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Zeitschrift Fur Gastroenterologie Apr 2024Mucinous-cystic neoplasms (MCN) account for 10% of all pancreatic cystic lesions. They are found almost exclusively in females. MCN have an ovarian-like stroma and often...
BACKGROUND
Mucinous-cystic neoplasms (MCN) account for 10% of all pancreatic cystic lesions. They are found almost exclusively in females. MCN have an ovarian-like stroma and often estrogen and progesterone receptors. During pregnancy, they can massively increase in size and transform into malignancy.
CASE REPORT
We report on a 29-year-old woman in whom a 35mm cyst in the pancreatic tail had been diagnosed several years ago. After workup the lesions had been classified as a pseudocyst. During pregnancy, the cyst massively increased in size and finally was resected. Histology showed a mucinous-cystic neoplasia with focal malignant transformation.
CONCLUSION
Cystic neoplasms of the pancreas require a differentiated management. While overtreatment should be avoided, malignant transformation always merits consideration - in particular if the cystic lesion is located in the pancreatic tail. Women with suspected MCN or cystic pancreatic lesions of uncertain etiology should be informed about the (rare) risk of a malignant transformation of an MCN and should be closely monitored during pregnancy.
PubMed: 38657617
DOI: 10.1055/a-2239-7898 -
Frontiers in Veterinary Science 2024Two intact male dogs were evaluated for symptoms, including hematuria, prostatomegaly, anuria, lethargy, and abdominal mass. Presurgical evaluations, including complete...
Two intact male dogs were evaluated for symptoms, including hematuria, prostatomegaly, anuria, lethargy, and abdominal mass. Presurgical evaluations, including complete physical examinations, blood examinations, abdominal radiography with contrast (only in Case 2), ultrasonography, and computed tomography and magnetic resonance imaging (only in Case 1), were performed. A paraprostatic cyst was diagnosed initially, and laparoscopic exploration and surgery were performed. Complete resection was performed in case 1, whereas partial resection with omentalization was performed in case 2. Histopathological examination of the tissue samples confirmed the presence of paraprostatic pseudocysts in both cases, with no evidence of an epithelial lining. These two cases represent the first documented instances of laparoscopic treatment for extraparenchymal prostatic cysts. The laparoscopic treatment proved feasible even in the case of a giant cyst causing anuria (Case 2). Paraprostatic cysts should be considered a potential differential diagnosis for abnormal urination accompanied by an abdominal mass, and long-term postoperative follow-up is necessary.
PubMed: 38650855
DOI: 10.3389/fvets.2024.1270819 -
Turkish Neurosurgery 2024To evaluate the efficacy of percutaneous ventriculoatrial shunting as a salvage method for pediatric patients with abdominal complications.
AIM
To evaluate the efficacy of percutaneous ventriculoatrial shunting as a salvage method for pediatric patients with abdominal complications.
MATERIAL AND METHODS
Data obtained from 9 patients with ventriculoperitoneal shunt dysfunctions owing to abdominal complications, who underwent ventriculoatrial shunting as salvage treatment at a single institution between January 2019 and September 2021 were retrospectively analyzed. All operations were conducted under the guidance of intraoperative fluoroscopy and ultrasound.
RESULTS
The mean age of the enrolled patients was 8.1 ± 1.2 years (2-15 years). Six (67%) patients were male and 3 (33%) were female. The mean number of the patients? ventriculoperitoneal shunt revisions until atrial catheter placement was 7.5 times. The reasons for intraperitoneal catheter failure included peritoneal adhesions in 4 (44.5%) patients, pseudocyst formation in 3 (33.3%), and peritonitis in 2 (22.2%). Seven patients from the study cohort had no problem after ventriculoatrial shunt placement. Only 1 patient had shunt dysfunction related to the ventricular catheter, and ventricular catheter and shunt valve revision was performed 26 months after ventriculoatrial shunt placement. The atrial catheter of the patient was intact. One patient died from the progression of her primary disease (medulloblastoma in the 4 < sup > th < /sup > ventricle), which was unrelated to the ventriculoatrial shunt.
CONCLUSION
Percutaneous ventriculoatrial shunting under the guidance of intraoperative fluoroscopy and ultrasound is a safe, effective, and easy alternative in patients with peritoneal complications and a history of multiple operations.
Topics: Humans; Female; Hydrocephalus; Child; Male; Child, Preschool; Adolescent; Ventriculoperitoneal Shunt; Retrospective Studies; Salvage Therapy; Treatment Outcome; Postoperative Complications; Reoperation
PubMed: 38650557
DOI: 10.5137/1019-5149.JTN.43472-23.2 -
Asian Journal of Endoscopic Surgery Jul 2024We present a rare case involving a 54-year-old man with a history of pancreatitis who developed a retroperitoneal lumbar vein aneurysm that was initially misidentified...
