early stage of pancreatitis to prevent an irreversible pancreatic damage.

Adolescent↗
PubMed1997

[Imaging of atypical cysts of the liver. Study of 26 surgically treated cases].

OBJECTIVES: Differential diagnosis between a benign cystic hepatic lesion, biliary cyst, and a potentially malignant lesion or biliary cystadenoma, is difficult. The aim of this study was to evaluate imaging features of atypical cystic liver lesions and the role of imaging techniques in determining a specific diagnosis. METHODS: Twenty-six patients with atypical cystic hepatic lesions were included in this study. All patients underwent surgery and pathological diagnosis was atypical hepatic cyst (n = 18), biliary cystadenoma (n = 4), hydatic cyst (n = 3), and ciliated hepatic foregut cyst (n = 1). We systematically reviewed US (n = 24), CT (n = 24), and MRI (n = 8) examinations. RESULTS: Septum were seen in both cystadenomas (US: n = 4, CT: n = 1) and hepatic cysts (US: n = 11, CT: n = 6). No mural nodules were seen. A thin wall was noted in both hepatic cysts (n = 2) and cystadenomas (n = 3). The intrahepatic biliary tract was dilated in 3 patients with hepatic cysts, 1 patient with cystadenoma, and 2 patients with hydatic cysts. Calcifications were noted in 1 patient with hepatic cyst, 3 patients with hydatic cysts, and in the case of ciliated hepatic foregut cyst. We found an associated typical hepatic cyst in 77% of cases (14/18) with atypical hepatic cysts; this was never found in other atypical cystic lesions (P < 0.01). CONCLUSION: In this series, no imaging features provided a differential diagnosis of atypical hepatic cysts and cystadenomas. The presence of associated typical hepatic cysts is helpful in suggesting the diagnosis of hepatic cyst.

Adult↗
PubMedDate not supplied

[Odontogenic cysts of the jaws. A clinicostatistical study].

In this paper a retrospective clinicostatistical study of 508 cases of odontogenic cysts of the jaws treated at the Department of Oral and Maxillofacial Surgery of the University of Athens during the last ten years 1977-1987 is undertaken, in order to evaluate their frequency and other aspects of clinical and therapeutic interest. These 508 odontogenic cysts represent 78.7% of the total number of cysts of the jaws treated in the same period in our department which means that the frequency of odontogenic cysts is still high. In regards to the incidence of each variety of odontogenic cysts, radicular cysts were found to have the highest frequency (59.6%), followed by the residual cysts (28.4%) and dentigerous cysts (12%). A higher incidence of odontogenic cysts in males (65.3%) than in females was also found, a fact which accords with that of other authors. The age distribution for patients with radicular cysts was the 3rd decade, for patients with residuals cysts the 6th decade and for patients with dentigerous cysts the 2nd decade. The majority of radicular and residual cysts was located in the maxilla whereas dentigerous cysts were more frequently located in the third molar mandibular area. Intraoral painless swelling was the most important clinical finding (74.6%). Radiologically the most frequent finding was that of a radiolucent area surrounded in 96.2% of our cases by a continuous radiopaque line. All these lesions were treated either by enucleation and apicoectomy of the teeth or by enucleation and extraction of the teeth followed by primary closure of the surgical cavity. In two cases of dentigerous cysts a two stage operation was performed. The results were highly satisfactory.

Adolescent↗