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161. Incidence and clinical predictors of cystic squamous cell carcinoma metastases in lateral cervical cysts. (Abstract)

Incidence and clinical predictors of cystic squamous cell carcinoma metastases in lateral cervical cysts. This study aimed to determine the incidence of metastatic squamous cell carcinoma in patients with an isolated cervical cystic mass, and to describe the clinical features that might predict the origin of cystic tumours.Adult patients with isolated lateral cervical cystic masses who were scheduled for surgery from 1st January 2010 to 31st August 2016 in two tertiary care referral centres (...) in Slovakia were analysed retrospectively.The incidence of cystic metastases in the whole cohort and in patients aged over 40 years were 9.9 per cent and 18.5 per cent, respectively. The incidence in patients aged over 40 years (18.5 per cent) was statistically significant (p = 0.003).The incidence of cystic squamous cell carcinoma metastases in lateral cervical cysts in patients aged over 40 years is high enough to call for excisional biopsy with frozen section, panendoscopy with direct biopsies

2019 Journal of Laryngology & Otology

162. Atypical thyroglossal duct cyst with intra-laryngeal and para-glottic extension. (Abstract)

Atypical thyroglossal duct cyst with intra-laryngeal and para-glottic extension. Thyroglossal duct cysts (TDC) are the most common congenital neck masses. Although they are anatomically closely related to the larynx, intra-laryngeal extension is very rare. We present a case, review the literature and discuss the challenges of intra-laryngeal TDC. A 55-year-old man presented with a neck mass associated with dysphagia. Computer Tomography neck scan showed a midline cyst extending to the pre (...) -epiglottic space with partial obliteration of the right pyriform sinus and narrowing of the larynx. The cyst was excised en-bloc via Sistrunk procedure. Intra-laryngeal TDC are surgically challenging due to risk of perforation into the aerodigestive tract.Copyright © 2019 Elsevier Inc. All rights reserved.

2019 American Journal of Otolaryngology

163. Preventing Restenosis of Marsupialized Rathke Cleft Cysts Using a Nasoseptal Flap Lining. (Abstract)

Preventing Restenosis of Marsupialized Rathke Cleft Cysts Using a Nasoseptal Flap Lining. Rathke cleft cysts (RCCs) are rare, benign lesions formed from remnants of Rathke pouch during embryologic development. However, following marsupialization, maintaining tract patency remains a challenge. Several techniques for decreasing stenosis have been described, including free mucosal grafting, silastic spacing, and using steroid-eluting stents. Nasoseptal flaps (NSFs) have a reliable vascular supply (...) symptomatic control, surgical complications, and RCC cavity patency.Seven patients underwent RCC marsupialization with no intraoperative cerebrospinal fluid leak, followed by circumferential lining of the marsupialized cavity with an NSF. In each case, no cyst re-accumulation or recurrent symptoms were noted, and the NSF lining provided long-term patency of the tract in all cases to a mean of 6.7 ± 10.1 months of follow-up, including one patient with sustained patency at 29 months follow-up.Utilization

2019 Laryngoscope

164. Laparoscopic management for aberrant hepatic duct in children with choledochal cysts. (Abstract)

Laparoscopic management for aberrant hepatic duct in children with choledochal cysts. The aim of the current study is to evaluate efficacy of laparoscopic treatment for aberrant hepatic duct (AHD) in children with cholecochal cysts (CDC).CDC children with AHDs who successfully underwent laparoscopic ductoplasties and hepaticojejunostomies between October 2001 and October 2017 were reviewed. The AHD variations were categorized into four subtypes and the surgical management varied according (...) patients with giant cysts had fluid collections, and were cured by drainages. One patient encountered duodenal injury at perforation site, and underwent laparoscopic repair. None of the patients had anastomotic stenosis, bile leak, cholangitis, intrahepatic reflux, pancreatic leak, pancreatitis, Roux-loop obstruction, or adhesive intestinal obstruction. Postoperative liver function tests and serum amylase level normalized within 1 year.Recognition and treatment based on different subtypes of AHDs

