Mediastinal esophageal cyst causing unilateral hyperlucent lung.

Unilateral emphysema secondary to bronchial obstruction by a foregut-derived mediastinal cyst is rare. Here we describe an infant with a unilateral hyperlucent lung due to compression on the left main bronchus by an esophageal cyst, visualized by chest computed tomography and magnetic resonance imaging. A chest roentgenogram and a perfusion scan presented the normalized left lung after resection of the cyst.     

Mediastinal parathyroid cyst with tracheal constriction.

A 63-year-old man visiting a physician for slight dyspnea, attributed to a lump on his neck, was found in ultrasonography and computed tomography to have a cyst extending from the left lobe of the thyroid gland to the superior mediastinum. Radiography showed right deviation of the trachea. The cyst disappeared after fine-needle aspiration, but cyst fluid subsequently reaccumulated and he was admitted to our hospital. No abnormalities were detected in tests of thyroid and parathyroid function or blood chemical analysis. The cyst was surgically removed and diagnosed as a nonfunctioning parathyroid cyst, based on the high-intact parathyroid hormone in cyst fluid. The patient recovered fully and has shown no recurrence in the 11 months to data since surgery.     

Hydatid cyst of the psoas. Report of a case

The authors report a case of hydatid cyst of the psoas muscle in 23 years old woman who presented a left lumboiliac mass. Ultrasonography and computed tomography contributed to the preoperative diagnosis. The cyst was removed by retroperitoneal approach by left lumbotomy. In the light of this case and the literature data, the authors discuss the diagnosis and therapeutic problems raised by hydatid cyst of the psoas muscle.     

Adrenal cystic lymphangioma. A case report]

Adrenal cysts are uncommon. A case of left adrenal cystic lymphangioma in 16 year old boy is reported. The adrenal cyst was a chance finding during radiological investigation for abdominal pain. Ultrasound and CT scan showed the cyst and suggested the correct diagnosis of cystic lymphangioma of the left adrenal gland. The patient underwent surgery and a left adrenalectomy was performed. Histology confirmed the previous diagnosis of cystic lymphangioma.     

Choroidal epithelial cyst of the cerebral hemisphere. An immunohistochemical study

A case of choroidal epithelial cyst in the left cerebral hemisphere of a 4-month-old infant is described. The cyst wall was composed of a single epithelial layer with a basement membrane and fibrous connective tissue. An immunohistochemical study revealed the presence of prealbumin in the cytoplasm of these cuboidal epithelial cells. This fact strongly suggested that the cuboidal epithelium lining the cyst wall originated from choroidal epithelial cells. The diagnostic usefulness of the immunohistochemical study in choroidal epithelial cysts is discussed.     

Porencephaly. Case report

A case of porencephaly in a 33-year-old male is presented. The patient exhibited right hemiparesis and generalized seizures. Computed tomography and, subsequently, craniotomy revealed a cerebral defect in the left parietal lobe, which communicated with the lateral ventricle. On angiography and at surgery, the cortical branches of the middle cerebral artery were found to be stretched over the surface of the cyst. Histopathological examination showed the outer membrane of the cyst to consist of arachnoid, subarachnoid space, vessels, pia mater, and a layer of degenerative brain tissue on histology. The diagnosis of porencephaly and its differentiation from arachnoid cyst are discussed.     

Thymoma arising in a thymic cyst.

We present a case of thymoma arising in the wall of the thymic cyst. A 77-year-old asymptomatic woman demonstrated an approximately 3.5 cm sized cystic mass in the left anterior mediastinum in the CT scan. The tumor was extirpated by a total thymectomy. Histologically, the cyst wall was lined by low cuboidal cells, but a markedly thickened wall was observed at the upper site of the mass, which was found to be thymoma. These findings may suggest that the thymoma originated from the wall of the thymic cyst.     

A case of arachnoid cyst in the middle cranial fossa presenting with trigeminal neuralgia

A 50-year-old man had been suffering from left trigeminal neuralgia for 30 years. CT scan revealed an arachnoid cyst occupying the anterior two-thirds of the left middle cranial fossa. Cerebral angiography showed elevation of the left middle cerebral artery and medial shift of the left posterior cerebral artery. Metrizamide CT showed that the cyst was not communicating with the subarachnoid space. Air CT revealed the root of the left trigeminal nerve in contact with the arachnoid cyst. The patient became completely free from the trigeminal neuralgia 6 months after cystoperitoneal shunt. This case seems to be a very rare case of trigeminal neuralgia caused by an arachnoid cyst.     

