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1.
Medicine (Baltimore) ; 99(21): e19435, 2020 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-32481248

RESUMO

There have been few studies on congenital nasal dermoid and sinus cysts (NDSCs) in infants.This study was performed to obtain clinical data for the diagnosis and treatment of NDSCs in infants.We performed a retrospective analysis of 11 infants admitted with NDSCs between 2014 and 2019. Patient demographics, lesion site, preoperative radiological findings, surgical technique, intraoperative findings, and postoperative sequelae were analyzed.In total, 11 infants (average age, 19 months; lowest age, 10 months) were included in this study. All patients presented with a nasal root mass, 2 patients also had nasal tip fistula, and only 1 case had a history of preoperative infection. Preoperative enhanced computed tomography (CT) examination showed nasal surface lesion (type I) in 3, nasal intraosseous (type II) in 5, intracranial epidural (type III) in 2, and intracranial dural (type IV) in 1 patient. The main surgical methods included direct resection with a vertical midline incision (9 patients), vertical incision + transnasal endoscopic resection + skull base repair (1 patient), and transverse incision of the lower margin of the left eyebrow (1 patient). All wounds healed well without serious complications.Using the 4-type classification method in combination with the preoperative CT findings to analyze the extent of NDSC in infants is helpful for formulating the surgical plan. Using vertical incision approach alone or combined with nasal endoscopy for minimally invasive surgery can meet the needs of complete resection and reconstruction.Our results provide clinical data that can help establish standardized criteria for the diagnosis and treatment of NDSCs in infants.


Assuntos
Cistos/diagnóstico por imagem , Cistos/cirurgia , Cisto Dermoide/diagnóstico por imagem , Cisto Dermoide/cirurgia , Neoplasias Nasais/diagnóstico por imagem , Neoplasias Nasais/cirurgia , Doenças dos Seios Paranasais/diagnóstico por imagem , Doenças dos Seios Paranasais/cirurgia , Tomografia Computadorizada por Raios X , Pré-Escolar , Cistos/congênito , Cisto Dermoide/congênito , Humanos , Lactente , Neoplasias Nasais/congênito , Doenças dos Seios Paranasais/congênito , Prognóstico , Estudos Retrospectivos
2.
Medicine (Baltimore) ; 99(10): e18988, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32150047

RESUMO

INTRODUCTION: Carbohydrate antigen 19-9 (CA 19-9) is a tumor glycolipid, frequently elevated in the serum of patients due to malignancies from gastrointestinal organs; in particular, the pancreas. This carbohydrate antigen is also expressed in benign diseases. PATIENT CONCERNS: A case of a 27-year-old female who has an unknown origin CA 19-9 elevation for 2 years. DIAGNOSIS: After the left ovarian cystectomy and microscopic examination, the final diagnosis is a dermoid cyst. The dermoid cyst shows increased F-fluorodeoxyglucose (F-FDG) uptake in the F-FDG positron emission tomography (PET)/computed tomography (CT) study. INTERVENTION AND OUTCOMES: The laparoscopic oophorocystectomy was performed. It was observed that the patient's CA 19-9 level returned to normal after the surgery 6 months later. This showed that the dermoid cyst was responsible for the abnormal CA 19-9 level. CONCLUSION: In this case, we can learn that the F-FDG PET/CT scan has potential use in patients with unknown origin of elevation CA 19-9.


Assuntos
Antígeno CA-19-9/sangue , Cisto Dermoide/diagnóstico , Cistos Ovarianos/diagnóstico , Adulto , Biomarcadores Tumorais/sangue , Cisto Dermoide/sangue , Cisto Dermoide/diagnóstico por imagem , Cisto Dermoide/cirurgia , Diagnóstico Diferencial , Feminino , Fluordesoxiglucose F18 , Humanos , Cistos Ovarianos/sangue , Cistos Ovarianos/diagnóstico por imagem , Cistos Ovarianos/cirurgia , Ovariectomia , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos
3.
World Neurosurg ; 136: 140-145, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31954900

RESUMO

BACKGROUND: This is a rare case of a patient presenting with epileptic seizures and headaches who was diagnosed with spontaneous intracerebral dermoid cyst rupture via radiographic imagery, and rupture was confirmed via a pathology report. CASE DESCRIPTION: We report the case of a woman aged 26 years who presented with a history of chronic headache for 9 years without other symptoms, and progressive worsening of her headache had occurred for 1 month prior to admission. Radiologic examination showed a large mass located in the left temporal fossa and a large amount of homogeneous matter in the subarachnoid space of the ipsilateral cerebral hemisphere, then the tumor was completely excised. A left pterional craniotomy was conducted under general anesthesia for removal of the tumor, and pathological examination showed a dermoid cyst. CONCLUSIONS: We discuss the clinical and radiologic features, as well as the treatment of this patient.


