Acute renal failure occurring from urinary retention due to a müllerian duct cyst

A patient with a müllerian duct cyst, which caused acute renal failure secondary to urinary retention, is reported. The case was treated successfully by transurethral unroofing of the cyst.     

Squamous cell carcinoma in a Müllerian duct cyst: Report of a case

A 36-year-old man presented with a pelvic mass which proved to be a Müllerian duct cyst. The cyst was determined to be squamous cell carcinoma which involved the rectum and the bladder. A total pelvic exenteration was carried out for complete resection.     

Umbilical cyst containing ectopic gastric mucosa originating from an omphalomesenteric duct remnant

An umbilical cyst originating from an omphalomesenteric duct remnant is extremely rare, and to the best of our knowledge, it has scarcely been reported in medical literature. We present ultrasonographic manifestations and computed tomographic findings of an umbilical cyst originating from an omphalomesenteric duct remnant in a 6-year-old girl. In cases of umbilical cyst, radiographic evaluation alone may not differentiate an omphalomesenteric duct remnant with heterotopic gastric mucosa from a urachal remnant, and surgical intervention is required.     

Management of a ruptured bile duct cyst

A case of a ruptured bile duct cyst in a 25-year-old male patient is presented. The initial management of the clinical presentation of acute abdomen consisted of an exploratory laparotomy and a T-tube cystostomy of a choledochal cyst. Two months later, he was admitted to our surgical department. Preoperative evaluation showed a type IV-A choledochal cyst. The patient underwent excision of the choledochal cyst, cholecystectomy, and the construction of a Roux-en-Y end-to-side hepaticojejunostomy.     

Persistent müllerian duct syndrome: How to deal with the müllerian duct remnants — a review

Persistent müllerian duct syndrome (PMDS) is usually a surprise finding either during orchidopexy or during routine inguinal hernia repair in male patients. Often, the surgeon would face a dilemma about what is to be done with the remnants of müllerian duct, i.e. the fallopian tubes, uterus and proximal vagina. Till recently, it was advised to retain these structures whenever it was felt that the complete excision of these structures may jeopardise the blood supply and integrity of the vas deferens. Recent reports of malignancy in these retained structures would justify more aggressive approach. In our patients with PMDS, we have removed the mucosa of the retained müllerian structures, without compromising the integrity and vascularity of the vas deferens, thus reducing the chances of malignancy.     

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,     

Gartner duct cyst simplified treatment approach

We present two patients with Gartner’s duct cyst managed with simple marsupialization and successful long-term follow up.     

超声引导下无水乙醇硬化治疗伴有射精管梗阻症状的苗勒管囊肿

目的:评价经直肠超声引导下无水乙醇硬化治疗伴有射精管梗阻症状的苗勒管囊肿的安全性和有效性,探讨该方法的临床价值。方法:对3例伴有射精管梗阻症状的前列腺苗勒管囊肿行超声引导下20 G针穿刺无水乙醇硬化治疗,超声随访评价疗效。结果:治疗后6个月全部囊肿均消失,超声检查射精管梗阻解除,无严重并发症发生。结论:超声引导下的无水乙醇硬化治疗安全有效,可成为临床治疗伴有射精管梗阻症状的前列腺苗勒管囊肿的新方法。     

Double cervical cyst derived from a single thyroglossal duct tract

Thyroglossal duct cysts are one of the most common congenital cervical pathologic findings in children. This type of cyst can be located anywhere between the base of the tongue and the sternal manubrium. We report the case of a patient with a double thyroglossal cyst, one located in the hyoid region and the other in the thyroid gland. The 2 cysts were connected by a permeable tract, which confirms that an involution failure of the embryonic remains of the thyroglossal duct was responsible for the development of the cyst. Intrathyroid cysts of the thyroglossal duct, though uncommon, should be included in the differential diagnosis of thyroid cysts in children.     

Bile duct cancer developed after cyst excision for choledochal cyst

Oncogenesis after cyst excision for choledochal cyst and suitable surgical procedures for this operation are discussed. The clinical data of 23 patients with cancer of the biliary tree after excision of choledochal cyst reported in the English-language and Japanese literature were reviewed, and data for 1353 Japanese patients with choledochal cyst and/or pancreaticobiliary malunion were analyzed. In the 23 patients reported in the literature, age at cyst excision ranged from 1 to 55 years (average, 23.0 ± 13.7 years), and cancers were detected at age 18–60 years (average, 32.1 ± 12.2 years), with intervals between cyst excision and cancer detection of 1–19 years (average, 9.0 ± 5.5 years). Sites of cancer development were: intrahepatic, six; anastomotic, eight; hepatic side residual cyst, three; and the intrapancreatic duct, six. In the Japanese patients with choledochal cyst and/or pancreaticobiliary malunion, the incidence of cancer associated with primary choledochal cyst and/or pancreaticobiliary malunion was 16.2% (219/1353). The incidence of cancer development after cyst excision in this population, of whom 1291/1353 underwent surgery, was assumed to be 0.7%. Nearly half of the 23 patients in the literature had undergone inadequate cyst excision. Oncogenesis of cancers after cyst excision is possibly different from that of choledochal cysts. Received for publication on Feb. 17, 1999; accepted on March 29, 1999     

Persistent Müllerian duct structures in cryptorchid male infants: surgical dilemmas.

