dermoid cysts

皮样囊肿
  • 文章类型: Journal Article
    背景:颅颈交界处的肿瘤样病变在临床表现和影像学上模拟肿瘤。我们的研究集中在三种常见的发育病理-表皮样,皮样和神经囊肿。方法:我们对119例报告中的170例患者进行了回顾性分析和荟萃分析。结果:中性囊肿占主导地位(81.2%)。前囊肿与神经囊肿有关,而后部与皮样/表皮样囊肿相关(p<0.001)。并发症发生率为27.2%,脑神经麻痹是最常见的。大多数患者的预后良好(75.2%),复发率低(12%)。皮样囊肿与异常更相关(p<0.001)。在138例神经囊肿中,15经历了复发,预测因素包括51-60岁和70岁以上,次全切除,并发症,结果较差(p<0.001)。完全切除的囊肿明显不太可能粘附到周围的脑组织(p<0.001)。CSF转流与年龄(p=0.010)和各种并发症(p<0.001)相关。受年龄影响的结果,并且脑积水与不良结局相关(p=0.002).结论:这项荟萃分析强调了全切除术在最小化复发率方面的重要性,并强调了细致的术前计划和影像学检查。我们的结果表明,边缘增强(p=0.047)和不良预后(p=0.007)是与复发相关的重要因素。此外,相关异常,以及患者的年龄和整体健康状况,显著影响手术结局和复发的可能性。
    Background: Tumor-like lesions at the craniovertebral junction mimic tumors in clinical presentation and imaging. Our study focuses on three common developmental pathologies-epidermoids, dermoids and neurenteric cysts. Methods: We conducted a retrospective analysis of a case series and a meta-analysis of 170 patients from 119 reports. Results: Neurenteric cysts predominated (81.2%). Anterior cysts were linked to neurenteric cysts, while posterior ones correlated with dermoid/epidermoid cysts (p < 0.001). Complications occurred in 27.2% of cases, with cranial nerve paresis being the most common. Most patients had excellent outcomes (75.2%) with low recurrence rates (12%). Dermoid cysts were more associated with anomalies (p < 0.001). Among 138 neurenteric cyst cases, 15 experienced recurrence, with predictors including ages 51-60 and over 70, subtotal resection, complications, and poor outcomes (p < 0.001). Cysts with total resection were significantly less likely to adhere to surrounding brain tissue (p < 0.001). CSF diversion was correlated with older age (p = 0.010) and various complications (p < 0.001). Age affected outcomes, and the hydrocephalus was linked to poor outcomes (p = 0.002). Conclusions: This meta-analysis underscores the importance of total resection in minimizing recurrence rates and emphasizes meticulous preoperative planning and imaging. Our results indicate that rim enhancement (p = 0.047) and poor outcome (p = 0.007) are significant factors associated with recurrence. Additionally, associated anomalies, as well as the patient\'s age and overall health, significantly influence the surgical outcomes and the likelihood of recurrence.
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  • 文章类型: Case Reports
    皮样囊肿的恶性转化很少见,鳞状细胞癌(SCC)是最常见的形式。此事件通常发生在大型肿瘤和中年妇女中。
    在这项研究中,提出了两个案例。他们是更年期,腹痛和附件包块是两者的常见表现。在成熟囊性畸胎瘤中出现的腺癌的病例1具有异常的肿瘤标志物,并在手术期间被诊断为冰冻切片。但是SCC转化的病例2具有正常的肿瘤标志物,冷冻切片对第一次手术没有帮助。两人都接受了完整的分期手术,由于病例1的IC1阶段,她接受了化疗,在病例2中,由于IA期,不需要辅助治疗。
    考虑到皮样囊肿恶性转化的稀有性,最佳手术方式和辅助治疗适应症需要进一步研究。
    UNASSIGNED: Malignant transformation in dermoid cysts is rare, and Squamous Cell Carcinoma (SCC) is the most common form. This event often occurs in large tumors and middle-aged women.
    UNASSIGNED: In this study, two cases are presented. They were menopause, and abdominal pain and adnexal mass was a common manifestation in both. Case 1 with adenocarcinoma arising in mature cystic teratoma had abnormal tumor markers and was diagnosed with a frozen section during surgery, but case 2 with SCC transformation had normal tumor markers, and the frozen section was not helpful in the first surgery. Both underwent complete staging surgery, and due to stage IC1 in case 1, she received chemotherapy, and in case 2, no adjuvant treatment was needed because of stage IA.
