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161. Pineal cyst surveillance in adults - a review of 10 years' experience. (PubMed)

Pineal cyst surveillance in adults - a review of 10 years' experience. Objective: Pineal cysts are common benign incidental findings in adults. There are no commonly accepted criteria for follow up or indications for intervention. We looked at our outcomes for this condition to explore their natural history and review our surveillance criteria. Method: Retrospective review of multidisciplinary team meetings at a tertiary neurosurgical centre over 10 years. Data relating to demographics (...) , presenting symptoms, maximum diameter, duration of surveillance, final diagnosis and overall outcome were extracted from electronic patient records and available MRI. Data were analysed using IBM SPSS version 24. Result: Seventy-seven pineal cysts were identified. Female to male ratio was 1.43, female mean age was 38.6 and male mean age was 50.4. An increase in referral frequency was observed over the study period (mean increase of 1.4 cases per year). Presenting symptoms of headache in 45% and visual

2019 British Journal of Neurosurgery

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

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

163. Roscovitine blocks collecting duct cyst growth in Cep164-deficient kidneys. (PubMed)

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

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

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

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

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

166. Biliary mucinous cystic neoplasm mimicking a hydatid cyst: a case report and literature review. (PubMed)

Biliary mucinous cystic neoplasm mimicking a hydatid cyst: a case report and literature review. Biliary mucinous cystic neoplasms are rare cystic lesions of the liver which carry pre-malignant potential. Given the scarcity of reports in the literature, they pose a considerable challenge to clinical management, particularly with regards to accurate pre-operative diagnosis.We present the case of a 37-year-old Tunisian woman who presented with subacute right upper quadrant pain and a large multi (...) -loculated cystic lesion, most consistent with a hydatid cyst. She underwent an open right hepatectomy, and pathology surprisingly revealed a biliary mucinous cystadenoma. Herein, we review the current literature on biliary mucinous cystic neoplasms, with a particular emphasis on diagnostic investigations, key radiological features and optimal treatment modalities.Biliary mucinous cystic neoplasms require a high index of suspicion and should be managed with complete surgical resection, as conservative

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2019 BMC Gastroenterology

167. Giant cell carcinoma of the lung presenting as an isolated cyst containing air: A case report. (PubMed)

Giant cell carcinoma of the lung presenting as an isolated cyst containing air: A case report. Pulmonary sarcomatoid carcinomas (PSCs) are rare tumors within the sarcomatoid carcinoma group. Giant cell carcinoma of the lung (GCCL) is a rare type of PSCs that consists entirely of highly pleomorphic tumor giant cells; the prognosis is poor.A patient presented with a single cyst and was diagnosed with GCCL. The patient was a 59-year-old male who was admitted to the hospital with a cough. A chest (...) computerized tomography (CT) scan showed a single, thin-walled cyst containing air in the left upper lobe of the lung. Bronchoscopy revealed chronic bronchitis. The initial diagnosis was pulmonary infection and the patient was treated with antibiotics. The cyst wall increased in thickness, and the cyst eventually formed a cavity.Surgery was performed, and a diagnosis of GCCL was established. The stage was pT1bN1M0 (equal to stage IIB).The patient underwent video-assisted thoracoscopic surgery and 4 cycles

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2019 Medicine

168. Capitonnage seems better in childhood pulmonary hydatid cyst surgery. (PubMed)

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

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

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

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

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

171. Growth Pattern of Kidney Cyst Number and Volume in Autosomal Dominant Polycystic Kidney Disease. (PubMed)

Growth Pattern of Kidney Cyst Number and Volume in Autosomal Dominant Polycystic Kidney Disease. To evaluate the growth pattern of kidney cyst number and cyst volume in association with kidney size, demographics, and genotypes in autosomal dominant polycystic kidney disease.Kidney cyst number and cyst volume were measured from serial magnetic resonance images, giving a maximum follow-up of 14.23 years, from 241 patients with autosomal dominant polycystic kidney disease (15-46 years old (...) strength groups.Imaging and genetic data were collected (at least one visit) for 236 participants. The mean height-adjusted total cyst number increased exponentially over time from a baseline value of 762 to 1715 at the last clinic visit, while the mean height-adjusted total cyst volume increased exponentially from 305 to 770 ml. Height-adjusted total kidney volume, height-adjusted total cyst number, and height-adjusted total cyst volume were all highly correlated over time. Female participants

2019 Clinical Journal of the American Society of Nephrology

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

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

173. Giant cell tumors combined with secondary aneurysmal bone cysts are more likely to develop postoperative recurrence: A retrospective study of 256 cases. (PubMed)

Giant cell tumors combined with secondary aneurysmal bone cysts are more likely to develop postoperative recurrence: A retrospective study of 256 cases. The epidemiology and clinicopathology of aneurysmal bone cysts (ABCs) secondary to giant cell tumors of bone (GCTBs) have been well documented in the previous literature. However, reports on whether secondary ABCs could affect the postoperative recurrence of GCTBs are rare. This study analyzed the effects of secondary ABCs and other relevant