Persistent Müllerian duct structures were found in 3 male cryptorchid infants aged 10--12 mo, during correction of a unilateral inguinal hernia. Division of the vas degerens, hysterectomy and scrotal orchidopexy were carried out. The authors believe that in subjects with a persistent müllerian duct syndrome, surgical placement of the testes into the scrotum should be performed. This is, as a rule, not possible without damage to the vas deferens which runs parallel and adheres closely to the surface of the uterus.     

Embryonal rhabdomyosarcoma of the common bile duct mimicking choledochal cyst

Embryonal rhabdomyosarcoma of the common bile duct is a very rare malignancy of childhood. The radiological appearance of the lesion is similar to that of congenital choledochal cyst if there is no local invasion to the adjacent tissues. The authors present a case of embryonal rhabdomyosarcoma of the common bile duct which was considered to be a congenital choledochal cyst preoperatively, and they discuss this very rare childhood tumor, with a brief survey of the literature. In conclusion, it is important to know that this rare tumor can simulate congenital choledochal cyst; it should be considered in the differential diagnosis of obstructive jaundice in children.     

Management of cervical thoracic duct cyst with cyst-venous anastomosis

INTRODUCTION

Cervical thoracic duct cyst (CTDC) is a rare cause of lateral neck mass. Surgical excision with ligation of the cervical thoracic duct is the current standard for definitive management with symptomatic patients. We report the first case of an alternative method of management performing a cyst venous anastomosis for decompression.

PRESENTATION OF CASE

A 77 year old female presented with a six month history of left arm pain, swelling and a left-sided cystic neck mass. She was treated with cyst-venous anastomosis between the cyst wall and the left internal jugular vein. At two year follow-up, she has had resolution of pain and no recurrence of the mass.

DISCUSSION

Many potential etiologies have been proposed for CTDC, though surgical management of this rare problem has consistently required cyst excision and thoracic duct ligation. Few innovative modes of therapy have been developed to address this problem in a less invasive manor. Maintaining a more natural thoracic duct anatomy decreases the likely of complications associated with duct ligation.

CONCLUSION

Cyst-venous anastomosis for the management of CTDC provides an effective, novel form of treatment which maintains the integrity of the thoracic duct and avoids potential complications associated with duct ligation.     

Stone-containing periampullary duodenal duplication cyst with aberrant pancreatic duct

This case report describes a unique variant of a duodenal duplication cyst in an 8-year-old boy who had recurrent episodes of upper abdominal pain. Imaging revealed a stone-containing cyst near the biliaropancreatic ducts and concomitant hydrops of the gallbladder. Open transduodenal marsupialization of the cyst and resection of the inflamed gallbladder were performed. Further episodes of pancreatitis did not occur for a follow-up of 2 years.     

Collecting duct carcinoma presenting as a bleeding complicated renal cyst

Collecting duct carcinoma is a rare type of renal cell carcinoma. It is usually diagnosed pathologically and carries a poor prognosis. Renal cell carcinoma arising within a cyst is also rare. We report a case of collecting duct carcinoma presenting as a giant, bleeding complicated renal cyst with minimal solid component. The patient had a relatively long survival after nephrectomy.      

先天性胆总管囊肿的手术治疗体会

目的:探讨先天性胆总管囊肿应用胆总管空肠KOUS-Y型手术的应用价值和手术方法。方法:回顾性分析我院1991年～1997年收治的11例手术病例。结果:全组无手术死亡,随访5～10年,生活质量好,无并发症发生。结论:胆总管空肠KOUX-Y型手术是治疗先天性胆总管囊肿的理想术式。     

先天性胆管囊肿癌变的诊断与治疗

目的探讨先天性胆管囊肿癌变的诊断与治疗方法。方法回顾性分析1993年—2004年解放军总医院收治的185例先天性胆管囊肿患者的临床及病理资料。结果185例中合并癌变27例,癌变率为14.6%。先天性胆管囊肿癌变与年龄密切相关(P<0.001),各年龄段癌变率分别为:0～9岁为0%,10～19岁5.1%,20～29岁9.1%,30～39岁16.2%,40～49岁26.7%,50～59岁33.3%,≥60岁50%。6例有胆肠内引流手术史。临床主要表现为上腹疼痛、发热、黄疸和体重下降。诊断方法包括腹部超声、CT、MRI和经内镜逆行胰胆管造影,术前确诊20例,但早期诊断困难。获得根治性切除9例(33.3%)。结论先天性胆管囊肿是一种癌前病变,随年龄增长癌变率急剧增加。儿童期实施完全性囊肿切除是预防胆管囊肿癌变的最有效方法。胆管囊肿癌变病例预后不佳。     

Large thoracic duct cyst – a case report and review of the literature

Large thoracic duct cysts are rare and standard lateral thoracotomy is usually used for resection. In the reported case the combination of an antero-lateral thoracotomy with a partial longitudinal median sternotomy (hemiclamshell approach) allowed an excellent visualization and dissection of a large thoracic duct cyst expanding in the anterior cervico-thoracic junction, and was associated with an uncomplicated recovery.