AIM To evaluate radiological imaging findings of patients who had been found to have pineal cyst(PC) in brain magnetic resonance imaging(MRI).METHODS A total of 9546 patients who had brain MRI examination in March 201...AIM To evaluate radiological imaging findings of patients who had been found to have pineal cyst(PC) in brain magnetic resonance imaging(MRI).METHODS A total of 9546 patients who had brain MRI examination in March 2010-January 2018 period were studied.Fiftysix patients(44 female and 12 male) found to have PC were evaluated.Eighteen of the patients had had follow-up examinations of 2-94 mo(mean 30.50 ± 28.83).PC dimensions and volume,radiological imaging features(signal intensities,contours,internal septationloculation and contrast-enhancement features) and natural history in cases who had been followed-up were evaluated by two radiologists.RESULTS Of 9546 patients,5555 were female(58.2%) and 3991 male(41.8%).Age range was 1-99(mean 43.18 ± 20.94).PC frequency was calculated to be 0.58%.Forty-four of the 56 patients(78.57%) with PC were female and 12 male(21.43%),and their age range was 5-61(mean 31.26 ± 12.73).Thirty-five of the PCs were typical(62.50%) and 21(37.50%) were atypical.No significant difference was found between initial and final imaging sizes of PCs which were monitored by follow-up examinations(P > 0.05).CONCLUSION PCs are cysts which do not show clear size and natural changes and are more frequently observed in females and in adult ages.Most of them are isointense with cerebrospinal fluid on T1 and T2 A weighted images,hyperintense compared to cerebrospinal fluid on fluidattenuated inversion recovery; sequence and smoothly contoured.Their typical forms have peripheral rim and multilocular ones may have septal contrast-enhancement.展开更多
AIM:To retrospectively evaluate the magnetic resonance imaging (MRI) features of adult retrorectal tumors and compare with histopathologic findings.METHODS:MRI features of 21 patients with preoperative suspicion of re...AIM:To retrospectively evaluate the magnetic resonance imaging (MRI) features of adult retrorectal tumors and compare with histopathologic findings.METHODS:MRI features of 21 patients with preoperative suspicion of retrorectal tumors were analyzed based on the histopathological and clinical data.RESULTS:Fourteen benign cystic lesions appeared hypointense on T1-weighted images,and hyperintense on T2-weighted images with regular peripheral rim.Epidermoid or dermoid cysts were unilocular,and tailgut cysts were multilocular.Presence of intracystic intermediate signal intensity was observed in one case of tailgut cyst with a component of adenocarcinoma.Six solid tumors were malignant lesions and showed heterogeneous intensity on MRI.Mucinous adenocarcinomas showed high signal intensity on T2-weighted and mesh-like enhancing areas on fat-suppressed T2-weighted images.There was a fistula between the mass and anus with an internal opening in mucinous adenocarcinomas arising from anal fistula.Gastrointestinal stromal tumors displayed low signal intensity on T1-weighted images,and intermediate to high signal intensity on T2-weighted images.Central necrosis could be seen as a high signal on T2-weighted images.CONCLUSION:MRI is a helpful technique to define the extent of the retrorectal tumor and its relationship to the surrounding structures,and also to demonstrate possible complications so as to choose the best surgical approach.展开更多
We here report a case of a 18-year-old man with a history of recurrent abdominal pain and a previous episode of severe acute pancreatitis. Abdominal ultrasonography, contrast enhanced multislice computer tomography, e...We here report a case of a 18-year-old man with a history of recurrent abdominal pain and a previous episode of severe acute pancreatitis. Abdominal ultrasonography, contrast enhanced multislice computer tomography, endoscopic retrograde cholangiopancreatography, endoscopic ultrasonography and magnetic resonance imaging demonstrated a cystic mass lesion. Only on delayed phase magnetic resonance images after GadoliniumBOPTA injection, it was possible to demonstrate the lesion's relationship with the biliary tree, differentiating the lesion from intraluminal duodenal diverticulum, and to achieve the diagnosis of duodenal duplication cyst, a recognized rare cause of acute pancreatitis. The diagnosis was confirmed by histology.展开更多
Ciliated hepatic foregut cyst (CHFC) is a very rare cystic lesion of the liver that is histologically similar to bronchogenic cyst. We report one case of CHFC that was hard to distinguish from solid-cystic neoplasm in...Ciliated hepatic foregut cyst (CHFC) is a very rare cystic lesion of the liver that is histologically similar to bronchogenic cyst. We report one case of CHFC that was hard to distinguish from solid-cystic neoplasm in imaging features. Magnetic resonance imaging was helpful in differentiating these cysts from other lesions.展开更多