    UNASSIGNED: Considering the rarity of malignant transformation in the dermoid cyst, the best surgical approach and adjuvant therapy indications need further research.
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  • 文章类型: Case Reports
    本报告的目的是介绍一例伪装成皮样囊肿的眼眶横纹肌肉瘤(RMS)。一名6岁的男孩,在门诊就诊,病史不明显,右眶鼻上区有明显的肿块,在过去的一个月里迅速增长。最可能的诊断是皮样囊肿,患者计划进行手术切除。由于存在支线血管,因此根据病变的出现,术中提出了很高的怀疑指数。组织病理学检查确定肺泡RMS。患者被转诊至儿科肿瘤科并开始静脉化疗。RMS可能伪装成各种条件,包括皮样囊肿和斑疹。在病变迅速增长的情况下,应提高高度怀疑指数。
    The purpose of this report is to present a case of orbital rhabdomyosarcoma (RMS) masquerading as a dermoid cyst. A six-year-old boy with an unremarkable medical history presented in the outpatient department with a palpable mass in the superonasal region of the right orbit, which had rapidly grown in the past month. The most likely diagnosis was dermoid cyst and the patient was scheduled for surgical excision. A high index of suspicion was raised intraoperatively based on the appearance of the lesion due to the presence of a feeder vessel. The histopathology examination identified alveolar RMS. The patient was referred to a pediatric oncology department and commenced intravenous chemotherapy. RMS may masquerade as various conditions, including dermoid cysts and chalazion. A high index of suspicion should be raised in cases with rapidly growing lesions.
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  • 文章类型: Case Reports
    皮样囊肿是儿童最常见的良性眼眶肿瘤之一,通常发生在单侧。轨道上的双侧皮样囊肿很少见。我们在这里报道,一例双侧眶皮样囊肿,一个29个月大的女婴.手术切除后患者预后良好。通过这个案例报告,我们希望增加对这种情况的认识和理解。
    Dermoid cysts are one of the most common benign orbital tumours in children and usually occur unilaterally. Bilateral dermoid cysts in the orbit are rare. We report here, a case of bilateral orbital dermoid cysts, in a 29-month-old baby girl. The patient\'s prognosis was favourable following surgical resection. Through this case report, we hope to increase the recognition and understanding of this condition.
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  • 文章类型: Case Reports
    卵巢病变对放射科医生来说是一种诊断挑战,应根据患者的年龄进行治疗,月经周期,和成像特性。这些病变可能是囊性的,混合,或以固体为主的结构。一般来说,良性病变的发生率以3:1的比例超过恶性病变。然而,在婴儿和青少年年龄组中,这变得罕见,仅占卵巢肿瘤病例的5%左右。该病例报告揭示了一个独特的情况,该情况涉及同时携带2种良性肿瘤的儿科患者:成熟的囊性畸胎瘤和浆液性囊腺瘤。
    Ovarian lesions represent a diagnostic challenge for the radiologist and should be approached according to the patient\'s age, menstrual cycle, and imaging characteristics. These lesions can be cystic, mixed, or solid-predominant structures. Generally, the occurrence of benign lesions surpasses that of malignant ones at a ratio of 3:1. However, within infantile and juvenile age groups, this becomes an infrequent occurrence, making up only about 5% of ovarian tumor cases. This case report sheds light on a unique scenario involving a pediatric patient who harbored 2 benign tumors simultaneously: a mature cystic teratoma and a serous cystadenoma.
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  • 文章类型: Case Reports
    此儿科病例报告描述了并发的精神下和舌状皮样囊肿的新发现,据我们所知,以前在文献中没有报道过。囊肿累及舌头的病因,嘴巴的地板,下颈部是多种多样的,代表先天性,炎症,和肿瘤来源。涉及这些区域的皮样囊肿并不常见,最常见的是在下巴下,舌下,和语言空间。表现出的症状随囊肿的大小和位置而变化。MRI是区分皮样囊肿与其他病因的首选方式。虽然介入技术已被用于治疗其他头颈部的皮样囊肿,对于涉及口腔和口底结构的患者,手术切除仍然是首选治疗方法。
    This pediatric case report describes the novel finding of concurrent submental and lingual dermoid cysts, which to our knowledge, has not been previously reported in the literature. The etiology of cysts involving the tongue, floor of the mouth, and submental neck is varied, representing congenital, inflammatory, and neoplastic sources. Dermoid cysts involving these regions are uncommon and are most frequently reported in the submental, sublingual, and lingual spaces. Presenting symptoms vary with cyst size and position relative to the mylohyoid muscle. MRI is the preferred modality to differentiate dermoid cysts from other etiologies. While interventional techniques have been utilized to treat dermoid cysts in other head and neck locations, surgical excision remains the preferred treatment for those involving oral and floor-of-mouth structures.
