Isolated Visceral Leishmaniasis Presenting as an Adrenal Cystic Mass

Abstract A 69-year-old woman presented with a large left retroperitoneal suprarenal mass. Radical resection of the left kidney and the mass revealed a cystic adrenal tumor with a weight of 1500 g. Histologic examination showed that the cyst was composed mostly of partially organized clotted blood. The periphery of the mass consisted of a thin rim of cortical and medullary adrenal tissue with superimposed granulomatous chronic inflammation. The infectious nature of the process was manifested by the scattered intracellular and extracellular Leishmania amastigotes that were found throughout the lesion. The differential diagnosis of cystic adrenal masses and the unusual presentation of visceral leishmaniasis are discussed in this context.

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Antenatally Diagnosed Suprarenal Cystic Teratoma

World Journal of Endocrine Surgery ◽

10.5005/jp-journals-10002-1166 ◽

2015 ◽

Vol 7 (2) ◽

pp. 44-46

Author(s):

Sandeep Agarwala ◽

Manisha Jana ◽

MK Singh ◽

Rajan Garg ◽

Ankur Mandelia ◽

...

Keyword(s):

Differential Diagnosis ◽

Antenatal Diagnosis ◽

Cystic Teratoma ◽

Female Child ◽

Cystic Mass ◽

Histological Diagnosis ◽

Mature Cystic Teratoma ◽

Suprarenal Mass

ABSTRACT A two months old female child presented to us with an antenatal diagnosis of left suprarenal mass. Laparotomy revealed a large cystic mass in the left suprarenal location which was completely excised. The histological diagnosis was a mature, cystic teratoma. Although, the diagnosis of adrenal teratoma is rare, it should be considered in the differential diagnosis of antenatally diagnosed suprarenal lesions. How to cite this article Garg R, Mandelia A, Agarwala S, Bhatnagar V, Singh MK, Jana M. Antenatally Diagnosed Suprarenal Cystic Teratoma. World J Endoc Surg 2015;7(2):44-46.

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Differential Diagnosis of Adrenal Masses Using Out-of-Phase Flash Imaging

Acta Radiologica ◽

10.3109/02841859209173173 ◽

1992 ◽

Vol 33 (3) ◽

pp. 262-265

Author(s):

Y. Tsushima ◽

H. Ishizaka ◽

T. Kato ◽

M. Matsumoto

Keyword(s):

Differential Diagnosis ◽

Adrenal Masses

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Parenchymal mucinous cystadenoma of the kidney: a case report and literature review

African Journal of Urology ◽

10.1186/s12301-021-00203-4 ◽

2021 ◽

Vol 27 (1) ◽

Author(s):

Mahmoudreza Kalantari ◽

Shakiba Kalantari ◽

Mahdi Mottaghi ◽

Atena Aghaee ◽

Salman Soltani ◽

...

Keyword(s):

Renal Cyst ◽

Left Kidney ◽

Previous History ◽

Mucinous Cystadenoma ◽

Single Layer ◽

Renal Cysts ◽

Cystic Mass ◽

Flank Pain ◽

History Of

Abstract Background Mucinous cystadenoma (MC) of the kidney is exceedingly rare. We found 22 similar cases in the literature. These masses are underdiagnosed due to radiologic similarities with simple renal cysts. Case presentation A 66-year-old man with a previous history of hypertension and anxiety was referred to our tertiary clinic with left flank pain. Ultrasound revealed a 60 mm-sized, complex cystic mass with irregular septa in the lower pole of the left kidney (different from last year's sonographic findings of a simple benign cyst with delicate septa). CT scan showed the same results plus calcification. Due to suspected renal cell carcinoma, a radical nephrectomy was performed. Postoperative histopathologic examination revealed a cyst lined by a single layer of columnar mucin-producing cells with small foci of pseudo-stratification, consistent with the MC’s diagnosis. The first follow-up visit showed normal blood pressure without medication and no flank pain and anxiety after a month. Conclusion It is quite challenging to distinguish the primary MC of the kidney from a simple renal cyst based on clinical and imaging findings. The radiologic features of these entities overlap significantly. Thus, complex renal cyst and renal cysts with mural nodules should be followed closely to detect malignancy earlier.