2019 Surgical endoscopy

165. Endoscopic removal of recurrent colloid cysts. (Abstract)

Endoscopic removal of recurrent colloid cysts. OBJECTIVERemoval of colloid cysts of the third ventricle using a purely endoscopic method has been established as a safe and advantageous technique. It is hypothesized that endoscopic removal in recurrent cases might pose more technical challenges and result in less success. The objective of this study was to assess the feasibility and outcomes of using a purely endoscopic approach for the management of recurrent colloid cysts compared to primary (...) cysts.METHODSA retrospective cohort study was performed on patients who underwent purely endoscopic removal of their colloid cyst. Descriptive statistics were compared for patients undergoing surgery for a recurrent cyst and those for a control cohort undergoing surgery for a primary cyst. Bivariate analysis was conducted using a Fisher's exact test for categorical variables and Mann-Whitney U-test for continuous variables.RESULTSIn total, 121 patients had a primary colloid cyst endoscopically removed and 10

2019 Journal of Neurosurgery

166. Aneurysmal bone cysts of the clavicle: a comparison of extended curettage and segmental resection with bone reconstruction. (Abstract)

Aneurysmal bone cysts of the clavicle: a comparison of extended curettage and segmental resection with bone reconstruction. Although curettage of an aneurysmal bone cyst (ABC) of the clavicle has a high rate of local recurrence, segmental resection is often avoided for treatment as it causes functional impairment and shoulder deformity. We evaluated the rate of local recurrence and functional outcomes of extended curettage vs. segmental resection with bone reconstruction for the treatment

2019 Journal of Shoulder and Elbow Surgery

167. An animal model of cutaneous cyst development enables the identification of three QTLs including the homologue of a human locus (TRICY1). (Abstract)

An animal model of cutaneous cyst development enables the identification of three QTLs including the homologue of a human locus (TRICY1). Using inbred BN and LE/Stm rats susceptible and resistant, respectively, to chemically induced cutaneous cyst development we were able to further unveil the genetic architecture of inherited multiple cyst formation. N-methyl-N-nitrosourea-treated (BN x LE) F2 intercross rats proved to develop differential numbers of cutaneous cysts, demonstrating epidermal (...) , trichilemmal and verrucous keratinization types. Male rats developed significantly more cysts per animal than females. QTL interval mapping yielded three loci on rat chromosomes 1, 8 and 11 (Ccd1, Ccd2, Ccd3) linked to cutaneous cyst formation. Ccd2 proved to be homologous to the human TRICY1 region which could further be narrowed down by genome comparison in both species. It contains 11 genes with evidence of expression in human keratinocytes.Copyright © 2019 The Authors. Published by Elsevier Inc. All

2019 Journal of Investigative Dermatology

168. The prevalence, clinico-demographics and outcomes of incidental and symptomatic renal cysts in a paediatric cohort undergoing ultrasonography. (Abstract)

The prevalence, clinico-demographics and outcomes of incidental and symptomatic renal cysts in a paediatric cohort undergoing ultrasonography. The growing availability of modern day imaging has resulted in an increase in the number of renal cysts detected in the paediatric population. Few publications have reported outcomes of these childhood cysts. The objective of our study was to assess the prevalence and evolution of renal cysts in children, and to describe clinical characteristics, mode (...) of presentation, and ultimate outcomes Methods: Our institutional ultrasound (US) database was searched for all abdominal US reports from 2006-2017. These were then cross-referenced with a manual retrospective chart review. Clinical characteristics including mode of presentation, cyst characteristics, and outcomes were analyzed using descriptive and non-parametric statistical methods Results: Of 70,500 abdominal US scans during the study period, 1,531 (2.2%) scans met inclusion criteria. 26% of cysts were

