成人骶尾部表皮样囊肿10例手术治疗体会

目的探讨成人骶尾部囊肿的手术方法和治疗效果.方法回顾性分析10例接受手术治疗的成人骶尾部表皮样囊肿,总结麻醉方法的选择、手术入路方式、止血方法和治疗效果.首选硬膜外麻醉、右侧卧位、骶尾部入路、低电量电刀逐步剥离,在手术最后阶段剥离囊肿与直肠粘连处.结果本组切除囊肿单发3例,分隔多发7例.病理报告均为表皮样囊肿,平均住院17.6(14～28)d.无死亡病例和严重并发症.结论硬膜外麻醉、骶尾部入路、低电量电刀剥离是切除骶尾部囊肿的最佳方法.     

盆底巨大表皮样囊肿1例报告

患者 ,女 ,3 7岁 ,因“左下腹胀痛不适伴排便不畅 2个月”入院。入院前 2个月 ,患者无明显诱因开始出现左下腹胀痛不适 ,疼痛呈间断性 ,以坐位时明显 ,伴大便不畅。查体发现盆腔内有一囊性包块 ,B超及CT检查均提示盆腔左侧后份巨大囊性占位。既往无外伤、手术史及特殊疾病史。查体 :生命体征正常 ,腹部稍膨隆 ,下腹深触压可触及子宫 ,阴道双合诊或经阴道、直肠行三合诊检查 ,于盆底直肠左侧可触及包块 ,约 11cm× 8cm大 ,质稍软 ,呈囊性 ,有轻触压痛 ,拟诊为盆底直肠左侧囊肿。于 2 0 0 3年 4月 2 4日行剖腹探查 ,术中见子宫稍大 ,子宫高…     

骶尾部囊肿3例

骶尾部囊肿在临床上较为少见,多在青春期发病,容易误诊、误治.2007年4月至2007年12月我科收治骶尾部囊肿3例,现报告如下.     

骶尾部囊肿53例的诊断与治疗

从1992年以来，我院收治骶尾部囊肿53例．报告如下。     

超声诊断睾丸表皮样囊肿1例

患者男,27岁,未婚。因无意间发现右侧阴囊肿物10d而就诊。查体:右侧阴囊皮肤下垂,松垂,右侧睾丸稍增大,可触及一实性肿物约40mm×25mm大小,质硬,无压痛。左侧睾丸及双侧附睾大小质地正常,无精索静脉曲张。辅助检查:甲胎蛋白<15ng/ml。磁共振显像(MRI)检查提示:     

骶前表皮样囊肿14例临床诊治分析

骶前表皮样囊肿是一种少见疾病,由于它所处的解剖位置使其诊断和治疗较为困难.自1996年5月至2004年10月,我们诊治14例,现将我们的诊治体会报道如下.     

骶尾部囊肿2例

我科2006年收治骶尾部囊肿2例,报告如下.例1:男,20岁,因间断骶尾部肿痛1年,门诊以"骶尾部囊肿"收我科住院治疗.     

腹腔镜治疗盆腔、骶尾部巨大皮样囊肿一例

皮样囊肿是一种错构瘤,可发生在身体的许多部位,但发生在骶尾部的较为少见,骶尾部合并盆腔的巨大皮样囊肿则更为罕见。既往对盆腔的巨大肿物多采用开腹手术治疗,此病例我们成功的施行了腹腔镜微创治疗,效果满意。     

高频超声诊断浅表组织表皮样囊肿120例

目的探讨高频超声诊断浅表组织表皮样囊肿的价值。方法对120例经病理证实的浅表组织表皮样囊肿的高频超声声像图进行回顾性分析。结果超声病变全部病变均发现为单房性,其中58例超声提示表皮样囊肿,43例误诊为实性包块,12例误诊为囊实性混合性肿块,7例无法判断囊实性。109例肿块边界清楚,49例内部呈低、中回声,分布均匀;59例内部为细密强回声夹杂小管道样低回声;12例回声不均匀,内可见到小片状无回声区。92例肿块探头加压可产生形变,但内部细密强回声缺乏流动感。所有肿块内部均未见血流信号。结论表皮样囊肿具有特征性声像图表现;超声在表皮样囊肿的诊断中可以发挥重要作用。     

