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Journal of Nippon Medical School =... Mar 2022Simple hepatic cysts are typically saccular, thin-walled masses with fluid-filled epithelial lined cavities. They arise from aberrant bile duct cells that develop during...
Simple hepatic cysts are typically saccular, thin-walled masses with fluid-filled epithelial lined cavities. They arise from aberrant bile duct cells that develop during embryonic development. With the development of diagnostic modalities such as ultrasonography (US), CT, and MRI, simple hepatic cysts are frequently detected in clinical examinations. US is the most useful and noninvasive tool for diagnosis of simple hepatic cysts and can usually differentiate simple hepatic cysts from abscesses, hemangiomas, and malignancies. Cysts with irregular walls, septations, calcifications, or daughter cysts on US should be evaluated with enhanced CT or MRI, to differentiate simple hepatic cysts from cystic neoplasms or hydatid cysts. Growth and compression of hepatic cysts cause abdominal discomfort, pain, distension, and dietary symptoms such as nausea, vomiting, a feeling of fullness, and early satiety. Complications of simple hepatic cysts include infection, spontaneous hemorrhage, rupture, and external compression of biliary tree or major vessels. Asymptomatic simple hepatic cysts do not require treatment. Treatment for symptomatic simple hepatic cysts includes percutaneous aspiration, aspiration followed by sclerotherapy, and surgery. The American College of Gastroenterology clinical guidelines recommend laparoscopic fenestration because of its high success rate and low invasiveness. Percutaneous procedures for treatment of simple hepatic cysts are particularly effective for immediate palliation of patient symptoms; however, they are not generally recommended because of the high rate of recurrence. Management of simple hepatic cysts requires correct differentiation from neoplasms and infections, and selection of a reliable treatment.
Topics: Cysts; Humans; Liver Diseases; Magnetic Resonance Imaging; Ultrasonography
PubMed: 34526451
DOI: 10.1272/jnms.JNMS.2022_89-115 -
Nature Medicine Jan 2021Neurofibromatosis type 1 (NF1) plexiform neurofibromas (PNs) are progressive, multicellular neoplasms that cause morbidity and may transform to sarcoma. Treatment of...
Neurofibromatosis type 1 (NF1) plexiform neurofibromas (PNs) are progressive, multicellular neoplasms that cause morbidity and may transform to sarcoma. Treatment of Nf1;Postn-Cre mice with cabozantinib, an inhibitor of multiple tyrosine kinases, caused a reduction in PN size and number and differential modulation of kinases in cell lineages that drive PN growth. Based on these findings, the Neurofibromatosis Clinical Trials Consortium conducted a phase II, open-label, nonrandomized Simon two-stage study to assess the safety, efficacy and biologic activity of cabozantinib in patients ≥16 years of age with NF1 and progressive or symptomatic, inoperable PN ( NCT02101736 ). The trial met its primary outcome, defined as ≥25% of patients achieving a partial response (PR, defined as ≥20% reduction in target lesion volume as assessed by magnetic resonance imaging (MRI)) after 12 cycles of therapy. Secondary outcomes included adverse events (AEs), patient-reported outcomes (PROs) assessing pain and quality of life (QOL), pharmacokinetics (PK) and the levels of circulating endothelial cells and cytokines. Eight of 19 evaluable (42%) trial participants achieved a PR. The median change in tumor volume was 15.2% (range, +2.2% to -36.9%), and no patients had disease progression while on treatment. Nine patients required dose reduction or discontinuation of therapy due to AEs; common AEs included gastrointestinal toxicity, hypothyroidism, fatigue and palmar plantar erythrodysesthesia. A total of 11 grade 3 AEs occurred in eight patients. Patients with PR had a significant reduction in tumor pain intensity and pain interference in daily life but no change in global QOL scores. These data indicate that cabozantinib is active in NF1-associated PN, resulting in tumor volume reduction and pain improvement.
