Unusually rapid development of a lateral neck mass: Diagnosis and treatment of a branchial cleft cyst. A case report

IntroductionBranchial cleft cysts are benign lesions caused by anomalous development of the branchial cleft. Cases that arise in the lateral neck region are often misdiagnosed, resulting initially in inappropriate management.Case presentationWe describe a 32-year-old woman with a swelling on the right side of her neck and no pain during palpation or neck motion.DiscussionThe patient was evaluated using fine-needle aspiration cytology (FNAC), ultrasound, and magnetic resonance imaging (MRI) scans. The MRI showed a right-sided cervical mass with hyperintense content, well-defined margins, and no evidence of infiltration into surrounding structures, while FNAC found a yellow, pus-like fluid, keratinised anuclear cells, squamous epithelium, and a matrix of amorphous debris.ConclusionBased on the images and the patient’s symptoms, a surgical intervention was performed.     

Symptomatic Rathke's cleft cyst in an old patient case report

Summary A 71-year-old woman with a symptomatic Rathke's cleft cyst is reported. Our patient is unique in that both metrizamide computed tomographic cisternography and a transsphenoidal surgery were safe and successful procedures in spite of the advanced age of the patient.     

A case report of Turner syndrome associated with Rathke cleft cyst

<正> It has not been reported that Turner syndromecould be associated with Rathke cleft cyst yet,nowwe report such a case found in our hospital.Clinical data:The patient,social sex female,15.3ys,was a junior high school student.Chief com-plaints:She had short stature for 10~+ years and no pu-berche.She was a first full term fetus with cephalicpresentation.The delivery was accomplished by episi-otomy and vacuum extracter with a history of neonatal     

Rathke's cleft cyst

Two cases of Rathke's cleft cyst which produced symptoms of compression of the optic chiasm are described. The first case has been followed for five years since the operation. No evidence of recurrence has been noticed. The prognosis after a partial removal of the cyst wall seems to be good with this lesion. In the second case, there was clinical and laboratory evidence of hypopituitarism and the CT scan revealed suggestive findings to differentiate the cyst from a pituitary adenoma.     

Rathke囊肿眼科首诊1例

患者女,62岁,因右眼视力下降2年余,于2008年1月16日来我院就诊。2年前右眼无明显诱因出现视物模糊,不能矫正,1年来右眼视力下降加重。既往双眼近视,否认眼外伤及全身病史。眼部检查：视力：双眼裸眼视力0．1,右眼-7．00DS矫正到0．3,左眼-1．00DS矫正到0．8。眼压：右眼17mmHg,左眼19mmHg。双眼裂隙灯检查角膜、虹膜、晶状体未见异常。     

滑膜囊肿1例

1 病倒资料 患者,男,50岁。因左大腿外侧发现条索状肿物伴疼痛15d,于2003年5月20日入院。查体：左大腿1/2中点以下,前外侧有一条索状肿物,近端较粗,远端较细,长约12cm,肌肉收缩时肿物明显,浅静脉无显露,皮温不高,质地韧,不活动,无明显压缩。     

Hemithyroid agenesis associated with a cervical thymic cyst.

A case is presented of a 7-yr-old boy with left hemithyroid agenesis associated with cervical thymic cyst. No left parathyroid glands were found. The diagnosis was established after surgical excision and histologic examination. Clinical and embryological implications of this condition are briefly discussed. No similar case has been found in the literature.     

Intraparathyroid cyst: a tumour of branchial origin and a possible pitfall for targeted parathyroid surgery