AIM:To determine the spectrum of pineal microstructures (solid/cystic parts) in a large clinical population using a high-resolution 3D-T2-weighted sequence. METHODS:A total of 347 patients enrolled for cranial magneti...AIM:To determine the spectrum of pineal microstructures (solid/cystic parts) in a large clinical population using a high-resolution 3D-T2-weighted sequence. METHODS:A total of 347 patients enrolled for cranial magnetic resonance imaging were randomly included in this study. Written informed consent was obtained from all patients. The exclusion criteria were artifacts or mass lesions prohibiting evaluation of the pineal gland in any of the sequences. True-FISP-3D-imaging (1.5-T, isotropic voxel 0.9 mm) was performed in 347 adults (55.4 ± 18.1 years). Pineal gland volume (PGV), cystic volume, and parenchyma volume (cysts exclud- ed) were measured manually. RESULTS:Overall, 40.3% of pineal glands were cystic. The median PGV was 54.6 mm 3 (78.33 ± 89.0 mm 3 ), the median cystic volume was 5.4 mm 3 (15.8 ± 37.2mm 3 ), and the median parenchyma volume was 53.6 mm 3 (71.9 ± 66.7 mm 3 ). In cystic glands, the standard deviation of the PGV was substantially higher than in solid glands (98% vs 58% of the mean). PGV declined with age (r = -0.130, P = 0.016). CONCLUSION:The high interindividual volume variation is mainly related to cysts. Pineal parenchyma volume decreased slightly with age, whereas genderrelated effects appear to be negligible.展开更多
Rathke cleft cysts are benign sellar lesions that are generally asymptomatic. Rathke cleft cyst can enlarge and become symptomatic. Surgical therapy is the mainstay of treatment for symptomatic RCC. The optimal surgic...Rathke cleft cysts are benign sellar lesions that are generally asymptomatic. Rathke cleft cyst can enlarge and become symptomatic. Surgical therapy is the mainstay of treatment for symptomatic RCC. The optimal surgical strategy remains debatable. We report our experience with this lesion and we discuss the advantages and disadvantages of each technique through a literature review.展开更多
Background: Ovarian cysts in pregnancy are common and are usually small benign functional cysts (corpus luteum and theca-lutein cysts) that usually resolve spontaneously between 14 and 16 weeks of gestation. However, ...Background: Ovarian cysts in pregnancy are common and are usually small benign functional cysts (corpus luteum and theca-lutein cysts) that usually resolve spontaneously between 14 and 16 weeks of gestation. However, large ovarian cysts are rare in pregnancy, with an incidence of 0.2% - 2%, and most of them are benign. The first-line diagnostic modality is ultrasonography. Complications of ovarian cysts in pregnancy include miscarriage, ovarian torsion, cyst rupture, etc. Laparotomy is the treatment modality commonly used in our setting, and histopathologic diagnosis is important for the prognosis of the treatment. Case Presentation: MC is a 32-year-old G3P2002 married housewife of the Bakweri tribe who was referred to our department because of progressive abdominal discomfort and shortness of breath for 1 month’s duration. Her medical history is consistent with two normal vaginal deliveries at term and the use of implants (for contraception) until one month prior to the index pregnancy. Her booking visit was at 16 weeks gestation at a primary (missionary) healthcare facility, and she underwent ultrasonography and was diagnosed with a singleton viable intrauterine pregnancy and a simple septate cystic mass measuring 17 cm situated on top of the uterus, appearing to originate from the left ovary. She was referred to seek the expertise of an obstetrician-gynecologist, but she came to our department at 35 weeks gestation and underwent cesarean birth at 37 weeks gestation. In the pathological review, serous cystadenoma was diagnosed, and there were no positive findings in peritoneal cytology. Conclusion: The ultrasonographic diagnosis of the huge ovarian cyst in the index case was after 16 weeks gestation because of her late booking visit at 16 weeks gestation. The index case deferred referral to the obstetrician because of a lack of finances, came to our department at 35 weeks gestation because of abdominal pain that may have resulted from a torsion of the ovarian cyst, and underwent cesarean birth because of malpresentation and fear of cyst rupture during labor. We recommend cesarean section in such cases because of suboptimal antenatal care uptake and histopathology of the specimen to exclude malignancy. .展开更多
