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Cureus Aug 2022Thyroglossal duct cysts (TGDC) are one of the most common congenital anomalies in the neck. Malignant transformation of these cysts is rare and synchronous involvement...
Thyroglossal duct cysts (TGDC) are one of the most common congenital anomalies in the neck. Malignant transformation of these cysts is rare and synchronous involvement of the thyroid gland is even rarer. We report a case of synchronous occurrence of carcinoma in the thyroglossal duct cyst and thyroid gland and review the relevant literature. A 24-year-old woman who presented with a midline cervical mass, clinical examination, and complementary study was suggestive of a thyroglossal cyst with papillary carcinoma on fine-needle aspiration biopsy (FNAB) synchronous with thyroid papillary carcinoma with no cervical ganglion metastases documentation. Sistrunk's procedure plus total thyroidectomy was performed. With the clinical resemblance of benign and malignant cysts and the limitations of imaging techniques to distinguish between them, FNAB might be of use. Surgical treatment is warranted for the treatment of thyroglossal duct cyst carcinoma, but controversy still exists as to the extent of the surgical intervention. Sistrunk's procedure seems to be considered the gold standard when there is no evidence of thyroid involvement. However, in the presence of concomitant thyroid carcinoma, total thyroidectomy and cervical lymphadenectomy for evident node metastases are required. In the case of synchronous thyroglossal and thyroid carcinoma, most authors recommend pursuing both radioiodine therapy and hormone ablation. Thyroglossal duct cyst carcinoma is an uncommon feature that can arise from clusters of thyroid cells found within the cyst as in the present case. When confronted with this diagnosis it is fundamental to take into consideration the possibility of synchronous lesions as well as the extent of local and distance disease, since it has a direct influence on the choice of treatment provided to the patient. As there was a synchronous presence of papillary carcinoma in both the thyroglossal cyst and the thyroid gland, both the Sistrunk procedure and total thyroidectomy were performed, and radioiodine therapy was pursued as well as hormone ablation.
PubMed: 36059313
DOI: 10.7759/cureus.28570 -
Hand (New York, N.Y.) May 2022Dorsal wrist ganglion cysts arise from the leakage of synovial fluid through tears in the scapholunate ligament and/or dorsal wrist capsule. An analogous disruption of...
BACKGROUND
Dorsal wrist ganglion cysts arise from the leakage of synovial fluid through tears in the scapholunate ligament and/or dorsal wrist capsule. An analogous disruption of the dorsal capsule is created with routine portal placement during wrist arthroscopy. We hypothesized that wrist arthroscopy would predispose to wrist ganglions.
METHODS
Using the Truven MarketScan Outpatient Services Database from 2015 to 2016, patients who underwent wrist arthroscopy and developed an ipsilateral wrist ganglion were identified. Exclusion criteria included ganglion diagnosis preceding arthroscopy and bilateral pathology. Postoperative ganglion diagnosis was modeled with logistic regression. Predictor variables included age, gender, comorbidities, and arthroscopic procedure.
RESULTS
In all, 2420 patients underwent wrist arthroscopy. Thirty (1.24%) were diagnosed with an ipsilateral wrist ganglion at a mean time of 4.0 months (standard deviation: 2.4, range: 0.2-9.0). Significant predictors of ganglion diagnosis included female gender (odds ratio [OR]: 4.0, < .01) and triangular fibrocartilage complex and/or joint debridement (OR: 0.13, < .01). By comparison, among all 24,718,751 outpatients who had not undergone wrist arthroscopy, 39,832 patients had a diagnosis of a wrist ganglion cyst (0.16%).
CONCLUSIONS
Wrist arthroscopy is associated with a postoperative rate of ganglion cyst formation that is nearly 8 times the rate in the general population. Additional studies are needed to investigate techniques that minimize the risk of this complication.
Topics: Arthroscopy; Female; Ganglion Cysts; Humans; Prevalence; Retrospective Studies; Wrist
PubMed: 32935572
DOI: 10.1177/1558944720939203 -
American Journal of Ophthalmology Case... Jun 2022To present the importance of considering conjunctival myxoid stromal tumors in the differential when evaluating eyelid lesions as these tumors could indicate undetected...
PURPOSE
To present the importance of considering conjunctival myxoid stromal tumors in the differential when evaluating eyelid lesions as these tumors could indicate undetected systemic syndromes including Zollinger-Ellison Syndrome, Carney complex, and other endocrine disorders.
OBSERVATIONS
We present the case of a 56-year-old Caucasian female who was evaluated for a solid cyst-like structure of the palpebral conjunctiva just temporal to, but not involving, the left lower eyelid punctum. The lesion was removed with histopathologic examination of the specimen revealing the lesion to be a myxoid spindle cell tumor, consistent with conjunctival myxoid stromal tumor.
