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Forty-one cases of mesenteric and omental cysts are reported. Histologically, several specific types could be distinguished: lymphangioma, 19 cases; nonpancreatic pseudocyst, 11 cases; enteric duplication cyst, six cases; mesothelial cyst, three cases; and enteric cyst, two cases. A lymphangioma is usually a multiloculated cyst located in the mesentery that shows no discernible wall on computed tomography (CT) and may have characteristics of fat on CT and magnetic resonance imaging. Abnormalities in the small bowel mucosa were frequently noted on barium studies. A nonpancreatic pseudocyst is usually a unilocular or multilocular cyst located in either the mesentery or the omentum, with abundant debris sonographically and an enhancing wall on CT. An enteric duplication cyst is a unilocular cyst with an enhancing wall on CT. Mesothelial and enteric cysts are anechoic, thin-walled cysts. Emphasis is placed on the importance of identifying lymphangioma, which is more difficult to manage than the other forms of mesenteric and omental cysts.

A case of a solitary nonparasitic liver cyst, presenting with intermittent jaundice, is described in a 61-year-old female. Twice during the condition's 19-month course deep jaundice developed, spontaneously subsiding to a state of mild icterus. Diagnosis was suggested by ultrasonography and scintigraphy, whereas retrograde cholangiography and arteriography did not contribute. At laparotomy a single large benign multilocular cyst was partially removed.

Four examples of multilocular cyst of the kidney occurring in adult Chinese women are reported. This uncommon lesion has distinctive sonographic and clinicopathological features. The aetiology and pathogenesis are unknown. The differential diagnosis, pre-operative evaluation, and treatment are discussed.

Sonographic examinations of 17 patients revealed 21 kidneys with anechoic sonolucent areas within the renal sinus. Computerized tomography was obtained in 3 patients and the mass effects were proven to be multilocular parapelvic cysts. These parapelvic cysts simulated renal sinus lipomatosis.

An unusual cystic renal tumour is described which resembles, superficially, the solitary multilocular cyst of the kidney, but which shows appreciable amounts of proliferating undifferentiated renal blastema. We believe that this tumour represents a partially differentiated nephroblastoma and that, as such, it provides support for the theory that Wilms' tumour is capable of undergoing maturation to a fully differentiated, benign cystic lesion.

The authors report on the method for the management of keratocysts which was first described by Voorsmitt in 1981. The method is as follows: the cyst was enucleated and the overlying oral mucosa was totally excised. The bone surface under the cyst wall was cauterized with Carnoy's solution. Three cases of keratocyst were treated by this method and no recurrence was seen during a maximum 16-month follow-up period. Case 1 was a 57-yearold female, with a multilocular cyst located in the right mandibular body. Case 2 was a 38-year-old female, with a monolocular cyst located in the left mental region. Case 3 was a 52-year-old male, with a monolocular cyst extending from the left mandibular molar region to the ascending ramus.This method seems to be beneficial for the management of keratocyst which is multilocular or located in a difficult region such as the ascending ramus.An experimental histological study on the cauterizing effect of Carnoy's solution was done on Japanese white rabbits and demonstrated that the cauterizing effect of Carnoy's solution was adequate when the application was for 3 minutes.

We report one liver cystadenocarcinoma and two cholangiocarcinomas coexisting with developmental liver cysts. The cystadenocarcinoma was a solitary multilocular cyst with histological features similar to those seen in ovarian mucinous cystadenocarcinoma. In contrast, the other two tumours were a mixture of solid adenocarcinoma and multiple non-neoplastic cysts containing serous fluid and lined mainly by atrophic epithelium. In both these cases renal cysts were also present and in one case there was focal malignant change of the epithelium lining the cysts from which the solid adenocarcinoma could have originated. Our observations support the view that cholangiocarcinoma associated with developmental liver cysts is an entity different from liver cystadenocarcinoma.

Intrarenal masses in children are uncommon, with Wilms’ tumor the most prevalent of these. Two cases are presented in which the preoperative evaluation of renal masses was highly suggestive of benign disease, renal abscess, and multilocular cyst. Surgical exploration was performed in both patients, and Wilms’ tumor was found and treated successfully with radical nephrectomy. These two cases emphasize the need for surgical exploration to accurately diagnose intrarenal masses in children even when all diagnostic modalities are suggestive, but not confirmatory, of benign disease.

A case of a multilocular cyst of the kidney, examined preoperatively also by means of CT, is reported.

Two case reports of Saudi patients with primary cardiac hydatid cysts are presented. In the first case, a multilocular cyst was located in the wall of the left ventricle, whereas in the second case a cyst was located in the pericardial sac and another cyst in the left ventricular wall. The diagnosis was based on a history of animal contact, full clinical examination, serological tests and the use of plain radiography, including conventional tomogram, two-dimensional echocardiography, computed tomography and thallium perfusion isotope scan. This study has indicated that non-invasive radiological methods are sufficient to diagnose cardiac echinococcosis and could provide the same information as, or even more than if invasive techniques were used. Further screening of the two patients showed no involvement of other organs by hydatid cysts.

Summary Central mucoepidermoid tumour is an uncommon tumour within the jawbones. The onset is insidious and the first symptom is usually swelling. The radiographic appearance resembles a multilocular cyst or ameloblastoma. Two new cases are presented, and their diagnosis, histopathology and treatment are discussed. The prognosis is fairly good after adequate surgical treatment.