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  • 文章类型: Case Reports
    皮样囊肿是皮下肿胀,通常是先天性的,起源于胚胎上皮沿胚胎闭合线的隔离。它们由皮脂腺液的混合物组成,角蛋白,胆固醇晶体,钙,毛囊,汗腺,和皮脂腺.它们作为一种非温柔的物质存在,受到很好的限制,公司的一致性,通常无症状。偶尔,皮样囊肿可以感染并形成脓肿。手术切除仍然是皮样囊肿治疗的关键。皮样囊肿最常见于头部,脸,脖子,和胸腹区域,在包皮(包皮)上非常罕见。我们报道了一名27岁男性出现中线阴茎肿块的病例,很难收回他的包皮,痛苦的性交。进行了基本的血液学和放射学检查以排除其他差异。手术切除了肿胀,组织病理学报告证明它是皮样的。此病例报告强调了在阴茎等罕见解剖位置存在皮样的可能性。
    Dermoid cysts are subcutaneous swellings that are usually congenital and originate from the sequestration of embryonic epithelium along the lines of embryonic closure. They are composed of a mixture of sebaceous fluid, keratin, cholesterol crystals, calcium, hair follicles, sweat glands, and sebaceous glands. They present as a non-tender mass that is well-circumscribed, firm in consistency, and usually asymptomatic. Occasionally, dermoid cysts can get infected and form an abscess. Surgical excision remains the linchpin of treatment for dermoid cysts. Dermoid cysts are most common on the head, face, neck, and thoracoabdominal region and are very rare on the prepuce (foreskin). We report the case of a 27-year-old male who presented with a midline penile mass, difficulty in retracting his prepuce, and painful intercourse. A basic hematological and radiological workup was done to rule out the other differentials. Surgical excision of the swelling was done, and a histopathology report proved it to be dermoid. This case report highlights the possibility of the presence of a dermoid at rare anatomical locations such as the penis.
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  • 文章类型: Journal Article
    目的:皮样囊肿(DCs)是先天性的,慢慢成长,并可能引起神经系统症状。相关文献有限,主要包括病例报告。我们报告了一系列源自中颅窝(MCFF)的DC,并调查了它们的人口统计信息,临床特征,影像学发现,外科手术,和预后结果。
    方法:我们回顾了2012年至2022年在我们中心接受鼻内镜手术(EES)的MCFF引起的DC患者。
    结果:共纳入5例DC患者(男2例,女3例),发病时平均年龄为46.2岁。所有DC均起源于MCFF,其中1例涉及中颅窝骨,另1例影响硬脑膜。1例(20.0%)患者有神经系统受累。入院后,所有患者均接受EES治疗,总切除率为100.0%(5/5).在中位随访73.2个月后,所有患者均实现了临床和放射学的完全改善.在长期随访中没有观察到手术相关的并发症或复发。
    结论:鼻内镜手术被认为是治疗MCFF中DCs的一种安全有效的方法。需要更大的样本量和更长的随访时间。
    OBJECTIVE: Dermoid cysts (DCs) are congenital, slowly growing, and may cause nervous system symptoms. Related literature is limited and mainly includes case reports. We report a case series of DCs originating from the middle cranial fossa floor (MCFF) and investigate their demographic information, clinical characteristics, imaging findings, surgical procedures, and prognostic outcomes.
    METHODS: We reviewed the patients with DCs arising from the MCFF undergoing endoscopic endonasal surgery (EES) in our center between 2012 and 2022.
    RESULTS: A total of 5 patients with DCs were enrolled (2 males and 3 females), with a mean age of 46.2 years at the onset. All DCs originated from the MCFF with 1 case involving the middle cranial fossa bone and another 1 case affecting the dura mater. One (20.0%) patient had neurological involvement. After admission, all patients received EES with a total resection rate of 100.0% (5 of 5). After a median follow-up of 73.2 months, all patients achieved complete clinical and radiological improvements. No surgical-related complications or relapses were observed during the long-term follow-up.
    CONCLUSIONS: Endoscopic endonasal surgery is considered a safe and effective approach for the treatment of DCs in the MCFF. A larger sample size and longer follow-up time are needed.
