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1.
Medicine (Baltimore) ; 99(3): e18818, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32011491

RESUMO

INTRODUCTION: Typical testicular epidermoid cysts (TECs) manifestate as a target sign or onion skin sign on ultrasonography and magnetic resonance (MR) imaging. Clinicians are increasingly aware of the imaging characteristics of typical TECs, which allow accurate diagnosis and successful treatment while preserving the testicle, but atypical TECs are likely to be misdiagnosed as a malignant intratesticular neoplasm, leading to complete testicular resection. PATIENT CONCERNS: A 26 year-old male patient complained of a painless enlargement of the left testicle that had been present for 1 month. The patient had no recent medical history of scrotal trauma or systemic infection. DIAGNOSIS: A round 48 mm × 45 mm × 43 mm mass was seen inside the left testicle. T2-weighted images of the lesion showed a thin hypointense capsule. T1-weighted images of the lesion showed a hyperintense nodule on the cyst wall, which appeared hypointense on T2-weighted and SPAIR images. After Gd-DTPA injection, the lesion was not enhanced; however, the nodule was enhanced on THRIVE images. These manifestations were consistent with a benign intratesticular lesion, and MR imaging diagnosed atypical TEC, which was confirmed by pathology after surgery. INTERVENTIONS: The patient was treated with organ-sparing surgery with testicular enucleation. OUTCOMES: The patient was re-examined with ultrasonography 3 months after surgery. The left residual testicular tissue appeared normal, and reproductive function was preserved. CONCLUSION: Urologists must be aware of the clinical and MR imaging characteristics of atypical TECs and the utility of preoperative MR imaging for the diagnosis of testicular lesions to ensure that organ-sparing surgery is performed rather than unnecessary orchiectomy.


Assuntos
Cisto Epidérmico/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Doenças Testiculares/diagnóstico por imagem , Adulto , Diagnóstico Diferencial , Cisto Epidérmico/cirurgia , Humanos , Masculino , Doenças Testiculares/cirurgia
3.
World Neurosurg ; 133: e218-e224, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31493609

RESUMO

OBJECTIVE: Delayed postoperative hemorrhage (DPOH) was a severe postoperative complication after intracranial epidermoid cyst (EC) surgery. This study was designed to investigate possible clinical data and image features related to DPOH in patients with EC. METHODS: We retrospectively investigated 186 cases of EC, and 8 cases presented an appearance of DPOH. Preoperative magnetic resonance imaging (MRI) and clinical data (age, sex, chief surgeon, tumor size, tumor location, and degree of resection) were reviewed and analyzed. The Student t test and the χ2 test were used, and statistical significance was defined as P < 0.05. RESULTS: A total of 8 patients suffered from DPOH. Seven patients (87.5%) with DPOH showed atypical mixed signal intensity on preoperative T1 MRI compared with typical low intensity in another DPOH case. Only 1 case of mixed signal intensity on T1 MRI was found in 178 patients without DPOH. The mixed signal intensity on preoperative T1 MRI was highly related to DPOH and mortality (both P < 0.001). There was no significant difference in other relative clinical data between patients with or without DPOH. CONCLUSIONS: Mixed signal intensity on preoperative T1 MRI might be associated with DPOH in patients with EC. The surgeon should pay more attention to this rarely atypical imaging before surgery. Further observations are necessary to illustrate the relationship between mixed signal intensity and DPOH in EC and to guide reasonable therapy.


Assuntos
Cistos do Sistema Nervoso Central/diagnóstico por imagem , Cisto Epidérmico/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Neuroimagem/métodos , Hemorragia Pós-Operatória/etiologia , Adolescente , Adulto , Idoso , Cistos do Sistema Nervoso Central/complicações , Cistos do Sistema Nervoso Central/cirurgia , Cisto Epidérmico/complicações , Cisto Epidérmico/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
4.
World Neurosurg ; 133: 271-274, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31639501

