Spontaneous regression of cysts of the cavum septi pellucidi (CSP) and cavum vergae (CV) is rare and little discussed. The authors present their case report of this phenomenon following a severe headache in a 23-year-old woman, in whom magnetic resonance imaging (MRI) had previously confirmed significant thinning of the left lateral cyst wall. We consider this finding to be a possible predisposing factor to rupture and the spontaneous regression of such cysts. In addition to the mechanism of cyst regression, the interrelated causes of their expansion and formation will be discussed.
- MeSH
- cysty * diagnostické zobrazování chirurgie MeSH
- dospělí MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- mladý dospělý MeSH
- septum pellucidum * diagnostické zobrazování chirurgie patologie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
PURPOSE: To report the rare case of a 29-year-old male with a history of keratoconus, who presented with a primary iris stromal cyst which eventually showed spontaneous regression. METHODS: Description of the clinical findings in the case of a 29-year-old male with a prior history of keratoconus, but no eye surgery or trauma, who consulted for an iris cyst in the left eye, diagnosed 9 months earlier. CASE REPORT: Slit-lamp examination revealed mild dyscoria, and a large cyst in the inferior quadrant of the iris. Ultrasound biomicroscopy and anterior segment optical coherence tomography of the left eye confirmed the presence of a giant iris cyst with thin walls, in contact with the corneal endothelium. Corneal endothelial cell density in the inferior cornea (close to the cyst) was 1805 cells/mm2 and 2066 cells/mm2 in the central area. After considering the risk of anterior chamber epithelial downgrowth following any surgical procedure of the cyst, the patient received conservative management. In the following months, the patient presented with 3 episodes of anterior uveitis, managed with topical corticosteroids. Finally, at approx. 21 months after the initial diagnosis, the cyst presented spontaneous regression. Anterior segment optical coherence tomography confirmed the absence of fluid inside the cyst remnants and the final endothelial cell densities evidenced endothelial cell loss (inferior cornea 738 cells/mm2 and central cornea 1605 cells/mm2). CONCLUSION: Conservative management should be considered in patients with cysts that show slow progression and are distant from the visual axis, in order to minimise the risk of complications following any surgical procedure of the cyst. In addition, the present case is one of the few of primary stromal iris cysts with spontaneous regression reported in the literature.
- MeSH
- akustická mikroskopie MeSH
- cysty * komplikace diagnostické zobrazování MeSH
- dospělí MeSH
- keratokonus * diagnóza MeSH
- lidé MeSH
- nemoci duhovky * komplikace diagnóza MeSH
- přední komora oční MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
INTRODUCTION: Ultrasound-guided percutaneous ethanol injection therapy (US-PEIT) is a minimally invasive procedure that may be performed as an alternative to surgery for the treatment of recurrent symptomatic thyroid cysts for which simple aspiration failed. The present study aimed at assessing US-PEIT in a large cohort of patients, identifying factors influencing treatment outcome. METHODS: Retrospective analysis of 193 patients with 200 thyroid cysts who underwent US-PEIT in 2004-2018. RESULTS: The initial median cyst volume was 8.5 mL [5.5-16.0]; median final volume at 12 months after the completion of therapy was 0.5 mL [0.2-1.3]. A Volume Reduction Rate (VRR) of 95.0% [86.7-98.0] was achieved. For successful US-PEIT, relatively small total amount of ethanol was needed, on average corresponding to 20.0% [16.7-28.6] of the initial cyst volume. VRR positively correlated with the initial cyst volume and negatively with the presence of complex cyst. Multiple regression analysis showed the presence of complex cyst as an independent predictor of treatment efficacy. CONCLUSION: US-PEIT of thyroid cysts of all sizes was very successful with using total amounts of ethanol, corresponding to ≈20% of the initial cyst volume.