AIM To highlight the salient magnetic resonance imaging(MRI) features of the intraneural ganglion cyst(INGC) of various peripheral nerves for their precise diagnosis and to differentiate them from other intra and extr...AIM To highlight the salient magnetic resonance imaging(MRI) features of the intraneural ganglion cyst(INGC) of various peripheral nerves for their precise diagnosis and to differentiate them from other intra and extraneural cystic lesions.METHODS A retrospective analysis of the magnetic resonance(MR) images of a cohort of 245 patients presenting with nerve palsy involving different peripheral nerves was done.MR images were analyzed for the presence of a nerve lesion,and if found,it was further characterized as solid or cystic.The serial axial,coronal and sagittal MR images of the lesions diagnosed as INGC were studied for their pattern and the anatomical extent along the course of the affected nerve and its branches.Its relation to identifiable anatomical landmarks,intraarticular communication and presence of denervation changes in the muscles supplied by involved nerve was also studied.RESULTS A total of 45 cystic lesions in the intra or extraneurallocations of the nerves were identified from the 245 MR scans done for patients presenting with nerve palsy.Out of these 45 cystic lesions,13 were diagnosed to have INGC of a peripheral nerve on MRI.The other cystic lesions included extraneural ganglion cyst,paralabral cyst impinging upon the suprascapular nerve,cystic schwannoma and nerve abscesses related to Hansen's disease involving various peripheral nerves.Thirteen lesions of INGC were identified in 12 patients.Seven of these affected the common peroneal nerve with one patient having a bilateral involvement.Two lesions each were noted in the tibial and suprascapular nerves,and one each in the obturator and proximal sciatic nerve.An intra-articular connection along the articular branch was demonstrated in 12 out of 13 lesions.Varying stages of denervation atrophy of the supplied muscles of the affected nerves were seen in 7 cases.Out of these 13 lesions in 12 patients,6 underwent surgery.CONCLUSION INGC is an important cause of reversible mono-neuropathy if diagnosed early and surgically treated.Its classic MRI pattern differentiates it from other lesions of the peripheral nerve and aid in its therapeutic planning.In each case,the joint connection has to be identified preoperatively,and the same should be excised during surgery to prevent further cyst recurrence.展开更多
A lymphoepithelial cyst(LEC)of the pancreas is a rare benign lesion.Because patients with LEC of the pancreas have a good prognosis,it is important that these lesions are accurately differentiated from other more aggr...A lymphoepithelial cyst(LEC)of the pancreas is a rare benign lesion.Because patients with LEC of the pancreas have a good prognosis,it is important that these lesions are accurately differentiated from other more aggressive pancreatic neoplasms for an appropriate treatment strategy.Previous studies have reported that a definitive diagnosis of LEC often cannot be obtained based solely on the findings of preoperative imaging(e.g.,Computed tomography or Magnetic resonance imaging).In this study,we reviewed four cases of pancreatic LECs to investigate the feature of LECs.We reviewed these cases with regard to symptoms,imaging findings,surgical procedures,and other clinical factors.We found that LEC was associated with unique characteristics on imaging findings.A preoperative diagnosisof LEC may be possible by comprehensively evaluating its clinical and imaging findings.展开更多
BACKGROUND Gastric duplication cysts(GDCs)are a relatively uncommon congenital developmental abnormality,mainly occurring in infants but very rarely in adults.Because of the variability in clinical presentation,it is ...BACKGROUND Gastric duplication cysts(GDCs)are a relatively uncommon congenital developmental abnormality,mainly occurring in infants but very rarely in adults.Because of the variability in clinical presentation,it is often quite challenging to diagnose GDCs in adults.We are presenting a case report of an adult diagnosed operatively as having a GDC with a literature review to summarize clinical and imaging features and the treatment selections of GDCs in adults so that doctors could have a comprehensive understanding of this disease and make a precise diagnosis and a suitable therapeutic decision for patients.CASE SUMMARY A 51-year-old man presented with recurrent epigastric pain and fullness for two years.No significant findings were noted during physical examination and routine blood tests were unremarkable.An abdominal ultrasound revealed a large cyst in the upper left abdominal quadrant.A following contrast-enhanced abdominal computed tomography(CT)scan demonstrated a hypodense cystic lesion between the spleen and stomach.The lesion had scattered calcification in the cyst wall without any significant enhancement.The lesion was initially thought to be a cystic lymphangioma.The patient underwent a surgical resection and intraoperatively it was noted that the lesion was closely adherent to the greater curvature of the stomach.Subsequently,a resection of the gastric mass along with a partial gastrectomy was performed.The patient recovered quickly with a complete symptomatic relief and did not show any further complications during the 8-month follow-up.CONCLUSION GDCs are quite rare in adults,with a multitude of symptoms,which is quite challenging for precise diagnosis before histological examination.Some imaging techniques involving CT,magnetic resonance imaging,and endoscopic ultrasound could provide valuable morphological features for differential diagnosis.展开更多