RESUMO

BACKGROUND: Epidermoid cysts (ECs) account for 0.5% to 1% of all spinal tumors. They can be congenital or acquired. Acquired spinal ECs are extremely rare and are mostly caused by trauma, or secondary to iatrogenic procedure such as lumbar punctures or surgery for spina bifida. As far as we know, this is the first report of a spinal EC complicating surgery for a lumbar disc herniation. CASE DESCRIPTION: A 69-year-old woman, with a history of L3-L4 lumbar disc herniation surgery 30 years earlier, presented because of low back pain, weakness of her lower limbs, and bladder dysfunction evolving for 2 years. Magnetic resonance imaging identified an intradural cystic lesion extending from the medullary cone to the L4 level, evoking an EC. The diagnosis was confirmed peroperatively. Neurologic motor signs improved postoperatively but not the sphincter disorders. CONCLUSIONS: Despite the extreme rarity of this event, we should be aware of the potential de novo development of epidermoid tumors in patients who undergo surgery for lumbar disc herniation. Concerns must be given to persistent low back pain and delayed neurologic symptoms in these patients.


Assuntos
Cauda Equina/diagnóstico por imagem , Cisto Epidérmico/etiologia , Deslocamento do Disco Intervertebral/cirurgia , Vértebras Lombares/cirurgia , Procedimentos Ortopédicos/efeitos adversos , Doenças do Sistema Nervoso Periférico/etiologia , Idoso , Cauda Equina/cirurgia , Cisto Epidérmico/diagnóstico por imagem , Cisto Epidérmico/cirurgia , Feminino , Humanos , Laminectomia , Vértebras Lombares/diagnóstico por imagem , Imagem por Ressonância Magnética , Doenças do Sistema Nervoso Periférico/diagnóstico por imagem , Doenças do Sistema Nervoso Periférico/cirurgia , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Resultado do Tratamento
5.
Indian J Pathol Microbiol ; 62(4): 605-607, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31611451

RESUMO

Splenic cysts are rare with an overall incidence of 0.07% in a large autopsy series and 0.5% among all the splenectomies done. The parasitic splenic cysts, usually caused by Echinococcus granulosus, account for 60% of all primary splenic cysts. The primary epithelial cysts account for 10% of all splenic cysts. We report a case of 30-year-old female presenting with left upper abdominal pain and heaviness. Computed tomography revealed a multiloculated cyst in spleen. Hydatid serology was negative. Total splenectomy was done. Histopathological evaluation was done and a diagnosis of primary epithelial splenic cyst was given.


Assuntos
Cisto Epidérmico/diagnóstico por imagem , Doenças Raras/diagnóstico por imagem , Baço/patologia , Esplenopatias/diagnóstico por imagem , Dor Abdominal/etiologia , Adulto , Feminino , Humanos , Baço/citologia , Esplenectomia , Tomografia Computadorizada por Raios X
6.
An Bras Dermatol ; 94(4): 452-454, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31644620

RESUMO

Proliferating trichilemmal cyst is an uncommon neoplasm arising from the follicular isthmus, whose histopathological hallmark is the presence of trichilemmal keratinization. We describe a case of proliferating trichilemmal cyst in a 57-year-old woman with a broad clinical, radiological, macroscopic and microscopic correlation.


Assuntos
Cisto Epidérmico/diagnóstico por imagem , Cisto Epidérmico/patologia , Couro Cabeludo/diagnóstico por imagem , Couro Cabeludo/patologia , Biópsia por Agulha Fina , Diagnóstico Diferencial , Cisto Epidérmico/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Couro Cabeludo/cirurgia , Ultrassonografia
7.
Anticancer Res ; 39(8): 4253-4258, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31366514

RESUMO

Different entities can be the cause of scalp neoplasia. In a phenotype with multiple cystic scalp lesions, the diagnosis must be made with particular caution because the appearance of apparently benign tumors does not necessarily correspond to the biological behaviour of the lesions. This case report describes diagnosis and therapy of a patient with multiple cystic tumors confined to the scalp. Diagnosis of benign lesions all over the scalp allowed an aesthetically pleasing surgical treatment result. Long-term follow-up control was offered to the patient because the histological diagnosis identified further small tumors of the same type as the large lesions, so further neoplasms are likely to develop.