Topics: Adolescent; Adult; Anilides; Animals; Disease Models, Animal; Female; Genes, Neurofibromatosis 1; Humans; Male; Mice; Mice, Mutant Strains; Neurofibroma, Plexiform; Neurofibromatosis 1; Pain Measurement; Prospective Studies; Protein Kinase Inhibitors; Pyridines; Quality of Life; Receptor Protein-Tyrosine Kinases; Translational Research, Biomedical; Young Adult
PubMed: 33442015
DOI: 10.1038/s41591-020-01193-6 -
Zhurnal Voprosy Neirokhirurgii Imeni N.... 2017A pineal cyst (PC) is a benign neoplasm in the pineal region, or more precisely in the pineal body. Most cysts are incidental findings and are not associated with... (Review)
Review
UNLABELLED
A pineal cyst (PC) is a benign neoplasm in the pineal region, or more precisely in the pineal body. Most cysts are incidental findings and are not associated with symptoms typical of patients seeking medical advice. Symptomatic cysts are discovered less often and, depending on the clinical picture, require different treatment approaches.
MATERIAL AND METHODS
We analyzed the literature data about the clinical picture, diagnosis, and treatment of PCs for more than a century (1914-2016).
CONCLUSION
To date, there is no single approach for managing PC patients. The indications for surgical treatment of symptomatic PCs are still not fully defined. It remains unclear which PC cases should be followed-up, and how often control examinations should be performed. More research of PCs is needed to develop new approaches to treatment of PC patients.
Topics: Cysts; Humans; Pineal Gland; Pinealoma
PubMed: 28914878
DOI: 10.17116/neiro2017814113-120 -
Turkish Neurosurgery 2020To evaluate the factors affecting the clinical and radiological findings of juxtafacet cyst patients.
AIM
To evaluate the factors affecting the clinical and radiological findings of juxtafacet cyst patients.
MATERIAL AND METHODS
Between January 2011 and December 2018, eight patients diagnosed with juxtafacet cyst were reviewed, retrospectively. Patient demographics; signs and symptoms; and neurological examination, radiological, and surgical findings were noted.
RESULTS
The mean age was 54 years (range, 34â€"69 years) with five (62.5%) females and three (37.5%) males. There were nine juxtafacet cysts in eight patients. Five cysts (55.5%) were located at the L3â€"L4 level, two cysts (22.2%) at the L4â€"L5 level, and two cysts (22.2%) at the L5â€"S1 level. In all patients with L3â€"L4 cysts, the intercrest line was intersecting the spinal column at L4 vertebral body level. The most frequent symptoms were back pain and radiculopathy. Magnetic resonance imaging and computerized tomography revealed degenerative facet arthropathy in six patients (75%). Three patients (37.5%) had a medical history of trauma. One patient (12.5%) was treated conservatively. Seven patients (87.5%) were advised to undergo surgical treatment.
CONCLUSION
Degeneration and instability are the main causes of juxtafacet cysts. They are mainly seen at the L4â€"L5 level due to higher movement capacity of this level. But, if the intercrest line intersects the spinal column at higher levels, degeneration and instability risks move to upper levels, and juxtafacet cysts may occur at the L3â€"L4 or upper levels.
Topics: Adult; Aged; Female; Ganglion Cysts; Humans; Intervertebral Disc Degeneration; Lumbosacral Region; Male; Middle Aged; Retrospective Studies; Synovial Cyst
PubMed: 32091121
DOI: 10.5137/1019-5149.JTN.27588-19.2 -
Monaldi Archives For Chest Disease =... Sep 2017Thoracic cage is the site of development of various primary or metastatic tumors. An aneurysmal rib cyst is a benign tumor arising from the chest wall. Aneurysmal rib...
Thoracic cage is the site of development of various primary or metastatic tumors. An aneurysmal rib cyst is a benign tumor arising from the chest wall. Aneurysmal rib cyst is considered a rare surgical entity and its presence must be followed by removal for histology examination. We present here the case of an aneurysmal rib cyst to a young 33-year-old female. The tumor was presented as an expanding left anterior second rib mass during a self-breast examination. Chest x-ray showed a shadow on the left upper lung area and CT scan revealed a large multicystic mass in the anterolateral left 2nd rib protruding underneath the thoracic major muscle. We discuss the clinicopathological characteristics of this tumor and its surgical management along with a short literature review.