Assuntos
Neoplasias Encefálicas/diagnóstico por imagem , Cisto Dermoide/diagnóstico por imagem , Epilepsia Parcial Contínua/diagnóstico , Convulsões/diagnóstico , Adulto , Neoplasias Encefálicas/complicações , Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/cirurgia , Cisto Dermoide/complicações , Cisto Dermoide/patologia , Cisto Dermoide/cirurgia , Epilepsia Parcial Contínua/etiologia , Feminino , Cefaleia/etiologia , Humanos , Imagem por Ressonância Magnética , Ruptura Espontânea , Convulsões/etiologia , Espaço Subaracnóideo/diagnóstico por imagem , Tomografia Computadorizada por Raios X
4.
J Craniofac Surg ; 31(2): e155-e156, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31977706

RESUMO

We report an adult case from Kiribati, with a large dermoid cyst, and resultant underlying plagiocephaly, that was managed well with surgical excision. We also discuss the pathogenesis of this condition and the optimum timing for surgical intervention to avoid the deformity.


Assuntos
Cisto Dermoide/cirurgia , Plagiocefalia/complicações , Cisto Dermoide/diagnóstico por imagem , Feminino , Humanos , Tomografia Computadorizada por Raios X , Adulto Jovem
5.
World Neurosurg ; 135: 72-75, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31821914

RESUMO

BACKGROUND: Dermoid cysts are benign, congenital rare lesions, frequently occurring in or near the midline. Rare localizations and variable radiologic findings have been described but remain exceptional. CASE DESCRIPTION: The authors present a rare case of a giant temporoparietal dermoid cyst in an adult female who was paucisymptomatic. No sign of rupture was identified, with a clinical presentation suggesting a slow-growing lesion. Gross total excision was performed with a favorable clinical and radiologic outcome. CONCLUSIONS: Rare localizations previously published in the literature are discussed for dermoid cysts. To our best knowledge, this is the first giant dermoid cyst presenting with this localization.


Assuntos
Cisto Dermoide/cirurgia , Neoplasias Supratentoriais/cirurgia , Encéfalo/diagnóstico por imagem , Cisto Dermoide/diagnóstico por imagem , Cisto Dermoide/patologia , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias Supratentoriais/diagnóstico por imagem , Neoplasias Supratentoriais/patologia
6.
Int J Gynaecol Obstet ; 148(3): 392-398, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31828777

RESUMO

OBJECTIVE: To analyze outcomes of IVF treatment among women diagnosed with an ovarian dermoid cyst (DC). METHODS: Retrospective analysis of women with an ovarian DC who underwent IVF with fresh blastocyst transfer at a single center in New York from January 2010 to March 2018. Outcomes were compared between women with conservative treatment and those with surgical excision of the DC. Multivariate logistic regression was used to assess associations between variables and the presence of a DC during treatment. RESULTS: Overall, 119 women with a DC were included. No differences were found in demographic characteristics, controlled ovarian hyperstimulation parameters, and IVF outcomes between women with an intact DC (n=65, 54.6%) and those who underwent cystectomy (n=54, 45.4%) (all P<0.05). Similarly, there was no difference in anti-Mϋllerian hormone and basal antral follicle count among women with a DC (respectively, ß=-0.1, P=0.8, and ß=-1.0, P=0.28) or resected DC (respectively, ß=0.9, P=0.07, and ß=1.5, P=0.08) as compared with control women with no DC (n=352). CONCLUSION: Ovarian reserve, embryo implantation and IVF success rates were not lower in the presence of an ovarian DC. Surgical therapy, if indicated, can be safely postponed until family planning goals have been achieved.


