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PubMed1998

The association of large ovarian cysts with cloacal exstrophy.

BACKGROUND/PURPOSE: Cloacal exstrophy can now be managed with excellent survival rates and reasonable long-term outcomes with many of these patients living into their late teens and early adulthood. In this report, the authors describe for the first time the association of large ovarian cysts with cloacal exstrophy. METHODS: From 1974 to 1996, 12 patients with cloacal exstrophy have been treated at C.S. Mott Children's Hospital. Massive ovarian cysts developed in four of these. These patients represent the subjects of this study. RESULTS: All four patients have been followed up beyond puberty and massive ovarian cysts have developed, which have caused significant morbidity. Three patients have required surgical intervention. All the patients had reached menarche before the development of the cysts. In all cases, the presentation was severe pelvic pain. Urinary tract obstruction from the large pelvic cysts developed in three of the four. The cysts were bilateral in three of four patients and measured 8 to 10 cm in diameter on ultrasound scan or computed tomography (CT). Cyst aspiration was attempted in two cases and was unsuccessful. Three of the four patients have required bilateral salpingo-oophorectomy. The indications for surgery were uncontrollable pelvic pain in one and urinary obstruction and uncontrollable pelvic pain in two. Surgical findings demonstrated massive thin-walled cysts with essentially no normal ovarian tissue in association with duplicated mullerian structures. The pathology findings were corpus luteal cyst in two and mucinous cystadenoma in one. The fourth patient with an 8- x 10-cm unilateral cyst is being followed up. CONCLUSIONS: The authors have described, for the first time, the association of massive ovarian cysts with cloacal exstrophy. These cysts can lead to severe pelvic pain and urinary tract obstruction. Bilateral oophorectomy has been required in most of these patients.

Adolescent↗
PubMed2001

Leak-proof puncture of ovarian cysts: instant mounting of plastic bag using cyanoacrylate adhesive.

BACKGROUND: Reliable leak-proof aspiration of cyst contents is required for treatment of large ovarian cysts by minilaparotomy. TECHNIQUE: Through a small abdominal wound a transparent plastic bag was instantly mounted onto the cyst surface using an ethyl-2-cyanoacrylate adhesive. A 1-2-cm-wide cut was made in the consolidated cyst wall through the inside of the bag and the contents directly aspirated. The fluid was trapped inside the bag without leaking into the abdominal cavity. This method can also be applied to relatively small cysts by holding the cyst just beneath the wound. EXPERIENCE: We used this method in 30 patients with unilateral ovarian cysts and in one patient with an ovarian cyst associated with an ipsilateral paraovarian cyst. All patients were successfully treated without spillage, although in one case a large mucinous ovarian cyst ruptured before surgery. CONCLUSION: Minilaparotomy using the instant adhesive is cost-effective, safe, reliable, and easily implemented. This procedure is also applicable to relatively small cysts and is a viable alternative to laparoscopic surgery for treatment of dermoid cysts showing considerable calcification.

Cyanoacrylates↗
PubMed2002

Prevalence of epididymal, seminal vesicle, prostate, and testicular cysts in autosomal dominant polycystic kidney disease.

OBJECTIVES: To assess the prevalence of cysts in the epididymis, seminal vesicles, prostate, and testes of patients with autosomal dominant polycystic kidney disease (ADPKD) and determine their clinical significance. Extrarenal cystic involvement is a well-known manifestation of ADPKD. Although a few reports exist about cysts in the epididymis, seminal vesicles, prostate, and testes, the true prevalence of cysts in these organs is not well known. METHODS: A prospective study, consisting of 104 male patients and 62 male controls, was designed at three medical centers to evaluate the prevalence of epididymal, seminal vesicle, prostatic, and testicular cysts in patients with ADPKD by abdominal, transrectal, and scrotal ultrasound examinations. RESULTS: Among the 104 patients, epididymal cysts were present in 19 (18%), seminal vesicle cysts were present in 41 (39%), and prostatic cysts were present in 7 patients (7%); the proportion in the control group was 24% (P >0.05), 2% (P <0.01), and 5% (P >0.05), respectively. Testicular cysts were detected in only 3 control patients. Of the 104 patients, 96 were married, and primary infertility was present in 5 patients (5%). CONCLUSIONS: We suggest that seminal vesicle cysts are frequent in ADPKD; epididymal cysts are not uncommon in ADPKD, but the frequency is not higher than in the control group; ADPKD should be looked for in patients with seminal vesicle cysts; and additional studies are necessary to evaluate the association between epididymal and seminal vesicle cysts and infertility in patients with ADPKD.

