Bronchogenic cyst of the right hemidiaphragm mimicking a hydatid cyst of the liver: report of the first pediatric case

Bronchogenic cyst (BC), which develops from abnormal budding of the tracheal diverticulum or ventral foregut, is a congenital bronchopulmonary malformation. Localization of the BC varies depending on the level of the abnormal budding. Thoracic or abdominal-sited diaphragmatic lesions are the rarest presentations of the BC. We present a case of BC that originated from the diaphragm and mimicking hydatid cyst of the liver in a 19-month-old girl. Diagnosis of a diaphragmatic lesion was confirmed during laparotomy and complete resection was successful.     

Congenital orbital sudoriferous cyst: radiological findings

We report an extremely unusual case of a 4-month-old boy who presented with a sudoriferous gland cyst of the orbit. Congenital sudoriferous cyst is extremely rare in both the adult and pediatric populations. The CT and MRI findings are presented and the pertinent literature reviewed.     

Duodenal duplication cyst communicating with an aberrant pancreatic duct

Duodenal duplication cyst (DDC) is an uncommon congenital anomaly and is the rarest site for intraabdominal duplications. We report a case of DDC communicating with an aberrant pancreatic duct in a 2-year-old girl, with features of possible occult relapsing pancreatitis. The duplication cyst was successfully enucleated with excision of the aberrant pancreatic duct. The literature is reviewed, and the diagnostic modalities and management options are discussed.     

Lingual Bronchogenic Cyst in a Child: An Unusual Site of Presentation

We describe a 4-year-old hispanic male with a bronchogenic cyst (BC) in the base of the tongue. To our knowledge, a BC has not been previously reported in the oral cavity. BC is a developmental anomaly believed to originate from abnormal detachments of accessory lung buds from the ventral foregut. We postulate that the unusual location of the BC in the present case is related to the primitive foregut origin of tongue epithelium posterior to the foramen cecum and the sulcus terminalis. A BC in the base of the tongue appears to represent the most proximal expression of aberrant accessory lung bud detachment from the primitive foregut.     

Isolated cardiac cysticercosis in an adolescent

Cardiac cysticercosis is a rare and typically asymptomatic infection. We report a case of a young man from Cameroon with a left ventricular cyst discovered during a screening echocardiogram. Computed tomography and plain films did not reveal additional cysts. Serology was negative. The patient had the cyst surgically removed for suspected echinococcosis. Sectioning demonstrated a cysticercus. The literature on cardiac cysticercosis is reviewed.     

Duplication cyst of the stomach presenting as hemoptysis.

We report a rare case of a 2-year-old boy with a gastric duplication cyst located in the stomach, presenting with vague abdominal pain, recurrent cough, hemoptysis and a lesion in the left lower lobe of the lung reported as a sequestration. The duplication cyst was attached to the diaphragm and lungs by a narrow tract. The cyst was excised. Subsequent scans of the chest showed regression of the lung lesion. We believe this to be the first case in the literature where the hemoptysis was cured and the pulmonary lesion regressed completely after excision of the duplication cyst of the stomach alone. Pulmonary resection was thus avoided.     

Vallecular cyst-revisited

We report a 3 months-old-male infant presented with recurrent cough, noisy breathing and regurgitation of feeds since 15 days of life. Examination revealed inspiratory stridor. CECT showed cystic lesion in base of tongue. After excision it was proved a case of vallecular cyst on histopathology. Although rare, vallecular cyst should be included in the differential diagnosis of congenital laryngeal stridor in neonates. The literature of vallecular cyst is being reviewed in the current article.     

Intramedullary neurenteric cyst presenting as infantile paraplegia: a case and review

The authors report a case of a 3-month-old male child with paraplegia in whom magnetic resonance imaging (MRI) revealed a nonenhancing intramedullary cystic lesion extending from the level of D1 to D7 without any other associated anomaly. Intraoperatively, these findings were confirmed and the spinal cord was found to have splayed circumferentially into a papery thin rim. The patient underwent marsupialization of the cyst with subtotal excision of the cyst wall. Histopathological examination revealed ciliated pseudostratified columnar epithelium consistent with the diagnosis of a neurenteric cyst. Intramedullary neurenteric cysts are rare developmental malformations, and out of the 13 previously reported cases, only 3 were evaluated by MRI. This is the first case report in the literature of an intramedullary neurenteric cyst presenting as infantile paraplegia. In the present report, the embryology, etiopathogenesis, radiological imaging and management of this rare clinical entity are discussed and a detailed literature review is presented.     

Neonatal sepsis presenting as a choledochal cyst

We report a case of a neonate who presented with Klebsiella sepsis and a fusiform dilation of the common bile duct on ultrasound suspected to be a choledochal cyst type Ia. In addition, a biliary sludge was noted in the gallbladder. All findings resolved with resolution of the sepsis. We discuss the case and review the literature regarding the association of sepsis with cholestasis and biliary sludge. CONCLUSIONS: we suggest that in any case of sepsis presenting as a choledochal cyst, it is essential to repeat the ultrasound after complete recovery before a surgery is planned.     

Completely isolated alimentary tract duplication in a neonate

A rare case of a completely isolated, alimentary tract duplication cyst in a 27-day-old neonate is reported. The duplication cyst was detected on antenatal fetal ultrasound and magnetic resonance (MR) imaging at 27 weeks’ gestational age. At surgery, the duplication cyst was in a retroperitoneal site with no apparent communication between the cyst and any portion of the alimentary tract. On histopathological examination, the diagnosis was a gastric duplication cyst. The patient’s postoperative course was uneventful. There have been eight cases of completely isolated duplication reported in the literature, of which seven were detected during the prenatal or neonatal period. No previous report in the English literature has described the fetal MR imaging findings of this type of duplication cyst.     