BACKGROUND Tailgut cysts are defined as congenital cysts that develop in the rectosacral space from the residue of the primitive tail.As a congenital disease,caudal cysts are very rare,and their canceration is even ra...BACKGROUND Tailgut cysts are defined as congenital cysts that develop in the rectosacral space from the residue of the primitive tail.As a congenital disease,caudal cysts are very rare,and their canceration is even rarer,which makes the disease prone to misdiagnosis and delayed treatment.We describe a case of caudal cyst with adenocarcinogenesis and summarize in detail the characteristics of cases with analytical value reported since 1990.CASE SUMMARY A 35-year-old woman found a mass in her lower abdomen 2 mo ago.She was asymptomatic at that time and was not treated because of the coronavirus disease 2019 pandemic.Two weeks ago,the patient developed abdominal distension and right waist discomfort and came to our hospital.Except for the high level of serum carcinoembryonic antigen,the medical history and laboratory tests were not remarkable.Magnetic resonance imaging showed a well-defined,slightly lobulated cystic-solid mass with a straight diameter of approximately 10 cm×9 cm in the presacral space,slightly high signal intensity on T2-weighted imaging,and moderate signal intensity on T1-weighted imaging.The mass was completely removed by laparoscopic surgery.Histopathological examination showed that the lesion was an intestinal mucinous adenocarcinoma,and the multidisciplinary team decided to implement postoperative chemotherapy.The patient recovered well,the tumor marker levels returned to normal,and tumor-free survival has been achieved thus far.CONCLUSION The case and literature summary can help clinicians and researchers develop appropriate examination and therapeutic methods for diagnosis and treatment of this rare disease.展开更多
BACKGROUND Previous studies reported that most of the intracranial dermoid cyst ruptures were spontaneous,and only a few were traumatic,with asymptomatic much rarer than the symptomatic ruptures.Hence,how to deal with...BACKGROUND Previous studies reported that most of the intracranial dermoid cyst ruptures were spontaneous,and only a few were traumatic,with asymptomatic much rarer than the symptomatic ruptures.Hence,how to deal with the asymptomatic traumatic rupture of intracranial dermoid cyst remains a challenge in the clinic.CASE SUMMARY A 59-year-old man was accidentally diagnosed with intracranial dermoid cyst through a cranial computed tomography(CT)scan due to a car accident.A mixed-density lesion with fat and a calcified margin was observed in the midline of the posterior fossa,accompanied with lipid droplet drifts in brain sulci,fissures,cisterns,and ventricles.After 1 wk of conservative observation,no change was observed on the updated cranial CT scan.After 2 wk of conservative observation,magnetic resonance imaging examination confirmed that the lesion was a traumatic rupture of a posterior fossa dermoid cyst with lipid droplet drifts.As the patient exhibited no adverse symptoms throughout the 2 wk,a 6-mo follow-up visit was arranged for him instead of aggressive treatment.Nonetheless,the patient did not show any abnormal neurological symptoms in the 6 mo of follow-up visits.CONCLUSION Asymptomatic traumatic rupture of intracranial dermoid cyst could be just followed or treated conservatively rather than treated aggressively.展开更多
BACKGROUND Teratoma is a common tumor,but rarely occurs in the parotid region.Only nine cases have been reported in the current literature.Although it is generally detected in infancy or childhood,it is commonly asymp...BACKGROUND Teratoma is a common tumor,but rarely occurs in the parotid region.Only nine cases have been reported in the current literature.Although it is generally detected in infancy or childhood,it is commonly asymptomatic.Computed tomography(CT)and magnetic resonance imaging(MRI)have important roles in the diagnosis of teratoma.CASE SUMMARY A 36-year-old man developed a lump located below the left auricular lobule 3 years ago.Physical examination revealed a nearly-circular tumor in the left parotid gland region with a defined border,firm texture,and significant movement.Calcification,fat,keratinized substances,and typical fat-liquid levels was observed on CT and MRI.A diagnosis of cystic teratoma of the parotid gland was established preoperatively and confirmed by postoperative pathology.Following surgery,the patient developed temporary facial paralysis.There was no recurrence of teratoma during the 15-mo follow-up period.CONCLUSION When an asymptomatic mass in the parotid region is identified,parotid gland teratoma should be included in the differential diagnosis.Imaging examinations are helpful in the diagnosis.展开更多
