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Plastic and Reconstructive Surgery.... Feb 2021Intraneural ganglion cysts are nonneoplastic mucinous cysts that form by the accumulation of thick mucinous fluid in the epineurium of peripheral nerves. Symptoms arise...
UNLABELLED
Intraneural ganglion cysts are nonneoplastic mucinous cysts that form by the accumulation of thick mucinous fluid in the epineurium of peripheral nerves. Symptoms arise from mechanical compression of adjacent nerve fascicles from the intraneural ganglion cyst, and include local or radiating pain, paresthesias, weakness, and muscle atrophy.
METHODS
Retrospective review of three cases of symptomatic intraneural ganglion cysts affecting the upper and lower extremity.
RESULTS
In our cases, the intraneural ganglion cysts were completely decompressed with resection of the articular branches, leading to improvement in the patient's symptoms.
CONCLUSIONS
Treatment of intraneural ganglion cysts requires an understanding of the underlying anatomy and pathophysiology; accurate early diagnosis is important and can lead to timely treatment and better outcomes.
PubMed: 33680635
DOI: 10.1097/GOX.0000000000003339 -
Turk Patoloji Dergisi 2015Bone cysts are benign lesions occurring in any bone, regardless of age. They are often asymptomatic but may cause pain, swelling, fractures, and local recurrence and may... (Comparative Study)
Comparative Study
OBJECTIVE
Bone cysts are benign lesions occurring in any bone, regardless of age. They are often asymptomatic but may cause pain, swelling, fractures, and local recurrence and may be confused with other bone lesions.
MATERIAL AND METHOD
We retrospectively re-evaluated 143 patients diagnosed with aneurysmal bone cyst (n=98, 68.5%), solitary bone cysts (n=17 11.9%), pseudocyst (n=10.7%), intraosseous ganglion (n=3, 2.1%), hydatid cyst (n=2; 1.4), epidermoid cyst (n=1, 0.7%) and cysts demonstrating "mixed" aneurysmal-solitary bone cyst histology (n=12, 8.4%), and compared them with nonparametric tests.
RESULTS
Aneurysmal bone cyst, solitary bone cysts and mixed cysts were frequently seen in the first two decades of life while the others occurred after the fourth decade. Aneurysmal bone cysts, intraosseous ganglion and pseudocysts were more common in women contrary to solitary bone cyst and mixed cysts (the female/male ratio was 1.22, 2 and 1.5 versus 0.7 and 0.5, respectively). Aneurysmal bone cyst, solitary bone cysts and "mixed" cysts were mostly seen in long bones, predominantly the femur, while epidermoid, hydatid and pseudocysts were all seen in flat bones like the vertebra, pelvis and mandible (p=0.001, chi-square). Repeat biopsies were performed in 19 cases (13.3%), 84.2% of which were aneurysmal bone cyst (5 conventional, 9 solid, 1 secondary and 1 subperiosteal) and three (15.8%) were mixed cysts (p=0.02, chi-square). Notably, some of them were located in inaccessible areas of pelvis (n=3), femur (n=3) and maxilla (n=2).
CONCLUSION
The most common and challenging intraosseous cysts are aneurysmal bone cysts, particularly the "solid" variant. The "mixed" aneurysmal-solitary bone cyst "subgroup" requires further research with larger series to be defined more thoroughly.
Topics: Adolescent; Adult; Age Factors; Aged; Biopsy; Bone Cysts; Bone Cysts, Aneurysmal; Child; Child, Preschool; Echinococcosis; Epidermal Cyst; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Predictive Value of Tests; Prognosis; Retrospective Studies; Sex Factors; Young Adult
PubMed: 25652560
DOI: 10.5146/tjpath.2014.01293 -
International Journal of Surgery Case... Jul 2023Periosteal ganglion cyst is a rare disorder, found only in 55 out of 100,000 people annually. Periosteal ganglion location may cause partial external cortical...
INTRODUCTION AND IMPORTANCE
Periosteal ganglion cyst is a rare disorder, found only in 55 out of 100,000 people annually. Periosteal ganglion location may cause partial external cortical destruction with irregular saucerization and erosion. This report presents a rare case of periosteal ganglion cyst that occurred of the cruris sinistra.