Adolescent↗
PubMed1999

Risk of breast cancer in women with palpable breast cysts: a prospective study. Edinburgh Breast Group.

BACKGROUND: 7% of women in the western world develop palpable breast cysts. Studies of the relation between cysts and breast cancer have conflicting results. There are two clearly defined types of cyst. We investigated whether one cyst type is associated with a higher rate of breast-cancer development than the other. METHODS: We studied 1374 women with palpable breast cysts presenting between 1981 and 1987, who had cysts aspirated between 1981 and 1989. Cysts were classified as type I if the sodium/potassium (Na+/K+) ratio in the cyst fluid was less than 3, or type II if the Na+/K+ ratio was 3 or more. Data on incidence of breast cancer were available until January, 1995, and we compared them with the expected numbers of cancers calculated from age-specific breast-cancer incidence in Scotland in 1988. FINDINGS: 65 cancers developed during follow-up. The overall standardised incidence rate of breast cancer in patients with palpable cysts was 2.81 (95% CI 2.17-3.59). The relative incidence rate was increased for all cyst types. The standardised incidence rate of developing breast cancer among women younger than 45 years was highest at 5.94 (2.97-10.63), with a significant trend for decreasing relative incidence rate with age (p<0.05). Women older than 54 years had a standardised incidence rate of 1.73 (0.86-3.10). The standardised incidence rate of breast cancer was highest in the first year after aspiration (7.02 [3.73-12.00]) but the risk was still raised after 5 years (2.68 [1.84-3.76]). INTERPRETATION: Women with breast cysts are at an increased risk of breast cancer, especially at younger ages. The type of cyst did not alter the associated relative incidence rate of breast-cancer development.

Adult↗
PubMed1999

Lingual cyst with respiratory epithelium: an entity of debatable histogenesis.

PURPOSE: The purpose of this report was to describe a new case of lingual cyst with respiratory epithelium, to review and analyze the literature regarding lingual cyst of foregut origin and lingual alimentary cyst, and to discuss the suitable terminology for these uncommon cysts. MATERIAL AND METHODS: Data from articles published in the English language between the years 1942 and 1947 were used. RESULTS: The review of the literature showed 53 lingual cysts of which 29 could be grouped into lingual alimentary tract cysts and 24 into lingual cysts of foregut origin. There was an overlap in histologic and clinical features and embryogenesis of both cysts. CONCLUSIONS: Differentiation between both cysts cannot be supported, and until further information is accumulated it is suggested that histologic descriptive terms be used such as lingual cyst with respiratory epithelium, lingual cyst with gastric epithelium, or lingual cyst with respiratory and gastric epithelium.

Child↗
PubMed1999

Differential diagnosis of peri- and postmenopausal ovarian cysts.

OBJECTIVES: To test the value of preoperative and intracystic parameters in the differential diagnosis of ovarian cysts. METHODS: Criteria for admission of 58 patients were age > 47 years, complete history, detection of CA 125 serum level, and ultrasound findings. Tumor markers (CA 125, cancer-associated serum antigen (CASA), CA 72-4), hormones (estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH)), epidermal growth factor (EGF) receptor and c-erb B-2 amplification rate were detected in cyst fluid. RESULTS: Of the 58 subjects, 9 (15.4%) had functional cysts, 37 (63.8%) had benign tumors and 12 (20.8%) had malignant tumors. No functional ovarian cyst presented as echoic or multilocular cyst sonographically. The serum CA 125 values demonstrated significant differences between the non-malignant and malignant patient groups (P < 0.0005). The majority (63.8%, n = 37) of ovarian cysts were obtained at laparotomy, whereas only 36.2% (n = 21) were laparoscopically operated. The cyst fluid levels of FSH (P < 0.005) and LH (P < 0.05) were significantly lower in the functional group than in the benign or malignant group. Malignant cysts were significantly different from non-malignant cysts regarding low E2 (P < 0.01), high FSH (P < 0.05) and CASA (P < 0.02) values. There were no significant correlations between EGF receptor (P = 0.14) and c-erb B-2 (P = 0.06) gene amplification rates and malignant histology. CONCLUSIONS: Simple ovarian cysts combined with normal serum CA 125 levels are candidates for conservative follow-up or laparoscopy. The serum CA 125 is a powerful marker for prediction of histology in postmenopausal ovarian cyst. Laparoscopic surgery may be considered in patients with multilocular sonographic findings and normal CA 125 serum level. Combining serum CA 125 levels with cyst fluid parameters (E2, FSH, CASA) improves the sensitivity and specificity in predicting malignancy.