A ciliated hepatic foregut cyst (CHFC) is a rare foregut developmental malformation usually diagnosed in adulthood. Five percent of reported cases of CHFC transform into squamous cell carcinoma. We report the presenta...A ciliated hepatic foregut cyst (CHFC) is a rare foregut developmental malformation usually diagnosed in adulthood. Five percent of reported cases of CHFC transform into squamous cell carcinoma. We report the presentation, evaluation, and surgical management of a symptomatic 45-year-old male found to have a 6.2 cm CHFC. Contrast tomography-guided fine-needle aspiration demonstrated columnar, ciliated epithelium consistent with the histologic diagnosis of CHFC. The intracystic levels of carbohydrate antigen (CA) 19-9 and carcinoembryonic antigen (CEA) were extremely high (978118 U/mL and 973 μg/L, respectively). Histologically, the wall of the cyst showed characteristic pseudopapillae lined with a ciliated stratified columnar epithelium, underlying smooth muscle, an outer fibrous layer and no atypia. Immunohistochemistry for CA19-9 and CEA was positive. This is the first case report of a CHFC in which levels of CA 19-9 and CEA were measured. Our findings suggest that a large sized multilocular cyst and elevated cyst CA19-9 and CEA levels do not exclude a CHFC from consideration in the diagnosis. CHFCs should be included in the differential diagnosis of hepatic lesions. Accurate diagnosis of a CHFC is necessary given its potential for malignant transformation, and surgical excision is recommended.展开更多
文摘AIM To evaluate radiological imaging findings of patients who had been found to have pineal cyst(PC) in brain magnetic resonance imaging(MRI).METHODS A total of 9546 patients who had brain MRI examination in March 2010-January 2018 period were studied.Fiftysix patients(44 female and 12 male) found to have PC were evaluated.Eighteen of the patients had had follow-up examinations of 2-94 mo(mean 30.50 ± 28.83).PC dimensions and volume,radiological imaging features(signal intensities,contours,internal septationloculation and contrast-enhancement features) and natural history in cases who had been followed-up were evaluated by two radiologists.RESULTS Of 9546 patients,5555 were female(58.2%) and 3991 male(41.8%).Age range was 1-99(mean 43.18 ± 20.94).PC frequency was calculated to be 0.58%.Forty-four of the 56 patients(78.57%) with PC were female and 12 male(21.43%),and their age range was 5-61(mean 31.26 ± 12.73).Thirty-five of the PCs were typical(62.50%) and 21(37.50%) were atypical.No significant difference was found between initial and final imaging sizes of PCs which were monitored by follow-up examinations(P > 0.05).CONCLUSION PCs are cysts which do not show clear size and natural changes and are more frequently observed in females and in adult ages.Most of them are isointense with cerebrospinal fluid on T1 and T2 A weighted images,hyperintense compared to cerebrospinal fluid on fluidattenuated inversion recovery; sequence and smoothly contoured.Their typical forms have peripheral rim and multilocular ones may have septal contrast-enhancement.
文摘AIM:To retrospectively evaluate the magnetic resonance imaging (MRI) features of adult retrorectal tumors and compare with histopathologic findings.METHODS:MRI features of 21 patients with preoperative suspicion of retrorectal tumors were analyzed based on the histopathological and clinical data.RESULTS:Fourteen benign cystic lesions appeared hypointense on T1-weighted images,and hyperintense on T2-weighted images with regular peripheral rim.Epidermoid or dermoid cysts were unilocular,and tailgut cysts were multilocular.Presence of intracystic intermediate signal intensity was observed in one case of tailgut cyst with a component of adenocarcinoma.Six solid tumors were malignant lesions and showed heterogeneous intensity on MRI.Mucinous adenocarcinomas showed high signal intensity on T2-weighted and mesh-like enhancing areas on fat-suppressed T2-weighted images.There was a fistula between the mass and anus with an internal opening in mucinous adenocarcinomas arising from anal fistula.Gastrointestinal stromal tumors displayed low signal intensity on T1-weighted images,and intermediate to high signal intensity on T2-weighted images.Central necrosis could be seen as a high signal on T2-weighted images.CONCLUSION:MRI is a helpful technique to define the extent of the retrorectal tumor and its relationship to the surrounding structures,and also to demonstrate possible complications so as to choose the best surgical approach.