2019 Journal of Urology

169. Case report: a giant arachnoid cyst masking Alzheimer's disease. (Full text)

Case report: a giant arachnoid cyst masking Alzheimer's disease. Intracranial arachnoid cysts are usually benign congenital findings of neuroimaging modalities, sometimes however, leading to focal neurological and psychiatric comorbidities. Whether primarily clinically silent cysts may become causally involved in cognitive decline in old age is neither well examined nor understood.A 66-year old caucasian man presenting with a giant left-hemispheric frontotemporal cyst without progression (...) for the APOEε3-gene. A diagnosis of MCI due to Alzheimer's disease was given and a co-morbidity with a silent arachnoid cyst was assumed. To investigate, if a potentially reduced CSF flow due to the giant arachnoid cyst contributed to the early manifestation of AD, we reviewed 15 case series of subjects with frontotemporal arachnoid cysts and cognitive decline. However, no increased manifestation of neurodegenerative disorders was reported.With this case report, we illustrate the necessity of a systematic

2019 BMC Psychiatry PubMed abstract

170. Symptomatic Tarlov cysts are often overlooked: ten reasons why-a narrative review. (Abstract)

Symptomatic Tarlov cysts are often overlooked: ten reasons why-a narrative review. Tarlov cysts (TCs) are dilations of nerve roots arising from pathologically increased hydrostatic pressure (HP) in the spinal canal. There is much controversy regarding whether these cysts are a rare source of pain or often produce symptoms. The aim of this review was to identify the reasons that symptomatic TCs (STCs) are easily overlooked.The literature was searched for data regarding pathogenesis (...) ; (7) examinations and treatments usually focus on the cysts as an underlying mechanism; however, essentially, increased HP is the main underlying mechanism for producing symptoms. Consequently, STCs may relapse after surgery; (8) bladder, bowel and sphincter dysfunction are not inquired about during history taking. (9) Unexplained pain is often attributed to depression, whereas depression is more likely the consequence of debilitating neuropathic pain. (10) The recognition of STCs is subject

2019 European Spine Journal

171. Antenatally-detected liver cysts: Causes and characteristics, indications for intervention. (Abstract)

Antenatally-detected liver cysts: Causes and characteristics, indications for intervention. The prevalence of antenatally-detected hepatic cysts is increasing owing to increased use of maternal ultrasonography (USS). Diagnostic precision, however, is challenging and subsequently there is no clear consensus on postnatal management. The aim of the study was to evaluate the natural history and long-term follow up of congenital simple hepatic cysts.Single-center review of prospectively-maintained (...) dataset collected over a 25-year period. Data are quoted as median (range).In the period 1991-2016, 31 infants presented with an antenatally-detected cyst which, on postnatal imaging, was likely confirmed as a simple parenchymal hepatic cyst. These together with a further infant who presented at 4 days without any antenatal imaging comprised the study group (n = 32). Gestational age at detection was 23 (13-38) weeks. Maximum antenatal cyst diameter was measured at 19 (4-120) mm. Only the largest

2019 Journal of Pediatric Surgery

172. Acute pancreatitis with Cullen's sign presentation in a case of mixed type I and II choledochal cyst. (Abstract)

Acute pancreatitis with Cullen's sign presentation in a case of mixed type I and II choledochal cyst. A 3 year old girl presented initially with acute severe hemorrhagic pancreatitis diagnosed by clinical features including a positive Cullen's sign and raised serum amylase. A contrast enhanced computed tomography (CECT) scan corroborated the same and also reported a type I choledochal cyst. Magnetic resonance cholangiopancreatography (MRCP) 2 months later reported a type II choledochal cyst (...) and a persistent pseudo pancreatic cyst. Intraoperative features and close perusal of the CECT and MRCP films showed the presence of mixed type I and II choledochal cyst. The case is reported for the presence of Cullen's sign, CECT and MRCP features of a mixed type I and II choledochal cyst and successful surgical outcome. It appears to be only the fifth case of mixed type I and II choledochal cyst in world literature in the pediatric age group, following the 4 previous cases in children reported from