CASE PRESENTATION
A male patient, 68 years old, came with complaint of a lump in the left cruris since one year ago. Nine months later, the lump has increased in size like a chicken egg and still felt painless. MRI result revealed a well-circumscribed multilocular cystic lesion in the peri-osseous soft tissue of the tibia. We performed directly excisional biopsy within the mass, and the histopathology result was periosteal ganglion cyst.
CLINICAL DISCUSSION
The exact pathogenesis of periosteal ganglion is unclear. Synovial herniation and mucoid degeneration of the connective tissue of the periosteum are two suggested mechanisms. In some cases, ganglion cysts may compress nearby nerves. Surgical treatment is recommended for patients who still experience symptoms after non-surgical management has failed. Complete resection of the cyst and surrounding periosteum is recommended to prevent recurrence. After 6 months post-operative follow up clinical examination, no recurrence symptoms founded on the patient.
CONCLUSION
Periosteal ganglion is a rare lesion and may mimic other bone surface lesions. Resection of the periosteal ganglion cyst with surrounding periosteum is important to prevent recurrence.
PubMed: 37343503
DOI: 10.1016/j.ijscr.2023.108395 -
Orthopaedics & Traumatology, Surgery &... Apr 2016Sciatica can occur due to a spinal lesion, intrapelvic tumor, diabetic neuropathy, and rarely piriformis syndrome. The causes of piriformis syndrome vary by a...
UNLABELLED
Sciatica can occur due to a spinal lesion, intrapelvic tumor, diabetic neuropathy, and rarely piriformis syndrome. The causes of piriformis syndrome vary by a space-occupying lesion. A ganglionic cyst can occur in various lesions in the body but seldom around the hip joint. In addition, sciatica due to a ganglionic cyst around the hip joint has been reported in one patient in Korea who underwent surgical treatment. We experienced two cases of sciatica from a piriformis ganglionic cyst and we report the clinical characterics and progress after non-operative treatment by ultrasonography-guided aspiration. The two cases were diagnosed by magnetic resonance imaging and were treated by ultrasonography-guided aspiration. We followed the patients for more than 6months. The symptoms of piriformis syndrome from the ganglion improved following aspiration and this conservative treatment is a treatment method that can be used without extensive incision or cyst excision.
LEVEL OF EVIDENCE
Level IV historical case.
Topics: Adult; Female; Ganglion Cysts; Humans; Magnetic Resonance Imaging; Male; Piriformis Muscle Syndrome; Sciatica
PubMed: 26969206
DOI: 10.1016/j.otsr.2015.11.018 -
Frontiers in Medicine 2020A Tarlov cyst (TC) is a perineural cyst filled with cerebrospinal fluid that originates from the dorsal ganglion or the spinal posterior nerve root. TCs are usually...
A Tarlov cyst (TC) is a perineural cyst filled with cerebrospinal fluid that originates from the dorsal ganglion or the spinal posterior nerve root. TCs are usually asymptomatic and incidentally found in the sacral region. Endopelvic extension of TCs is uncommon and can be misdiagnosed as an adnexal mass on gynecological ultrasound imaging. We performed a search for all clinical studies of TCs that mimicked adnexal masses that had been published through October 12, 2020. We placed no restrictions on language or year of publication in our search, and we performed searches with the following keywords: perineural cyst, Tarlov cyst, sclerotherapy, management, and prognosis. We included all misdiagnosed cases or cases considered as adnexal masses on pelvic sonography. We identified 21 cases of TCs mimicking adnexal masses and conducted a comprehensive analysis of these 21 cases to assess the epidemiology, symptoms, initial diagnoses, provisional ultrasound diagnoses, confirmative modalities, sizes, locations, treatments, and outcomes. The 21 cases included 16 symptomatic cases (76%) and 5 cases with incidental findings (24%), and the average patient age was 41.3 years. The initial diagnosis was performed with ultrasonography in all cases. The most frequent misdiagnosis was unspecified adnexal mass. Confirmative diagnostic modalities were MRI only (67%), CT only (5%), and both MRI and CT (28%). Treatments were surgery (33%), conservative treatment (19%), percutaneous intervention (5%), and alcohol sclerotherapy (5%). In two symptomatic cases misdiagnosed as pelvic masses, cystectomy was performed and leakage of cerebrospinal fluid occurred, necessitating repair of the leak. In one of the asymptomatic patients, cauda equina syndrome occurred after alcohol sclerotherapy for misdiagnosed TC. However, the patient improved with no neurologic deficit after 18 months of conservative treatment. The possibility of large TCs should be considered when assessing adnexal masses in sonography. Since TCs can masquerade as pelvic masses, they should be considered if the mass appears tubular/cystic or multilocular/multiseptate, does not move with respiration, and originates from the sacrum in sonography with or without neurologic symptoms. Accurate diagnosis can prevent medical mismanagement and reduce patient discomfort.