Assuntos
Cisto Epidérmico/cirurgia , Neoplasias/cirurgia , Neoplasias Cutâneas/cirurgia , Adulto , Cisto Epidérmico/diagnóstico , Cisto Epidérmico/diagnóstico por imagem , Cisto Epidérmico/fisiopatologia , Feminino , Humanos , Neoplasias/diagnóstico , Neoplasias/diagnóstico por imagem , Neoplasias/fisiopatologia , Couro Cabeludo/diagnóstico por imagem , Couro Cabeludo/fisiopatologia , Couro Cabeludo/cirurgia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/diagnóstico por imagem , Neoplasias Cutâneas/fisiopatologia
8.
An. bras. dermatol ; 94(4): 452-454, July-Aug. 2019. graf
Artigo em Inglês | LILACS | ID: biblio-1038305

RESUMO

Abstract: Proliferating trichilemmal cyst is an uncommon neoplasm arising from the follicular isthmus, whose histopathological hallmark is the presence of trichilemmal keratinization. We describe a case of proliferating trichilemmal cyst in a 57-year-old woman with a broad clinical, radiological, macroscopic and microscopic correlation.


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Couro Cabeludo/patologia , Couro Cabeludo/diagnóstico por imagem , Cisto Epidérmico/patologia , Cisto Epidérmico/diagnóstico por imagem , Couro Cabeludo/cirurgia , Ultrassonografia , Biópsia por Agulha Fina , Diagnóstico Diferencial , Cisto Epidérmico/cirurgia
9.
World Neurosurg ; 130: 110-114, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31284058

RESUMO

BACKGROUND: Intracranial epidermoid cysts are benign, congenital, keratinizing, squamous epithelial-lined cysts filled with keratin. They are uncommon and often pose a surgical challenge owing to the adherence to surrounding structures. They are typically found at the cerebellopontine angle or in the parasellar region, where they are associated with abnormal development of the Rathke pouch; involvement of the pituitary stalk is rare. CASE DESCRIPTION: The patient's electronic health record was queried for relevant data. A systematic review of the literature using dedicated search terms for cases of infundibular epidermoid cysts was conducted. We present a unique case of a 55-year-old male who presented with vision changes and was found to have a parasellar epidermoid cyst confined to the pituitary stalk. The patient underwent endoscopic transsphenoidal resection, and gross total resection was achieved. The patient's postoperative course was significant for possible chemical meningitis and the development of panhypopituitarism. The patient's vision subjectively improved after surgery. CONCLUSIONS: Although 3 other cases of epidermoid cysts involving the pituitary stalk were identified, our patient's tumor was unique in that it was confined to the stalk. Our patient's case highlights a surgical approach to parasellar epidermoid cysts and the possible complications associated therewith.


Assuntos
Cisto Epidérmico/diagnóstico por imagem , Cisto Epidérmico/cirurgia , Hipófise/diagnóstico por imagem , Hipófise/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade
10.
World Neurosurg ; 130: 122-128, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31255725

RESUMO

BACKGROUND: Spinal dysraphism refers to a group of congenital malformations affecting the spine and the spinal cord. Although there are several varieties, all have one thing in common, i.e., faulty closure of midline structures at embryogenesis. Rarely, these anomalies are associated with spinal inclusion cysts. Lipomyelocele (LMC) is a type of spinal dysraphism wherein the neural elements along with fat herniate through a posterior defect in the spine. A vast majority of these anomalies are seen in the lumbosacral region, and their occurrence in the cervical region is extremely rare. CASE DESCRIPTION: A 45-year-old female patient presented with swelling over the nape of her neck since birth, with recent-onset paresthesia and unsteady gait. On local examination, a soft fluctuant swelling with blackish discoloration of skin was noted at the nape of the neck. Radiographs revealed congenital C4-C5 block vertebra with defect in posterior elements from C4 to C6. Magnetic resonance imaging revealed a cervical LMC with extramedullary intradural congenital inclusion cyst. Other notable findings were dorsal dermal sinus in cervical region, low lying tethered cord, and aberrant right subclavian artery. In our literature review, we could find only 1 case report of a cervical LMC and no cases reported of cervical LMC with congenital inclusion cyst. CONCLUSIONS: Herein, we report a case of a cervical LMC with a spinal inclusion cyst.


Assuntos
Vértebras Cervicais/diagnóstico por imagem , Cisto Epidérmico/complicações , Cisto Epidérmico/diagnóstico por imagem , Meningomielocele/complicações , Meningomielocele/diagnóstico por imagem , Feminino , Humanos , Pessoa de Meia-Idade
11.
BMJ Case Rep ; 12(7)2019 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-31320371

RESUMO

We report the first clinical case on the successful use of proton beam therapy in the management of malignant transformation of intracranial epidermoid cyst. A 43-year-old man was initially diagnosed as this disease with left facial paresis, hypesthesia and hypoalgesia in the territories of the trigeminal nerve. After failure of surgical interventions, he was referred to our radiation centre. We performed a postoperative proton beam therapy for treatment. We delivered a total dose of 57 GyE in 31 fractions. He tolerated the treatment well with mild acute toxicities and remained healthy and functional by 2-year follow-up postradiotherapy. No evidence of delayed radiation-induced neurotoxicity was observed.


