Unicystic Ameloblastoma of Mandible: A Case Report

Ameloblastoma is a neoplasm that originates from odontogenic epithelium. It is the second most common neoplasm of the oral cavity. Unicystic ameloblastomas refer to those cystic lesions that show clinical, radiographic, or gross features of a jaw cyst, but on histologic examination show a typical ameloblastomatous epithelium lining part of the cyst cavity, with or without luminal and/ or mural growth. Even though the lesion is not that aggressive as the solid ameloblastoma, an accurate diagnosis should be made. This lesion needs to be treated more aggressively than any other periapical lesions.

Treatment of a giant hepatic echinococcal cyst with percutaneous drainage and in vivo assessment of the protoscolicidal effect of praziquantel

Therapy choices for cystic echinococcisis (CE) are stage-specific: surgical, minimally invasive, medical or observation without intervention. PAIR (percutaneous aspiration, instillation of a scolicide, and re-aspiration) has been considered the treatment of choice for uncomplicated echinococcal liver cysts. However, PAIR carries the risk of toxic cholangitis or hypernatremia and that the cyst frequently refills with bile after withdrawing the catheter. We treated a patient with a giant CE 1 liver cyst with puncture drainage (PD) under albendazole coverage. Drainage enabled us to monitor the morphology of protoscolices under praziquantel (PZQ) co-medication. Protoscolices degenerated within 5 days of PZQ 50 mg/kg/d. The cyst cavity solidified with no evidence of reactivation or secondary spread. Percutaneous treatments can replace surgery in a significant number or cases with hepatic CE. PD allows to assess microscopically the viability of protoscolices under co-medication with PZQ–albendazole and to avoid the instillation of topical scolicides.

Titan Nickelide in the Treatment of Dystrophic Bone Cysts in Children

The aim of the study was to assess the efficiency of surgical treatment of patients with dystrophic bone cysts by the method of cyst cavity filling with fine-grain porous titanium nickelide. Methods. The research involved patients with dystrophic bone cysts. 30 patients had an operation of a single-stage opening of the cyst cavity and grafting the residual bone cavity with fine-grain titanium nickelide. Results. The applied treatment method was proven to be effective in the immediate postoperative and long-term periods.Conclusion. Clinical practice demonstrates that the method of dystrophic bone cyst treatment by opening of the cyst cavity with the following grafting with the granules of titanium nickelide gives more positive outcomes compared to the traditional method. This technology allows to reduce the number of post-operational complications and negative outcomes in the long-term perspective.

Radiofrequency ablation in management of simple non-parasitic liver cysts

Purpose. Comparison of the long-term outcomes of the treatment of simple liver cysts by traditional and modified RFA methods.Materials and methods. From 2015 to 2018, US-guided RF ablation was used to treat simple nonparasitic hepatic cysts in 14 patients. There were 15 operated cysts in total. 7 patients of group A underwent standard RFA session without temperature restrictions. 7 patients of group B with localization of cysts closely to large vessels and bile ducts or the area of portal fissure, underwent RFA at 60 °C with preinjection of 10% NaCl solution into the cyst cavity. During the intervention, the temperature of the surrounding electrode tissue and the exposure time were recorded.Results. All patients underwent interventions satisfactorily; no complications were observed. In group A, the mean cyst diameter was 50.3 ± 15.2 mm, and the mean initial cyst volume was 77.09 ± 23.2 cm3. In group B, the mean cyst diameter was 61.8 ± 14.9 mm, and the mean initial cyst volume was 137.8 ± 39.2 cm3. After 3 months, the overall decrease in the volume of operated cysts on CT was in group A – 27.1%, in group B – 50.6%; after 6 months – 49.8% and 60.4%, respectively. After 12 months, similar indicators in group A amounted to 64.2%, in group B – 79.2%. 1.5 years after surgery, the volume of operated cysts in group A decreased by 65.2%, in group B by 91.2%; and after 2 years – by 68.9% and 93.6%, respectively. The total decrease of cyst volume at the last control in group B was 24.7% more than in group A. The decrease in cyst volume by more than 50% was noted in group A in 37.5%, in group B – in 85.7%. Complete reduction of the cyst cavity was noted in group A in 25%, in group B in 28.5%. The difference in the decrease of the cyst volumes between the groups after 2 years is statistically significant (p = 0.03), thus it can be concluded that a significantly more pronounced decrease in cyst volumes was observed in group B than in group A.Conclusion. Preinjection into the cystic cavity of a 10% solution of NaCl allowed to achieve a more pronounced decrease of the cystic cavities with the lower RFA temperature regime. At a temperature of 60 °C, the thermal damage minimally spreads to adjacent healthy liver tissue andis sufficient for the radical treatment of the cystic cavity. This makes possible to use the modified RFA method for cysts, located close to the large vessels and bile ducts.