- Klíčová slova
- thyroid cyst, ultrasound-guided percutaneous ethanol injection therapy, volume reduction rate,
- MeSH
- cysty diagnostické zobrazování farmakoterapie MeSH
- dospělí MeSH
- ethanol terapeutické užití MeSH
- injekce do léze MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- nemoci štítné žlázy diagnostické zobrazování farmakoterapie MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ultrasonografie MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- ethanol MeSH
We present a case of megalencephalic leukoencephalopathy with subcortical cysts without macrocephaly and who initially presented with severe psychiatric symptoms. The patient presented with presented with late-onset secondary generalized focal motor seizures, gait ataxia and mild spasticity with hyperreflexia. MRI showed diffuse white matter hyperintensities and bilateral anterotemporal cysts. Genetic analysis confirmed the causal MLC1 mutation and Turner's syndrome. Surprisingly, our patient had no macrocephaly, which is a typical finding in MCL1 mutations; we emphasize that comorbid unrelated Turner's syndrome could explain the absence of macrocephaly: although short stature is typical, microcephaly is not associated with Turner's syndrome. Our observation thus argues for detailed investigations in cases presenting with an atypical clinical picture.
- Klíčová slova
- Depression, Epilepsy, Macrocephaly, Megalencephalic leukoencephalopathy with subcortical cysts, Turner’s syndrome,
- MeSH
- cysty komplikace diagnostické zobrazování MeSH
- dědičné demyelinizační nemoci CNS komplikace diagnostické zobrazování MeSH
- dospělí MeSH
- lidé MeSH
- megalencefalie * MeSH
- Turnerův syndrom komplikace diagnostické zobrazování MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
BACKGROUND & AIMS: Polycystic liver disease (PLD) occurs in two genetic disorders, autosomal-dominant polycystic kidney disease (ADPKD) and autosomal-dominant polycystic liver disease (ADPLD). The aim of this study is to compare disease severity between ADPKD and ADPLD by determining the association between diagnosis and height-adjusted total liver volume (hTLV). METHODS: We performed a cross-sectional analysis with hTLV as endpoint. Patients were identified from the International PLD Registry (>10 liver cysts) and included in our analysis when PLD diagnosis was made prior to September 2017, hTLV was available before volume-reducing therapy (measured on computed tomography or magnetic resonance imaging) and when patients were tertiary referred. Data from the registry were retrieved for age, diagnosis (ADPKD or ADPLD), gender, height and hTLV. RESULTS: A total of 360 patients (ADPKD n = 241; ADPLD n = 119) met our inclusion criteria. Female ADPKD patients had larger hTLV compared with ADPLD (P = 0.008). In a multivariate regression analysis, ADPKD and lower age at index CT were independently associated with larger hTLV in females, whereas in males a higher age was associated with larger hTLV. Young females (≤51 years) had larger liver volumes compared with older females (>51 years) in ADPKD. CONCLUSION: Aetiology is presented as a new risk factor associated with PLD severity. Young females with ADPKD represent a subgroup of PLD patients with the most severe phenotype expressed in hTLV.
- Klíčová slova
- ADPKD, ADPLD, polycystic liver disease, risk factors,
- MeSH
- cysty diagnostické zobrazování epidemiologie genetika MeSH
- dospělí MeSH
- fenotyp MeSH
- genetická predispozice k nemoci MeSH
- hodnocení rizik MeSH
- játra diagnostické zobrazování MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie * MeSH
- nemoci jater diagnostické zobrazování epidemiologie genetika MeSH
- počítačová rentgenová tomografie * MeSH
- polycystické ledviny autozomálně dominantní diagnostické zobrazování epidemiologie genetika MeSH
- prediktivní hodnota testů MeSH
- průřezové studie MeSH
- registrace MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- senioři MeSH
- sexuální faktory MeSH
- stupeň závažnosti nemoci MeSH
- věkové faktory MeSH
- velikost orgánu MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
- Geografické názvy
- Belgie epidemiologie MeSH
- Nizozemsko epidemiologie MeSH
BACKGROUND: A pineal cyst is a relatively common benign condition of the pineal gland. The clinical management of patients with a pineal cyst remains controversial, especially when patients present with nonspecific symptoms. METHODS: We performed a prospective study between 2000 and 2016. All patients with a pineal cyst >7 mm were included. Epidemiologic data, presenting symptoms, surgical results, and radiographic and clinical follow-up were documented. RESULTS: A total of 110 patients were enrolled in the present study. The most common presenting symptoms were tension headache (62.7%), vertigo (16.4%), migraine (12.7%), syncope (10.9%), nausea (8.2%), and diplopia (8.2%). Symptoms worsened during the follow-up period in 17 patients (15.5%), improved in 13 patients (11.8%), and remained stable in 81 patients (73.6%). The mean follow-up was 79.2 months. A pineal cyst increased in size during the follow-up in 6 patients (5.5%) and decreased in size in 9 patients (8.2%). Twenty-one patients underwent pineal cyst resection; 20 patients (95.2%) reported some improvement in their presenting symptoms, and 10 patients (47.6%) were symptom free after the surgery. CONCLUSION: We present the largest clinical series of patients with pineal cysts. Surgery, if indicated properly, is a legitimate treatment modality for symptomatic patients with satisfactory results. Relief of symptoms, even nonspecific ones, is achieved in the majority of cases. Simple growth of the cyst in the first decades of life is a part of the natural course and should not be considered as an indication for surgery.
