Diagnosis and surgical management of idiopathic bile duct cysts in a bearded dragon (Pogona vitticeps)

The case presented shows the clinical signs, diagnosis and surgical management of idiopathic bile duct cysts in a bearded dragon (Pogona vitticeps). A 12-year-old female bearded dragon presented with constipation resulting from the consumption of sand. A soft mass about 4 cm wide could be palpated in the mid-coelom after the substrate passed. The animal started eating, but soon started showing signs of kyphosis. Ultrasound, radiography and computed tomography examinations revealed that the mass was a cyst 4 cm in diameter. Diagnostic laparotomy was performed and the large cyst and affected liver tissue were removed with a partial hepatectomy. Cytology of the cyst was unremarkable, but histopathological examination showed the lesions to be bile duct cysts. No sign of malignancy or inflammation could be seen.

Parasagittal cystic meningioma mimicking hemangioblastoma: A case report

Background: Cystic meningioma is a rare variety with similar histological profiles like the solid tumors. It has been documented in both supratentorial and infratentorial compartments presenting radiologically as a large cyst with mural nodule mimicking hemangioblastoma. Case Description: We managed a middle-aged woman who presented with recurrent seizures and brain MRI revealed left frontal cystic parasagittal tumor with mural nodule. She had left frontal awake craniotomy and gross total tumor excision. Histology confirmed meningothelial meningioma. Conclusion: Cystic meningioma is rare but should be high in differentials of cystic intracranial tumor with dural based nodules. Awake craniotomy is possible for the excision of parasagittal tumor most especially when it is frontal in location.

Parasagittal cystic meningioma mimicking hemangioblastoma: A case report

Background: Cystic meningioma is a rare variety with similar histological profiles like the solid tumors. It has been documented in both supratentorial and infratentorial compartments presenting radiologically as a large cyst with mural nodule mimicking hemangioblastoma. Case Description: We managed a middle-aged woman who presented with recurrent seizures and brain MRI revealed left frontal cystic parasagittal tumor with mural nodule. She had left frontal awake craniotomy and gross total tumor excision. Histology confirmed meningothelial meningioma. Conclusion: Cystic meningioma is rare but should be high in differentials of cystic intracranial tumor with dural based nodules. Awake craniotomy is possible for the excision of parasagittal tumor most especially when it is frontal in location.

Ligament Balancing in Severe Osteoarthritis Knee with Large Cyst and Bursae - A Rare Case Report with Review of Literature

The main indication of total knee replacement (TKR) is pain and restricted range of motion of the knee. The key to a successful total knee replacement is correct alignment in flexion and extension. Here we report a case of TKR in severe osteoarthritis (O / A) knee with a large cyst on the medial side of the knee, resulting in the problem of ligament balancing and management with help of an Arthrex Internal brace. Proper diagnosis and treatment plan help to overcome the challenging cases of varus knee. The indication of total knee replacement is pain and restricted range of motion of the knee. Several authors have reported successful outcomes on patient satisfaction in the follow-up of almost ten to fifteen years. 1 Additionally, the results of surgery are satisfactiry with good implant survival. 2 But some patients indeed have poor results and some may require revision surgery in a short duration. The key to a successful total knee replacement is correct alignment and stability in flexion and extension.3 The ligament after balancing of the correctly aligned knee must consider the function of the resected ligaments in flexion and extension, because in TKR both anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) are usually sacrificed. In other words, total knee replacement is a soft tissue surgery in which bone is replaced. In the varus knee, medial side structures are tight and compensatory laxity on the lateral side. So knee stability should be managed by the remaining ligamentous structures that are both medial and lateral collateral and capsular ligaments. 4 The gap technique is the gold standard for ligament balancing in total knee replacement. 5 That is the execution of equal medial and lateral gaps as well as balanced flexion and extension gaps. This is usually obtained by medial side release in varus knee as the medial side is contracted and lateral side release in valgus knee accordingly. Here we report a case of TKR in severe osteoarthritis knee with a large cyst on the medial side of the knee, resulting in the problem of ligament balancing and management.

Uncommon radiologic computed tomography appearances of the chest in patients with lymphangioleiomyomatosis

Lymphangioleiomyomatosis (LAM) is a rare destructive lung disease characterized by multiple thin-walled pulmonary cysts. The currently proposed diagnostic algorithm emphasizes the characteristic cystic appearance on high-resolution computed tomography (HRCT) so uncommon HRCT appearances present challenges to establishing the proper LAM diagnosis. The objective of this study is to accrue uncommon chest HRCT appearances, determine frequencies in both tuberous sclerosis complex (TSC)-associated LAM (TSC-LAM) and sporadic LAM (S-LAM) patients. 311 females referred to our hospital, including 272 S-LAM patients (mean age 39.2 years) and 39 TSC-LAM patients (mean age 38.3 years), were retrospectively evaluated. We found 2 types of radiologic findings likely to make HRCT cyst appearance atypical: characteristics of the cyst itself and uncommon findings in addition to cysts. We found that approximately 80% of LAM patients, whether TSC-associated or sporadic, showed typical HRCT appearance with mild to severe cystic destruction. The remaining 20% displayed unusual profiles in cyst appearance as well as additional findings aside from cyst: the former includes large cyst, thickened walls, and irregularly shaped whereas the latter includes ground glass attenuation and diffuse noncalcified nodules. It is important to be aware of various radiologic findings that make HRCT cystic appearance atypical of LAM.

Hydatid disease presenting as dense breast implant

We present an interesting case of a pulmonary cyst, thought from the original radiograph to be a dense breast implant. We also present a computed tomography image of the large cyst and the characteristic histological findings of the cause.

P685 Isolated Large Cardiac Hydatid Cyst in the Interventricular Septum

Hydatidosis or cystic echinococcosis is caused by infection with the metacestode stage of the tapeworm Echinococcus . Cardiac hydatid cyst is a rare disease (%0.5-%2) and its symptom is depending on the size and site of infection. The growth of hydatid cyst is usually slow and asymptomatic and just about 10% of patients with cardiac hydatid cyst are symptomatic . The left ventricle is the site of cardiac hydatid cysts in 55% to 60% of cases.Involvement of the interventricular septum is quite rarer.Surgical excision is the preferred treatment. We are reporting a patient with cardiac hydatidosis who was medically treated mass cause of refused the surgery.A 27-year-old woman presented with atypical chest pain and dyspnea. Transthoracic echocardiography revealed a large cyst in the interventricular septum. Thoracic computed tomography showed a cystic lesion in that site, and magnetic resonance imaging confirmed the presence of a 32× 34-mm mass. The patient was treated with albendazole 10 mg/kg for 6 months. After a 6-month follow-up, echocardiography revealed reduction in the size of the cyst. We consider this is the infrequent documented case of cardiac hydatid cyst which regressed with only medical treatment Abstract P685 Figure. Hydatid Cyst in the IVS