We present a rare case involving a 54-year-old man with a history of pancreatitis who developed a retroperitoneal lumbar vein aneurysm that was initially misidentified as a pancreatic pseudocyst. Subsequent imaging revealed an enlarged mass and retroperitoneal perforation. Despite initial hesitation, the patient eventually underwent radical surgery that enabled the successful removal of the mass, which was near the inferior vena cava. Pathological examination confirmed varicose veins, and the final diagnosis was lumbar vein aneurysm in the retroperitoneum. The patient's postoperative recovery was uneventful, with no symptoms or recurrence observed on 6-month follow-up imaging. We investigated a potential link between pancreatitis and recurrent bleeding due to weakened venous walls. The findings from this case underscore the rarity of venous aneurysms and the diagnostic and treatment challenges due to the limited number of cases; furthermore, they emphasize that surgery should be carefully considered based on the lesion location and associated risks.
Topics: Male; Humans; Middle Aged; Vena Cava, Inferior; Lumbar Vertebrae; Aneurysm; Veins; Pancreatitis
PubMed: 38622753
DOI: 10.1111/ases.13311 -
Scientific Reports Apr 2024This study aimed to automatically detect epiretinal membranes (ERM) in various OCT-scans of the central and paracentral macula region and classify them by size using...
This study aimed to automatically detect epiretinal membranes (ERM) in various OCT-scans of the central and paracentral macula region and classify them by size using deep-neural-networks (DNNs). To this end, 11,061 OCT-images were included and graded according to the presence of an ERM and its size (small 100-1000 µm, large > 1000 µm). The data set was divided into training, validation and test sets (75%, 10%, 15% of the data, respectively). An ensemble of DNNs was trained and saliency maps were generated using Guided-Backprob. OCT-scans were also transformed into a one-dimensional-value using t-SNE analysis. The DNNs' receiver-operating-characteristics on the test set showed a high performance for no-ERM, small-ERM and large-ERM cases (AUC: 0.99, 0.92, 0.99, respectively; 3-way accuracy: 89%), with small-ERMs being the most difficult ones to detect. t-SNE analysis sorted cases by size and, in particular, revealed increased classification uncertainty at the transitions between groups. Saliency maps reliably highlighted ERM, regardless of the presence of other OCT features (i.e. retinal-thickening, intraretinal pseudo-cysts, epiretinal-proliferation) and entities such as ERM-retinoschisis, macular-pseudohole and lamellar-macular-hole. This study showed therefore that DNNs can reliably detect and grade ERMs according to their size not only in the fovea but also in the paracentral region. This is also achieved in cases of hard-to-detect, small-ERMs. In addition, the generated saliency maps can be used to highlight small-ERMs that might otherwise be missed. The proposed model could be used for screening-programs or decision-support-systems in the future.
Topics: Humans; Epiretinal Membrane; Tomography, Optical Coherence; Retrospective Studies; Visual Acuity; Neural Networks, Computer
PubMed: 38605115
DOI: 10.1038/s41598-024-57798-1 -
Cureus Mar 2024One frequent side effect of chronic pancreatitis is pancreatic pseudocyst. Abdominal pain and vomiting are common complaints that the patient presents with. However,...
One frequent side effect of chronic pancreatitis is pancreatic pseudocyst. Abdominal pain and vomiting are common complaints that the patient presents with. However, atypical manifestations of pancreatic pseudocyst still confound medical professionals worldwide, making identification challenging and ultimately increasing the risk of fatal consequences. We describe the case of a 41-year-old man who had decompensated liver cirrhosis linked to alcohol intake. The patient presented with dysphagia and yellowish skin discolouration, which, upon further investigation, turned out to be peripancreatic pseudocysts extending into the mediastinum. Diagnostic challenges arose due to the rare occurrence of a pancreatic pseudocyst located in the mediastinum. Patient was treated with a culture-sensitive antibiotic and on follow up he was doing well.
PubMed: 38601379
DOI: 10.7759/cureus.55909 -
Revista Espanola de Patologia :... 2024This is the second article in a two-part series published in this journal, in which we examine the histopathological characteristics, as well as the differential... (Review)
Review
This is the second article in a two-part series published in this journal, in which we examine the histopathological characteristics, as well as the differential diagnosis, of the main entities that present as cystic and pseudocystic structures in cutaneous biopsy. In this second article, we address ciliated cutaneous cysts, branchial cysts, Bartholin's cysts, omphalomesenteric cysts, thymic cysts, thyroglossal duct cysts, synovial cysts, and median raphe cysts, as well as mucocele, ganglion, and auricular and digital myxoid pseudocysts.