超声诊断甲状腺舌管囊肿1例

患者女,47岁,因颈部微痛3天就诊,否认近日患上呼吸道感染及甲状腺疾病史。查体：体温正常,颈部无红肿,未扪及明显包块,颈部正中及稍偏左、偏右均有轻压痛。常规超声：双侧甲状腺大小、形态正常,实质回声均匀。CDFI：甲状腺内未见异常血流信号。沿峡部向上方扫查,     

Intramedullary epidermoid cyst. A case report

The authors add to the literature a case report of a 32-year-old man with an intramedullary epidermoid cyst at the level of D 3/4, that was successfully operated on. There are several previous reports in the literature, but only five of these include MRI studies.     

Management of an epidermoid cyst of the intrahepatic ducts

Epidermoid cysts of the biliary tree have not previously been described. A baby boy presented with a prenatally diagnosed echolucent intrahepatic cyst. Postnatal radioisotope study of the liver demonstrated that the cyst communicated with the biliary tree. Follow-up ultrasound at 6 months demonstrated that the cyst was filled with echogenic material consistent with either blood or biliary debris. Due to the potential for obstruction and cholangitis, surgery was planned. The cyst was located at the confluence of the right and left hepatic ducts and involved all of the common hepatic duct. The entire cyst was resected except for the patch containing 3 duct orifices: the opening of both hepatic ducts as well as the orifice leading to the common bile duct. A Roux-en-Y cyst jejunostomy was created to allow drainage of both left and right hepatic ducts. The connection also provided access to the cyst remnant through the common duct for future endoscopic monitoring of potential malignant transformation.     

A large epidermoid cyst developing in the palm: A case report

INTRODUCTIONEpidermoid cysts, also called atheromas, are frequently observed. These cysts originate mostly in the pilosebaceous apparatus but rarely in areas without hair, such as the palm and sole. The mechanism of their development has been reported to be epidermal inclusion secondary to trauma or human papillomavirus (HPV)-60 infection. We report the patient who developed an epidermoid cyst in the palm without any known cause.PRESENTATION OF CASEA 93-year-old male noticed a mass in the left palm 3 years earlier, was diagnosed with an epidermoid cyst based on incisional biopsy, and underwent incision drainage several times during the 3-year period. However, since the cyst spontaneously ruptured and was infected, debridement and resection of the cyst were performed. The postoperative course was favorable, without signs of infection. The pathological diagnosis of the resected specimen was an epidermoid cyst.DISCUSSIONThis case was a rare epidermoid cyst originating in an area without hair, and there was neither a clear history of injury nor findings strongly suggesting HPV-60 infection. Causes other than repeated loading on the palm could not be considered for epidermal inclusion. To our knowledge, this case is the largest reported epidermoid cyst.CONCLUSIONEpidermoid cysts are frequently observed, but their development in areas without hair is rare, and its mechanism has not been clarified. The association between this cyst and trauma or HPV is clear. However, repeated loading on areas such as the palm that tend to undergo chronic loading can also be a cause, as in this patient.     

Orbital epidermoid cyst. Case report

Epidermoid tumors represent 1% of all primary intracranial tumors. Most of them occur intradurally in cerebellopontine angle and parasellar citerns. The intra-orbital location accounts for 4 to 5% of all primary intra-orbital tumors. We report the case of a 23-year-old girl with progressive right proptosis who had developed 6 months earlier. The tumor was removed via an external orbitotomy approach. Histology confirmed the diagnosis.     

