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121. Endovascular Management of Renal Arteriovenous Fistula With Large Aneurysm Masquerading as a Renal Cyst. (Abstract)

Endovascular Management of Renal Arteriovenous Fistula With Large Aneurysm Masquerading as a Renal Cyst. Large renal aneurysms can masquerade as simple renal cysts on ultrasound, especially if Doppler examination is not routinely done to assess flow characteristics. We present a case report of a 26-year-old male, as a clinical challenge in urology, who had minimal symptoms, yet had an arteriovenous fistula with a large aneurysm which was diagnosed as a parapelvic cyst on ultrasound

2020 Urology

122. Aspiration-sclerotherapy versus laparoscopic de-roofing in the treatment of renal cysts: which is better? Full Text available with Trip Pro

Aspiration-sclerotherapy versus laparoscopic de-roofing in the treatment of renal cysts: which is better? To compare the clinical efficiency between aspiration-sclerotherapy (AS) and laparoscopic de-roofing (LD) in the management of renal cysts through meta-analysis of comparative studies.A comprehensive literature search was performed by PubMed, MEDLINE, Ovid and Web of Science for relevant studies published up to January 2020. The statistical analyses were conducted with Review Manager 5.3.0 (...) and Stata 15.1. The sensitivity analysis was also carried out to confirm the reliability of this Meta-analysis.Our searches of literature generated 6 studies (1547 patients incorporated) comparing AS with LD in the impacts of renal cyst therapy. Of these, 6 studies contained 1106 and 441 patients who were treated with AS and LD, respectively. The outcome of this meta-analysis indicated that LD group was superior in symptomatic successful rate [Odds Ratio (OR): 0.28; 95%Confidence Interval (CI): 0.09

2020 BMC Nephrology

123. Association of simple renal cysts and chronic kidney disease with large abdominal aortic aneurysm. Full Text available with Trip Pro

Association of simple renal cysts and chronic kidney disease with large abdominal aortic aneurysm. Abdominal aortic aneurysms (AAA) primarily affect men over 65 years old who often have many other diseases, with similar risk factors and pathobiological mechanisms to AAA. The aim of this study was to assess the prevalence of simple renal cysts (SRC), chronic kidney disease (CKD), and other kidney diseases (e.g. nephrolithiasis) among patients presenting with AAA.Two groups of patients (97 AAA

2020 BMC Nephrology

124. Type IV choledochal cyst with polycystic kidney disease: a case report. Full Text available with Trip Pro

Type IV choledochal cyst with polycystic kidney disease: a case report. Choledochal cysts are divided into 5 types. Physicians believe that Caroli disease (which refers to type V biliary cysts) is a special type of biliary cyst caused by a mutation in the PKHD1 gene and is associated with autosomal recessive polycystic kidney disease (ARPKD). There is currently no clear association between other types of choledochal cysts and polycystic kidney disease.We report a 65-year-old male patient (...) with jaundice, decreased appetite, and itchy skin. His biochemistry test results indicated obstructive jaundice disease. Cross-sectional imaging showed a type IVA choledochal cyst accompanied by autosomal dominant polycystic kidney disease (ADPKD). Due to economic difficulties, the patient achieved percutaneous transhepatic cholangial drainage (PTCD) instead of surgery.To our knowledge, this is the second case report of the coexistence of type IVA choledochal cysts and ADPKD. We conclude that it is vital

2020 BMC Gastroenterology

125. Elevated hemoglobin A1c is associated with the presence of pancreatic cysts in a high-risk pancreatic surveillance program. Full Text available with Trip Pro

Elevated hemoglobin A1c is associated with the presence of pancreatic cysts in a high-risk pancreatic surveillance program. Emerging evidence demonstrates that surveillance of individuals at high-risk (HRIs) of developing pancreatic adenocarcinoma allows for identification and treatment of resectable tumors with improved survival. Population-based data suggest that hyperglycemia may be present up to three years before the development of pancreatic cancer. We investigated whether elevated (...) hemoglobin A1c (HbA1c) is associated with the development of pancreatic cysts in a pancreatic surveillance program.We performed a retrospective study of HRIs who underwent pancreatic surveillance at a single institution between May 2013 and March 2019, according to published criteria. We collected demographic information, clinical data including HbA1c, and imaging results. We compared data using univariable and multivariable analyses. Our primary outcome was the presence of pancreatic cysts on initial

2020 BMC Gastroenterology

126. Closed Cyst Resection for Liver Hydatid Disease: a New Standard. (Abstract)

Closed Cyst Resection for Liver Hydatid Disease: a New Standard. Although radical resections are recommended for the surgical management of liver hydatid disease (LHD), whether closed (CCR) or opened (OCR) cyst resections should be performed remains unclear. The aim of this study was to compare the postoperative and long-term outcomes of CCR and OCR for primary and recurrent LHD.Medical charts of patients who underwent surgery at a single centre were retrospectively reviewed and compared (...) ). The mean time to recurrence was 10.5 (± 8) years.Closed cyst resection for LHD is a safe and effective approach with a low risk of recurrence. Considering that recurrence could appear more than 10 years after surgery, follow-up of patients should be adapted.