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Ameloblastoma of the maxillary sinus: conservative surgical management considering high recurrence risk potential

BMJ Case Reports ◽

10.1136/bcr-2020-241487 ◽

2021 ◽

Vol 14 (5) ◽

pp. e241487

Author(s):

Lukas S Fiedler ◽

Annette Wunsch

Keyword(s):

Maxillary Sinus ◽

Radical Resection ◽

Recurrence Risk ◽

Flexible Endoscopy ◽

Cystic Mass ◽

High Rate ◽

Sinus Surgery ◽

Nasal Passage ◽

Lateral Sinus ◽

Sinus Wall

Ameloblastoma (AM) in the maxillary sinus is rare. This benign entity shows locally invasive, destructive and aggressive behaviour and a high rate of recurrence. Therefore, the course of treatment is radical resection. We report the case of a 38-year-old man presenting with signs of recurrent sinusitis in the Ear, Nose and Throat Department. Transnasal flexible endoscopy revealed a cystic mass in the right inferior and middle nasal passage. CT scan showed an obliterated right maxillary sinus with a ballooning effect and pressure atrophy of the lateral sinus wall, without possible differentiation of the middle and low nasal turbinate. The patient was treated with transnasal functional sinus surgery; pathology stated AM. AM in the maxillary sinus is rare, locally destructive and therefore as a gold standard is resected radically to prevent recurrence. We demonstrate a conservative approach; explicitly, we combined a transvestibular and functional endoscopic sinus surgery resection of the AM to maintain function and reduce the possibility of postoperative impairments. Whether the strategy of treatment for AM is conservative, it nonetheless can result in a recurrence-free status. Nevertheless, inclusion into an oncological follow-up-programme with regularly performed MRI and CT is recommended.

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Huge retrovesical hydatid cyst with pelvic localization as the primary site: a case report

Acta Radiologica ◽

10.1080/02841850701422138 ◽

2007 ◽

Vol 48 (8) ◽

pp. 918-920 ◽

Cited By ~ 2

Author(s):

A. M. Halefoglu ◽

A. Yasar

Keyword(s):

Differential Diagnosis ◽

Abdominal Pain ◽

Case Report ◽

Hydatid Cyst ◽

Cystic Mass ◽

Primary Site ◽

Cystic Disease ◽

The World ◽

Indirect Hemagglutination ◽

Indirect Hemagglutination Test

We present a patient with symptoms of abdominal pain and frequent urination due to a huge mass in the retrovesical region. All imaging modalities revealed a cystic mass containing small daughter cysts located between the urinary bladder and rectum. Its characteristics led us to suspect the presence of a hydatid cyst, and an indirect hemagglutination test for Echinococcus granulosus was found positive. No other involvement of hydatid cystic disease was detected. The primary site for the hydatid disease was therefore regarded as the pelvis, on which only a few cases have been reported previously. The patient started albendazole therapy, but refused operation. Hydatid cyst should always be considered in the differential diagnosis of abdominopelvic masses in endemic regions of the world.

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Hepatic hydatid cyst: a masquerader

International Surgery Journal ◽

10.18203/2349-2902.isj20201898 ◽

2020 ◽

Vol 7 (5) ◽

pp. 1688

Author(s):

Krishan Kumar Kanhaiya ◽

Bhimsi Kandoriya ◽

Vineet Pandey ◽

Viresh Kumar ◽

Sushanto Neogi

Keyword(s):