Age Distribution↗
PubMed1993

Arthroscopic treatment of meniscal cysts.

Historically meniscal cysts have been treated with either an open total menisectomy, isolated cyst excision, or a combination of the two procedures. The advent of arthroscopic techniques has led to innovative treatment options for meniscal cyst management. A review of meniscal cysts and the results of arthroscopic treatment form the basis of this study. From 1986 to 1991, 18 patients with meniscal cysts were treated by arthroscopic cyst decompression. Thirteen men and five women comprised the study group and had an average age of 28 years. The follow-up period ranged from 6 to 60 months (average 26). Eight of the cysts were medial and 10 were lateral. A horizontal cleavage tear was noted in all cases, and 15 partial and three subtotal menisectomies were performed in conjunction with an intraarticular cyst decompression. There have been no recurrences to date, and all patients returned to their previous level of activity. Parameniscal cysts may result from synovial fluid tracking through a horizontal cleavage tear. Successful treatment of the meniscal cyst must include appropriate management of the torn meniscus, which can be entirely arthroscopic, consisting of a partial or subtotal meniscectomy, identification of the cyst opening, and cyst decompression.

Adult↗
PubMed2002

Recurrence of chocolate cysts after laparoscopic ablation.

STUDY OBJECTIVE: To estimate the recurrence rate of chocolate cysts 3 to 12 months after ablative laparoscopic surgery. The secondary outcome measure was the need for a repeat surgical procedure. DESIGN: Prospective cohort study (Canadian Task Force classification II-2). SETTING: Tertiary referral center for laparoscopic treatment of endometriosis. PATIENTS: Seventy-three consecutive women with chocolate cysts larger than 2 cm. INTERVENTION: Laparoscopy at which cyst capsules were vaporized or coagulated with the potassium-titanyl-phosphate (KTP) laser or Bicap bipolar diathermy. MEASUREMENTS AND MAIN RESULTS: There were 96 cysts (23 bilateral) in 73 women (1 patient underwent a two-stage procedure). Their mean diameter was 4.79 cm (range 2-25 cm). The median r-AFS score was 56 (range 22-128), and 55 patients (75.3%) had stage 4 disease. The KTP laser was used in 50 women (68.5%) and bipolar diathermy in 23 (31.5%). At 12 months, 5 patients (6.9%) were lost to follow-up, and 12 had a recurrent cyst. Therefore, the cyst recurrence rate/patient was 16.4% (12/73) and the rate/cyst was 12.5% (12/96). Women who had recurrences were significantly more likely to have bilateral cysts, 7/12 (58.3%), than those with single cysts, 16/61 (26.2%, p =0.032). Bicap bipolar diathermy was associated with a recurrence rate of 20.8% (5/24). The rate in women who had KTP laser ablation was 14.3% (7/49, NS). Eighteen patients had repeat operations (including on recurrent cysts). Therefore the reoperation rate was 24.6% (18/73). No major surgical complications occurred. One woman had a postoperative wound infection after a second procedure to remove an ovary with a recurrent cyst. CONCLUSION: Laparoscopic cyst fenestration followed by capsule ablation is safe and effective treatment for preventing recurrence of chocolate cysts.

Adult↗
PubMed1988

Laryngeal cysts: clinical relevance of a modified working classification.

Laryngeal cysts from 72 patients were examined and reclassified according to a modified working classification. In this series, 47 patients (66 per cent) had epithelial cysts, 11 patients (15 per cent) oncocytic cysts and 14 patients (19 per cent) tonsillar cysts. Epithelial cysts were commonest in the region of the epiglottis (20/47) and laryngeal ventricle (24/47). Oncocytic cysts tended to lie in the region of the ventricle whereas tonsillar cysts occurred almost exclusively in the valleculae, epiglottis and pyriform region (13/14). The authors conclude that the modified working classification of laryngeal cysts is easy to apply, of clinical relevance, and allows classification of cysts where operative trauma to the specimen obscures the relationship of the cyst to the surface epithelium. The origin and significance of tonsillar cysts are discussed and a relationship to the lympho-epithelial cyst of the oral cavity is suggested.