Assuntos
Tratamento Conservador/métodos , Cisto Dermoide/cirurgia , Neoplasias Ovarianas/cirurgia , Teratoma/cirurgia , Adulto , Cisto Dermoide/diagnóstico por imagem , Transferência Embrionária/métodos , Feminino , Fertilização In Vitro/métodos , Humanos , Indução da Ovulação/métodos , Gravidez , Taxa de Gravidez , Estudos Retrospectivos
7.
J Craniofac Surg ; 30(6): e506-e508, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31756879

RESUMO

Congenital masses in the lateral brow are most commonly dermoid cysts and can often be excised surgically without additional investigation. These dermoids may rarely develop intracranial extension due to underlying bony erosions and become less prominent over time - a "disappearing dermoid." However, the authors present an unusual alternative case in which an off-midline frontal encephalocele initially presented as a firm irreducible mass but exhibited changing characteristics over time.


Assuntos
Cisto Dermoide/diagnóstico por imagem , Encefalocele/diagnóstico por imagem , Feminino , Humanos , Lactente
8.
Autops. Case Rep ; 9(3): e2019095, July-Sept. 2019. ilus
Artigo em Inglês | LILACS | ID: biblio-1021055

RESUMO

Dermoid cyst (DC) is a cystic lesion of developmental origin and uncertain etiology that rarely affects the floor of the mouth. We report a case of a large lesion found in the submental and submandibular region in a 25-year-old male patient. Computed tomography revealed extensive hypodense lesion in the submental and submandibular space without peripheral enhancement. The microscopical analysis showed a cystic cavity lined by orthokeratinized stratified squamous epithelium. The cystic capsule was composed of dense fibrous connective tissue containing cutaneous attachments, such as sebaceous and sweat glands. The diagnosis of DC was made. The differential diagnosis of expansive sublingual lesions can be clinically challenging due to the similarity with several lesions frequently observed in this region. Herein, we describe a case of extensive DC arising in the floor of the mouth, presenting clinical, imaging, and microscopical features.


Assuntos
Humanos , Masculino , Adulto , Neoplasias Maxilomandibulares , Cisto Dermoide/patologia , Cisto Dermoide/complicações , Cisto Dermoide/diagnóstico por imagem , Soalho Bucal/lesões
9.
Int J Pediatr Otorhinolaryngol ; 126: 109623, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31400658

RESUMO

PURPOSE: to differentiate sublingual thyroglossal duct cyst (TGDC) from midline dermoid cyst (DC) with diffusion weighted imaging (DWI). MATERIALS AND METHODS: Retrospective analysis of 22 consecutive patients (11 male and 11 female aged 5-15 years) with midline cystic lesion at floor of mouth. They underwent DWI of floor of mouth. Apparent diffusion coefficient (ADC) of the cystic lesions was calculated and correlated with surgical findings. RESULTS: The mean ADC value of TGDC of 1st observer was (2.20 ±â€¯0.28 × 10-3 mm2/s) and of 2nd observer was (2.28 ±â€¯0.27 × 10-3 mm2/s) was significantly higher than that of DC (P = 0.001) whose ADC of 1st observer was (1.55 ±â€¯0.15 × 10-3 mm2/s) and of 2nd observer was (1.53 ±â€¯0.11 × 10-3 mm2/s). There was excellent inter-observer agreement of both readings (r = 92%, P = 0.001). When ADC of 1.76 and 1.62 × 10-3 mm2/s was used as a threshold value for differentiating TGDC from DC, the best results were obtained with area under the curve of 0.94 and 0.96, accuracy of 90% and 86%, sensitivity of 91% and 91%%, specificity of 90% and 80%, negative predictive value of 90% and 88% and positive predictive value of 92% and 84% of both reviewers respectively. CONCLUSION: DWI is reliable and reproducible imaging modality for differentiation sublingual TGDC from DC.


Assuntos
Cisto Dermoide/diagnóstico por imagem , Imagem de Difusão por Ressonância Magnética , Cisto Tireoglosso/diagnóstico por imagem , Adolescente , Área Sob a Curva , Criança , Pré-Escolar , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade , Glândula Sublingual/diagnóstico por imagem
10.
J Craniofac Surg ; 30(6): 1760-1763, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31261317