Topics: Adult; Aftercare; Bone Cysts, Aneurysmal; Female; Humans; Ribs; Thoracic Wall; Thoracotomy; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 29424198
DOI: 10.4081/monaldi.2017.860 -
Ear, Nose, & Throat Journal Mar 2024Pilomatrixomas are benign neoplasms derived from hair follicle matrix cells. They are among the most common soft tissue head and neck tumors of childhood.... (Review)
Review
Pilomatrixomas are benign neoplasms derived from hair follicle matrix cells. They are among the most common soft tissue head and neck tumors of childhood. Pilomatrixomas are typically isolated, slow-growing, firm, nontender masses that are adherent to the epidermis but mobile in the subcutaneous plane. This clinical presentation is so characteristic that many experienced surgeons will excise suspected pilomatrixomas without prior imaging. We reviewed the results of this approach to determine whether physical examination alone differentiates pilomatrixomas from other similar soft tissue lesions of the pediatric head and neck. Computerized review of all pilomatrixomas over a 20-year period in a single academic pediatric otolaryngology practice. 18 patients presented to our pediatric otolaryngology practice between 2001 and 2021 with historical and physical findings consistent with pilomatrixoma. Of the 18 patients, 7 were male and 11 were female. Ages ranged from 1.5 to 14 years, with a mean of 7.5 years. Most of the lesions (12) were located in the head and face, while the rest (6) were found in the neck. All patients were treated with complete surgical excision. Pathology confirmed pilomatrixoma in 15 patients. The remaining 3 children were found to have an epidermal inclusion cyst, a ruptured trichilemmal cyst, and a giant molluscum contagiosum lesion, respectively. One additional patient presented with a small lesion of the auricular helix that was thought to be a dermoid cyst, but proved to be a pilomatrixoma on histologic examination. As pilomatrixomas are common and have a very characteristic presentation, surgical excision without prior diagnostic imaging will lead to correct treatment in the majority of cases. High resolution ultrasonography can help to confirm the diagnosis preoperatively, but is not definitive in large case series. Most of the cystic lesions that imitate pilomatrixoma will ultimately require surgical excision.
Topics: Child; Humans; Male; Female; Infant; Child, Preschool; Adolescent; Pilomatrixoma; Skin Neoplasms; Hair Diseases; Head and Neck Neoplasms; Epidermal Cyst
PubMed: 34549614
DOI: 10.1177/01455613211044778 -
BMJ Case Reports Aug 2012Congenital omental cysts are rare intra-abdominal pathology, which are difficult to diagnose preoperatively; as such a high index of suspicion is required for accurate... (Review)
Review
Congenital omental cysts are rare intra-abdominal pathology, which are difficult to diagnose preoperatively; as such a high index of suspicion is required for accurate preoperative diagnosis. We present a case of congenital omental cyst in a 3-year-old girl who presented with huge abdominal distension. We performed diagnostic examinations including ultrasonography and CT of the abdomen. An omental cyst was diagnosed because of its position and connection to the surrounding tissues. She was operated and cyst was excised completely. Histological examination revealed an omental cyst with endothelial lining and haemorrhagic fluid inside. She had an uneventful recovery and doing well, without recurrence at follow-up of 24 months. Clinicians must rigorously pursue a preoperative diagnosis, as it may prevent a surprise upon laparotomy and result in proper management.
Topics: Abdominal Pain; Child, Preschool; Cysts; Female; Humans; Laparotomy; Omentum; Peritoneal Diseases; Treatment Outcome
PubMed: 22865812
DOI: 10.1136/bcr-2012-006643 -
Ceska a Slovenska Oftalmologie :... 2020Eye globe enucleation due to other than a malignant tumor is very rare today. Solitary intraocular neurofibroma without other signs of neurofibromatosis is a rare...