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  • 文章类型: Journal Article
    目的:皮样囊肿在脊髓肿瘤中并不常见,它们自发破裂进入syrinx腔的现象非常罕见。我们旨在分析影像学特征和病因,并提出了一些手术策略,这种不寻常的现象。
    方法:我们回顾性分析了14例脊髓皮样囊肿破裂进入颈胸椎腔。有6例男性和8例女性,年龄21至46岁,从C1到L3的syrinx腔中有脂滴。皮样囊肿总是位于圆锥处。根据病人的投诉,临床表现,和成像结果,我们在一个阶段或多个阶段采用了肿瘤切除和/或syrinx腔抽吸术。
    结果:3例患者由于有皮样囊肿切除史,仅进行了空洞抽吸手术。一期有8例患者进行了皮样囊肿切除术和注射器腔抽吸术。由于在9个月的随访中出现了新的症状,一名患者分两个阶段进行了手术。两名患者仅接受了肿瘤切除术,因为他们没有表现出由颈胸syrinx引起的类似症状或体征。轴向磁共振成像表明,脂滴总是不在中心,而是偏心的。本组随访期间临床疗效满意。
    结论:脂滴充满脊髓空洞,并不完全局限于中央运河。根据主要投诉和相关标志,我们采取了不同的手术策略,取得了满意的临床效果。
    OBJECTIVE: Dermoid cysts are uncommon in spinal cord tumors, and the phenomenon of their spontaneous rupture into the syrinx cavity is quite rare. We aimed to analyze the imaging characteristics and etiologies, and propose some surgical strategies, for this uncommon phenomenon.
    METHODS: We retrospectively reviewed 14 cases with spinal dermoid cysts that ruptured into the cervical and thoracic syrinx cavity. There were six male and eight female cases, aged 21 to 46 years, who had lipid droplets in the syrinx cavity from C1 to L3. The dermoid cysts were always located at the conus. Based on patients\' complaints, clinical manifestations, and imaging results, we adopted tumor excision and/or syrinx cavity aspiration in one stage or multiple stages.
    RESULTS: Three patients had only a syrinx cavity aspiration surgery due to a history of dermoid cyst excision. Eight patients had dermoid cyst resection and syrinx cavity aspiration in one stage. One patient was operated upon in two stages due to the development of new symptoms at nine months follow-up. Two patients underwent only tumor resection since they did not show similar symptoms or signs caused by the cervicothoracic syrinx. The axial magnetic resonance imaging indicated that the lipid droplets were always not at the center but were eccentric. The clinical effect was satisfactory during the follow-up period in this group.
    CONCLUSIONS: The lipid droplets filled the spinal syrinx cavity, not entirely confined to the central canal. Based on the chief complaints and associated signs, we adopted different surgical strategies and had satisfactory clinical results.
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  • 文章类型: Case Reports
    很少有双侧和复发性畸胎瘤的报道。我们介绍了一名21岁的未产女性的病例,该女性出现在外部机构,抱怨左侧腹部疼痛,并被发现患有双侧卵巢畸胎瘤。医生进行了剖腹手术。五年后,患者出现在我们的设施,抱怨腹痛。影像学检查显示,她接受了双侧腹腔镜膀胱切除术,第二次发生双侧皮样囊肿。患者保持了生育能力,并在2年后分娩了新生儿。31岁时,在定期检查期间,再次发现该患者的双侧皮样囊肿发生率为三分之一,为此她接受了保留卵巢的双侧腹腔镜膀胱切除术。总之,腹腔镜切除皮样囊肿对于保留年轻患者的生育能力至关重要。术后超声定期检查对于筛查复发和防止疼痛表现是必要的。
    Very few cases of bilateral and recurrent teratomas have been reported. We present the case of a 21-year-old nulliparous female who presented to an outside facility complaining of left flank pain and was found to have bilateral ovarian teratomas. The physician proceeded with a laparotomy. Five years later, the patient presented to our facility complaining of abdominal pain. Imaging revealed a second incidence of bilateral dermoid cysts for which she underwent a bilateral laparoscopic cystectomy. The patient retained her fertility and was able to deliver a newborn 2 years later. At the age of 31, and during a regular check-up, the patient was found again to have a third incidence of bilateral dermoid cysts for which she underwent bilateral laparoscopic cystectomy with preservation of her ovaries. In conclusion, laparoscopic removal of dermoid cysts is of utmost importance to retain the fertility of young patients. Regular check-up by ultrasound post-operatively is necessary to screen for recurrences and prevent painful presentations.
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