RESUMO

BACKGROUND: While the risk for intracranial extension of midline nasoglabellar dermoid cysts is well-described, the risk in non-midline dermoid cysts and role of preoperative imaging in these lesions is less understood. This study aims to address this gap and provide preoperative recommendations. MATERIALS AND METHODS: A retrospective review was performed evaluating patients who underwent excision of craniofacial dermoid cysts by a single surgeon. Findings on preoperative physical examination and imaging modalities were compared to intraoperative findings to assess effectiveness of each in predicting bony erosion. A treatment algorithm is proposed. RESULTS: Twenty-eight patients were included and 50% had intraoperatively confirmed bony erosion. Bony erosion was identified in 100% of lesions immobile on examination, compared to 30% of mobile lesions (P = 0.001). Bony erosion was identified in 40.9% of lateral brow cysts compared to 83.3% of lesions located elsewhere (P = 0.03), in 60% of patients with periorbital sequelae compared to 47.8% without periorbital sequelae, and in 66.7% of patients with reported change in cyst size with Valsalva compared to 48.0% without change with Valsalva. Sensitivities for preoperative identification of bony erosion were as follows: physical examination 57.1%, US 11.1%, MRI 66.7%, and CT 100%. CONCLUSIONS: A management algorithm for non-midline dermoid cysts is presented. CT or MRI is recommended for lesions that are immobile, in atypical locations, or have associated periorbital sequelae or change with Valsalva. The authors feel there is no role for ultrasound and don't recommend routine imaging in patients with non-midline dermoid cysts without features suggestive of bony erosion.


Assuntos
Doenças Ósseas/diagnóstico por imagem , Cisto Dermoide/diagnóstico por imagem , Crânio/diagnóstico por imagem , Doenças Ósseas/etiologia , Criança , Pré-Escolar , Cisto Dermoide/complicações , Cisto Dermoide/cirurgia , Feminino , Humanos , Lactente , Imagem por Ressonância Magnética , Masculino , Estudos Retrospectivos
11.
No Shinkei Geka ; 47(7): 769-776, 2019 Jul.
Artigo em Japonês | MEDLINE | ID: mdl-31358696

RESUMO

Dermoid cysts are rare benign intracranial neoplasms derived from embryonal remnant tissues. Here, we describe a case of dermoid cyst located in the right frontal lobe, which showed repeated changes on CT. An 11-year-old girl was referred to our hospital to treat a brain neoplasm. Brain CT and MRI revealed a cystic tumor in the right frontal lobe. Incidentally, brain CT had been performed 6, 2, and 1 year before the presentation, which demonstrated repeated changes in the tumor over the clinical course. Gross total resection of the tumor was achieved through right frontal craniotomy. Histological findings revealed keratin flakes, mature bones, cholesterol crystals, and granulation with macrophages. The cyst wall was composed of squamous epithelium with adnexal structures, such as hair follicles and sebaceous glands. Therefore, we diagnosed the tumor as a dermoid cyst. The postoperative course was uneventful, and she was discharged on postoperative day 10 without neurological deficits. Dermoid cysts are difficult to be diagnosed on routine neuroimaging. An accurate diagnosis requires details of the clinical course and analysis of both imaging and pathological studies.


Assuntos
Neoplasias Encefálicas , Cisto Dermoide , Neoplasias Encefálicas/diagnóstico por imagem , Criança , Craniotomia , Cisto Dermoide/diagnóstico por imagem , Feminino , Lobo Frontal , Humanos , Imagem por Ressonância Magnética
12.
J Clin Neurosci ; 67: 172-177, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31088770

RESUMO

Intracranial dermoids (ID) are relatively uncommon. They are usually located in the midline or posterior fossa, and present in the first three decades of life. Rupture of IDs are a rare occurrence, and can present with diverse clinical features. They have a characteristic appearance on Computerized Tomography (CT) and Magnetic-Resonance-Imaging (MRI). Here we retrospectively review the clinical features, radiology, treatment and outcomes of ruptured IDs managed in our institute. We did a retrospective review of all the IDs from 2011 to 2017 that presented to us with rupture, or that were diagnosed to have ruptured based on imaging characteristics. Nine patients qualified for our study. The data of all 9 patients was analyzed retrospectively and their demographic details, clinical variations, and radiological features were studied and analyzed. Mode of management and outcome was assessed. Mean age of the patients was 32.1 years (SD 7.65) with male-female ratio of 7:2. Patients presented with either headache or seizures in the majority. Two patients had hydrocephalus requiring shunts. Despite their varied location and clinical features, all lesions showed similar and characteristic radiological features-namely, fat droplets in subarachnoid spaces, hypo-intensity on Susceptibility-Weighted-Imaging (SWI) with chemical shift artifact. Treatment of patients varied from medical management in 4, to cerebrospinal fluid (CSF) diversion in 2 and surgery for the lesion in 3 cases. Ruptured IDs present with a wide array of clinical features. Imaging characteristics are fairly distinct and consistent, which aids in diagnosis. Decision for mode of management has to be decided based on case-by-case basis.