PubMed: 33425933
DOI: 10.3389/fmed.2020.577301 -
Journal of Surgical Case Reports Mar 2022A 49-year-old patient, with a maternal history of arthritis, presented with an extra-capsular lump of the left knee. Following magnetic resonance imaging (MRI) scan and...
A 49-year-old patient, with a maternal history of arthritis, presented with an extra-capsular lump of the left knee. Following magnetic resonance imaging (MRI) scan and excision biopsy, the lump proved to be a benign ganglion cyst. The scan had also shown focal subchondral cyst formation and articular cartilage wear in the medial femoral condyle and patella, with no other abnormality. Four years later, she presented with identical symptoms and signs in the right knee. MRI scan confirmed a symmetrical pattern of ganglion and subchondral cyst location and size. Although both ganglion and subchondral cysts of the knee are common, their development is poorly understood and this combination of cyst formation and chondral wear has not been previously documented. Symmetry of end-stage knee osteoarthritis (OA) is recognized by clinicians. We speculate that OA of the knee begins asymptomatically with point-specific loss of articular cartilage, typically reflecting an inherent and bilateral vulnerability to degeneration.
PubMed: 35350211
DOI: 10.1093/jscr/rjac064 -
Journal of Orthopaedic Surgery and... Apr 2018Ganglion cyst of cruciate ligaments is a rare lesion; the prevalence is 0.3-0.8%. The purpose of this study was to present clinical features of symptomatic posterior...
BACKGROUND
Ganglion cyst of cruciate ligaments is a rare lesion; the prevalence is 0.3-0.8%. The purpose of this study was to present clinical features of symptomatic posterior cruciate ligament (PCL) cyst, introduce the arthroscopic excision technique, and evaluate the clinical outcome.
METHODS
A series of 11 patients with symptomatic PCL cyst from November 2012 to December 2014 were involved in this retrospective study. Detailed medical history collecting and physical examination were conducted. Magnetic resonance imaging (MRI) scan was used to confirm the diagnosis. Arthroscopic resection was performed, and the sample of the cyst was taken for pathologic examination. The follow-up averaged 30.7 months. International Knee Documentation Committee (IKDC) score, the range of motion (ROM), and MRI evaluations were obtained pre- and postoperatively to assess the surgical outcome. SPSS software was used for statistics analysis.
RESULTS
Eight males and 3 females with 6 left knees and 5 right knees were enrolled, the mean age was 34.4 years, and the duration of symptom was 19.0 months. All cases had a definite history of knee trauma or injury. The most common symptom was knee pain at flexion or in flexion-associated activities. MRI revealed the location and size of the cyst in each case. Pathologic examination showed the cyst wall was composed of dense fibroconnective tissue and widespread thick bundles of collagen, which is similar to the structure of ganglion cyst. At the final follow-up, MRI evaluation showed no cyst recurrence. The preoperative ROM and IKDC score were 2.3° to 108.6° and 40.5 ± 11.3, respectively, compared with the postoperative ROM and IKDC score which were 0° to 134.1° and 85.5 ± 4.8 (p < 0.05) separately.
