An unusual presentation of giant pancreatic pseudocyst in the parietal wall

A true cyst is a localized fluid collection covered by a capsule lined by epithelium, whereas, a pseudocyst does not consist specific lining of cells. We report one such case of a 37-year-old gentleman with giant pancreatic pseudocyst in the anterior abdominal wall which had developed secondary to acute necrotizing pancreatitis. A contrast-enhanced computed tomography scan showed a pseudocyst in the lesser sac and left pre-renal fossa. He was planned for exploration but within a month, he was at the emergency with yet another episode of gastric outlet obstruction with a huge hypogastric swelling compressing the stomach. The patient was resuscitated and immediately posted for exploratory laparotomy. To the surprise of surgeons, the lump was just below the umbilicus with whatsoever no relation with the pancreas. However, the expert opinion of the histopathologists suggested it to be a pseudocyst.

Current status and progress in the treatment of congenital liver cyst

Liver cyst is a relatively common benign liver disease. According to the cause of the disease, it can be divided into two types: non-parasitic liver cyst and parasitic liver cyst. Congenital liver cyst is the most common non-parasitic liver cyst in clinical practice, also known as true cyst, which mainly include simple liver cyst and polycystic liver diseases (PLD). In recent years, with the popularization of ultrasound and other examinations, the detection rate of liver cyst has increased year by year, but there is no unified consensus on the treatment of liver cysts. This article reviews the conservative treatment, puncture drainage, aspiration sclerotherapy, surgical treatment and other treatment options for congenital liver cysts, as well as the technological progress in recent years.

A new way of modeling the true pancreatic cyst

Currently, the pathogenesis of the formation and development of cysts has not been fully studied. This creates the need to analyze existing and fi nd new ways to model pancreatic cysts.The aim: create a new way of modeling the true pancreatic cystMaterials and methods: in an experiment on 7 mongrel dogs, a new method of forming a model of a true cyst of the head of the pancreas was developed, by creating a reservoir from the 12-type intestine with the pancreas, with suturing to the posterior wall of the pyloric part of the stomach.Results: the model of the pancreas cyst proposed by the authors meets the criteria of the true pancreatic cyst and can be used in experimental studies of various methods of cyst treatment.Conclusions: this method is technically simple in execution and allows one-step, in less time to perform the operation.

Plunging ranula in 26 years old male: a case report

<p>Ranula is a bluish translucent cystic lesion in the floor of mouth. It can be true cyst occurring due to obstruction of the sublingual gland or a minor salivary gland or a pseudocyst as a result of ductal injury leading to extravasation and accumulation of saliva in surrounding tissues. Two variants of ranula are described in the literature: simple oral ranula and deep diving or plunging ranula. We report a case of plunging ranula with both oral and cervical components which is treated successfully by surgical excision. This case report involves an unusually large ranula involving floor of mouth with cervical extension, more towards left side, in a 26 years old male. It is successfully removed in- toto by transcervical approach. The patient was followed up on a regular basis and was disease free.</p>

Cysts of the Mediastinum

Mediastinal cysts are fluid-filled lesions surrounded by a thin wall with an epithelial lining. These cysts are typically congenital, account for approximately 15-20% of all mediastinal masses, and may be found in any mediastinal compartment. Although mediastinal cysts may be initially detected on chest radiography, these lesions are optimally evaluated with computed tomography (CT) or magnetic resonance imaging (MRI). Cysts typically manifest as well-circumscribed, spherical lesions of water attenuation or signal, buy may appear heterogeneous when complicated by hemorrhage or infection. A focused differential diagnosis may be generated based on lesion location. For instance, bronchogenic cysts are most common in the middle mediastinum and pericardial cysts are typically found in the right cardiophrenic angle. Other mediastinal cysts include esophageal duplication and neurenteric cyst. Although meningocele is not a true cyst, it exhibits a cystic appearance on imaging.

Invasive EEG in Tumoural Epilepsy

Long-term epilepsy-associated tumours (LEATs) are usually dysembryoplastic neuroepithelial tumours (DNTs) and gangliogliomas. Both usually show childhood-onset intractable partial epilepsy, concordant focal EEG abnormalities, and predominant temporal location. Imaging showing typical pseudocystic pattern is suggestive of DNT. Gangliogliomas are characterized by association of a true cyst and nodular contrast enhancement. However, less typical patterns may also be seen, rendering differentiation between the two difficult. Stereo-EEG has demonstrated intrinsic epileptogenicity of both, the typical interictal pattern consisting of repetitive spikes on depressed background activity. Ictal onset discharges arise from tumour in all cases, spreading to peritumoural and secondarily distant areas. Intratumoural stimulations elicit seizures similar to spontaneous seizures. Hippocampus is involved early in most temporal tumours. Epileptogenic zone organization differs according to DNT subtypes, co-localized with tumour in simple and complex forms, and more extended in non-specific forms. In gangliogliomas, the epileptogenic zone is similar to that observed in non-specific DNTs.

A Giant Lymphatic Cyst of the Adrenal Gland: Report of a Rare Case and Review of the Literature

Lymphatic type of adrenal cysts is most common; however, this type of endothelial cyst is quite rare in excessively large adrenal cysts. A 37-year-old Japanese woman was admitted to our institution with distension of her left flank and the upper quadrant of her abdomen. Abdominal ultrasonography revealed a cystic lesion with a homogenous anechoic texture, and measuring 21 cm in diameter. Computed tomography and magnetic resonance imaging displayed a giant cystic lesion adjacent to the liver, pancreas, kidney, and spleen. The origin of the cyst was not identified. We were not able to make a preoperative diagnosis; therefore, the patient underwent resection of the mass by open laparotomy for therapeutic diagnosis. Intraoperatively, the mass was identified to be cystic and adhered to the left adrenal gland. It was filled with more than 2000 mL of serous brown-red fluid. The content of the cyst contained no atypical cells on cytological examination. The wall of the cyst was composed of a lining of a single layer of lymphatic vessel–derived cells, and the cyst was pathologically classified as a true cyst. No abdominal symptoms were observed and a postoperative radiological work-up showed no evidence of recurrence during a 6-year follow-up period. We describe a case of a patient with a giant lymphatic cyst of the adrenal gland. The preset data suggest that surgeons should decide treatment strategy for large adrenal cysts in consideration of hormonal function, degree of size, and possibility of malignancy.