CONCLUSIONS AND IMPORTANCE
Myxoid tumors are an abnormal proliferation of mesenchymal cells. These are most commonly found in the heart and less commonly in the bone, skin, and skeletal muscle. Myxoid tumors of the conjunctiva are a very rare reported finding and most reported cases involving the conjunctiva occur on the bulbar conjunctiva. Our patient was found to have a conjunctival myxoid stromal tumor of the palpebral conjunctiva. As these are rare lesions, we believe that considering this as a differential when evaluating eyelid margin lesions is important due to the association of these tumors with systemic conditions including Zollinger-Ellison Syndrome, Carney complex, and other Endocrine disorders.
PubMed: 35243164
DOI: 10.1016/j.ajoc.2022.101427 -
Human Vaccines & Immunotherapeutics Dec 2023
Topics: Humans; Ganglion Cysts; Peroneal Nerve; COVID-19; Magnetic Resonance Imaging
PubMed: 37941376
DOI: 10.1080/21645515.2023.2278357 -
Cureus Feb 2024Ganglion cysts are typically periarticular soft tissue lesions commonly found in the wrist and forearm, with spinal involvement being rare. We present a clinical case of...
Ganglion cysts are typically periarticular soft tissue lesions commonly found in the wrist and forearm, with spinal involvement being rare. We present a clinical case of a 54-year-old female with a ganglion cyst at the L3-L4 level, causing radiculopathy symptoms. Despite initial difficulty in diagnosis due to MRI findings, surgical resection confirmed the extradural mass as a ganglion cyst. Postoperative recovery was uneventful, with immediate relief of radiculopathy symptoms. Challenges included distinguishing between synovial and ganglion cysts and accurately locating the cyst intraoperatively. This case highlights the importance of considering ganglion cysts in the differential diagnosis of spinal lesions and underscores the efficacy of surgical management for symptomatic relief.
PubMed: 38544603
DOI: 10.7759/cureus.54934 -
Acta Medica Lituanica 2019An intraneural ganglion cyst is a non-neoplastic gelatinous cyst, which can be found within the epineurium of a peripheral nerve and lead to signs and symptoms of...
BACKGROUND
An intraneural ganglion cyst is a non-neoplastic gelatinous cyst, which can be found within the epineurium of a peripheral nerve and lead to signs and symptoms of peripheral neuropathy. Early diagnosis and appropriate surgical treatment of this condition is a key to a successful outcome.
MATERIALS AND METHODS
We describe a case of a patient with peroneal nerve neuropathy caused by an intraneural ganglion cyst. Postsurgically, only partial relieve of the symptoms was achieved because of delayed diagnosis.
RESULTS
The aetiology of intraneural ganglia is controversial and historically different pathogeneses of this condition have been described. Diagnosis of these cysts is based on MRI. Multiple surgical treatment strategies have been developed based on different pathogenesis of the formation of these cysts, but neuropathy is reversible only, if this condition is diagnosed and treated early.
PubMed: 31632190
DOI: 10.6001/actamedica.v26i2.4036 -
Orthopaedic Surgery Feb 2023Arthroscopic excision of dorsal wrist ganglion (DWG) cysts has recently become an alternative to open surgery, with the advantage of lower recurrence. However, in...
OBJECTIVES
Arthroscopic excision of dorsal wrist ganglion (DWG) cysts has recently become an alternative to open surgery, with the advantage of lower recurrence. However, in recurrent cases, whether re-excision using an arthroscopic approach would achieve favorable outcomes has not been determined. This study aimed to evaluate the clinical outcomes of function evaluation and recurrence rate after arthroscopic excision of recurrent DWG cysts.
METHODS
A total of 11 consecutive patients with clinically diagnosed recurrent DWG cysts were retrospectively reviewed between November 2017 and March 2020. Extensive re-excision of the ganglion cyst and its surrounding pathological capsule was performed using an arthroscopic approach. Magnetic resonance imaging (MRI) was routinely performed before surgery to identify the location and limits of the cyst. All patients were followed up for a minimum of 2 years. A second recurrence was recorded if a mass reappeared at the same site with a positive transillumination test. Pain during activity was evaluated using the visual analog scale (VAS). The active range of motion (ROM) of the wrist was measured using a goniometer, and the hand grip strength was measured using a digital dynamometer. Comparative analysis between the pre- and postoperative indexes was performed using Student's t-test.