Penile epidermoid cyst in an elderly patient

Although cutaneous epidermoid cysts are common lesions, penile localization of them is quite rare especially in elderly ages. A case of 70-year-old man with a rapidly growing penile epidermoid cyst that extended to under the symphysis pubis is reported. The cystic mass was excised totally and histopathologic examination revealed the epidermoid cyst. There has been no finding of recurrence for one year follow-up period.     

A large epidermoid cyst of breast mimicking carcinoma: A case report and review of literature

INTRODUCTIONTriple assessment of a suspicious breast lesion may not always provide a definite diagnosis. We report a case of epidermoid cyst of breast, which caused diagnostic dilemma in spite of a thorough triple assessment and entailed mastectomy.PRESENTATION OF CASEA 69-year-old woman presented with a large painful retroareolar left breast mass. Clinical examination, ultrasound and mammography were highly suspicious of malignancy. However, core biopsy suggested a benign lesion. Due to size of the lesion and diagnostic uncertainty, various options were discussed with the patient. She opted for a simple mastectomy. The histology confirmed a large epidermoid cyst.DISCUSSIONIt is rare for an epidermoid cyst to present as such an advanced lesion, mimicking carcinoma. Excision of such a large retroareolar ‘benign’ lesion, however, may sometime entail mastectomy. This is the first reported case of an epidermoid cyst of breast necessitating mastectomy.CONCLUSIONDiagnostic dilemma while dealing with a suspected breast cancer is not rare. Involvement of multidisciplinary team as well as patient is important in the decision-making. The report illustrates a rare presentation of a deep seated large epidermoid cyst of breast, which mimicked carcinoma, caused diagnostic confusion and entailed mastectomy. We strongly advocate the option of breast reconstruction in such cases.     

指骨表皮样囊肿一例

患者男 ,38岁 ,左拇指外伤 2 0年 ,局部肿痛 2 0天入院。查体 :左拇指指甲弯曲畸形 ,末节手指尺侧缘肿胀 ,轻压痛 ,似有波动感。Ｘ线片显示 :左拇末节指骨远端尺侧缘可见半圆形骨质缺损区 ,边缘光滑硬化 ,无骨膜反应。ＣＴ检查 :左拇末节指骨内缘被软组织肿块挤压呈弧形凹陷 ,软组织影呈抱球状 ,0 6ｃｍ× 0 6ｃｍ× 1 2ｃｍ大小 ,ＣＴ值 4 8Ｈｕ ,受压骨边缘光滑整齐有硬化缘。化验 :碱性磷酸酶、血沉、血常规均正常。初步诊断 :左拇指末节指骨表皮样囊肿。术中所见 :拇指末节手指尺侧缘皮下有一0 5ｃｍ× 0 5ｃｍ× 1 5ｃｍ包块 ,质软…     

Adjacent epidermoid cyst and primary central nervous system lymphoma: case report

BACKGROUND: Except for cases with radiotherapy or phacomatosis, multiple primary brain tumors of different histologic types are rare. The authors report the association of an epidermoid cyst and a primary CNS lymphoma. CASE DESCRIPTION: A 66-year-old man with a 20-year history of gait disturbance was admitted because of recently worsening symptoms. Magnetic resonance imaging showed an abnormal mass in the posterior fossa. The mass lesion had the appearance of a cystic tumor with a large mural nodule. Gross total removal of the tumor was performed. Histologic examination disclosed the cystic portion to be an epidermoid, whereas the nodular portion exhibited the histologic and immunohistochemical features of a malignant lymphoma. The lymphoma cells were shown to harbor EBV by in situ hybridization. CONCLUSIONS: To our knowledge, this is the first report of the coexistence of an epidermoid cyst and primary CNS lymphoma. When the lesions are adjacent, a definite preoperative diagnosis can be difficult. Epstein-Barr virus-associated CNS lymphoma is rare among the immunologically normal population. The possible pathogenesis for the coexistence of these 2 tumors is discussed.