Assuntos
Cistos do Sistema Nervoso Central/radioterapia , Neoplasias Cerebelares/radioterapia , Cisto Epidérmico/radioterapia , Carcinoma de Células Escamosas de Cabeça e Pescoço/radioterapia , Adulto , Transformação Celular Neoplásica , Cistos do Sistema Nervoso Central/diagnóstico por imagem , Cistos do Sistema Nervoso Central/patologia , Cistos do Sistema Nervoso Central/cirurgia , Neoplasias Cerebelares/diagnóstico por imagem , Neoplasias Cerebelares/patologia , Neoplasias Cerebelares/cirurgia , Ângulo Cerebelopontino , Cisto Epidérmico/diagnóstico por imagem , Cisto Epidérmico/patologia , Cisto Epidérmico/cirurgia , Humanos , Imagem por Ressonância Magnética , Masculino , Procedimentos Neurocirúrgicos , Terapia com Prótons , Carcinoma de Células Escamosas de Cabeça e Pescoço/diagnóstico por imagem , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/cirurgia
12.
Clin Nucl Med ; 44(10): 834-835, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31306209

RESUMO

A 63-year-old woman with neuroendocrine carcinoma of the colon was referred to our department for staging with Tc-octreotide scan. Two focal, highly intense, superficial lesions were detected in patient's scalp and paralumbar region, medial to the right kidney. Pathology correlation was recommended, revealing them both to be benign trichilemmal cysts. This unexpected finding strengthens the hypothesis of Merkel cell carcinoma and trichilemmal cysts originating from pluripotent stem cells of adnexal epithelium, making a neuroendocrine differentiation for the latter plausible.


Assuntos
Cisto Epidérmico/diagnóstico por imagem , Achados Incidentais , Octreotida/análogos & derivados , Compostos de Organotecnécio , Carcinoma Neuroendócrino/complicações , Carcinoma Neuroendócrino/diagnóstico por imagem , Carcinoma Neuroendócrino/patologia , Cisto Epidérmico/complicações , Feminino , Humanos , Pessoa de Meia-Idade , Estadiamento de Neoplasias
14.
BMC Urol ; 19(1): 52, 2019 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-31185974

RESUMO

BACKGROUND: Testicular epidermoid cysts (TECs) are rare benign testicular neoplasms. As TECs are rarely associated with germ cell tumours (GCTs), the understanding of biological behaviour and clinical management of TEC is unresolved. METHODS: We retrospectively searched the files of patients treated for testicular neoplasms and germ cell cancer in the time from 2000 to 2017. Those with TEC were subjected to closer review looking to clinical and histological features, and to results from imaging with ultrasonography (US), contrast enhanced sonography (CEUS) and magnetic resonance imaging (MRI). RESULTS: Among 589 patients undergoing surgery for testicular tumour, nine simple TECs were identified (1.5, 95% confidence intervals 0.53-2.50%). Median age was 26 years. Imaging revealed sharply demarcated roundish lesions with avascular central areas. Eight patients underwent testis-sparing excision with no recurrence ensuing. One had orchiectomy because of large size of the mass. Histologically, TECs consisted of cornifying squamous cell epithelium and no accompanying germ cell neoplasia in situ. Two additional cases (0.3% of all) required orchiectomy because these TECs were associated with ipsilateral GCT. CONCLUSIONS: TEC is usually a benign lesion that can safely be diagnosed with US, CEUS and MRI due to its roundish shape and its avascular centre. Histologically, this TEC corresponds to the prepubertal-type teratoma unrelated to germ cell neoplasia in situ of the 2016 WHO classification. The other subtype of TEC that is associated with invasive GCT represents a teratoma of postpubertal-type. From a clinical point of view it could be easier to differentiate between a "simple TEC" which is benign (prepubertal type) and a "complex TEC" which is malignant because of its association with invasive GCT.