RESULTS
After a mean follow-up period of 29.3 months (range, 24-34 months), no second recurrence of the cyst was recorded. The VAS score improved from 1.4 to 0.3 (t = 3.833, p = 0.003), and residual pain was reported by three patients (VAS score = 1 for each). Active wrist flexion increased from 73.6° to 78.2° (t = 2.887, p = 0.016). No significant changes were found in active wrist extension or hand grip strength (p > 0.05). No major complications occurred during the study.
CONCLUSION
Arthroscopic excision of a recurrent DWG cyst yielded satisfactory results with no second recurrence, significant pain relief, and good wrist function at a minimum of 2-year follow-up. Clear identification of the location and limits of the ganglion based on preoperative MRI could be helpful to achieve complete excision and therefore prevent a second recurrence.
Topics: Humans; Wrist; Ganglion Cysts; Retrospective Studies; Hand Strength; Arthroscopy; Pain; Treatment Outcome
PubMed: 36465035
DOI: 10.1111/os.13576 -
Journal of Wrist Surgery Aug 2021Arthroscopy nowadays has become a widespread technique for the treatment of orthopaedic pathologies. Small-joint arthroscopy has evolved and, through direct...
Arthroscopy nowadays has become a widespread technique for the treatment of orthopaedic pathologies. Small-joint arthroscopy has evolved and, through direct visualization, enables diagnosis and immediate treatment of intra-articular lesions. The arthroscopic resection has become a minimally invasive alternative for the open technique. We intend to describe the technique, literature review, and results of arthroscopy for the surgical treatment of wrist volar synovial cysts. Thirty-nine patients submitted to arthroscopy for the treatment of wrist volar synovial cyst were included and assessed in this study, during the period of January 2015 to May 2017 with a complete assessment in minimum follow-up of 6 months. The technique was indicated for patients with pain and functional impairment for longer than 4 months, with no improvement with conservative measures, or for patients with cosmetic complaints, or those who presented the cyst for more than 3 months. We demonstrated good outcomes in regard to pain, range of motion, and complications in arthroscopic resection of volar wrist ganglion. Arthroscopic resection of volar synovial is a useful and safe technique. It is a low-morbidity, minimally invasive procedure that carries few complications and is a good alternative to the open technique.
PubMed: 34381641
DOI: 10.1055/s-0040-1721438 -
Surgical Neurology International 2019Extensive studies have been performed about the synovial cyst and intraspinal extradural ganglion cyst. Here, we describe a new type of the cyst with entirely different...
BACKGROUND
Extensive studies have been performed about the synovial cyst and intraspinal extradural ganglion cyst. Here, we describe a new type of the cyst with entirely different histological characteristics, which we are now calling a "Spontaneous Degenerative Epidural Cyst."
CASE DESCRIPTION
A 74-year-old male presented with low back pain, bilateral lower extremity radiculopathy, and a cauda equina syndrome. He exhibited a partial left foot drop (Grade 3/5) and hypoesthesia in the sacral region. The magnetic resonance imaging (MRI) showed two cysts at the L4-L5 level; Cyst I was in the left foramen and Cyst II was within the epidural space between the dura and ligamentum flavum. Cyst I was removed through an endoscopic transforaminal approach; it originated from the left facet joint and with synovial lining was confirmed to be a synovial cyst. Cyst II required an endoscopic interlaminar approach, and pathology revealed granulation tissue with micro-calcification, woven bone formation, hemosiderin pigment, and focal cystic change consistent with our designation "Spontaneous Degenerative Epidural Cyst."
CONCLUSION
"Spontaneous Degenerative Epidural cyst" should be considered among the differential diagnostic consideration for the different lumbar cysts. High-resolution MRI is the most useful in diagnosing these lesions, while full endoscopic treatment provides for adequate resection of these lesions.
PubMed: 31528396
DOI: 10.25259/SNI-175-2019 -
Vascular Specialist International Jun 2020Adventitial cystic disease (ACD) is a very rare condition characterized by the accumulation of a cyst filled with gelatinous substance in the adventitia of a vessel... (Review)
Review
Adventitial cystic disease (ACD) is a very rare condition characterized by the accumulation of a cyst filled with gelatinous substance in the adventitia of a vessel adjacent to the joint area. The cyst usually compresses the vessel lumen, causing claudication or leg swelling. The disease usually affects the popliteal artery. However, several cases of venous ACDs particularly in the common femoral or external iliac vein have been reported. The definition, diagnosis, and optimal treatment of ACD remain controversial because of its rarity and the inconsistent use of terminology. The heterogeneity of the reported cases is more prominent in venous ACD. Herein, the accurate terminology of cysts correlated to the joint (synovial cyst, ganglion cyst, and adventitial cyst) and the pathogenesis, anatomy, and optimal therapy of venous ACD are discussed in detail to establish reporting standards for future studies.
PubMed: 32611837
DOI: 10.5758/vsi.200029