文摘We here report a case of a 18-year-old man with a history of recurrent abdominal pain and a previous episode of severe acute pancreatitis. Abdominal ultrasonography, contrast enhanced multislice computer tomography, endoscopic retrograde cholangiopancreatography, endoscopic ultrasonography and magnetic resonance imaging demonstrated a cystic mass lesion. Only on delayed phase magnetic resonance images after GadoliniumBOPTA injection, it was possible to demonstrate the lesion's relationship with the biliary tree, differentiating the lesion from intraluminal duodenal diverticulum, and to achieve the diagnosis of duodenal duplication cyst, a recognized rare cause of acute pancreatitis. The diagnosis was confirmed by histology.
文摘Ciliated hepatic foregut cyst (CHFC) is a very rare cystic lesion of the liver that is histologically similar to bronchogenic cyst. We report one case of CHFC that was hard to distinguish from solid-cystic neoplasm in imaging features. Magnetic resonance imaging was helpful in differentiating these cysts from other lesions.
文摘AIM:To determine the spectrum of pineal microstructures (solid/cystic parts) in a large clinical population using a high-resolution 3D-T2-weighted sequence. METHODS:A total of 347 patients enrolled for cranial magnetic resonance imaging were randomly included in this study. Written informed consent was obtained from all patients. The exclusion criteria were artifacts or mass lesions prohibiting evaluation of the pineal gland in any of the sequences. True-FISP-3D-imaging (1.5-T, isotropic voxel 0.9 mm) was performed in 347 adults (55.4 ± 18.1 years). Pineal gland volume (PGV), cystic volume, and parenchyma volume (cysts exclud- ed) were measured manually. RESULTS:Overall, 40.3% of pineal glands were cystic. The median PGV was 54.6 mm 3 (78.33 ± 89.0 mm 3 ), the median cystic volume was 5.4 mm 3 (15.8 ± 37.2mm 3 ), and the median parenchyma volume was 53.6 mm 3 (71.9 ± 66.7 mm 3 ). In cystic glands, the standard deviation of the PGV was substantially higher than in solid glands (98% vs 58% of the mean). PGV declined with age (r = -0.130, P = 0.016). CONCLUSION:The high interindividual volume variation is mainly related to cysts. Pineal parenchyma volume decreased slightly with age, whereas genderrelated effects appear to be negligible.
文摘Rathke cleft cysts are benign sellar lesions that are generally asymptomatic. Rathke cleft cyst can enlarge and become symptomatic. Surgical therapy is the mainstay of treatment for symptomatic RCC. The optimal surgical strategy remains debatable. We report our experience with this lesion and we discuss the advantages and disadvantages of each technique through a literature review.
文摘Background: Ovarian cysts in pregnancy are common and are usually small benign functional cysts (corpus luteum and theca-lutein cysts) that usually resolve spontaneously between 14 and 16 weeks of gestation. However, large ovarian cysts are rare in pregnancy, with an incidence of 0.2% - 2%, and most of them are benign. The first-line diagnostic modality is ultrasonography. Complications of ovarian cysts in pregnancy include miscarriage, ovarian torsion, cyst rupture, etc. Laparotomy is the treatment modality commonly used in our setting, and histopathologic diagnosis is important for the prognosis of the treatment. Case Presentation: MC is a 32-year-old G3P2002 married housewife of the Bakweri tribe who was referred to our department because of progressive abdominal discomfort and shortness of breath for 1 month’s duration. Her medical history is consistent with two normal vaginal deliveries at term and the use of implants (for contraception) until one month prior to the index pregnancy. Her booking visit was at 16 weeks gestation at a primary (missionary) healthcare facility, and she underwent ultrasonography and was diagnosed with a singleton viable intrauterine pregnancy and a simple septate cystic mass measuring 17 cm situated on top of the uterus, appearing to originate from the left ovary. She was referred to seek the expertise of an obstetrician-gynecologist, but she came to our department at 35 weeks gestation and underwent cesarean birth at 37 weeks gestation. In the pathological review, serous cystadenoma was diagnosed, and there were no positive findings in peritoneal cytology. Conclusion: The ultrasonographic diagnosis of the huge ovarian cyst in the index case was after 16 weeks gestation because of her late booking visit at 16 weeks gestation. The index case deferred referral to the obstetrician because of a lack of finances, came to our department at 35 weeks gestation because of abdominal pain that may have resulted from a torsion of the ovarian cyst, and underwent cesarean birth because of malpresentation and fear of cyst rupture during labor. We recommend cesarean section in such cases because of suboptimal antenatal care uptake and histopathology of the specimen to exclude malignancy. .
