Cutaneous ciliated cyst: A case report

Cutaneous ciliated cyst are relatively rare benign lesions, found in the dermis or subcutis of the lower extremities of young females in their second and third decades. The cysts are typically lined by ciliated cuboidal to columnar epithelium, showing pseudostratified areas and focal squamous metaplasia is occasionally present. Immunohistochemical studies have demonstrated that the cysts can be PR and ER positive, similar to the epithelia of the fallopian tubes. The pathogenesis of the cyst is yet being studied, some hypotheses have been proposed including the Mullerian heterotopias, ciliated metaplasia of eccrine sweat glands, and embryonic remnants of the cloacal membrane. We report a cutaneous ciliated cyst over the right gluteus area in a 29 year old female. On histologic examination, the cyst was lined by ciliated columnar epithelium, showing occasional papillary projections.

A wretched condition

Although rare, cleft bladder was known to the ancients: the infants did not die after birth, but grew up incontinent. Combined with abnormal genitalia, the malformation was confused with hermaphroditism, the most loathed congenital anomaly. Three grades were discerned in the 17th century: epispadias, where the urethra opens at the anterior side of the penis; bladder exstrophy with open anterior bladder wall; and cloacal exstrophy with common outlet for stool and urine. Explanations of its origin included obstructed urethra, short umbilical cord, and bursting allantois, bladder, abdominal wall, or cloacal membrane. As the incontinent children suffered from painful inguinal eczema, urine collecting devices were constructed from copper and tin, and from rubber once vulcanization was invented. Correcting operations were attempted from 1852 with limited success. Today, stepwise corrective surgery begins by closing the bony pelvis, bladder, and the abdominal wall, followed by epispadias repair and penis remodelling. No controlled trials or international protocols have come forth, and the long-term prognosis is all but satisfying.

A case report on continent isolated male epispadias.

Epispadias is a rare congenital anomaly in which the urethral opening is on the dorsal surface of penis. Its incidence is 1 in 117000 newborn males and 1 in 484000 in newborn females. Its etiology is considered as because of failure of medial migration of mesenchyme between the ectodermal and endodermal layers of cloacal membrane due to premature rupture of cloacal membrane. Epispadias often presents as exstrophy epispadias complex, a wide spectrum of abnormalities that consist of classic bladder exstrophy, Epispadias and cloacal exstrophy. This case was not a part of exstrophy epispadias complex and it was an isolated continent epispadias which is extremely rare and it was managed with Cantwell Ransley epispadias repair technique.

Abnormal Expression of Fgf9 during the Development of the Anorectum in Rat Embryos with Anorectal Malformations

The study objective was to investigate the role of fibroblast growth factor 9 (Fgf9) in normal and anorectal malformation (ARM) embryos during the development of the anorectum. Fgf9 expression was assayed in both normal rat embryos and embryos with ARM induced by exposure to ethylenethiourea (ETU) on embryonic day 10 (E10). Fgf9 expression was assayed by immunohistochemical staining, Western blotting, and real-time quantitative polymerase chain reaction (qRT-PCR). Immunohistochemical staining revealed spatiotemporal changes in Fgf9 expression between E13 and E16. Fgf9-positive cells predominated in the mesenchyme of the cloaca on E13 and E14 and at the fusion site of the urorectal septum and cloacal membrane, rectal epithelium, and anal membrane on E15. Fgf9-positive cells were obviously decreased after the anal membrane ruptured on E16. Fgf9-positive staining was significantly decreased in embryos with ARM compared with normal embryos from E13 to E15. The results of Western blots and qRT-PCR were consistent, with significantly increased Fgf9 expression in the hindgut and rectum of normal embryos than in embryos with ARM from E13 to E15. However, there was no difference between the two groups on E16. These results suggested that the anorectal embryogenesis might depend on the induction of Fgf9 signal. The expression of Fgf9 was downregulated in ETU-induced ARM embryos, which might be related to the development of ARM.

Bifid phallus with complete duplication and a separate scrotum in a German shepherd dog: a case report

Diphallia or penile duplication is a rare congenital abnormality thought to result from duplication of the cloacal membrane in the early developmental stages in the uterus. The present case concerned a 4-year old intact male German shepherd dog. The patient presented with a complaint of paraphimosis. Clinical, laboratory, radiological and ultrasonographic examinations were carried out. Semen samples collected prior to surgery were examined. Following amputation, the penis with paraphimosis was sent for histopathological investigation. Karyotype analysis of the patient was also performed. As well as the first report of this abnormality in Turkey, this case report represents the first report of this condition in a German shepherd dog.

The Cutaneous Ciliated Cyst in Young Male: The Possibility of Ciliated Cutaneous Eccrine Cyst

Cutaneous ciliated cyst was described as a painless cyst occurring on the lower limbs of women between the ages of 15 and 30 years. The cysts are typically lined by ciliated cuboidal to columnar epithelium with pseudostratified areas and focal squamous metaplasia is occasionally present. Immunohistochemical studies have demonstrated that the cysts are PR and ER positive, similar to the epithelia of the fallopian tubes. However, outliers of cutaneous ciliated cysts, including those in male patients and in unexpected locations such as the scalp, finger, and scapular area, have been reported. Thus, some hypotheses have been proposed including the Mullerian heterotopias, ciliated metaplasia of eccrine sweat glands, and embryonic remnants of the cloacal membrane. We report a rare case of cutaneous ciliated cyst on the left shoulder of a 7-year-old boy and this is the eighth case of cutaneous ciliated cyst in male patients. Moreover, through reviewing the articles, we try to propose the classification of the cutaneous ciliated cysts into the cutaneous Mullerian cysts and the ciliated cutaneous eccrine cysts.