Assuntos
Cistos do Sistema Nervoso Central/patologia , Cisto Dermoide/patologia , Adulto , Cistos do Sistema Nervoso Central/diagnóstico por imagem , Cisto Dermoide/diagnóstico por imagem , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Ruptura Espontânea , Tomografia Computadorizada por Raios X
13.
World Neurosurg ; 128: 206-208, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31051309

RESUMO

Rupture of the spinal dermoid is rare. There may be intracranial deposition of fat secondary to it. We report a case of an adult male who presented with features of obstructive hydrocephalus secondary to ruptured lumbar dermoid. A 42-year-male presented with acute-onset headache and vomiting for 2 days. There was grade 3 papilledema on fundus examination. Magnetic resonance imaging showed ventriculomegaly with aqueductal obstruction. Multiple T1 and T2 hyperintense deposits were also noted along the ventricular wall. Magnetic resonance imaging of the spine showed a T1, T2 hyperintense intramedullary lesion at the lumbar region with multiple fat deposits along the spinal axis. He underwent endoscopic third ventriculostomy and is doing well at the 6-month follow-up. He is asymptomatic for the spinal lesion. Silent rupture of the spinal dermoid causing obstructive hydrocephalus is rare. These patients may remain asymptomatic for the spinal lesion and improves with cerebrospinal fluid diversion.


Assuntos
Cisto Dermoide/diagnóstico por imagem , Hidrocefalia/diagnóstico por imagem , Lipídeos , Neoplasias da Medula Espinal/diagnóstico por imagem , Espaço Subaracnóideo/diagnóstico por imagem , Adulto , Cisto Dermoide/complicações , Humanos , Hidrocefalia/etiologia , Hidrocefalia/cirurgia , Imagem por Ressonância Magnética , Masculino , Neuroendoscopia , Ruptura Espontânea , Neoplasias da Medula Espinal/complicações , Tomografia Computadorizada por Raios X , Ventriculostomia
15.
Radiographics ; 39(4): 1019-1035, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31125295

RESUMO

Germ cell tumors, because they contain immature and mature elements, can differentiate into different tissue types. They can exhibit unusual imaging features or manifest in a syndromic fashion. The authors describe these features and assign them to one of the following categories: (a) unusual manifestations of metastatic disease (growing teratoma syndrome, choriocarcinoma syndrome, ossified metastases, and gliomatosis peritonei); (b) autoimmune manifestations (sarcoidlike reaction and paraneoplastic syndromes); (c) endocrine syndromes (sex hormone production, struma ovarii, and struma carcinoid); or (d) miscellaneous conditions (ruptured dermoid cyst, squamous cell carcinoma arising from a mature teratoma, Currarino triad, fetus in fetu, pseudo-Meigs syndrome, and pancreatitis). Rare conditions associated with germ cell tumors demonstrate characteristic imaging findings that can help lead to the appropriate diagnosis and management recommendations. When evaluating for potential metastatic disease, alternative benign diagnoses should be considered (eg, growing teratoma syndrome, ossified metastases, ruptured dermoid cyst, gliomatosis peritonei, and sarcoidlike reaction), which may impact management. Germ cell tumors may also lead to life-threatening complications such as extensive hemorrhage from choriocarcinoma metastases or the rupture of mature teratomas, cases in which timely diagnosis is crucial. Autoimmune and endocrine manifestations such as paraneoplastic encephalitis, autoimmune hemolytic anemia, and hyperthyroidism may occur owing to the presence of germ cell tumors and can create a diagnostic dilemma for clinicians. Knowledge of the syndromic and unusual imaging findings associated with germ cell tumors helps guide appropriate management. ©RSNA, 2019.