2019 Journal of Surgical Oncology

174. Management of congenital microphthalmos and anophthalmos with orbital cyst. (PubMed)

Management of congenital microphthalmos and anophthalmos with orbital cyst. To study the effects of an individualized treatment approach to children with congenital microphthalmos and anophthalmos.Patients with congenital microphthalmos or anopthalmos with orbital cysts who were referred to Beijing Tongren Hospital between July 2009 and July 2017 were included in this retrospective case series study. For patients ≤6 years of age, the cyst was retained to promote orbital development unless (...) a prosthesis could not be fitted at all or disproportionate orbital growth was detected. Hydrogel orbit expanders were implanted initially if orbital volume was poor. For patients >6 years of age, the cyst was removed if it caused cosmetic problems or unsatisfactory prosthesis fitting. Eyelid procedures were performed after puberty to improve appearance.The study included 26 orbits of 24 patients. Of the 14 patients ≤6 years, 3 underwent cyst excision, 8 were treated with conformers only, and 3 had

2019 JAAPOS - Journal of the American Association for Pediatric Ophthalmology and Strabismus

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

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

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

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

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2019 BMC Surgery

177. Awake bedside nasal endoscopy for primary management of neonatal dacryocystoceles with intranasal cysts. (PubMed)

Awake bedside nasal endoscopy for primary management of neonatal dacryocystoceles with intranasal cysts. To present outcomes of neonatal dacryocystoceles treated through endoscopic intranasal cyst marsupialization (EICM) without general anesthesia and nasolacrimal duct (NLD) probing or irrigation.Records of eleven consecutive infants diagnosed with unilateral or bilateral congenital cysts associated with the nasolacrimal system between January 2016 and February 2019 at our institution were (...) retrospectively reviewed.Age at diagnosis ranged from 0 to 56 days, and 45.5% were male. 54.5% had dacryocystitis before surgical intervention. Patients were initially treated with a combination of massage and topical antibiotics; some received parenteral antibiotics if infected. Nearly all patients (90.9%) had one or more intranasal cysts. Of these patients, two underwent lacrimal probing and EICM in the operating room. One underwent EICM only in the operating room. Another patient initially failed bedside

2019 International Journal of Pediatric Otorhinolaryngology

178. Endoscopic diagnosis of pancreatic cysts. (PubMed)

Endoscopic diagnosis of pancreatic cysts. Pancreatic cystic lesions (PCLs) are increasingly identified on abdominal imaging. Given the malignant potential of certain cyst subtypes and the poor survival rates of pancreatic cancer, accurate diagnosis and appropriate management of these cysts are critical.Advances in endoscopic ultrasound (EUS)-guided diagnostics have increased the accuracy of differentiating PCLs. These include cyst fluid molecular analysis, EUS-guided needle-based confocal laser (...) endomicroscopy, and EUS-guided through the needle microforceps biopsy. This review encapsulates recent advances in the endoscopic management of PCLs with a specific focus on EUS-guided diagnosis.It is important to accurately diagnose pancreatic cystic lesions with malignant potential where the definitive management is surgical resection. Misdiagnosis can result in inadvertent surgery of an otherwise benign lesion or malignant progression of a precancerous cyst. Moreover, pancreatic surgery is associated

2019 Current opinion in gastroenterology

179. Pediatric thyroglossal duct cysts: Post-operative complications. (PubMed)

Pediatric thyroglossal duct cysts: Post-operative complications. Thyroglossal duct cysts (TGDCs) result from incomplete involution of the thyroglossal duct and are resected with a Sistrunk-procedure. We studied and graded severity of postoperative complications in children who underwent this procedure, with corresponding risk factors.In our electronic health record system we reviewed the medical records of all patients aged <18 years, with surgically treated TGDC between 01-01-2005 and 31-12 (...) -2015 in two university hospitals. Risk factors (age, gender, recurrence at presentation, treatment hospital, cyst inflammation, cyst rupture, drain placement, antibiotics or postoperative infection) were studied by univariate analysis. The Clavien-Dindo surgical complication classification was used as postoperative surgical grading system.Of the ninety-one patients, with a mean age of 4.4 years, seven were referred from other hospitals with a recurrent TGDC. 24 patients (26.4%) had a complication

2019 International Journal of Pediatric Otorhinolaryngology

180. Testicular epidermoid cysts: a reevaluation. (PubMed)

Testicular epidermoid cysts: a reevaluation. Testicular epidermoid cysts (TECs) are rare benign testicular neoplasms. As TECs are rarely associated with germ cell tumours (GCTs), the understanding of biological behaviour and clinical management of TEC is unresolved.We retrospectively searched the files of patients treated for testicular neoplasms and germ cell cancer in the time from 2000 to 2017. Those with TEC were subjected to closer review looking to clinical and histological features

2019 BMC Urology

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