Cysts↗
PubMed2002

Expression of cytokeratins (CKs) 8, 13 and 18 and their mRNA in epithelial linings of radicular cysts: implication for the same CK profiles as nasal columnar epithelium in squamous epithelial lining.

OBJECTIVE: Our objective was to specify cytokeratin (CK) patterns in lining epithelia of radicular cysts which are sometime lined with ciliated columnar epithelia as seen in the nasal epithelia. MATERIALS AND METHODS: We examined the CK expression in 52 radicular cysts obtained from 32 maxillary and 20 mandibular lesions and investigated CK-mRNA expression using in situ hybridization in 24 maxillary and 13 mandibular cysts and reverse transcription-polymerase chain reaction (RT-PCR) in 24 maxillary cysts. RESULTS: Of the maxillary cysts, 20, 29 and 19 squamous epithelial linings were positive for CK8, CK13 and CK18, respectively; of the mandibular cysts, 10, 20 and 11 linings were positive for these CKs, respectively. The expression patterns of CK18(+)-CK13(-), CK18(+)-CK13(+) and CK18(-)-CK13(+) were observed in 3, 16 and 13 linings of the maxillary cysts and 0, 11 and 9 linings of the mandibular cysts, respectively. In situ hybridization revealed the expression of CK18-mRNA in 9 and 4 linings of 24 maxillary and 13 mandibular cysts examined, respectively. With RT-PCR, we explored that both CK18- and CK13-mRNA were expressed not only in the normal nasal and gingival epithelia but also in the examined maxillary cyst linings although their expression levels differed correlating with the difference in CK staining. CONCLUSION: It is concluded that CK13- and CK18-mRNA are constitutively expressed in columnar and squamous epithelial cells, respectively, and that the variant CK expression patterns with CK18-mRNA expression in maxillary radicular cysts are indicative of the possibility of phenotypic transformation in the cyst linings.

Adult↗
PubMed1999

Epithelial splenic cysts in an intrapancreatic accessory spleen and spleen.

A rare case of cysts simultaneously occurring in the intrapancreatic accessory spleen and spleen in a 49-year-old female is reported. The patient underwent distal pancreatomy for a cystic tumor of the pancreas, and a splenectomy. A multilocular cyst (4.3 x 2.6 cm) in an accessory spleen at the pancreas tail, and a solitary cyst (1.2 x 0.9 cm) of the spleen were found. The cyst in the intrapancreatic accessory spleen was lined by non-keratinizing stratified squamous epithelium, and the spleen cyst by a single layer of flat epithelium; these lining cells were positive for Alcian blue stain and periodic acid-Schiff reaction, and were immunohistochemically positive for cytokeratin, HBME-1 and Sialyl-Tn. Epithelial membrane antigen, carcinoembryonic antigen and CA19-9 were positive in the accessory spleen cyst but were negative in the spleen cyst. An electron microscopic examination of the flat epithelium of the spleen cyst revealed numerous microvilli on the surface, cytoplasmic microfilaments, and a number of tight junctions between adjacent cells. These features suggested that the two cysts differ in nature, and origin; the accessory spleen cyst may be an embryonic inclusion of the pancreas duct while the spleen cyst may be an inclusion cyst of the mesothelium.

Biomarkers↗
PubMed2002

Comparison of ovarian cyst formation in women using the levonorgestrel-releasing intrauterine system vs. hysterectomy.

