BACKGROUND: Intracystic hematoma in arachnoid cyst are a very rare pathology that commonly occurs after head trauma, while spontaneous intracystic hematomas in arachnoid cyst associated with subdural hematoma is extremely rare. Currently there are 33 patients of spontaneous intracystic hematomas in arachnoid cyst reported in the literature. In this case report we present an adult patient with concomitant chronic subdural hematoma with intracystic hematoma in arachnoid cyst.
METHODS: A 19-year-old Egyptian Arabian female patient presented to the outpatient clinic complaining of severe headache of 1-month duration that was progressive in nature. Provisionally, it was thought that it might be an arachnoid cyst with associated chronic subdural hematoma along with intracystic hematoma. Decision to proceed with craniotomy and cyst evacuation was made.
CONCLUSIONS: Concomitant intracystic hematoma in arachnoid cyst along with subdural hematoma is a serious condition that might be life-threatening if not well managed.

OBJECTIVE: This systematic review aimed to assess the different treatments of benign maxillo-mandibular radiolucent bone lesions over 4 cm to propose a management algorithm.
METHODS: A literature search was conducted using MEDLINE/PubMed, Scopus, Google Scholar, Virtual Health Library databases, and gray literature. Randomized or non-randomized clinical trials and case series with 10 or more patients with a minimum follow up of 1 year, published in French or English until August 2023, were included. The risk of bias was assessed for all papers included.
RESULTS: Of 1433 records identified, 22 were included in this review, reporting data from 1364 lesions. Ameloblastoma was the most common lesion (51.22%) and mandible was the most common site (81.21%). Initial conservative treatment was prevalent (71.04%). Recurrence was higher after conservative (13.8%) than after radical treatments (6.5%). Multilocularity, cortical perforation, dental element preservation were linked to a higher recurrence risk.
CONCLUSIONS: This study has shown importance of understanding specific characteristics and recurrence risk in benign maxillomandibular osteolytic lesions. Multidisciplinary team approval, personalized approach based on lesion type and patient are crucial. The presence of at least one risk factor could lead to therapeutic decision. Despite limitations, the study informed lesion management and provided precise recommendations.

Retroareolar cysts (RCs) are a benign self-resolving condition primarily affecting pubertal individuals. However, their presentation as asymptomatic bluish areolar lumps remains underreported in the literature, with only six cases previously documented. This lack of awareness may lead to the oversight of RCs during diagnosis. To address this, we conducted a comprehensive literature review using PUBMED, and we further added three more cases. The mean time for clinical resolution was found to be 2.3 years. In light of these findings, we proposed a diagnostic and management algorithm to guide clinicians in their approach to RCs in pediatric patients. The algorithm involves thorough clinical examination, medical history assessment, and echographic investigation with color Doppler analysis. Regular follow-up visits are recommended until resolution of the lesions. Notably, due to the consistently favorable outcome of RCs, aggressive diagnostic interventions can be avoided, providing reassurance to patients and their families. It is crucial for paediatricians to stay updated on this underreported condition to ensure timely recognition and appropriate management. Dermatologists should be the first specialists to be consulted in cases of suspected RCs. Increasing awareness among healthcare professionals will contribute to improved diagnosis and management of this benign condition. In conclusion, RCs are a benign self-resolving condition commonly observed during puberty. Their presentation as asymptomatic bluish areolar lumps may often be overlooked. Through this study, we highlighted the importance of early recognition, proposed a diagnostic and management algorithm, and emphasized the favorable prognosis of RCs, which allows for a conservative approach to their management.

UNASSIGNED: Foreign body reaction to non-absorbable alloplastic orbital implants utilized for bony reconstruction are infrequently documented in the literature. We present the workup and surgical management of a giant cystic mass encapsulating a patient\'s alloplastic orbital implant, which was ultimately deemed to be a result of foreign body reaction.
UNASSIGNED: A 41-year-old male patient with distant history of a right orbital floor fracture had undergone repair with the placement of a nylon foil implant. The patient presented twenty years later with progressive ipsilateral globe proptosis and was found to have a giant inferior orbital cyst. Surgical exploration and removal of the implant and capsule were performed. Histopathology confirmed a delayed foreign body reaction around the patient\'s alloplastic implant.
UNASSIGNED: Alloplastic implants may result foreign body reaction and cyst encapsulation as a delayed complication.