Differential Diagnosis ◽

Hydatid Cyst ◽

Surgical Excision ◽

Hepatic Cyst ◽

Cystic Mass ◽

Hepatic Hydatid Cyst ◽

Adrenal Cyst ◽

Upper Abdominal ◽

Hepatic Hydatid

Liver is the most common organ involved in echinococcosis. Organs affected by E granulosus are the liver (63%), lungs (25%) and muscles (5%). Rest of the organs are rarely affected. Adrenal cysts are uncommon. Their size may range widely and the origin of large adrenal cysts is often difficult to distinguish from other organs, including the kidney, pancreas, spleen, and liver. A large right-sided adrenal cystic mass can rarely be mistaken for a hepatic cyst by imaging. In this report, authors have described an adrenal cyst in a 28 year old lady, who was diagnosed preoperatively to have a hepatic hydatid cyst but intraoperatively it was found to be of adrenal origin. The size of the adrenal cyst can vary from a few millimetres up to 50 cm in diameter. Majority of the adrenal cysts are unilateral, while 8-10% of those cysts have been noted to be present bilaterally. The majority of cases are diagnosed between the 3rd and 6th decades. Although uncommon, Adrenal cyst should be considered as one of the differential diagnosis of upper abdominal cysts. Surgical excision is advisable when the cysts are symptomatic, greater than 5 cm in diameter and in the case of suspecting malignancy.

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Primary Urachal Hydatid Cyst in a Child: A Case Report

Iranian Journal of Parasitology ◽

10.18502/ijpa.v14i2.1151 ◽

2019 ◽

Author(s):

Tugay TARTAR ◽

Unal BAKAL ◽

Mehmet SARAC ◽

Ibrahim AKDENIZ ◽

Ahmet KAZEZ

Keyword(s):

Differential Diagnosis ◽

Hydatid Cyst ◽

Abdominal Wall ◽

Pediatric Surgery ◽

Anterior Abdominal Wall ◽

Cystic Mass ◽

Parasitic Disease ◽

Pathologic Evaluation ◽

School Of Medicine ◽

Median Incision

The hydatid cyst (HC) is an endemic parasitic disease worldwide. Although the HC can locate in every part of a body, it rarely occurs over the abdominal wall. A 12-year-old female patient was brought to Department of Pediatric Surgery, Firat University School of Medicine, Elazig, Turkey in 2017. She had been suffering from abdominal pain for one week. A lump was determined underneath her skin in the suprapubic region. It was swollen, tense and movable. A cystic mass filling the midline was found in the radiological bladder superior. It was an anechoic cyst causing ondulation on the muscles of the anterior abdominal wall. The sizes of the mass were measured approximately as 9x7 cm (mesentery cyst?). The cystic mass was occurred in the urachal area of the anterior abdominal wall, not in the abdomen. After the cyst was emptied with applying mini median incision below the umbilicus, we saw the germinative membrane inside the cyst. Diagnosis of the HC was confirmed with the pathologic evaluation. For the differential diagnosis of a pure cystic mass, which can locate in every part of a body, diagnosis of the HC should be considered.

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Splenic Nodules: Canine Visceral leishmaniasis?

Acta Scientiae Veterinariae ◽

10.22456/1679-9216.108488 ◽

2021 ◽

Vol 49 ◽

Author(s):

Gilsan Aparecida De Oliveira ◽

Vitória Aline Santos Sarmento ◽

Isabelle Vanderlei Martins Bastos ◽

Alberon Ribeiro De Araújo ◽

Lígia Buzzá Roo De Mendonça ◽

...

Keyword(s):