Infected pseudocyst of adrenal gland. Case report.

A large adrenal pseudocyst was found in a 58-year-old woman presenting with pain in the left hypochondrium and septicemia. Initial blood- and cystic fluid cultures all showed Staphylococcus aureus. After antibiotic therapy the cyst was removed. We have found no previous report of a bacteria-containing infected adrenal cyst in an adult.     

Spontaneous disappearance of cerebellopontine angle arachnoid cyst: report of a case

A case of a cerebellopontine angle arachnoid cyst spontaneously disappeared is reported. A 1-year-and-11-month old boy was suffered from sudden onset of left facial palsy. CT scan demonstrated dilatation of left internal auditory canal and a cystic lesion in the left cerebellopontine angle. Neurological examination disclosed only left facial palsy and left hearing loss. There was no signs and symptoms of increased intracranial pressure. He was followed up by CT scan. Repeated CT scan showed non-enhanced cystic lesion, the attenuation value of which was similar to that of cerebrospinal fluid. The cyst expanded gradually, and the brain stem was severely compressed. Then operation was planned under the diagnosis of left cerebellopontine angle arachnoid cyst about 2 years after the onset. But CT scan performed before operation showed disappearance of the cyst. Without operation the patient was followed by CT scan. There is no recurrence of the cyst. Natural history of arachnoid cyst will be well understood with repeated CT scan.     

Spontaneous peripelvic extravasation secondary to ovarian cyst: a case report.

We present a case of spontaneous peripelvic extravasation caused by ureteral obstruction secondary to an ovarian cyst. A 47-year-old woman with lower abdominal pain visited our emergency clinic. Emergency computed tomographic scan revealed extravasation around the left kidney and a left ovarian cyst. She was diagnosed to have spontaneous peripelvic extravasation by retrograde pyelography. A double pigtail stent was placed and the ovarian cyst was removed surgically. Intravenous pyelography performed after removal of the stent revealed neither urinary extravasation nor obstruction.     

A huge presacral Tarlov cyst. Case report

Perineural cysts have become a common incidental finding during lumbosacral magnetic resonance (MR) imaging. Only some of the symptomatic cysts warrant treatment. The authors describe the successful operative treatment of a patient with, to the best of their knowledge, the largest perineural cyst reported to date. A 29-year-old woman had been suffering from long-standing constipation and low-back pain. During an obstetric investigation for infertility, the clinician discovered a huge presacral cystic mass. Computed tomography myelography showed the lesion to be a huge Tarlov cyst arising from the left S-3 nerve root and compressing the ipsilateral S-2 nerve. The cyst was successfully treated by ligation of the cyst neck together with sectioning of the S-3 nerve root. Postoperative improvement in her symptoms and MR imaging findings were noted. Identification of the nerve root involved by the cyst wall, operative indication, operative procedure, and treatment of multiple cysts are important preoperative considerations.     

Lumbar spinal synovial cyst presenting with neurological deficit. A case report and review of the literature

A spinal synovial cyst is a rare condition. We reported a case of lumbar spinal synovial cyst presenting neurological deficit. A 78-year-old woman was admitted to our hospital with the low back pain radiating to the left buttock. A myelography with computed tomography and magnetic resonance imaging revealed an extradural cystic lesion at the L5 and S1 level. At the time of surgery, a standard posterior approach was used to expose the posterior elements from L5 to S1. An en bloc laminectomy and total removal of the cyst was performed at the L5 to S1 level. The postoperative recovery was uneventful except for a slight pain in the left leg which persisted for some time.     

Unusual presentation of a large tension bronchogenic cyst in an adult.

A routine chest radiograph in a 20 year old man revealed a giant air filled cavity of the left hemithorax under tension. At thoracotomy a large left lower lobe intraparenchymal cyst required lobectomy and the pathological findings were consistent with a bronchogenic cyst. Although tension bronchogenic cysts are common in infants, this case demonstrates their unusual presentation in an adult.     

Concurrent cysts of the mediastinum, pleura and neck.