Assuntos
Cisto Epidérmico/diagnóstico por imagem , Neoplasias Embrionárias de Células Germinativas/diagnóstico por imagem , Neoplasias Testiculares/diagnóstico por imagem , Testículo/diagnóstico por imagem , Adolescente , Adulto , Criança , Cisto Epidérmico/cirurgia , Humanos , Masculino , Neoplasias Embrionárias de Células Germinativas/cirurgia , Estudos Retrospectivos , Neoplasias Testiculares/cirurgia , Testículo/cirurgia , Adulto Jovem
16.
World Neurosurg ; 128: 514-526, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31121364

RESUMO

BACKGROUND: Suprasellar epidermoid cysts (SECs) constitute a large portion of so-called pearly tumors. Despite their insidious development and infiltration into vital neurovascular structures, they have a friable consistency, which particularly facilitates their resection; the only alternative to surgery is wait-and-see policy. We present a case of SEC in a patient with bitemporal hemianopia and no other significant symptoms and results of analysis of data on surgical treatment of 71 similar cases reported in the last 4 decades. CASE DESCRIPTION: A 29-year-old man presented with 1 year blurred vision. Bitemporal hemianopia was detected by perimetry. The patient was otherwise fit and well, with no significant past medical history. Magnetic resonance imaging showed an extra-axial suprasellar lesion with expansion toward the prepontine cistern, which showed restricted diffusion. The patient was operated on via a binostril endoscopic transtuberculum-transplanum endonasal approach. Pathologic examination confirmed the diagnosis of epidermoid cyst. The postoperative course was complicated by third cranial nerve palsy, rhinorrhea, which required reoperation, and diabetes insipidus. Otherwise, the patient made a good recovery and reported subjective improvement of visual acuity. Gradually, the left third cranial nerve function improved and there was neither any long-term complication nor recurrence on 6 months follow-up study. CONCLUSIONS: A suprasellar location frequently impedes the gross total resection of epidermoid cysts. Endoscopic endonasal approaches might be more effective in resection of lesions that do not extend laterally beyond the cranial nerves. The introduction of magnetic resonance imaging and surgical endoscopy were fundamental achievements in SEC management. There is a constant need for quality case reports on the management of these intracranial tumors.


Assuntos
Cistos do Sistema Nervoso Central/cirurgia , Cisto Epidérmico/cirurgia , Neuroendoscopia/métodos , Adulto , Cistos do Sistema Nervoso Central/complicações , Cistos do Sistema Nervoso Central/diagnóstico por imagem , Rinorreia de Líquido Cefalorraquidiano , Diabetes Insípido , Cisto Epidérmico/complicações , Cisto Epidérmico/diagnóstico por imagem , Hemianopsia/etiologia , Humanos , Imagem por Ressonância Magnética , Masculino , Cirurgia Endoscópica por Orifício Natural , Doenças do Nervo Oculomotor , Complicações Pós-Operatórias , Osso Esfenoide/diagnóstico por imagem , Osso Esfenoide/cirurgia
17.
World Neurosurg ; 128: 14-17, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31054339

RESUMO

BACKGROUND: An epidermoid cyst arising from diploic space in the skull can cause an intracranial mass effect with compression of the underlying venous sinuses. CASE DESCRIPTION: A 66-year-old woman came to us with a persistent headache and unsteadiness. Computed tomography demonstrated an occipital bone cystic lesion with an intracranial mass effect overlying the torcular herophili, with high-intensity findings in diffusion-weighted magnetic resonance imaging. Cerebral angiogram demonstrated obstruction of the torcular herophili with development of diploic venous drainage. The patient underwent removal of the lesion and a cranioplasty procedure. The diagnosis was torcular epidermoid cyst. The postoperative course was uneventful, and the symptoms were resolved. CONCLUSIONS: Development of diploic venous drainage contributed to avoidance of critical intracranial hypertension during slow growth of a torcular epidermoid cyst.