Diaphragmatic Multivesicular Hydatid Cyst

The hydatid cyst of the diaphragm is defined as the development of a hydatid cyst in the diaphragm muscle. Primary or secondary it stills a rare localization, accounting for 1% of the thoracic locations. We report a case of a hydatid cyst of diaphragm in a 57 -year-old female who was admitted to our clinic for right basithoracic pain. CT reported a giant hydatid cyst including multiple vesicles at the right lower thoracic cavity. Surgical exploration revealed an independent giant diaphragmatic hydatid cyst. We performed cystotomy and more than 100 daughter vesicles were removed from the cyst. The rest of the giant cyst cavity was excised.

Surgical excision of a giant pedunculated hydatid cyst of the liver

Hydatid disease is caused by a tape worm Echinococcus Granulosus that lives in the intestines of the definitive host which is the dog or other carnivore. Human is the accidental intermediate host and become infected by ingesting contaminated vegetables or water with the eggs of the parasite. A-37-year old male presented with right side abdominal pain for 2 months. Abdominal examination showed a large right side abdominal mass extending from the right subcostal region to the right iliac fossa. CT-scan showed two cystic lesions in the right lobe of the and a third one extending to the pelvis. During surgery aspiration of 10 liters of bile stained fluid done. Excision of the cysts done. Tube drain put inside the cyst cavity with omentoplasty. There was bile leak to the drain which stopped over one month. The patient received anthelminthic medication for 3 months.

Percutaneous Lauromacrogol Foam Sclerotherapy for the Treatment of Acute Airway Compression Caused by Lymphatic Malformations in Infants

Management of LMs still remains a challenge especially for those suffering from complications such as acute airway compression. In this study, we retrospectively evaluated the efficacy and safety of percutaneous lauromacrogol foam sclerotherapy for the patients with acute airway compression caused by lymphatic malformations (LMs) in infants. Five cases of infants with acute airway compression caused by LMs were treated with lauromacrogol foam sclerotherapy in the radiology department from February 2013 to August 2015 at Wuhan Medical and Healthcare Center for Women and Children, China. By CT examination and the DSA imaging, LMs were diagnosed and progressed cervical and sublingual LMs combined with hemorrhages were observed and suppression of the trachea was noticed as well, resulting in the difficulty with breathing and feeding. For all the patients, we extracted most cyst liquid from the LMs to reduce the surface tension and alleviate the respiratory pressure symptoms under the guidance of ultrasound. Subsequently, the lauromacrogol foam was injected percutaneously into the cyst of LMs. The dose of the agent was determined according to the size of the LMs, which was 3-8 ml in our study. After treatment, autonomous respiration and independent eating were observed. When the procedures were completed after 16 cycles, the cyst cavity became atrophic and then nearly vanished. During the follow-up period (a minimum of three months and a maximum of two years), 4 patients were clinically proved to be cured and one patient was significantly improved. There was no recurrence, serious complications, or adverse reactions. Our study demonstrated that percutaneous sclerotherapy combined with lauromacrogol foam is a safe, effective therapy for acute airway compression caused by LMs, especially giving a good cosmetic result.

Management of Large Residual Cyst in Elderly Patient with Decompression Alone: Case Report

SummaryBackground/Aim:Residual cysts comprise approximately 10% of all odontogenic cysts. They are more commonly seen in 4th-6th decades of life, and occur due to incomplete previous surgical removal of a radicular cyst; or due to left epithelial remnants stimulated by tooth extraction. These lesions are often treated with enucleation. However, this procedure is not always the ideal treatment solution for elderly people due to the presence of physical and mental disorders, and risk of jaw fracture.Case Report: In this case report, the successful treatment of a large residual cyst in the symphysis of a 93 year-old female patient by performing decompression alone is presented. A plastic drain was placed on the wall of the cyst to allow irrigation. Regeneration was observed in the cyst cavity 3 months after surgery. The 1-year follow up showed that the majority of the cyst cavity was filled with new bone.Conclusions: In elderly patients, large inflammatory cysts can be successfully treated with decompression considering the limited regeneration capacity and difficulties in follow-up.

Endoscopic Treatment of Colonic Duplication Cyst: A Case Report and Review of the Literature

Colonic duplication cysts are a rare congenital abnormality commonly presenting before two years of age. In adults, it has been rarely reported, most often as an incidental finding. We report a case of 42-year-old female complaining of constipation and lower abdominal pain. Patient’s CT scan of the abdomen showed a cystic lesion at hepatic flexure and the diagnosis was confirmed endoscopically using endoscopic ultrasound (EUS). The cyst was treated employing hot snare to expose the cyst cavity. On our literature search, there have been no reported cases of colonic duplication cyst treated endoscopically. We here discuss incidence, diagnosis, characteristics, and treatment of duplication cysts with special emphasis on endoscopic therapy.