UNASSIGNED: This systematic review aims to determine the best modality for the management of meniscal cysts and its associated meniscus tear; whether the meniscal cyst treated via arthroscopy or open methods and whether meniscal debridement or repair achieves better results.
UNASSIGNED: This systematic review was performed using PRISMA guidelines. A literature search of PubMed, EMBASE and Cochrane was carried out in July 2020 using the search terms \'meniscal cyst\' and \'treatment\'. All clinic studies that included filters for papers in the last 20 years, English language, and meniscal cysts found in humans were included. Studies that contained case reports, were in any language other than English, and with subjects that were not humans were excluded. The methodology quality assessment was performed through the modified Coleman methodology score (CMS).
UNASSIGNED: A total of 166 results were obtained from PubMed, Cochrane library and EMBASE. Of them, 12 duplicates were identified across the databases and removed from consideration. Six papers were found relevant from EMBASE in which 1 was eventually included in this paper. In total, 12 papers were used in this study. The weighted mean age of the patients was 35.1 years, with total of 523 meniscal cysts, of which 488 of these cysts are associated with meniscal tears (93.31%). The studies included performed cystectomies and/or decompression of meniscal cysts while some left the meniscal cyst alone and dealt with the meniscal lesion instead. All clinical scores showed significant improvement following surgical procedures.
UNASSIGNED: Both arthroscopic and open methods can be used for meniscal cysts treatment. Open cystectomy rather than decompression seemed to confer lower risk of cyst recurrences and complications. It is inconclusive to whether meniscal repair or meniscus debridement influenced recurrence and outcome scores. A recommendation for meniscus repair cannot be made due to insufficient high-quality level I or II trials.

Torsion of an epididymal cyst is one of the rare and least-known causes of acute scrotal pain. Epididymal cysts, when large, can undergo occasional complications like infection or, rarely they might undergo torsion, needing emergency surgery. We present a case of a 37-year-old gentleman with acute scrotal pain to the scrotum. Testicular torsion was suspected clinically, but sonography revealed a normal-appearing testis and a large left-sided epididymal cyst with internal echoes and dependent debris. A diagnosis of epididymal cyst torsion was suspected based on sonographic findings. Exploratory surgery showed a reddish, inflamed epididymal cyst that had undergone torsion on its pedicle. The cyst was excised leading to symptomatic relief to the patient. Due to the rarity of this condition, such cases are often misdiagnosed clinically as testicular torsion. Ultrasonography helps in aiding the correct diagnosis and the radiologist needs to be familiar with the radiological aspects of diagnosing torsion of epididymal cysts.

Paradental cyst (PC) is an uncommon type of odontogenic cyst of inflammatory origin, which develops near the cervical margin of the outside of the root of a vital tooth. The category of paradental cyst includes the buccal bifurcation cyst, which is found in the buccal area adjacent to the mandibular first or second molars in children. A conclusive diagnosis of a PC needs to correlate the surgical, radiographic, and histologic findings. When strict diagnosis is neglected, they can be easily misdiagnosed and mistreated. PCs associated with mandibular first and second molars and those associated with the mandibular third molar may have slightly different clinical manifestations but have almost completely different treatment principles due to the distinction in location. For the third molars, removal of both the tooth and the cyst is preferred. However, when the first or second molars are affected, it may be advisable to perform enucleation of the lesion while preserving the associated tooth. There are also more conservative methods to retain vital permanent teeth within the mandibular arch. Additionally, the cyst wall primarily consisted of granulation tissue firmly attached to the periodontal ligament space. The exact origin of these cysts was a subject of ongoing debate, but they were believed to primarily arise from either the reduced enamel epithelium or the inflammatory proliferation of junctional/sulcular epithelium, which originate from the superficial mucosa during tooth eruption. The aim of the present review was to update information on clinical manifestations, diagnosis and treatment strategies of cysts and discuss their pathogenic mechanisms. Raising familiarity with the distinctive features is beneficial for accurately diagnosing these lesions and effectively caring for the patients.