Assuntos
Doenças Ósseas/complicações , Transtornos Cerebrovasculares/etiologia , Cavidades Cranianas , Cisto Epidérmico/complicações , Idoso , Doenças Ósseas/diagnóstico por imagem , Doenças Ósseas/patologia , Doenças Ósseas/cirurgia , Transtornos Cerebrovasculares/diagnóstico por imagem , Transtornos Cerebrovasculares/cirurgia , Constrição Patológica/diagnóstico por imagem , Constrição Patológica/etiologia , Constrição Patológica/cirurgia , Cavidades Cranianas/patologia , Cisto Epidérmico/diagnóstico por imagem , Cisto Epidérmico/patologia , Cisto Epidérmico/cirurgia , Feminino , Humanos , Hipertensão Intracraniana/etiologia , Osso Occipital
18.
Am J Case Rep ; 20: 580-586, 2019 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-31015391

RESUMO

BACKGROUND Epidermal inclusion cysts rarely develop in the breast. The cysts that do develop within the breast typically present as cutaneous or subcutaneous cysts. They more rarely present in a subareolar location or in a ruptured state. Thus far, 5 cases of ruptured epidermal inclusion cysts in subareolar locations have been reported in the English literature. Furthermore, clinical presentation of nipple discharge is rare in epidermal inclusion cysts of the breast; only 4 such cases has been reported. CASE REPORT A 58-year-old female presented with a 1-month history of bloody discharge from her left nipple. Mammography showed focal asymmetry in the left subareolar region; sonography showed a left subareolar mass with irregular shape, indistinct margin, heterogeneous echogenicity, and posterior enhancement. The mass was surgically excised; a pathological diagnosis of ruptured epidermal inclusion cyst with foreign body reaction and abscess formation was established. In this case, the clinical presentation of bloody nipple discharge was peculiar; furthermore, mammographic and sonographic features were indistinguishable from breast malignancy or typical breast abscess. CONCLUSIONS A ruptured epidermal inclusion cyst can present in an unusual subareolar location, combined with bloody nipple discharge; importantly, this can radiologically resemble breast malignancy.


Assuntos
Doenças Mamárias/diagnóstico por imagem , Doenças Mamárias/patologia , Cisto Epidérmico/diagnóstico por imagem , Reação a Corpo Estranho/diagnóstico por imagem , Mamilos/cirurgia , Biópsia por Agulha , Doenças Mamárias/cirurgia , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Diagnóstico Diferencial , Cisto Epidérmico/patologia , Cisto Epidérmico/cirurgia , Feminino , Reação a Corpo Estranho/cirurgia , Humanos , Imuno-Histoquímica , Mamografia/métodos , Pessoa de Meia-Idade , Mamilos/diagnóstico por imagem , Mamilos/patologia , Doenças Raras , Medição de Risco , Ruptura Espontânea/diagnóstico por imagem , Ruptura Espontânea/cirurgia , Resultado do Tratamento , Ultrassonografia Doppler em Cores
20.
Acta Medica (Hradec Kralove) ; 62(1): 39-42, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30931896

RESUMO

Spinal epidermoid cysts are benign tumors. Syringomyelia secondary to intramedullary tumors are frequently observed. However, the association between syringomyelia and spinal intradural extramedullary epidermoid cyst in the conus medullaris region is extremely rare. We present the case of a 3-year-old male who was admitted with paraparesis and urinary retention. Magnetic resonance imaging (MRI) of the spine demonstrated intradural extramedullary lesion, compatible with epidermoid cyst, that at the conus medullaris level and a large syringomyelia extending from T4 to L1 vertebrae. Total microsurgical excision of the cyst was performed. No additional drainage was carried out for the syringomyelic cavity. Histopathological examination verified the diagnosis of the epidermoid cyst. Total excision of the cyst and disappearance of the syringomyelia were observed on MRI at 15 days postoperatively. We have clarified the etiology, clinical, histopathological and radiological features, differential diagnosis, and treatment modalities of spinal epidermoid cysts. In addition, we have discussed the possible mechanisms of syringomyelia formation in spinal intradural lesions.


Assuntos
Cisto Epidérmico/cirurgia , Paraparesia/patologia , Doenças da Medula Espinal/cirurgia , Medula Espinal/patologia , Siringomielia/patologia , Retenção Urinária/patologia , Pré-Escolar , Cisto Epidérmico/complicações , Cisto Epidérmico/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Masculino , Paraparesia/diagnóstico por imagem , Paraparesia/etiologia , Medula Espinal/diagnóstico por imagem , Doenças da Medula Espinal/complicações , Doenças da Medula Espinal/patologia , Siringomielia/diagnóstico por imagem , Resultado do Tratamento , Retenção Urinária/diagnóstico por imagem , Retenção Urinária/etiologia
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