Hydatid cyst of the pancreas:Report of an undiagnosed case of pancreatic hydatid cyst and brief literature review

AIM: To overview the literature on pancreatic hydatid cyst(PHC) disease, a disease frequently misdiagnosed during preoperative radiologic investigation.METHODS: PubMed, Medline, Google Scholar, and Google databases were searched to identify articles related to PHC using the following keywords: hydatid cyst, hydatid disease, unusual location of hydatid cyst, hydatid cyst and pancreas, pancreatic hydatid cyst, and pancreatic echinococcosis. The search included let-ters to the editor, case reports, review articles, original articles, meeting presentations and abstracts that had been published between January 2010 and April 2014 without any restrictions on language, journal, or country. All articles identified and retrieved which contained adequate information on the study population(including patient age and sex) and disease and treatment related data(such as cyst size, cyst location, and clinical man-agement) were included in the study; articles with in-sufficient demographic and clinical data were excluded. In addition, we evaluated a case of a 48-year-old fe-male patient with PHC who was treated in our clinic.RESULTS: A total of 58 patients, including our one new case,(age range: 4 to 70 years, mean ± SD: 31.4 ± 15.9 years) were included in the analysis. Twenty-nine of the patients were female, and 29 were male. The information about cyst location was available from studies involving 54 patients and indicated the follow-ing distribution of locations: pancreatic head(n = 21), pancreatic tail(n = 18), pancreatic body and tail(n = 8), pancreatic body(n = 5), pancreatic head and body(n = 1), and pancreatic neck(n = 1). Extra-pancreatic locations of hydatid cysts were reported in the studies involving 44 of the patients. Among these, no other focus than pancreas was detected in 32 of the patients(isolated cases) while 12 of the patients had hydatid cysts in extra-pancreatic sites(liver: n = 6, liver + spleen + peritoneum: n = 2, kidney: n = 1, liver + kidney: n = 1, kidney + peritoneum: n = 1 and liver + lung: n = 1). Serological information was available in the studies involving 40 patients, and 21 of those pa-tients were serologically positive and 15 were serologi-cally negative; the remaining 4 patients underwent no serological testing. Information about pancreatic cyst size was available in the studies involving 42 patients; the smallest cyst diameter reported was 26 mm and the largest cyst diameter reported was 180 mm(mean ± SD: 71.3 ± 36.1 mm). Complications were avail-able in the studies of 16 patients and showed the fol-lowing distribution: cystobiliary fistula(n = 4), cysto-pancreatic fistula(n = 4), pancreatitis(n = 6), and portal hypertension(n = 2). Postoperative follow-up data were available in the studies involving 48 patients and postoperative recurrence data in the studies of 51 patients; no cases of recurrence occurred in any patient for an average follow-up duration of 22.5 ± 23.1(range: 2-120) mo. Only two cases were reported as having died on fourth(our new case) and fifteenth days respectively. CONCLUSION: PHC is a parasitic infestation that is rare but can cause serious pancreato-biliary complica-tions. Its preoperative diagnosis is challenging, as its radiologic findings are often mistaken for other cystic lesions of the pancreas.     

Mediastinal parathyroid cyst. Report of a case and review of the literature

A case of mediastinal parathyroid cyst is presented, including a review of the world literature and a discussion of the etiology, diagnosis, and management.     

Paratesticular dermoid cyst. Report of a case and review of the literature

It is discussed a dermoid cyst case that depends on paratesticular structures, clinical entity which has low frequency of presentation. It is analyzed the controversial terminology of this tumours and are established anatomopathological criteria for this disease.     

Infected urachal cyst in an adult - a case report and review of literature

Infected urachal cysts are a rare clinical manifestation in adults. We present the case of a female patient with an infected urachal cyst, discuss the embryology, clinical presentation, diagnostics and the therapeutic procedure and make a comparison with the literature.     

Hydatid cyst of trapezius muscle: an unusual localisation. Report of a case and review of the literature

The muscular localisation of hydatid cyst is very uncommon. The authors report a recently observed case of hydatid cyst of the trapezius muscle. An 81-year-old man presented with a 9-months history of a slow-growing painless mass in his left shoulder associated with itching. US examination showed a large multiloculated cystic mass, strongly suspicious of a hydatid cyst. At operation, under local anesthesia, complete surgical resection of the cystic mass was performed. The patient tolerated surgery very well. The postoperative course was uneventful and the patient was discharged from hospital on postoperative day 2. No recurrence occurred after 11 months. Muscular hydatidosis is very rare and can cause a variety of diagnostic problems, especially in the absence of typical radiological findings. The possibility of hydatid disease should always be kept in mind in the differential diagnosis of muscular masses, especially in endemic areas.     