BACKGROUND: Many cutaneous lesions are clinically suspected as \"cyst\"; however, following histopathological examination, are found to be more significant lesions. Here, we examine the frequency and features of malignancies with cutaneous cysts in the clinical differential.
METHODS: A retrospective study of surgical pathology specimens at the James A. Haley Veterans\' Hospital from January 2018 to December 2022 was conducted. Cutaneous specimens containing the clinical diagnosis of \"cyst\" were included. The clinicopathological features were summarized.
RESULTS: Premalignant or malignant neoplasms accounted for 4.5% of all specimens submitted with cysts in the clinical differential. Most cyst-mimicking cancers were basal cell carcinoma (BCC) or squamous cell carcinoma (SCC); however, cancers with poorer prognoses, such as Merkel cell carcinoma and melanoma, also clinically masqueraded as cysts. The BCCs were predominately nodular, and the SCCs were largely well-differentiated and invasive. Many exhibited clinical signs and symptoms compatible with benign cysts, such as central punctum, pain, and rapid growth. Identified risk factors included history of prior non-melanoma skin cancer diagnosis, previous excision, and immunosuppression.
CONCLUSIONS: Many lesions clinically concerning cutaneous cysts were found to be malignancies following histopathological review. Accordingly, following biopsy all cyst-like lesions should be examined microscopically, especially in certain clinical contexts in which the incidence of skin cancer is increased.

UNASSIGNED: Mediastinal lesions are uncommon. However, because of the vital structures in the mediastinum, large lesions specifically can lead to life-threatening situations. Treatment and management vary considerably with the disease. Therefore, the correct histopathologic diagnosis is important. Here we review lesions that have the potential to present as a giant lesion in the mediastinum. While we focus on the review of histopathologic, immunohistochemical (IHC), and molecular features of these lesions, clinical symptoms and characteristics and prognosis will also be discussed.
UNASSIGNED: \"Giant\" was arbitrarily defined as a size of at least 10 cm in greatest dimension. The 2021 World Health Organization (WHO) classification of mediastinal tumors was searched for tumors reported to be larger than 10 cm. Tumors that can present as giant mediastinal lesions based on our own experience were also included. PubMed search was then performed for these lesions.
UNASSIGNED: A great variety of mediastinal lesions can present as giant mass. Those include for instance tumors of blood and lymph vessels, tumors of neurogenic origin, mesenchymal neoplasms, thymic epithelial tumors (TETs), and non-neoplastic cysts. Lesions range from benign to malignant. This review focuses on the most common lesions.
UNASSIGNED: Many benign and malignant lesions can become a large mass in the mediastinum. Their correct diagnosis is important for the treatment and management of the patient.

UNASSIGNED: Posterior interosseous nerve syndrome secondary to compression by a synovial cyst at the elbow is a rare and often unrecognized pathology. Early management relies on complete neurolysis to achieve satisfactory functional recovery. Increasing awareness among the orthopedics will help in the early diagnosis of the disease and in the initiation of early and proper treatment.
METHODS: In this article, we report the case of a 32-year-old patient with posterior interosseous nerve syndrome secondary to compression by a synovial cyst of the elbow. Surgical management combined with post-operative rehabilitation resulted in indolence with good functional recovery.
UNASSIGNED: Posterior interosseous nerve syndrome secondary to compression by a synovial cyst at the elbow is a rare entity. Anatomically, the deep branch of the radial nerve or posterior interosseous nerve passes through the Fröhse\'s arch or arch of the supinator muscle at the elbow, then travels between the two heads of this muscle. Several anatomical structures may compress the NIOP. Clinically, it presents as paralysis or paresis of the extensor muscles of the fingers and the abductor muscle of the thumb. Limitation of the ulnar extensor carpi may be responsible for radial deviation of the carpus in some cases. MRI is the radiological examination of choice. Electromyography plays a contributory role in diagnosis prior to surgical exploration. Surgical excision is the treatment of choice. It may be combined with radial neurolysis for better recovery. Progression after surgical treatment is generally favourable.
CONCLUSIONS: Ignorance of posterior interosseous nerve palsy syndrome frequently leads to misdiagnosis. Early management relies on complete neurolysis to achieve satisfactory functional recovery.