2020 Journal of Gastrointestinal Surgery

127. FUS-NFATC2 or EWSR1-NFATC2 Fusions Are Present in a Large Proportion of Simple Bone Cysts. (Abstract)

FUS-NFATC2 or EWSR1-NFATC2 Fusions Are Present in a Large Proportion of Simple Bone Cysts. A simple bone cyst (SBC) is a benign bone lesion of unknown etiology. It can be differentiated from an aneurysmal bone cyst (ABC) by radiologic and histopathologic features, as well as by the absence of fusions of the USP6 gene characteristic of an ABC. In an attempt to differentiate between ABC and SBC in a recurrent bone cyst, we performed targeted RNA sequencing and found an EWSR1-NFATC2 fusion (...) and no fusion of the USP6 gene. We subsequently analyzed additional 10 cysts, consistent with SBCs after radiologic-pathologic correlation, for the presence of an NFATC2 gene fusion, by targeted RNA sequencing, reverse-transcription polymerase chain reaction (RT-PCR) and Sanger sequencing, and fluorescent in situ hybridization. Targeted RNA sequencing showed a FUS-NFATC2 fusion in 4 of 11 SBCs and an EWSR1-NFATC2 fusion in 2 of 11 SBCs. No fusion was identified in 3 SBCs and the analysis was not successful

2020 American Journal of Surgical Pathology

128. Surgical Resection of an Adventitial Cyst of the Right Brachiocephalic Vein. (Abstract)

Surgical Resection of an Adventitial Cyst of the Right Brachiocephalic Vein. Adventitial cystic disease is an uncommon vascular anomaly known to occur in peripheral vessels but mediastinal appearances are extremely rare. Herein, we report the case of an adventitial cyst occurring in the right brachiocephalic vein which might have been associated with ovarian hyperstimulation syndrome.Copyright © 2020 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

2020 Annals of Thoracic Surgery

129. Huge aneurysmal bone cyst secondary to giant cell tumor of the hand phalanx: a case report and related literature. Full Text available with Trip Pro

Huge aneurysmal bone cyst secondary to giant cell tumor of the hand phalanx: a case report and related literature. Aneurysmal bone cyst (ABC) secondary to Giant Cell Tumor of bone (GCT) is a rare lesion, of which the incidence is about 0.011 to 0.053 per 100,000 every year. There are only a few previous case reports, and most of them occur in the spine, long bones or flat bones.We report one case of a patient who complained of "progressive enlargement of the mass on right-hand fifth finger (...) for 5 years with ulceration for 6 months". After the imaging examination in our hospital, it was diagnosed as a "huge bone tumor on the proximal phalanx of the right-hand fifth finger", then wide excision and amputation of the fifth finger were made. The pathological examination diagnosed the mass as aneurysmal bone cyst secondary to giant cell tumor, 13 × 8 × 6 cm3, with no local infiltration observed. No recurrence and metastasis occurred 18 months after the operation, and the patient recovered

2020 BMC Cancer

130. Synovial Cysts Confounding Access to the Dorsal S1 Neural Foramen in Transforaminal Epidural Steroid Injections. (Abstract)

Synovial Cysts Confounding Access to the Dorsal S1 Neural Foramen in Transforaminal Epidural Steroid Injections. The S1 dorsal foramen is the route for 30% of lumbar transforaminal epidural injections; it is therefore important to identify structures impeding S1 foraminal access. The study objective was to characterize the imaging findings, prevalence, and anatomic origin of synovial cysts presenting within the S1 neural foramen.A case series (N = 14) established imaging characteristics of S1 (...) synovial cysts. Imaging studies of 400 patients undergoing epidural injections were reviewed for lesions compromising S1 foraminal access. Cadaveric dissections defined the relationship of the inferior recess of the L5-S1 facet to the S1 dorsal foramen.Elderly patients (mean age = 76) exhibited S1 synovial cysts. Synovial cysts were typically 1-2 cm in diameter, hyperintense on sagittal T2 weighted magnetic resonance images (MRIs), fluid-density on computed tomography, and dorsal to the S1 spinal nerve

2020 Pain Medicine

131. Endoscopic bimanual sharp dissection technique for gross-total resection of colloid cysts: technical note. (Abstract)