- Klíčová slova
- Conservative treatment, Headache, Magnetic resonance imaging, Natural history, Neurosurgery, Pineal cyst, Pineal gland,
- MeSH
- cysty komplikace diagnostické zobrazování chirurgie MeSH
- dítě MeSH
- dospělí MeSH
- epifýza mozková diagnostické zobrazování chirurgie MeSH
- hydrocefalus etiologie MeSH
- kohortové studie MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- mladiství MeSH
- mladý dospělý MeSH
- nádory mozku diagnostické zobrazování chirurgie MeSH
- neurochirurgie metody MeSH
- tenzní bolesti hlavy etiologie MeSH
- vertigo etiologie MeSH
- výsledek terapie MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Primary iris stromal cyst characteristically presents as a smooth, round, translucent mass in the anterior chamber. In small children it tends to grow rapidly and may be confused with intraocular malignancy. Management is difficult, and recurrences are frequent. We report 2 cases of primary iris stromal cyst in which recurrence was detected relatively early using ultrasound biomicroscopy and successfully managed with iridectomy.
- MeSH
- akustická mikroskopie * MeSH
- cysty diagnostické zobrazování chirurgie MeSH
- dítě MeSH
- iridektomie MeSH
- kojenec MeSH
- lidé MeSH
- nemoci duhovky diagnostické zobrazování chirurgie MeSH
- přední komora oční diagnostické zobrazování MeSH
- recidiva MeSH
- zraková ostrost fyziologie MeSH
- Check Tag
- dítě MeSH
- kojenec MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- práce podpořená grantem MeSH
Mesenteric cyst is a pathologic fluid collection that very rarely occurs anywhere in the mesentery of the gastrointestinal tract from the duodenum to the rectum. The etiology of mesenteric cysts has not yet been completely understood. It ranges from tumorous, infectious, lymphatic and embryological to post-traumatic or post-operative origin. Symptoms of the illness are usually non-specific, caused mainly by intestinal obstruction. Diagnosis is often accidental. Therapy is exclusively surgical. In the following text, the authors present a case report of a 50-year-old patient operated on due to a mesenteric cyst. The patient had undergone bilateral nephrectomy for polycystic kidney disease and was followed up for polycystic liver disease. CT accidentally revealed a mesenteric cyst around 14 cm in size in the right meso-hypogastrium. It was necessary to perform its histological verification before the planned renal transplantation.
- MeSH
- cysta mezenteria diagnóza diagnostické zobrazování chirurgie MeSH
- cysty diagnostické zobrazování MeSH
- lidé středního věku MeSH
- lidé MeSH
- náhodný nález * MeSH
- nemoci jater diagnostické zobrazování MeSH
- polycystická choroba ledvin diagnostické zobrazování chirurgie MeSH
- radiografie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
Asymptomatic voluminous splenic cysts can be detected as an accidental finding whereas those with surrounding organs compression might be sought after. After succesful diagnosis a reasonable therapy proceeds. There are two treatment options, either a commonly used surgical management including resection or unroofing of the cyst (a better option), or splenectomy. The authors present two case reports of not revolutionary but yet rarely used splenic cyst drainage and sclerotisation procedure with very good outcomes.
- MeSH
- asymptomatické nemoci MeSH
- cysty diagnóza diagnostické zobrazování terapie MeSH
- dospělí MeSH
- drenáž metody MeSH
- intervenční radiografie MeSH
- lidé MeSH
- nemoci sleziny diagnóza diagnostické zobrazování terapie MeSH
- počítačová rentgenová tomografie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