OBJECTIVE: To analyze the effect of the levonorgestrel-releasing intrauterine system (LNG-IUS) on ovarian cyst formation, endometrial thickness and the size of uterus and uterine fibroids by ultrasonography. SUBJECTS AND METHODS: This was a prospective, randomized trial comparing the LNG-IUS and hysterectomy in 236 women (age range 35-49 years) referred for menorrhagia. Transvaginal ultrasound examination was used to study the presence of ovarian cysts, uterine size, endometrial thickness, and the size of the uterus and uterine fibroids during a 12-month follow-up period. RESULTS: At baseline examination, 12 ovarian cysts were detected, eight in the LNG-IUS group and four in the hysterectomy group. During the follow-up period, 14 new cysts had emerged at 6 months and 14 new cysts had emerged at 12 months in the LNG-IUS group, whereas the corresponding figures in the hysterectomy group were three and eight, respectively. All but one of the 14 new cysts (94.1%) detected at 6 months in the LNG-IUS group resolved spontaneously, whereas two out of the eight cysts detected at the baseline examination persisted for 12 months. Three cysts were removed at operation. The relative risk of the occurrence of ovarian cysts was significantly higher in women with LNG-IUS, compared with women who underwent hysterectomy. LNG-IUS did not affect the size of the uterus or uterine fibroids, but it was associated with a decrease in endometrial thickness. The occurrence of cysts did not correlate with age or follicle stimulating hormone levels, but a weak positive correlation between the occurrence of cysts and the presence of irregular bleeding was observed. CONCLUSIONS: LNG-IUS use in the treatment of menorrhagia was associated with the development of ovarian cysts, but these were symptomless and showed a high rate of spontaneous resolution. LNG-IUS did not affect the size of the uterus or the size of uterine fibroids, but decreased the thickness of the endometrium.

Adult↗
PubMed1997

Changes in size of the functional cyst on ultrasonography during early pregnancy.

To clearly define the clinical behaviors of the functional cyst by ultrasonography and distinguish this cyst from other sonolucent ovarian cysts in pregnancy, changes in functional cyst size during early pregnancy were retrospectively evaluated with the cyst diameters derived from ultrasonic records of 58 pregnant patients with functional cysts. Of the 58 cases, 7 cases of functional cysts over 6 cm in diameter and 5 cases after 15 weeks were observed. Percent changes in cyst size per weeks of gestation were calculated from diameters of all cases. These percent changes were averaged respectively in four chronologic groups (5-7, 7-9, 9-12, and 12-15 weeks of gestation). As a result, although the mean percent change in cyst size showed a tendency to increase from 5 to 7 weeks (+0.9% per week), it turned negative after 7 weeks, and the decreasing tendency grew as gestation advanced (7-9 weeks: -8.3% per weeks; 9-12 weeks: -11.7% per weeks; 12-15 weeks: -15.2% per week). Therefore, the result showed that the maximum cyst size is reached at about 7 weeks with gradual diminution thereafter and the sonolucent ovarian cyst may be followed as a functional cyst, even if it is large or persists after 14 weeks.

Adnexa Uteri↗
PubMed1997

Perinatal management of enteric duplication cysts of the tongue.

Intra-oral enteric duplication cysts are rare. We recently treated two infants with prenatally diagnosed large sublingual enteric duplication cysts. Antenatal aspiration of the cyst was attempted in one infant without success. Because of the potential for airway obstruction and respiratory distress at delivery, preparation for an immediate tracheostomy was made in case oral intubation was impossible. Fortunately, aspiration of the cyst provided adequate access to the oropharynx for intubation in both infants. The placental cord was not divided until the airway was secured to minimize the potential for anoxic injury. Complete excision of the cyst was subsequently done in one patient. The other infant had an initial marsupialization and laser ablation of the cyst mucosa but the cyst recurred. Cyst excision at 9 months of age resolved the problem. Pathological examination revealed columnar-lined mucosa consistent with enteric duplication cysts. An enteric duplication cyst may present as a large sublingual mass with potential for airway obstruction in the newborn infant. Antenatal diagnosis allows for the proper preparation of personnel and equipment in the management of these neonates during delivery. If the airway is compromised, aspiration of the cyst can be done to improve the access to the oropharynx for intubation. Preparation for emergent tracheostomy should be done before delivery in case oral intubation is not possible. Subsequent complete cyst excision is the treatment of choice.

Airway Obstruction↗
PubMed1982

Supratentorial extracerebral cysts of the middle cranial fossa. A report of 23 consecutive cases of the so-called temporal lobe agenesis syndrome.

23 cases of supratentorial extracerebral cysts of the Sylvian fissure in children and adult patients are reported. There were 21 male and 2 female patients and the medial age was 15 years (range 2--60 years). The cysts were located in the left middle cranial fossa in 18 cases, in two cases there were bilateral cysts and three patients only had right-sided lesions. In 14 patients the presence of the cyst was uncomplicated. In two of these patients the cyst was detected only incidentally. Four patients had subdural haematomas in addition to the cyst. Two patients had subdural haematomas and were hydrocephalic as well. Three patients had large cysts and hydrocephalus. We did not encounter intracystic bleeding. Operation on the cysts by uncapping them was done in four cases. In all four instances histological examination of the cyst wall revealed that it was composed of arachnoid. Uncapping of the cyst was not followed by its diminution in any of the four patients. It seems that uncapping of such cysts is not a helpful treatment and that surgical treatment in our cases should have been restricted to complications such as subdural haematomas and hydrocephalus. A search for better operative methods for the treatment of large extracerebral supratentorial cysts of the middle cranial fossa should be undertaken.