Mesothelial cyst of the diaphragm. Report of a case and review of the literature

A case of mesothelial cyst of the right hemidiaphragm in a 44 year old man is reported. Origin (most likely due to a recess of the primary coelomiatic cavity), topographical, histological and therapeutic features are discussed, stressing that it is now more frequently recognised thanks to progress in diagnostic imaging techniques. Complete surgical excision is mandatory to definitely differentiate such lesion from primary diaphragmatic neoplasm, not infrequently malignant.     

Müllerian duct cyst. Report of a case and review of the literature

Stranguria in a 35-year-old man was caused by an orange-sized cyst of the Müllerian duct. The case is reported and the literature is reviewed. The most reliable diagnostic method is cystoscopic tubulation through the prostatic utricle. The simplest form of treatment is subsequent evacuation of the cyst through the tube. Alternatively, marsupialization of the posterior cyst wall at laparotomy is preferable to attempted extirpation, which is always difficult and usually gives rise to complications.     

Congenital tracheo-oesophageal fistula in the adult. Report of a case and review of the literature.

Congenital tracheo-oesophageal fistula without atresia can persist and remain undetected until adulthood. We present such a case and give a review of the literature. Symptoms are commonly present during infancy, but to confirm diagnosis of a fistula is often exceedingly difficult. We visualized the fistula in our case by means of a bronchofibrescope when all the other available tests had failed. The speculations as to how these patients reach adult life have been many, but we consider that we have found an important and hitherto undescribed answer to this question, namely a sphincter mechanism in the fistula.     

重复膀胱2例报告并文献复习

目的：提高对重复膀胱的认识及诊疗水平。方法：回顾性分析2例重复膀胱患者的临床资料。2均为女性,年龄21和27岁。分别以下腹部不适和尿频、尿痛就诊。术前诊断1例为左肾萎缩、左输尿管下段张;另1例为膀胱憩室,并发膀胱结石继发感染。结果：1例术中发现左输尿管下端连接一个肌性囊袋,此囊袋与一个盲管相连,将此囊袋和盲管与左肾和输尿管一并切除,病理检查诊断为重复膀胱尿道,左肾萎缩;另1例中见膀胱被一个肌性中隔分为左右两腔,借中隔中下部孔互相连通,切除的中隔病理检查为膀胱组织。2例均术后8天痊愈出院,随访无异常。结论：重复膀胱罕见,常并发其他器官发育异常。影像学检查可为诊断提供助,手术是唯一能根治的方法。     

Appendiceal torsion in an adult: case report and review of the literature

PURPOSE: Torsion of the appendix is a rare cause of acute abdomen with presentation, treatment, and prognosis virtually identical to that of acute appendicitis. METHODS: We present a case of appendiceal torsion in a 44-year-old male, which is to our knowledge the first in an African-American man, and we review all of the reported adult cases in the English language literature. CONCLUSION: This condition may have occurred when a normal appendix is encountered and no other pathologic findings exist.     

Trichoepithelioma: Report of an unusual case and review of the literature

Trichoepitheliomas are benign and uncommon skin tumors presenting in the head and neck region. Although they can be solitary, they occur more frequently as multiple lesions with an autosomal dominant inheritance. To the surgeon, they often present the problem of clinical differentiation from basal-cell carcinoma. An unusual case is described, and experience in the treatment of 19 patients is reviewed.     

Dermoid cyst in bony pelvis that coexists with pheochromocytoma: Report of a case and review of the literature

A 42-year-old man presented with right lower quadrant abdominal pain and dysuria. The bladder was displaced to the right side of the pelvis in excretory urography. Abdominal CT revealed a mass in right adrenal gland, measuring 8 cm in diameter. There was also a cystic mass; filling left half of the bony pelvis and displacing bladder to the right, measuring 14.5 x 10, 5 x 7 cm. The patient underwent right adrenalectomy and pelvic mass excision. Pathologic examination showed that the adrenal mass was pheochromocytoma and pelvic mass was dermoid cyst. This case is the first one in literature that an intrapelvic dermoid cyst is not derived from an organ coexists with pheochromocytoma.