PURPOSE
Eye globe enucleation due to other than a malignant tumor is very rare today. Solitary intraocular neurofibroma without other signs of neurofibromatosis is a rare benign tumor and few cases have been reported to date.
MATERIAL AND METHODS
In 10 year interval from Jan 1 2007 to Dec 31 2016 we analyzed non-malignant eye globe enucleations.
RESULTS
Of the 49 enucleated blind eyes, each patient had visual acuity with no light perception, 34 (69.4%) were indicated for enucleation due to complications following previous postoperative surgery after trauma, 14 patients (28.6%) were due to secondary glaucoma and other complications following previous intraocular surgery, and in one patient (2%) the primary isolated intraocular neurofibroma was verified after enucleation.
CASE REPORT
A patient with isolated intrabulbar neurofibroma has been monitored since childhood for intraocular lesion and histologically verified at adult age. At the time of enucleation, he was 25 years old, squint since childhood and was observed for hamartoma in his right eye since he was 13 years old. Due to the progression of intrabulbar lesion, loss of visual acuity (functional state - no light perception) and secondary glaucoma, the right eye globe was enucleated at adult age and histopathological examination confirmed intraocular neurofibroma in the absence of neurofibromatosis.
CONCLUSION
Every enucleated eye globe should be subjected to a thorough histopathological examination. Isolated intraocular neurofibromas can occur as isolated orbital or intrabulbar masses without systemic features.
Topics: Adolescent; Adult; Child; Eye Enucleation; Eye Neoplasms; Glaucoma; Humans; Male; Neurofibroma; Visual Acuity
PubMed: 33126800
DOI: 10.31348/2020/13 -
Korean Journal of Radiology Mar 2020Ultrasonography (US) is usually the first imaging examination performed to evaluate palpable or visible superficial soft tissue lesions that are common in children.... (Review)
Review
Ultrasonography (US) is usually the first imaging examination performed to evaluate palpable or visible superficial soft tissue lesions that are common in children. Although clinical assessments, such as age at presentation, clinical course, and overlying skin discoloration, are important for the differentiation of pediatric soft tissue lesions, US allows a specific diagnosis of some typical benign lesions and helps in guiding further investigation since it provides detailed information about the lesion location, characterization including solid versus cystic, vascularity, and compressibility. Therefore, sufficient knowledge of the normal anatomy, proper ultrasonographic techniques, and the imaging findings of common and uncommon soft tissue lesions in children are crucial for accurate assessment and management of patients. In this article, we review the techniques and imaging findings focusing on the ultrasonographic features of a variety of superficial soft tissue lesions detected in children.
Topics: Adolescent; Child; Child, Preschool; Fasciitis; Female; Hemangioendothelioma; Humans; Infant; Infant, Newborn; Kasabach-Merritt Syndrome; Lipoblastoma; Male; Myofibromatosis; Neurofibroma; Sarcoma, Kaposi; Soft Tissue Neoplasms; Ultrasonography; Vascular Malformations
PubMed: 32090527
DOI: 10.3348/kjr.2019.0343 -
Dermatology Online Journal Oct 2011A 59-year-old man presented for evaluation and excision of non-tender, fleshy nodules that were arranged in a dermatomal distribution from the left side of the chest to... (Review)
Review
A 59-year-old man presented for evaluation and excision of non-tender, fleshy nodules that were arranged in a dermatomal distribution from the left side of the chest to the left axilla. A biopsy specimen of a nodule was consistent with a neurofibroma. Owing to the lack of other cutaneous findings, the lack of a family history of neurofibromatosis, and the dermatomal distribution of the neurofibromas, this patient met the criteria for a diagnosis of segmental neurofibromatosis (SNF) according to Riccardi's definition of SNF and classification of neurofibromatosis. Because the patient has no complications of neurofibromatosis 1 no medical treatment is required.
Topics: Humans; Male; Middle Aged; Neurofibromatosis 1; Physical Examination; Prevalence
PubMed: 22031651
DOI: No ID Found