文摘AIM To highlight the salient magnetic resonance imaging(MRI) features of the intraneural ganglion cyst(INGC) of various peripheral nerves for their precise diagnosis and to differentiate them from other intra and extraneural cystic lesions.METHODS A retrospective analysis of the magnetic resonance(MR) images of a cohort of 245 patients presenting with nerve palsy involving different peripheral nerves was done.MR images were analyzed for the presence of a nerve lesion,and if found,it was further characterized as solid or cystic.The serial axial,coronal and sagittal MR images of the lesions diagnosed as INGC were studied for their pattern and the anatomical extent along the course of the affected nerve and its branches.Its relation to identifiable anatomical landmarks,intraarticular communication and presence of denervation changes in the muscles supplied by involved nerve was also studied.RESULTS A total of 45 cystic lesions in the intra or extraneurallocations of the nerves were identified from the 245 MR scans done for patients presenting with nerve palsy.Out of these 45 cystic lesions,13 were diagnosed to have INGC of a peripheral nerve on MRI.The other cystic lesions included extraneural ganglion cyst,paralabral cyst impinging upon the suprascapular nerve,cystic schwannoma and nerve abscesses related to Hansen's disease involving various peripheral nerves.Thirteen lesions of INGC were identified in 12 patients.Seven of these affected the common peroneal nerve with one patient having a bilateral involvement.Two lesions each were noted in the tibial and suprascapular nerves,and one each in the obturator and proximal sciatic nerve.An intra-articular connection along the articular branch was demonstrated in 12 out of 13 lesions.Varying stages of denervation atrophy of the supplied muscles of the affected nerves were seen in 7 cases.Out of these 13 lesions in 12 patients,6 underwent surgery.CONCLUSION INGC is an important cause of reversible mono-neuropathy if diagnosed early and surgically treated.Its classic MRI pattern differentiates it from other lesions of the peripheral nerve and aid in its therapeutic planning.In each case,the joint connection has to be identified preoperatively,and the same should be excised during surgery to prevent further cyst recurrence.
文摘A lymphoepithelial cyst(LEC)of the pancreas is a rare benign lesion.Because patients with LEC of the pancreas have a good prognosis,it is important that these lesions are accurately differentiated from other more aggressive pancreatic neoplasms for an appropriate treatment strategy.Previous studies have reported that a definitive diagnosis of LEC often cannot be obtained based solely on the findings of preoperative imaging(e.g.,Computed tomography or Magnetic resonance imaging).In this study,we reviewed four cases of pancreatic LECs to investigate the feature of LECs.We reviewed these cases with regard to symptoms,imaging findings,surgical procedures,and other clinical factors.We found that LEC was associated with unique characteristics on imaging findings.A preoperative diagnosisof LEC may be possible by comprehensively evaluating its clinical and imaging findings.
文摘BACKGROUND Gastric duplication cysts(GDCs)are a relatively uncommon congenital developmental abnormality,mainly occurring in infants but very rarely in adults.Because of the variability in clinical presentation,it is often quite challenging to diagnose GDCs in adults.We are presenting a case report of an adult diagnosed operatively as having a GDC with a literature review to summarize clinical and imaging features and the treatment selections of GDCs in adults so that doctors could have a comprehensive understanding of this disease and make a precise diagnosis and a suitable therapeutic decision for patients.CASE SUMMARY A 51-year-old man presented with recurrent epigastric pain and fullness for two years.No significant findings were noted during physical examination and routine blood tests were unremarkable.An abdominal ultrasound revealed a large cyst in the upper left abdominal quadrant.A following contrast-enhanced abdominal computed tomography(CT)scan demonstrated a hypodense cystic lesion between the spleen and stomach.The lesion had scattered calcification in the cyst wall without any significant enhancement.The lesion was initially thought to be a cystic lymphangioma.The patient underwent a surgical resection and intraoperatively it was noted that the lesion was closely adherent to the greater curvature of the stomach.Subsequently,a resection of the gastric mass along with a partial gastrectomy was performed.The patient recovered quickly with a complete symptomatic relief and did not show any further complications during the 8-month follow-up.CONCLUSION GDCs are quite rare in adults,with a multitude of symptoms,which is quite challenging for precise diagnosis before histological examination.Some imaging techniques involving CT,magnetic resonance imaging,and endoscopic ultrasound could provide valuable morphological features for differential diagnosis.
