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Indian Journal of Plastic Surgery :... Apr 2024Giant cell tumors of the tendon sheath (GCTTS) of the hand are considered the second most common benign tumors of the hand after ganglion cysts. Excision biopsy is...
Giant cell tumors of the tendon sheath (GCTTS) of the hand are considered the second most common benign tumors of the hand after ganglion cysts. Excision biopsy is considered the standard treatment at present. They are notorious for having a very high rate of recurrence as given in many studies. Many factors are said to be associated with recurrence of the tumors. The goal of this study is to evaluate the long-term results of a series of 48 patients operated on at a single institute and to find out if there is any correlation between the proposed risk factors with recurrence. A retrospective analysis was done in cases of GCTTS operated on between 2015 and 2021. The patients were invited for follow-up for a minimum of 2 years, and the patient files were reviewed. Further data were collected at follow-up including recurrence, range of movement, sensation, skin necrosis, scarring, and digital neuropathy. A data analysis was done. The correlation between the proposed risk factors and recurrence was calculated with the Pearson correlation coefficient. A -value of less than 0.05 was considered statistically significant. During the 6 years, 48 patients were operated on. Recurrence was observed in eight patients (16%) at an average of 38.7 months from the time of surgery. Of the risk factors, tumors with satellite nodules and tumor adjacency to joint correlated significantly with recurrence. No complications were observed during follow-up. GCTTS of the hand has a high propensity to recur. The presence of satellite nodules and proximity to interphalangeal joints are two important risk factors for recurrence. Magnification during surgery ensures complete excision of the tumor and reduces the chance of recurrence.
PubMed: 38774731
DOI: 10.1055/s-0044-1779657 -
Arthroscopy Techniques Apr 2024Extra-articular ganglion cysts arising from the gastrocnemius tendon near popliteal vessels can cause pain and claudication. Open resection of this kind of cyst has been...
Extra-articular ganglion cysts arising from the gastrocnemius tendon near popliteal vessels can cause pain and claudication. Open resection of this kind of cyst has been described frequently because the vessels can be well protected with a retractor. However, it's a challenge to remove cysts that are near vessels under arthroscopy, because a retractor cannot be used in arthroscopic surgery. This article will report a method of arthroscopic resection for extra-articular ganglion cysts near popliteal vessels.
PubMed: 38690351
DOI: 10.1016/j.eats.2024.102910 -
Cureus Mar 2024Intraosseous ganglions (IOGs) are actually quite common but one spanning two adjacent carpal bones is uncommon. We report a case with an IOG spanning the scaphoid and...
Intraosseous ganglions (IOGs) are actually quite common but one spanning two adjacent carpal bones is uncommon. We report a case with an IOG spanning the scaphoid and lunate, which was treated surgically. A 16-year-old right-handed female noticed left wrist pain that started spontaneously five years previously. Physical findings indicated carpal instability in the left wrist. Posteroanterior radiographs of the left wrist showed small cysts in the lunate and scaphoid, while the lateral radiograph revealed volar flexion of the lunate. Bone curettage was performed using sharp curettes, and due to the physical findings of carpal instability, temporary scapho-trapezoidal joint fixation was done using two Kirchner wires. Two years post-surgery, wrist pain had significantly improved and carpal instability findings disappeared. Computed tomography revealed no obvious collapse of carpal bones and expansion of bone defects in the lunate and scaphoid. Bone formation was observed in the bone curettage area of the scaphoid.
PubMed: 38606224
DOI: 10.7759/cureus.56045 -
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 -
Polymers Mar 2024Poly-L-lactic acid (PLLA) implants have been used for bone fixation for decades. However, upon insertion, they can cause a foreign body reaction (FBR) that may lead to... (Review)
Review
Poly-L-lactic acid (PLLA) implants have been used for bone fixation for decades. However, upon insertion, they can cause a foreign body reaction (FBR) that may lead to complications. On 15 December 2023, a systematic review was conducted to search for articles on the PubMed, MeSH term, and Scopus databases using the keywords 'PLLA' and 'foreign body reaction'. The articles were reviewed not only for the question of FBR, its severity, and the manifestation of symptoms but also for the type of implant and its location in the body, the species, and the number of individuals included. A total of 71 original articles were identified. Of these, two-thirds reported on in vivo trials, and one-third reported on clinical applications. The overall majority of the reactions were mild in more than half of the investigations. Symptoms of extreme and extensive FBR mainly include osteolysis, ganglion cysts, and swelling. The localization of PLLA implants in bone can often result in osteolysis due to local acidosis. This issue can be mitigated by adding hydroxyapatite. There should be no strong FBR when PLLA is fragmented to 0.5-4 µm by extracorporeal shock wave.
PubMed: 38543422
DOI: 10.3390/polym16060817 -
Cureus Feb 2024We experienced two cases of intractable hallux ganglion. Case 1 was a 70-year-old woman with a recurrent ganglion and severe pain on the plantar aspect of the hallux....