Endoscopic bimanual sharp dissection technique for gross-total resection of colloid cysts: technical note. Neuroendoscopic resection of colloid cysts has gained tremendous popularity over the last 2 decades because of good clinical outcomes and a low complication profile. However, in comparison to microsurgical resections, endoscopic resection has a lower rate of gross-total resection, which leaves the patient at risk for cyst recurrence. At present, there is still ongoing debate as to the best (...) surgical approach for colloid cysts. Endoscopic resection as a technique has to compete with the good outcomes of microsurgical resections with respect to a long-term recurrence-free outcome. It is the authors' belief that gross-total resection should be the aim of endoscopic cyst resection. In this technical note, they describe their surgical technique for achieving safe gross-total resection of colloid cysts by using a ventriculoscopic system. The surgical technique includes a far anterolateral entry

2020 Journal of Neurosurgery

132. 3D, Weightbearing Topographical Study of Periprosthetic Cysts and Alignment in Total Ankle Replacement. (Abstract)

3D, Weightbearing Topographical Study of Periprosthetic Cysts and Alignment in Total Ankle Replacement. We investigated the association between hindfoot residual malalignment assessed on weightbearing computed tomography (WBCT) images and the development of periprosthetic cysts (PPCs) after total ankle replacement (TAR). We hypothesized that PPCs would be found predominantly medially in the varus configuration and laterally in the valgus configuration.Cases of primary TAR with available WBCT (...) imaging of the ankle were included in this retrospective study. The location of the PPC was marked and the following volumes were calculated: total (TCV), medial (MCV), central (CCV), and lateral (LCV) cyst volumes. Hindfoot alignment was measured as Foot and Ankle Offset (FAO), with 95% confidence intervals (95% CIs) calculated to define varus (<95% CI) and valgus (>95% CI) groups. Cyst volumes were compared between these 2 groups. The American Orthopaedic Foot & Ankle Society (AOFAS) score

2020 Foot & Ankle International

133. Bone Cysts and Osteolysis in Ankle Replacement. (Abstract)

Bone Cysts and Osteolysis in Ankle Replacement. Total ankle replacements (TARs) have higher rates of osteolysis than hip or knee replacements. It is unclear whether this is a pathologic immunologic process in response to wear debris, or expansion of pre-existing osteoarthritic bone cysts. We aimed to determine the incidence of bone cysts in patients with end-stage ankle arthritis prior to surgery and review the literature on bone cysts and osteolysis in relation to TAR.This is a descriptive (...) /prevalence study in which all patients with end-stage ankle arthritis underwent plain radiographic imaging and computed tomographic (CT) scans prior to TAR surgery. Their imaging was assessed for the presence of cysts, measured on sagittal, axial, and coronal slices of the CT scan at the widest diameter. All cysts that would be removed as a result of the bone resection for the implant were excluded using digital analysis software. We assessed 120 consecutive patients with mean age of 63.4 years.Seventeen

2020 Foot & Ankle International

134. Simple renal cyst and its association with sac shrinkage after endovascular aneurysm repair for abdominal aortic aneurysms. (Abstract)

Simple renal cyst and its association with sac shrinkage after endovascular aneurysm repair for abdominal aortic aneurysms. Patients with abdominal aortic aneurysm (AAA) frequently have simple renal cyst (SRC), a common manifestation of connective tissue degeneration. This study aimed to determine whether SRC is a risk factor for failure of sac shrinkage after endovascular aneurysm repair (EVAR).Between October 2013 and May 2017, there were 155 consecutive patients with an infrarenal AAA

2020 Journal of Vascular Surgery

135. Huge intrameniscal cyst successfully treated by open debridement and combined arthroscopic and open repair: a case report. Full Text available with Trip Pro

Huge intrameniscal cyst successfully treated by open debridement and combined arthroscopic and open repair: a case report. Meniscal cysts are not uncommon in clinical practice, with reported incidence rates varying from 1 to 22%. Most meniscal cysts are parameniscal cysts, which are created by extravasation of synovial fluid through the meniscal tear into the adjacent soft tissue. In contrast, intrameniscal cysts in which the fluid collects in the meniscus are very rare. We encountered (...) a teenager with a huge intrameniscal cyst accompanied by a small vertical meniscal tear in the red-white zone of the upper surface of the medial meniscus. A literature search revealed no information regarding the appropriate treatment methods and results for this type of lesion.A 14-year-old boy presented to our outpatient clinic because of right knee pain that had been present for the previous 2 months. The patient participated in Hapkido, but had no specific trauma history. Magnetic resonance imaging

2020 BMC Musculoskeletal Disorders

136. Pediatric physeal slide-traction plate fixation for pathological distal femoral fracture caused by unicameral bone cyst in adolescents. Full Text available with Trip Pro