A 14-year-old male was found to have a mediastinal mass on chest radiograph. Chest computed tomography scans showed a cystic lesion behind the left main bronchus. Magnetic resonance imaging revealed additional cystic lesions in the left chest and root of the neck. He underwent excision of mediastinal mass and a pleural cyst. The neck lesion was presumed to be a cystic hygroma. Histological examination of the two lesions resected showed them to be a foregut cyst and a benign mesothelial cyst. We know of no other report of concurrent multicystic lesions in the chest and neck and hypothesize that these cysts may have a common embryonic origin.     

A case of infected renal cyst suspected of originating from retrograde infection

A 63-year-old man who had undergone Miles' operation for rectal cancer in another hospital was referred due to a high fever and renal failure. Abdominal computed tomographic (CT) scan revealed metastatic liver tumor, paraaortic lymph node swelling, bilateral hydronephrosis and a left simple renal cyst located at the lower pole. Bilateral ureteral stenting was undertaken for relieving ureteral obstruction. Serum creatinine and high fever improved immediately. However, at 11 days after the ureteral stenting the high fever recurred. CT scan and ultrasonography revealed persistent left hydronephrosis and a change of left simple renal cyst into infected cyst. After an exchange of left ureteral stent and percutaneous pus drainage from the left infected renal cyst, high fever declined immediately. A review of the literature suggests that this is the 100th case report of infected renal cyst in Japan. We discuss the clinical features, etiology, imaging study and treatment of infected renal cyst.     

A case of infected renal cyst extending to leg abscess

A 45-year-old woman was referred to our hospital with the chief complaint of left flank pain, left leg pain and loss of appetite. Computed tomography scan and magnetic resonance imaging demonstrated a large cystic mass in the left kidney, which we diagnosed as an infected renal cyst. Under ultrasonic guidance, percutaneous puncture and drainage of the renal cyst were performed. After her leg pain worsened, computed tomography revealed abscesses in the left leg, suggesting an infected renal cyst extending to the leg through the obturator foramen. Under general anesthesia, incision and drainage were performed. Cultures from the cyst and abscess fluid showed Klebsiella pneumoniae. Our case is the 82nd case of an infected renal cyst in the Japanese literature.     

Recurrent bronchogenic cyst causing recurrent laryngeal nerve palsy.

A case of a 50-year-old male who developed left recurrent laryngeal nerve palsy due to a bronchogenic cyst is presented. The bronchogenic cyst recurred following incomplete excision and multiple attempts at percutaneous aspiration. Recurrent laryngeal nerve palsy is an unusual complication of bronchogenic cysts. This case highlights the need for complete excision of these cysts and the lack of efficacy of cyst aspiration.     

Craniocervical junction synovial cyst associated with atlanto-axial dislocation--case report.

A 51-year-old female presented with a rare case of synovial cyst at the cruciate ligament of the odontoid process associated with atlanto-axial dislocation, manifesting as a history of headache and numbness in her left extremities for 5 months, and progressive motor weakness of her left leg. Neuroimaging studies revealed a small cystic lesion behind the dens, which severely compressed the upper cervical cord, and atlanto-axial dislocation. The cyst was successfully removed via the transcondylar approach. C-1 laminectomy and foramen magnum decompression were also performed. Posterior craniocervical fusion was carried out to stabilize the atlanto-axial dislocation. The cyst contained mucinous material. Histological examination detected synovial cells lining the fibrocartilaginous capsule. Synovial cysts of this region do not have typical symptoms or characteristic radiographic features. Careful preoperative evaluation of the symptoms and a less invasive strategy for removal of the cyst are recommended.     

Atypical meningioma with large cyst. Case report

A 29-year-old male presented with loss of consciousness and generalized seizure, followed by right hemiparesis and speech disturbance. Computed tomography and magnetic resonance imaging showed a solid, enhanced tumor with a cyst in the left frontal area with surrounding edema and mild mass effect. The cyst wall was also enhanced. The preoperative diagnosis was cystic falx meningioma. The tumor was totally resected, but most of the cyst wall adhered tightly to the surrounding brain and could not be removed. Histological examination revealed atypical meningioma and tumor cells in the cyst wall. The patient received local radiotherapy to the residual cyst wall with a total dose of 50 Gy.