Background: Parathyroid cysts account for 0.5% of parathyroid pathologies. They usually contain sky‐high levels of parathyroid hormone (PTH) but are not necessarily associated with primary hyperparathyroidism (PHPT). Their origin is subject to debate. We provide evidence for a branchial origin and illustrate some potential problems they pose for targeted parathyroid surgery. Methods: The present study is a single institution retrospective study of 1702 parathyroid and 10 021 thyroid operations performed over a period of 12 years (1990?2001). Twenty‐three cases of parathyroid cyst were found: three palpable neck masses, four cases associated with PHPT and 16 incidental findings at the time of thyroid surgery. Intracystic PTH measurements and immunostaining of the lining wall of the cyst were obtained in 16 out of 23 and 18 out of 23 cases, respectively. Results: Intracystic PTH levels were elevated in 15 out of 16 cases (average 3877, range 36 000?23 pg\mL). The wall of the cyst stained positively for epithelial cuboidal cell markers (CK +ve) and negatively for PTH (PTH ?ve) in 18 out of 18 cases. In only one quarter of the cases associated with PHPT was the cyst the hypersecreting gland, nevertheless it contained less than the average PTH level (1440 vs 3877) and did not take up sestamibi. Results were conflicting in the other three cases. Histological studies on the present series suggest a branchial pouch origin. Conclusion: Despite containing high levels of PTH, parathyroid cysts are of branchial origin and when associated with PHPT are rarely responsible for the disease. Targeted parathyroid surgery should not rely only on ultrasound and intraparathyroid PTH measurements.     

Abscess formation in Rathke's cleft cyst

Summary Two patients are discussed who presented at our Institute with endocrine dysfunction and sellar enlargement. CT scans revealed intra and suprasellar expanding lesions with ring enhancement. The postoperative histological examination showed remnants of Rathke's cleft cyst together with signs of inflammation. CT and MRI pictures, and possible mechanisms of abscess formation in this region are discussed.     

Choledochal cyst or pancreatic (retention) cyst: A case report

Right upper quadrant cystic lesions can be difficult to differentiate using noninvasive imaging modalities. The following case report dicuss the common cystic lesions of the hepatoduodenal ligament and right sided pancreas.     

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.     

Presacral epidermoid cyst: Report of a case

(Received for publication on Dec. 26, 1996; accepted on July 8, 1997)     

Cerebellopontine angle epithelial cyst. A case report

A case of epithelial cyst in the cerebellopontine angle is reported. The cyst wall showed glandular epithelium with areas of non-keratinized stratified epithelium and flattened cuboidal cells. The glandular areas stained positively with antibodies to cytokeratin. In addition, the cyst wall contained areas of arachnoid tissue. This, and the unusual position of the cyst, suggest that the epithelial elements in the cyst wall may be metaplastic in origin. Similar previously described cysts were considered to be endodermal in origin.     

Laparoscopic excision of a newborn rectal duplication cyst

Congenital rectal duplication cyst is a rare entity treated with surgical excision. Without treatment, a rectal duplication cyst may cause a variety of complications, most notably, transforming into a malignancy. We report on a 7-week-old girl who was found to have a rectal duplication cyst. The rectal duplication cyst was successfully excised laparoscopically. Rectal duplication cysts are rare alimentary tract anomalies generally discovered during childhood. Complications include symptoms arising from the cyst and the possibility of malignant degeneration. They are typically managed by surgical excision.     

Atypical first branchial cleft fistula: A case report

IntroductionFirst branchial cleft anomalies (FBCA) are rare. They have an estimated incidence of 1 in 100,000. Type I are those that embryologically duplicate the membrane (cutaneous) external auditory canal.The aim of this case is to describe an unusual path of a type II first branchial cleft fistula tract in a 3 years old child and its surgical management in the academic hospital of Casablanca.Case presentationThis case is about a 3 year old girl who presented to the Ear Nose Throat (ENT) consultation for recurrent right lateral cervical infection. Clinical examination found an unsightly scar attached to an orifice giving pus located near the right mandibular angle suggesting type II first branchial cleft anomaly.Surgical excision was performed under general anesthesia by the superficial parotidectomy approach, the facial nerve was identified and preserved. The fistula cord was dissected and followed, it went under the facial nerve and the parorid gland to end under the digastric muscle where we tied it up. The postoperative check-up did not show any complications. The follow-up period was 12 months; the clinical examination did not find any sign of recurrence.ConclusionFirst branchial cleft fistula are rare and can be in form of cyst or fistula. Its management is surgical excision keeping the tract cyst of the fistula intact with facial nerve preservation.