Differential Diagnosis ◽

Visceral Leishmaniasis ◽

Animal Health ◽

Rapid Test ◽

Good Alternative ◽

Canine Visceral Leishmaniasis ◽

Biochemical Alterations ◽

University Center ◽

Protein Levels ◽

Endemic Areas

Background: Canine visceral leishmaniasis (CVL) is a parasitic disease of high lethality caused by the protozoan Leishmania infantum in Brazil and is often related to splenomegaly. However, splenic nodules in dogs, although frequent, have not previously been reported as associated with CVL, but with neoplastic diseases. Considering that most dogs infected are oligosymptomatic or asymptomatic and that splenic nodules are common to other diseases, it is prudent to differentially diagnose CVL in view of its high zoonotic potential and lethality. The objective of the study was to describe a case of splenomegaly with splenic nodules associated with CVL in an asymptomatic dog treated with 2% miltefosina. Case: A 5-year-old male Rottweiler with 41 kg, with a history of inappetence, apathy and weight loss was referred to the Veterinary Medicine School Clinic of the Cesmac University Center, Maceió, AL, Brazil. However, during palpation a slight increase in the spleen was noted. Hematological, hemoparasite, biochemical and abdominal ultrasonographic examinations were requested to clarify the clinical suspicion of hemoparasitosis. The hematological and biochemical results respectively showed the following: normocytic normochromic anemia, hyperproteinemia and thrombocytopenia, in addition to hypoalbuminemia, with elevated total protein levels. The test for hemoparasites was negative. Ultrasonography showed mixed echogenicity suggestive of nodules. The rapid test for Ehrlichia, Anaplasma and L. infantum was performed. It was positive only for L. infantum. ELISA, IFAT and qPCR tests were performed to confirm the result. The test showed a cut-off result of 0.371 for ELISA, positive for RIFI at a cut-off of 1:40 and qPCR with less than 1 fg and with amplification above 36 cycles. In view of these results, treatment with 2% miltefosine at a dose of 1 mL/ 10 kg was started once a day, after feeding, for 28 days. The animal was monitored throughout treatment and re-evaluated every 10 days for 30 days, showing signs of clinical development, presenting satisfactory results.Discussion: Canine splenomegaly can be associated with a variety of disease possibilities. In asymptomatic canine visceral leishmaniasis (CanL), the slight increase in spleen and the presence of splenic nodules may lead to a false diagnosis. Splenic nodules may be associated with dogs of advanced age and may be due to lymphoid nodular hyperplasia, which causes nodules with echogenicity, hyperechoic regions with well demarcated irregularity, with centralized hypoechoic areas and an absence of hematological and biochemical alterations. The cause of splenomegaly associated with nodules may be difficult to diagnose and require much time and effort. Therefore, diseases such as visceral leishmaniasis of high lethality must be the priority in differential diagnosis in endemic areas in order to minimize the risk of transmission. In addition to allowing an early intervention aiming at good animal health results and preventive measures, such as the use of repellent collars that reduce the risk of phlebotomo infection. The differential diagnosis of CVL is necessary in endemic areas, even in asymptomatic dogs that may present splenic alterations suggestive of other diseases. Treatment with 2% miltefosine was shown to be, in this case, effective at reducing the splenic nodules and a good alternative for the quality of life of the animal.

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The human Bosniak model applied to a cat with renal cystadenoma

Tierärztliche Praxis Ausgabe K Kleintiere / Heimtiere ◽

10.15654/tpk-140268 ◽

2015 ◽

Vol 43 (01) ◽

pp. 45-49

Author(s):

F. Del Chicca ◽

M. Ruetten ◽

B. Gerber ◽

P. Baloi

Keyword(s):

Weight Loss ◽

Differential Diagnosis ◽

Needle Biopsy ◽

Left Kidney ◽

Abdominal Ultrasound ◽

Imaging Features ◽

Bosniak Classification ◽

Core Needle ◽

Computed Tomographic ◽

Malignant Lesions

SummaryA 13-year-old domestic shorthair cat was presented with weight loss and azotemia. Abdominal ultrasound revealed a large cystic spaceoccupying lesion with multiple septae in the left kidney. A core needle biopsy yielded a renal cystadenoma originating from the epithelial cells. This report describes the clinical, ultrasonographic and computed tomographic features and the growth progression of a renal cystadenoma. We describe the first attempt to apply the human Bosniak classification to a cat with renal cystic neoplasia to differentiate between benign and malignant lesions. Cystadenoma should be a differential diagnosis in cases of renal cystic space-occupying lesions. Other differentials, imaging features to differentiate benign and malignant lesions and the risk of malignant transformation will be discussed.

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