Pediatric physeal slide-traction plate fixation for pathological distal femoral fracture caused by unicameral bone cyst in adolescents. Most patients suffering from distal femoral unicameral bone cysts (UBCs) are adolescents that require an early return to normal activities, including school attendance and sports exercises. However, the optimal choice of implants for such patients remains controversial. This study evaluated the application of pediatric physeal slide-traction plate (PPSP

2020 BMC Musculoskeletal Disorders

137. Massive splenic cyst in pregnancy: case report. Full Text available with Trip Pro

Massive splenic cyst in pregnancy: case report. Primary splenic cysts are very rarely diagnosed in pregnancy, with only thirteen cases described in the literature. We examine the approach towards diagnosing and managing uniquely large abdominal masses that significantly complicate obstetric care.A 37-year-old primigravida woman presented with abdominal distension and discomfort, yet otherwise asymptomatic. On ultrasound, an incidental pregnancy at 25 weeks of gestation and a large pelvic lesion (...) were discovered. MRI defined a 28 × 29 cm lobulated, complex cystic mass in the upper abdomen. The patient underwent two ascitic drainages throughout her pregnancy. At 34 weeks of gestation, she had a classical caesarean section. Then at five-weeks postpartum, she underwent a laparotomy and total splenectomy with 16 L of fluid drained. Histopathological analysis revealed an epithelial cyst of the spleen. Her recovery was complicated by complete portal vein thrombosis.This case describes the largest

2020 BMC Pregnancy and Childbirth

138. Misdiagnosis of a twin pregnancy with double-corner uterine rupture following salpingectomy and protrusion of the amniotic sac as an adnexal cyst: a case report. Full Text available with Trip Pro

Misdiagnosis of a twin pregnancy with double-corner uterine rupture following salpingectomy and protrusion of the amniotic sac as an adnexal cyst: a case report. Salpingectomy-associated uterine rupture during intrauterine pregnancy is rare in the clinic. We report a case of pregnancy with bilateral rupture of the uterine horns after bilateral salpingectomy.A 30-year-old woman of Han ethnicity presented with right epigastric pain at 28 weeks and 6 days of gestation. Examination by colour (...) Doppler ultrasound showed the following: "Twin live births with normal foetal umbilical artery blood flow indexes and a 183 mm × 112 mm anechoic zone in the right front of the uterus". Initially, we made an incorrect judgement wherein we considered the amniotic sac that was protruding into the abdominal cavity to be an adnexal cyst. Fortunately, the diagnosis of uterine rupture was confirmed before the protruded amniotic sac broke. The mother did not bleed much, and the twin foetuses survived in our

2020 BMC Pregnancy and Childbirth

139. Lacrimal ductal cyst of the medial orbit: a case report. Full Text available with Trip Pro

Lacrimal ductal cyst of the medial orbit: a case report. The lacrimal ductal cyst (dacryops) is an uncommon clinical entity. It occurs anywhere that lacrimal gland tissue is present but most often appears as an expanding mass in the region of the lacrimal gland. The presence involving the medial part of the orbit is rare, ectopic location can be misleading in the differential diagnosis of orbital masses. The authors report a 53-year-old man who presented with dacryops occurred in an unusual (...) ) studies revealed the presence of an isolated cystic lesion. The mass was completely removed via a transcutaneous approach, histopathologic findings were consistent with the lacrimal ductal cyst. The ocular motility and high IOP returned to normal. There had been no post-operative complications or signs of recurrence over five months follow-up.Lacrimal ductal cysts can present in the medial orbit, clinicians should include this entity in the differential diagnosis of orbital masses and be aware of its

2020 BMC Ophthalmology

140. Medical treatment for an isolated renal multilocular hydatid cyst in an elderly: a case report. Full Text available with Trip Pro

Medical treatment for an isolated renal multilocular hydatid cyst in an elderly: a case report. Almost all cases of renal hydatid cysts need surgical intervention for treatment. We report a case of isolated renal hydatid cyst treated successfully only with medical therapy.This case is a 79-year-old veterinarian presented with right flank pain, hydatiduria and positive echinococcus granulosus serology. A 70*50 mm cyst with daughter cysts in mid-portion of right kidney on presentation was changed (...) into a 60*40 mm cyst without daughter cysts at last follow-up. Due to patient's refusal of surgery, our patient received medical treatment including praziquantel and albendazole. After completion of first round of treatment, recurrence occurred and the same treatment was repeated. At last, the cyst became inactive and calcified with negative serology and no clinical symptoms under medical treatment.The treatment of choice in renal hydatid cyst is surgery; although there are some reports about

2020 BMC Nephrology

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