We experienced two cases of intractable hallux ganglion. Case 1 was a 70-year-old woman with a recurrent ganglion and severe pain on the plantar aspect of the hallux. The continuity between the mass and the distal flexor hallucis longus (FHL) tendon sheath was confirmed. The ganglion was resected along with part of the tendon sheath, and the tendon sheath was incised as proximally as possible. Case 2 was a 69-year-old woman with a ganglion on the dorsal aspect of the interphalangeal joint that repeatedly ruptured due to thinning of the skin. The ganglion was contiguous with the joint capsule but not with the FHL tendon sheath, and the entire capsule was resected. There was no recurrence one year after surgery in either case. The risk of recurrence of an intractable hallux ganglion can be reduced by blocking the synovial supply route and lowering the pressure inside the joint or tendon sheath.
PubMed: 38510867
DOI: 10.7759/cureus.54423 -
Cureus Feb 2024Acromioclavicular ganglion cysts are uncommon, with only a limited number of cases reported in the medical literature. This case report presents a unique instance of an...
Acromioclavicular ganglion cysts are uncommon, with only a limited number of cases reported in the medical literature. This case report presents a unique instance of an acromioclavicular ganglion cyst in an 81-year-old male patient, outlining the clinical presentation, diagnostic approach, and successful surgical management. The purpose of this report is to contribute to the existing body of knowledge on this rare condition and highlight the importance of accurate diagnosis and appropriate intervention.
PubMed: 38487147
DOI: 10.7759/cureus.54089 -
Medicine Mar 2024Conjunctival myxoma is a rare benign tumor, which can mimic more common conjunctival lesions such as a cyst, lymphangioma, amelanotic nevus, neurofibroma, amelanotic...
RATIONALE
Conjunctival myxoma is a rare benign tumor, which can mimic more common conjunctival lesions such as a cyst, lymphangioma, amelanotic nevus, neurofibroma, amelanotic melanoma, or lipoma. We describe a patient with the conjunctival myxoma, who was initially misdiagnosed as a conjunctival cyst. This case report includes intraoperative photographs and various immunohistochemical staining images.
PATIENTS CONCERNS
A 55-year-old woman presented with a painless mass in the superotemporal conjunctiva of the left eye, which she had noticed 1 month ago. The patient had no previous history of trauma or eye surgery. Slit-lamp examination revealed a well-circumscribed, freely movable, pinkish, semi-translucent mass on the temporal bulbar conjunctiva, suggestive of a conjunctival cyst.
DIAGNOSES
Histopathological analysis showed stellate- and spindle-shaped cells within the loose myxoid stroma, confirming a diagnosis of conjunctival myxoma.
INTERVENTIONS
The conjunctival lesion was completely excised under local anesthesia.
OUTCOMES
After 4 months of follow-up, the patient remained in good health without recurrence of the conjunctival lesion and no evidence of any systemic abnormality.
LESSONS
Myxoma is an extremely uncommon benign tumor derived from primitive mesenchyme. Considering the rarity of the tumor and its similarity to other conjunctival tumors, diagnosis can be challenging. Ophthalmologists should consider myxoma as a possible differential diagnosis when encountering conjunctival lesions. Surgical excision is essential to confirm the diagnosis and careful systemic evaluation is required to prevent potentially life-threatening underlying systemic conditions.
Topics: Female; Humans; Middle Aged; Conjunctival Neoplasms; Myxoma; Conjunctiva; Cysts; Skin Neoplasms
PubMed: 38457580
DOI: 10.1097/MD.0000000000037342 -
Journal of Orthopaedic Case Reports Feb 2024Intraosseous ganglion cysts are an uncommon variant found in the subchondral bone. We report here the development of an intraosseous ganglion cyst of the proximal tibia...
Tibial Component Revision Arthroplasty Using Porous Tantalum Cone for Symptomatic Progressive Periprosthetic Proximal Tibial Ganglion Cyst about All-Polyethylene Tibia Primary Total Knee Replacement: A Case Report and Review of Literature.
INTRODUCTION
Intraosseous ganglion cysts are an uncommon variant found in the subchondral bone. We report here the development of an intraosseous ganglion cyst of the proximal tibia in the setting of a prior left total knee arthroplasty (TKA) with an all-polyethylene tibial component.
CASE REPORT
The cyst was diagnosed on routine follow-up radiographs approximately 4 years status post-TKA. Although initially asymptomatic, 1 year later the patient presented with progressive knee pain and ambulation limitations, so revision TKA was indicated. Computed tomography confirmed an osteolytic lesion suggestive of a penetrating ganglion. Given the absence of malrotation or malalignment of the well-fixed femoral component, the decision was made to proceed with tibial revision to stemmed component cemented through a porous tantalum cone. Postoperatively, the patient had complete resolution of pain and instability with 0-120° of stable range of motion, which has persisted to the latest follow-up at over 6 months post-operative, with radiographic resolution of the cyst.
CONCLUSION
This case demonstrates a ganglion cyst surrounding total knee implants as a possible source of persistent pain following TKA. To our knowledge, this is the first report of such a case. This case demonstrates that refractory painful knee implants secondary to tibial ganglion cysts can be treated successfully with revision arthroplasty.
PubMed: 38420232
DOI: 10.13107/jocr.2024.v14.i02.4244 -
British Journal of Hospital Medicine... Feb 2024
Topics: Humans; Ganglion Cysts; Skin; Knee Joint; Ligaments, Articular; Quadriceps Muscle
PubMed: 38416521
DOI: 10.12968/hmed.2023.0400