Adolescent↗
PubMed2004

Extradural arachnoid cysts: a study of seven cases.

Analysis of the management of 7 cases of extradural arachnoid cyst is presented. A brief review of the literature on the subject is presented. Seven cases of extradural arachnoid cysts were treated surgically between the years 1996 to 2002. These patients were analysed retrospectively. The average follow-up period was 32 months. Three patients were males and four were females and their ages ranged from 12 to 35 years. The patients presented with predominant complaint of progressive motor deficits. There were two cysts in the dorsal region, four in the dorsolumbar region and one in the cervicodorsal region. The extradural arachnoid cyst was located posterior to the dural tube and in the midline in six cases and all these cysts had bilateral multiple intervertebral foraminal extensions. In the case with a cervicodorsal cyst, the cyst was anterolateral to the dural tube and there was no foraminal extension. The surgery comprised of wide exposure of the cyst and radical marsupialization or resection of the cyst wall. There was no recurrence of the cyst during the period of follow-up. Radical resection of the walls leads to a lasting cure from extradural arachnoid cyst. The site of communication of the cyst contents with subarachnoid CSF could not be identified during the surgery in the series.

Adolescent↗
PubMed1998

The prevalence of seminal vesicle cysts in autosomal dominant polycystic kidney disease.

BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) is a systemic hereditary disorder characterized by bilateral diffuse renal cysts. Extrarenal involvement is a well known manifestation of ADPKD. Data relating to the association between seminal vesicle cysts and ADPKD are limited. The aims of this study are to evaluate the frequency of seminal vesicle cysts in ADPKD and to assess the relationship between seminal vesicle cysts, with cysts in the liver and prostate, and creatininaemia. METHODS: Forty five male patients (mean age 40 years, range 13-67) were included in the study. Each subject underwent a formal interview, physical examination; and abdominal and transrectal ultrasonography. Three patients were infertile, but one of the patients also had varicocele. RESULTS: Seminal vesicle cysts were present in 27 (60%) patients. Liver and prostate cysts were present in 19 (42%) and five (11%) patients, respectively. There was a positive correlation between seminal vesicle cysts, cysts in the liver, and serum creatinine concentrations. CONCLUSION: Our conclusions are: (i) seminal vesicle cysts are not uncommon in ADPKD; (ii) ADPKD should be looked for in patients with seminal vesicle cysts, and (iii) the clinical significance of seminal vesicle cysts in ADPKD remains to be defined.

Adolescent↗
PubMed1999

Surgical management of calcaneal unicameral bone cysts.

Unicameral bone cysts are not seen commonly in the calcaneus. Little is known about the etiology and natural history of these lesions. Calcaneal cysts often are symptomatic, although some of these lesions are detected as incidental findings. Treatment has been advocated based on the fear of pathologic fracture and collapse. Several published series have been divided in their favor for either open treatment or injection management. These series are small, and the optimal treatment is still in question. The current study compared the efficacy of methylprednisolone acetate injection treatment with curettage and bone grafting in the treatment of unicameral bone cysts of the calcaneus. All patients treated for unicameral bone cysts of the calcaneus during the past 7 years at two institutions were reviewed. Eleven patients met inclusion criteria. All diagnoses were confirmed radiographically or histologically. Demographic information, presenting complaints, diagnostic imaging, treatment modalities, and outcome were analyzed. Long term radiographic and subjective followup was obtained. Eighteen surgical procedures were performed on 11 patients with 12 cysts. Nine injections performed on six patients failed to show healing of the cyst. Nine cysts treated with curettage and bone grafting showed cyst healing. At mean followup of 28 months (range, 12-77 months), all 11 patients had no symptoms; there were no recurrences of the cyst in the nine patients who underwent bone grafting and persistence of the cyst in the two patients who underwent injection therapy. This review reports one of the largest series of cysts in this location. The results indicate that steroid injection treatment, although useful in other locations, may not be the best option for the management of unicameral bone cysts in the calcaneus. Curettage and bone grafting yielded uniformly good results.

Adolescent↗