Assuntos
Neoplasias Embrionárias de Células Germinativas/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Canal Anal/anormalidades , Canal Anal/diagnóstico por imagem , Doenças Autoimunes/diagnóstico por imagem , Doenças Autoimunes/imunologia , Carcinoma de Células Escamosas/diagnóstico por imagem , Coriocarcinoma/irrigação sanguínea , Coriocarcinoma/diagnóstico por imagem , Coriocarcinoma/secundário , Cisto Dermoide/diagnóstico por imagem , Anormalidades do Sistema Digestório/diagnóstico por imagem , Feminino , Feto/anormalidades , Feto/diagnóstico por imagem , Humanos , Masculino , Neoplasias Embrionárias de Células Germinativas/secundário , Neoplasias Neuroepiteliomatosas/diagnóstico por imagem , Neoplasias Neuroepiteliomatosas/secundário , Segunda Neoplasia Primária/diagnóstico por imagem , Ossificação Heterotópica/diagnóstico por imagem , Pancreatite/diagnóstico por imagem , Pancreatite/etiologia , Síndromes Endócrinas Paraneoplásicas/diagnóstico por imagem , Síndromes Endócrinas Paraneoplásicas/etiologia , Síndromes Paraneoplásicas/diagnóstico por imagem , Síndromes Paraneoplásicas/imunologia , Neoplasias Peritoneais/diagnóstico por imagem , Neoplasias Peritoneais/secundário , Gravidez , Reto/anormalidades , Reto/diagnóstico por imagem , Sacro/anormalidades , Sacro/diagnóstico por imagem , Siringomielia/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos
16.
World Neurosurg ; 127: 350-353, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30930322

RESUMO

BACKGROUND: Frontotemporal dermal sinus tracts with associated dermoid cysts are very rare, with only 1 found in the largest series to date and 10 total documented case reports. CASE DESCRIPTION: We present the first case to our knowledge of a dermal sinus tract associated with 2 intradiploic dermoid cysts in the rare location of the pterion and sphenosquamosal suture. The patient was a 15-month-old girl presenting with periorbital cellulitis who was found to have 2 connected intradiploic cysts on radiographic imaging. The mass was excised, and pathology was consistent with a ruptured dermoid cyst. CONCLUSIONS: We review of the literature and argue for early identification and prophylactic surgical resection to avoid complications associated with infection and to mitigate risk of subtotal resection.


Assuntos
Cisto Dermoide/cirurgia , Lobo Frontal/cirurgia , Espinha Bífida Oculta/cirurgia , Lobo Temporal/cirurgia , Cisto Dermoide/complicações , Cisto Dermoide/diagnóstico por imagem , Feminino , Lobo Frontal/diagnóstico por imagem , Humanos , Lactente , Espinha Bífida Oculta/diagnóstico por imagem , Lobo Temporal/diagnóstico por imagem
17.
BMJ Case Rep ; 12(3)2019 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-30936324

RESUMO

Tubo-ovarian abscesses (TOAs) are inflammatory masses involving the fallopian tube, ovary and occasionally other adjacent pelvic organs. A 32-year-old woman with no significant medical history presented with a chief complaint of lower abdominal pain. Initial CT of the abdomen was suggestive of a colon abscess; however, a repeat CT suggested a TOA. The left ovary was densely adherent to the left pelvic sidewall and the rectosigmoid colon. The content of the ovary was consistent with a dermoid and suspected of superinfection. Pathological examination of the tissue revealed normal ovarian cortical tissue, hair cells, melanin, and epidermal and neural tissue, as well as evidence of a foreign object resembling vegetable matter. The vegetable fibre found in this patient's biopsy was of an unclear aetiology, but probably indicates a perforation of the bowel. Any cause of bowel perforation adjacent to the adnexa can lead to TOA, therefore providing a rational speculation for this case.


Assuntos
Dor Abdominal/etiologia , Abscesso/diagnóstico por imagem , Antibacterianos/uso terapêutico , Cisto Dermoide/patologia , Doenças das Tubas Uterinas/diagnóstico por imagem , Doenças Ovarianas/diagnóstico por imagem , Superinfecção/patologia , Dor Abdominal/diagnóstico por imagem , Dor Abdominal/patologia , Abscesso/patologia , Abscesso/terapia , Adulto , Ampicilina/uso terapêutico , Cisto Dermoide/diagnóstico por imagem , Cisto Dermoide/terapia , Doxiciclina/uso terapêutico , Doenças das Tubas Uterinas/patologia , Doenças das Tubas Uterinas/terapia , Feminino , Humanos , Perfuração Intestinal/patologia , Laparoscopia , Doenças Ovarianas/patologia , Doenças Ovarianas/terapia , Ovariectomia , Ovário/patologia , Sulbactam/uso terapêutico , Superinfecção/tratamento farmacológico , Tomografia Computadorizada por Raios X , Resultado do Tratamento
18.
BMJ Case Rep ; 12(4)2019 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-31023732

RESUMO

A 4-month-old boy presented with a cystic swelling at the floor of the mouth causing acute airway compromise. The only previous history of note, was a tongue tie release at 3 days old. CT scan suggested a dermoid cyst with extensive floor of mouth abscess. He had an excision of the cyst and drainage of the superimposed abscess and made a good recovery. The histology report revealed a dermoid cyst which is a rare diagnosis in a child, particularly within the oral cavity. Early treatment is required to remove these lesions especially when they cause airway compromise or swallowing difficulties. This is the first case to our knowledge which suggests tongue tie release procedures causes a predisposition to the development of dermoid cysts in the oral cavity.