Topics: Female; Humans; Cysts; Diagnosis, Differential; Bartholin's Glands
PubMed: 38599743
DOI: 10.1016/j.patol.2023.11.007 -
International Medical Case Reports... 2024Pancreatic pseudocysts are benign lesions that typically originate within the pancreatic parenchyma, or peripancreatic tissue. They commonly occur following recurrent...
Pancreatic pseudocysts are benign lesions that typically originate within the pancreatic parenchyma, or peripancreatic tissue. They commonly occur following recurrent episodes of pancreatitis or trauma. In this article, we present a case of a giant pancreatic pseudocyst with unusual trans-spatial extensions and spontaneous size decrement in a 40-year-old male patient with a history of alcohol abuse. He presented with chronic epigastric pain, and a physical examination showed only mild abdominal tenderness. Initial computed tomography showed a giant (18.4cm in its largest axis) pancreatic pseudocyst with left subdiaphragmatic and gastrohepatic extensions and concurrent splenic cysts. On follow-up ultrasound, the pseudocyst showed a significant spontaneous size decrement to less than half of its initial size. The giant size and trans-spatial characteristics of the pseudocyst, along with a relatively benign symptomatology and subsequent spontaneous shrinkage, constitute unique aspects of this case.
PubMed: 38596401
DOI: 10.2147/IMCRJ.S458492 -
World Journal of Orthopedics Mar 2024Tumoral calcinosis is a condition characterized by deposits of calcium phosphate crystals in extra-articular soft tissues, occurring in hemodialysis patients. Calcium...
BACKGROUND
Tumoral calcinosis is a condition characterized by deposits of calcium phosphate crystals in extra-articular soft tissues, occurring in hemodialysis patients. Calcium phosphate crystals are mainly composed of hydroxyapatite, which is highly infiltrative to tissues, thus making complete resection difficult. An adjuvant method to remove or resolve the residual crystals during the operation is necessary.
CASE SUMMARY
A bicarbonate Ringer's solution with bicarbonate ions (28 mEq/L) was used as the adjuvant. After resecting calcium phosphate deposits of tumoral calcinosis as much as possible, while filling with the solution, residual calcium phosphate deposits at the pseudocyst wall can be gently scraped by fingers or gauze in the operative field. A 49-year-old female undergoing hemodialysis for 15 years had swelling with calcium deposition for 2 years in the shoulders, bilateral hip joints, and the right foot. A shoulder lesion was resected, but the calcification remained and early re-deposition was observed. Considering the difficulty of a complete rection, we devised a bicarbonate dissolution method and excised the foot lesion. After resection of the calcified material, the residual calcified material was washed away with bicarbonate Ringer's solution.
CONCLUSION
The bicarbonate dissolution method is a new, simple, and effective treatment for tumoral calcinosis in hemodialysis patients.
PubMed: 38596192
DOI: 10.5312/wjo.v15.i3.302 -
Imaging Science in Dentistry Mar 2024This study aimed to evaluate age-stratified radiographic features in temporomandibular joint osteoarthritis using cone-beam computed tomography.
PURPOSE
This study aimed to evaluate age-stratified radiographic features in temporomandibular joint osteoarthritis using cone-beam computed tomography.
MATERIALS AND METHODS
In total, 210 joints from 183 patients (144 females, 39 males, ranging from 12 to 88 years old with a mean age of 44.75±19.97 years) diagnosed with temporomandibular joint osteoarthritis were stratified by age. Mandibular condyle position and bony changes (flattening, erosion, osteophytes, subchondral sclerosis, and subchondral pseudocysts in both the condyle and articular eminence, thickening of the glenoid fossa, joint space narrowing, and joint loose bodies) were evaluated through cone-beam computed tomography. After adjusting for sex, the association between age groups and radiographic findings was analyzed using both a multiple regression model and a multinomial logistic regression model (α=0.05).
RESULTS
The prevalence of joint space narrowing and protruded condyle position in the glenoid fossa significantly increased with age (<0.05). The risks of bony changes, including osteophytes and subchondral pseudocysts in the condyle; flattening, erosion, osteophyte, and subchondral sclerosis in the articular eminence; joint loose bodies; and thickening of the glenoid fossa, also significantly rose with increasing age (<0.05). The number of radiographic findings increased with age; in particular, the increase was more pronounced in the temporal bone than in the mandibular condyle (<0.05).
CONCLUSION
Increasing age was associated with a higher frequency and greater diversity of bony changes in the temporal bone, as well as a protruded condyle position in the glenoid fossa, resulting in noticeable joint space narrowing in temporomandibular joint osteoarthritis.
PubMed: 38571783
DOI: 10.5624/isd.20230229