CONCLUSIONS
We conclude that the etiology of symptomatic PCL cyst is most likely associated with trauma, pain on flexion is a typical manifestation of symptomatic PCL cyst, MRI evaluation is an ideal examination for the diagnosis, and arthroscopic resection of symptomatic PCL cysts has a good outcome with no recurrence.
Topics: Adolescent; Adult; Arthroscopy; Female; Follow-Up Studies; Ganglion Cysts; Humans; Knee Joint; Magnetic Resonance Imaging; Male; Middle Aged; Posterior Cruciate Ligament; Range of Motion, Articular; Retrospective Studies; Treatment Outcome; Young Adult
PubMed: 29653540
DOI: 10.1186/s13018-018-0798-x -
Skin Appendage Disorders Aug 2023Subungual myxoid cysts and subungual glomus tumors demonstrate characteristic features on magnetic resonance imaging (MRI) and ultrasound (US). It is not yet...
INTRODUCTION
Subungual myxoid cysts and subungual glomus tumors demonstrate characteristic features on magnetic resonance imaging (MRI) and ultrasound (US). It is not yet well-established whether US is congruent to MRI in diagnostic evaluation of these subungual lesions.
METHODS
Participants with clinical suspicion for subungual glomus tumors or subungual myxoid cysts were recruited. After clinical evaluation, participants underwent radiography, MRI, and US plus biopsy, aspiration, or excision where possible. Differential diagnoses were revised after review of imaging, and imaging findings were compared to definitive diagnosis by pathology, aspiration, or clinical course.
RESULTS
All lesions were visible on both US and MRI and size estimates agreed between the two modalities. US and MRI findings of subungual glomus tumors and subungual myxoid cysts agreed with their known respective imaging characteristics.
CONCLUSIONS
Diagnosis of subungual myxoid cysts and subungual glomus tumors agreed between US and MRI. We provide sample MRI and US imaging parameters for optimal evaluation of subungual myxoid cysts and glomus tumors. We demonstrate that subungual MRI evaluation can be performed without special equipment, allowing for evaluation by most radiology departments. Lastly, US is user-dependent and may be non-inferior for a sonographer familiar with subungual US.
PubMed: 37564693
DOI: 10.1159/000530397 -
International Journal of Surgery Case... 2019Liposarcoma is one of the most common soft tissue sarcomas in adults, but liposarcoma arising primarily from the stomach is very rare.
INTRODUCTION
Liposarcoma is one of the most common soft tissue sarcomas in adults, but liposarcoma arising primarily from the stomach is very rare.
PRESENTATION OF CASE
A 56-year-old man was referred to our hospital with abdominal distension and discomfort. A computed tomography scan showed a huge mass located between the stomach and transverse colon. The preliminary differential diagnoses were sarcoma with a mucinous component, gastrointestinal stromal tumor, lymphangioma, and mesenteric cyst. Upper and lower endoscopy was not performed because the patient declined. The patient underwent surgical resection, and the tumor was completely removed. Macroscopic examination revealed a 39-×26-×20-cm tumor weighing 13,000g. On histological examination, the tumor was diagnosed as a myxoid liposarcoma in the gastric submucosa. The patient was still doing well 2 years postoperatively.
DISCUSSION
Preoperative diagnosis of liposarcoma of the stomach is difficult. In the present case, the tumor was very large but was able to be resected completely.
CONCLUSION
Even in patients with very large myxoid liposarcoma, curative resection can provide a good prognosis.
PubMed: 31252381
DOI: 10.1016/j.ijscr.2019.06.025 -
Anais Brasileiros de Dermatologia 2020A 58-year-old female patient presented with a single-digit clubbing on the second finger of her right hand two years previously. After investigation with imaging and...
A 58-year-old female patient presented with a single-digit clubbing on the second finger of her right hand two years previously. After investigation with imaging and incisional biopsy, superficial acral fibromyxoma was diagnosed. A brief review on single-digit clubbing and its causes is presented, focusing on superficial acral fibromyxoma.
Topics: Female; Fibroma; Fingers; Ganglion Cysts; Humans; Hypertrophy; Middle Aged; Soft Tissue Neoplasms
PubMed: 32448714
DOI: 10.1016/j.abd.2020.01.006