2019 Journal of Pediatric Surgery

173. Capitonnage seems better in childhood pulmonary hydatid cyst surgery. (Abstract)

Capitonnage seems better in childhood pulmonary hydatid cyst surgery. Pulmonary hydatid disease remains an important healthcare problem. Conservative operative interventions including cystotomy or cystotomy with capitonnage are the two commonly used techniques. However, there is no scientific consensus over selection of these operative interventions.The aim of this study is to compare these two methods: capitonnage and uncapitonnage in the surgery of childhood pulmonary hydatid cyst in regard

2019 Journal of Pediatric Surgery

174. A monoallelic two-hit mechanism in PLCD1 explains the genetic pathogenesis of hereditary trichilemmal cyst formation. (Abstract)

A monoallelic two-hit mechanism in PLCD1 explains the genetic pathogenesis of hereditary trichilemmal cyst formation. Trichilemmal cysts are common hair follicle-derived intradermal cysts. The trait shows an autosomal dominant mode of transmission with incomplete penetrance. Here, we describe the pathogenetic mechanism for the development of hereditary trichilemmal cysts. By whole exome sequencing of DNA from blood samples of five affected individuals and subsequent Sanger sequencing (...) of a family cohort including 35 affected individuals, we identified a combination of the Phospholipase C Delta 1 (PLCD1) germline variants c.903A>G, p.(Pro301Pro) and c.1379C>T, p.(Ser460Leu) as a high-risk factor for trichilemmal cyst development. Allele-specific PCRs and cloning experiments showed that these two variants are present on the same allele. Analysis of tissue from several cysts revealed that an additional somatic PLCD1 mutation on the same allele is required for cyst formation. In two

2019 Journal of Investigative Dermatology

175. Laparoscopic fenestration for a large ruptured splenic cyst combined with an elevated serum carbohydrate antigen 19-9 level: a case report. (Full text)

Laparoscopic fenestration for a large ruptured splenic cyst combined with an elevated serum carbohydrate antigen 19-9 level: a case report. Non-parasitic splenic cysts are associated with elevated serum carbohydrate antigen (CA) 19-9 levels. We report a case in which a 23-year-old female exhibited a large ruptured splenic cyst and an elevated serum CA19-9 level.The patient, who experienced postprandial abdominal pain and vomiting, was transferred to our hospital and was found to have a large (...) splenic cyst during an abdominal computed tomography (CT) scan. On physical examination, her vital signs were stable, and she demonstrated rebound tenderness in the epigastric region. An abdominal CT scan revealed abdominal fluid and a low-density region (12 × 12 × 8 cm) with enhanced margins in the spleen. The patient's serum levels of CA19-9 and CA125 were elevated to 17,580 U/mL and 909 U/mL, respectively. A cytological examination of the ascitic fluid resulted in it being categorized as class II

2019 BMC Surgery PubMed abstract

176. A case report of ectopic pancreatitis in an isolated enteric duplication cyst. (Full text)

A case report of ectopic pancreatitis in an isolated enteric duplication cyst. Isolated enteric duplication cyst is an intestinal duplication cyst found in a distant location from the intestinal tract and it is said to have its own blood supply. Meckel's diverticulm is considered as an antimesenteric structure and has its own blood supply. However, there are some reported cases of Meckele's diverticum in the mesenteric side. Ectopic pancreas may be found in both entities.A 5-year-old girl (...) . Pathologically, the wall of the lesion consisted of small bowel like tissue, and pancreatic tissue was seen beneath the mucosa. There were some post inflammatory changes in the pancreatic tissue. Retrospectively on thin slice enhanced CT, an independent blood supply was noted. Based on these findings, a diagnosis of ectopic pancreatitis in an iliac intestinal duplication cyst was made.Isolated enteric duplication cyst in the root of ileal mesentery and mesenteric Meckel's diverticulum have similarities