文摘BACKGROUND Tailgut cysts are defined as congenital cysts that develop in the rectosacral space from the residue of the primitive tail.As a congenital disease,caudal cysts are very rare,and their canceration is even rarer,which makes the disease prone to misdiagnosis and delayed treatment.We describe a case of caudal cyst with adenocarcinogenesis and summarize in detail the characteristics of cases with analytical value reported since 1990.CASE SUMMARY A 35-year-old woman found a mass in her lower abdomen 2 mo ago.She was asymptomatic at that time and was not treated because of the coronavirus disease 2019 pandemic.Two weeks ago,the patient developed abdominal distension and right waist discomfort and came to our hospital.Except for the high level of serum carcinoembryonic antigen,the medical history and laboratory tests were not remarkable.Magnetic resonance imaging showed a well-defined,slightly lobulated cystic-solid mass with a straight diameter of approximately 10 cm×9 cm in the presacral space,slightly high signal intensity on T2-weighted imaging,and moderate signal intensity on T1-weighted imaging.The mass was completely removed by laparoscopic surgery.Histopathological examination showed that the lesion was an intestinal mucinous adenocarcinoma,and the multidisciplinary team decided to implement postoperative chemotherapy.The patient recovered well,the tumor marker levels returned to normal,and tumor-free survival has been achieved thus far.CONCLUSION The case and literature summary can help clinicians and researchers develop appropriate examination and therapeutic methods for diagnosis and treatment of this rare disease.
文摘BACKGROUND Previous studies reported that most of the intracranial dermoid cyst ruptures were spontaneous,and only a few were traumatic,with asymptomatic much rarer than the symptomatic ruptures.Hence,how to deal with the asymptomatic traumatic rupture of intracranial dermoid cyst remains a challenge in the clinic.CASE SUMMARY A 59-year-old man was accidentally diagnosed with intracranial dermoid cyst through a cranial computed tomography(CT)scan due to a car accident.A mixed-density lesion with fat and a calcified margin was observed in the midline of the posterior fossa,accompanied with lipid droplet drifts in brain sulci,fissures,cisterns,and ventricles.After 1 wk of conservative observation,no change was observed on the updated cranial CT scan.After 2 wk of conservative observation,magnetic resonance imaging examination confirmed that the lesion was a traumatic rupture of a posterior fossa dermoid cyst with lipid droplet drifts.As the patient exhibited no adverse symptoms throughout the 2 wk,a 6-mo follow-up visit was arranged for him instead of aggressive treatment.Nonetheless,the patient did not show any abnormal neurological symptoms in the 6 mo of follow-up visits.CONCLUSION Asymptomatic traumatic rupture of intracranial dermoid cyst could be just followed or treated conservatively rather than treated aggressively.
文摘BACKGROUND Teratoma is a common tumor,but rarely occurs in the parotid region.Only nine cases have been reported in the current literature.Although it is generally detected in infancy or childhood,it is commonly asymptomatic.Computed tomography(CT)and magnetic resonance imaging(MRI)have important roles in the diagnosis of teratoma.CASE SUMMARY A 36-year-old man developed a lump located below the left auricular lobule 3 years ago.Physical examination revealed a nearly-circular tumor in the left parotid gland region with a defined border,firm texture,and significant movement.Calcification,fat,keratinized substances,and typical fat-liquid levels was observed on CT and MRI.A diagnosis of cystic teratoma of the parotid gland was established preoperatively and confirmed by postoperative pathology.Following surgery,the patient developed temporary facial paralysis.There was no recurrence of teratoma during the 15-mo follow-up period.CONCLUSION When an asymptomatic mass in the parotid region is identified,parotid gland teratoma should be included in the differential diagnosis.Imaging examinations are helpful in the diagnosis.
文摘A ciliated hepatic foregut cyst (CHFC) is a rare foregut developmental malformation usually diagnosed in adulthood. Five percent of reported cases of CHFC transform into squamous cell carcinoma. We report the presentation, evaluation, and surgical management of a symptomatic 45-year-old male found to have a 6.2 cm CHFC. Contrast tomography-guided fine-needle aspiration demonstrated columnar, ciliated epithelium consistent with the histologic diagnosis of CHFC. The intracystic levels of carbohydrate antigen (CA) 19-9 and carcinoembryonic antigen (CEA) were extremely high (978118 U/mL and 973 μg/L, respectively). Histologically, the wall of the cyst showed characteristic pseudopapillae lined with a ciliated stratified columnar epithelium, underlying smooth muscle, an outer fibrous layer and no atypia. Immunohistochemistry for CA19-9 and CEA was positive. This is the first case report of a CHFC in which levels of CA 19-9 and CEA were measured. Our findings suggest that a large sized multilocular cyst and elevated cyst CA19-9 and CEA levels do not exclude a CHFC from consideration in the diagnosis. CHFCs should be included in the differential diagnosis of hepatic lesions. Accurate diagnosis of a CHFC is necessary given its potential for malignant transformation, and surgical excision is recommended.