Isolated enteric duplication cyst with respiratory epithelium: case report and review of the literature

Enteric duplication cysts are uncommon congenital abnormalities. We report a case of an enteric cyst duplication located a few centimeters proximal to the ileocecal valve in a patient with vague abdominal symptoms. Histological examination showed an ileal duplication cyst lined with ciliated bronchial epithelium. Duplication cysts of the alimentary tract are uncommon, and their epithelial lining varies. Bronchial respiratory epithelium is extremely rare at the terminal ileum. Our case is only the second case described in the literature.     

A giant intramedullary spinal epidermoid cyst of the cervicothoracic region

Intramedullary epidermoid cysts of the spinal cord are rare lesions. The authors report a case of giant intramedullary epidermoid cyst at the cervicothoracic region. A 6-year-old boy presented with motor and sensory loss related to a spinal intramedullary epidermoid cyst. Almost all cyst content was liquid and it was surgically removed totally in two successive operations. To the author's knowledge, this is the largest intramedullary epidermoid cyst published in the literature and no other case of intramedullary epidermoid cyst with a complete liquid content has been reported before. The authors discuss the clinical features, MR imaging characteristics and surgical findings of this rare tumor and review the associated literature.     

Choledochal cyst associated with an accessory hepatic duct identified by intra-operative endoscopy: case report and literature review

We report a case of a choledochal cyst (CC) associated with accessory hepatic duct (AHD) and review the literature, focusing on biliary reconstruction. CC is only rarely associated with AHD. Intra-operative endoscopy is invaluable for confirming anatomical relations and highly recommended for routine use. Reconstructive surgery is feasible for AHD in CC cases.     

Splenoptosis complicated by a large splenic cyst: case report and discussion of combined management

Splenoptosis is a rare condition in children. Its association with a cyst is rare. A case of splenoptosis complicated by a large cyst is reported. The child presented with features of intermittent abdominal pain, constipation and clinical examination revealed a mass apparently rising out of the pelvis. Ultrasound confirmed the mass as spleen with a 15 cm cyst in the lower pole. At surgery the cyst was marsupialised and splenopexy undertaken placing the cyst in a retro-peritoneal pouch. This is only the second report of such a case in the English literature.     

Colonic atresia and choledochal cyst: a rare combination

Colonic atresia and choledochal cyst are rare congenital abnormalities and there are few cases of their coexistence reported in the literature. We report a case of choledochal cyst and colonic atresia in a term neonate. Our prenatal ultrasonographic and intraoperative findings support the idea that these two entities may be related.     

Coincidence of a ductal pancreatic cyst and a gastric duplication cyst: a case report.

We report a case of two abdominal cystic formations in an 18-month-old girl. Laparotomy was performed with surgical removal of both cysts. The cysts were connected by a fibrous bridge. Histology revealed a gastric duplication cyst and a ductal pancreatic cyst originating from an aberrant pancreatic lobe. No fistula was found either to the alimentary tract or in either of the cysts. The clinical picture and treatment are described and compared to findings in the literature.     

Mesenteric cyst infected with non-typhoidal salmonella infection

Although extra-intestinal non-typhoidal Salmonella infections are common in developing countries, infection of the mesenteric cyst with Salmonella enteritidis is an extremely rare occurrence. Review of the English literature has revealed one report up to this date. The case of a 4-year-old boy with a mesenteric cyst infected with Salmonella enteritidis is presented.     

Ciliated epithelium in a midgut enteric duplication: a case report.

We report the case of a 7-year-old male child with a cystic tumour attached to the caecum close to the ileocaecal valve. The histological examination showed that the cyst had a ciliated epithelial lining, containing serous and mucous glands, with surrounding smooth muscle, inner circular and outer longitudinal layers. The cyst was interpreted as an intestinal duplication lined with respiratory epithelium. This structure and its location, originating from the midgut, is not in accordance with the typical conception of the embryogenesis. The clinical picture and treatment are described and compared to other findings in the literature.     

Craniocervical neurenteric cyst without associated abnormalities

Spinal neurenteric (NE) cyst is an uncommon congenital cyst and frequently found in the cervical region. The clinical symptoms associated with this entity depend on the site of the lesion and are not typical for all such cysts. A definitive diagnosis can only be made by biopsy and histological examination. MRI can confirm these cystic masses and is the method of choice for their imaging investigation. They are often connected by a fibrous tract, fistula or cleft to structures derived from the primitive gut in the thoracic or abdominal cavities and are commonly associated with anterior spina bifida or other vertebral anomalies. We report a case of craniocervical NE cyst without associated abnormalities and discuss the implications for clinical diagnosis and management by a thorough review of the literature.     

Paraurethral cyst: is conservative management always appropriate?

Paraurethral cyst, arising from cystic dilatation of a paraurethral gland in a girl, is rarely reported in infancy. Although the lesion has a reported incidence of between 1 in 2000 and 1 in 7000 live female births, only 41 examples have been reported previously in the English literature. The management of this lesion is controversial. Surgical excision has been advocated, but spontaneous rupture has also been reported. The latter has prompted some authors to recommend non-operative treatment. We report a female infant whose paraurethral cyst failed to resolve despite a 6-month observation period. She eventually required surgery. The management of our case and the experience in the literature is discussed.