2019 BMC Surgery PubMed abstract

177. Roscovitine blocks collecting duct cyst growth in Cep164-deficient kidneys. (Abstract)

Roscovitine blocks collecting duct cyst growth in Cep164-deficient kidneys. Nephronophthisis is an autosomal recessive kidney disease with high genetic heterogeneity. Understanding the functions of the individual genes contributing to this disease is critical for delineating the pathomechanisms of this disorder. Here, we investigated kidney function of a novel gene associated with nephronophthisis, CEP164, coding a centriolar distal appendage protein, using a Cep164 knockout mouse model (...) . Collecting duct-specific deletion of Cep164 abolished primary cilia from the collecting duct epithelium and led to rapid postnatal cyst growth in the kidneys. Cell cycle and biochemical studies revealed that tubular hyperproliferation is the primary mechanism that drives cystogenesis in the kidneys of these mice. Administration of roscovitine, a cell cycle inhibitor, blocked cyst growth in the cortical collecting ducts and preserved kidney parenchyma in Cep164 knockout mice. Thus, our findings provide

2019 Kidney International

178. The impact of ganglion cell layer cysts in diabetic macular oedema treated with anti-vascular endothelial growth factor. (Abstract)

The impact of ganglion cell layer cysts in diabetic macular oedema treated with anti-vascular endothelial growth factor. To investigate the prevalence and impact of ganglion cell layer cysts (GCLC) in patients with diabetic macular oedema (DME) under continuous anti-vascular endothelial growth factor (VEGF) therapy.The clinical findings and spectral domain optical coherence devices of baseline visits and follow-up after 12-24 and 36 months of DME patients under continuous anti-VEGF therapy were (...) retrospectively collected and analysed for the impact of GCLC cysts. Previously established prognostic parameters were also assessed.A total of 110 eyes of 110 DME patients (mean age 64 ± 10 years) were included. At baseline, 17% eyes had GCLC. With GCLC, the best-corrected visual acuity (BCVA) improvement was in mean 8.4 ± 2.4 Early-Treatment-Diabetic-Retinopathy-Study (ETDRS) letters less over the course of 36 months compared to the group lacking GCLC (p = 0.0009). Eyes with GCLC showed 68 ± 23.4 μm less

2019 Acta ophthalmologica

179. Clinical outcome after decompression of intraneural peroneal ganglion cyst and its morphologic correlation to postoperative nerve ultrasound. (Abstract)

Clinical outcome after decompression of intraneural peroneal ganglion cyst and its morphologic correlation to postoperative nerve ultrasound. Intraneural ganglion cysts are rare and benign mucinous lesions that affect peripheral nerves, most frequently the common peroneal nerve (CPN). The precise pathophysiological mechanisms of intraneural ganglion cyst development remain unclear. A well-established theory suggests the spread of mucinous fluid along the articular branch of the peroneal nerve (...) as the underlying mechanism. Clinical outcome following decompression of intraneural ganglion cysts has been demonstrated to be excellent. The aim of this study was to evaluate the correlation between clinical outcome and ultrasound-detected morphological nerve features following decompression of intraneural ganglion cysts of the CPN.Data were retrospectively analyzed from 20 patients who underwent common peroneal nerve ganglion cyst decompression surgery at the Universität Ulm/Günzburg Neurosurgery Department

2019 Journal of Neurosurgery

180. Development and evaluation of a patient-specific surgical simulator for endoscopic colloid cyst resection. (Abstract)

Development and evaluation of a patient-specific surgical simulator for endoscopic colloid cyst resection. Endoscopic resection of third-ventricle colloid cysts is technically challenging due to the limited dexterity and visualization provided by neuroendoscopic instruments. Extensive training and experience are required to master the learning curve. To improve the education of neurosurgical trainees in this procedure, a synthetic surgical simulator was developed and its realism, procedural (...) content, and utility as a training instrument were evaluated.The simulator was developed based on the neuroimaging (axial noncontrast CT and T1-weighted gadolinium-enhanced MRI) of an 8-year-old patient with a colloid cyst and hydrocephalus. Image segmentation, computer-aided design, rapid prototyping (3D printing), and silicone molding techniques were used to produce models of the skull, brain, ventricles, and colloid cyst. The cyst was filled with a viscous fluid and secured to the roof of the third

2019 Journal of Neurosurgery

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