Assuntos
Abscesso/microbiologia , Transtornos de Deglutição/etiologia , Cisto Dermoide/patologia , Drenagem/métodos , Abscesso/patologia , Doença Aguda , Anquiloglossia/complicações , Anquiloglossia/patologia , Cisto Dermoide/complicações , Cisto Dermoide/diagnóstico por imagem , Cisto Dermoide/cirurgia , Humanos , Lactente , Masculino , Soalho Bucal/patologia , Soalho Bucal/cirurgia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
19.
Int J Pediatr Otorhinolaryngol ; 122: 89-92, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30991206

RESUMO

OBJECTIVES: To evaluate the use of ultrasound to distinguish between thyroglossal duct cysts (TGDC) and dermoid cysts (DC) for surgical planning. To validate the SIST (septae + irregular wall + solid components = TGDC) scoring system proposed by Oyewumi et al. [1]. METHODS: This was a retrospective chart review of pediatric patients with midline neck masses who presented between the years of 2005 and 2014 and underwent preoperative ultrasound and surgical resection. Two pediatric radiologists blinded to diagnosis reviewed each US for 14 separate characteristics. According to the SIST scoring system, one point was given for each of the following: internal septae, irregular walls, and solid components. RESULTS: 45 patients met inclusion criteria. Final pathologic diagnosis showed 29 patients had TGDC, 16 had DC. The majority of patients with both TGDC and DC earned SIST scores of 0. CONCLUSION: While ultrasound remains a useful part of the work-up of lesions of the head and neck in children, this small retrospective study was not able to validate the previously proposed SIST scoring system None of the parameters discussed in the original paper was found to be a statistically significant determinant of TGDC.


Assuntos
Cisto Dermoide/diagnóstico por imagem , Cisto Tireoglosso/diagnóstico por imagem , Cisto Tireoglosso/cirurgia , Ultrassonografia , Criança , Pré-Escolar , Cisto Dermoide/patologia , Diagnóstico Diferencial , Emolientes , Feminino , Humanos , Lactente , Masculino , Pescoço , Período Pré-Operatório , Estudos Retrospectivos , Método Simples-Cego , Cisto Tireoglosso/patologia
20.
Gynecol Endocrinol ; 35(7): 612-617, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30727778

RESUMO

To determine if patients with a DC respond similarly to ovarian stimulation when compared to patients without a DC. Infertility patients with a DC that underwent IVF between January 2009 and December 2016 were included. A cystic mass with mixed echogenicity, internal echoes similar to thick bands, fatty-fluid level, or an echogenic tubercle with acoustic shadow (Rokitansky nodule) within two years of the cycle characterized the diagnosis. The z-score compared the standard deviations (SDs) in patients with/without a DC and were compared to a nomogram (expected oocytes minus oocytes obtained divided by the SD), adjusted for age and number of oocytes retrieved, built utilizing cycles from noninfertile female patients. Thirty-nine patients with DC and 7839 patients without DC were identified. The mean number of oocytes (8.6 ± 5.8 vs. 8.5 ± 7.7, p = .43) and MIIs (6.7 ± 4.7 vs. 7.0 ± 6.7, p = .74) retrieved were similar. When cycles with and without a DC were compared to the nomogram (z-score of 0), cycles with a DC presented a z-score for ovarian response of 0.1921 SDs from the mean, and patients without DC presented a z-score of -0.2065 SDs from the mean (similar and less than -1.0). After building a population 'normal' response as a template, patients with and without a DC responded similar to COS.


Assuntos
Cisto Dermoide/diagnóstico por imagem , Fertilização In Vitro , Neoplasias Ovarianas/diagnóstico por imagem , Indução da Ovulação , Adulto , Feminino , Humanos , Recuperação de Oócitos , Gravidez , Taxa de Gravidez , Estudos Retrospectivos , Ultrassonografia
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