Summary A sequestrated segment of the right lower lobe associated with tuberculosis is described in a girl of 10. The anomalous artery supplied lung which contained a multilocular cyst with no communication with the bronchial tree. The tuberculous lesion lay in lung adjacent to the broncho-pulmonary defect and involved the wall of the cyst at one point.

A case of a unilateral multilocular cyst of the kidney in a 22-month-old child is presented. Multilocular cysts of the kidney are rare, this case being the tenth in the pediatric age group reported in the literature. Multilocular cysts of the kidney are differentiated from multicystic disease, polycystic disease, and simple cyst of the kidney. A set of criteria for categorizing multilocular cysts is reiterated. Some proposed theories of etiology of renal cysts are mentioned. Multilocular cysts of the kidney most commonly present as abdominal masses found on a routine examination and are most often misdiagnosed as Wilm's tumors. Hematuria is seen less frequently. The treatment is nephrectomy or simple resection where the opposite kidney is absent or insufficient.

Three cases of multilocular cyst of the kidney, studied by selective renal angiography, are reported. Angiographic findings in these cases and in 6 others in the literature are reviewed. 1–4 Four of these 9 cases exhibited neovascularity.

A case of multilocular renal cyst histologically consistent with clear cell carcinoma is reported. This case is unusual in that the cyst had features indicative of a developmental malformation superimposed by a neoplasm. The controversy over the pathogenesis of multilocular cystneoplasm versus developmental anomaly-is unsettled. This case illustrates the possiblity that multilocular cysts can be developmental defects which subsequently become the origin of neoplastic transformation of the dysgenetic tissue.

A 69-year-old female was referred to Roswell Park Memorial Institute for management of a right kidney tumor. Her evaluation included excretory urography, ultrasound, computerized axial tomography (CT scan), and selective renal angiography. Fine needle aspiration cytology was felt to be consistent with primary renal cell carcinoma. In spite of the radiological appearance of a benign lesion, a right radical nephrectomy was performed because of the positive cytology on fine needle aspiration. The pathological diagnosis was a solitary multilocular cyst of the kidney.

A case of multilocular cyst of the kidney with calcification is presented and pertinent literature is reviewed. With our present knowledge, a multilocular cyst cannot be clearly differentiated from a malignant renal tumor by preoperative evaluation. Conservative surgery with operative evaluation of the lesion is suggested.

Since the first recorded case of multilocular cyst of the kidney in 1892 there have been more than 65 cases reported in the English literature, including 5 cases of multilocular cyst associated with renal cell carcinoma. At least 2 patients have had cyst removal without nephrectomy. We present the second case of in vivo removal of a multilocular cyst in a solitary kidney and the only such case with an associated renal cell carcinoma.

SUMMARY The pathology, symptoms, diagnosis and treatment of a case of cystic malformation of the seminal vesicle has been described. A further case report is added to the previous literature of the condition.

A case report of cystic adenocarcinoma of the kidney, closely resembling benign multilocular cyst of the kidney radiologically, is presented. The implications of cases such as this regarding the management of multiloculated cystic renal lesions are stressed.

We report on a 7-year-old boy with a multilocular cyst of the left kidney, which was managed by conservative surgery. Multilocular renal cysts in early childhood have been reported previously and have invariably resulted in nephrectomy. The unusual features of this case are described and the importance of diagnostic ultrasound and the potential for conservative surgery are emphasized.

We report 2 cases of multilocular cyst (multilocular cystic nephroma) of the kidney in children who presented with sudden rapid growth of a renal mass.

A case of a multilocular cyst in a child is documented, and a brief review of reported cases of multilocular cysts in pediatric age groups is presented. These cases can be divided into two subgroups based on the presence or absence of embryonic tissue within the cysts. The significance of this embryonic tissue with regard to histogenesis and prognosis of the multilocular cysts is discussed.

Summary We describe a child with a multilocular renal cyst who presented with a renal mass and pain due to haemorrhage into the cyst. This type of presentation has not been reported previously.

A multilocular cyst of the kidney in an adult with malignant papillary adenocarcinomatous transformation is described. The histogenesis and prognosis of multilocular cysts are discussed with special reference to their relationship with Wilms' tumour.

The case of a 17-month-old girl with a multilocular renal cyst is presented. Clinically and radiologically the cyst simulated a Wilm's tumor and was treated by nephrectomy. Simple excision may be equally effective in a few cases provided a correct preoperative diagnosis of the nature and extent of the lesion can be made.

Multilocular renal cyst is an uncommon focal, unilateral, cystic, epithelial lesion of uncertain pathogenesis. Because nephroblastomatous foci have been found on microscopic examination of several of the reported cases, some authors have proposed that multilocular cysts are differentiated and cystic forms of Wilms' tumour. This proposition is analysed and it is concluded that three possibly interrelated lesions may be defined: (1) Wilms' tumours showing cystic differentiation. (2) Lesions macroscopically indistinguishable from multilocular cyst containing variably differentiated nephroblastomatous foci. All such cases have been described in infants. (3) Typical multilocular renal cysts, which have described in children and adults. Review of the literature shows that several cases have been included in the second category solely because of the presence of small intraseptal tubules. Consequent anomalies of interpretation are highlighted and a further case of multilocular cyst in an adult female is reported in which ultrastructural examination, recorded for the first time, confirms the epithelial nature of the cyst lining cells which resemble simplified renal tubular epithelium.

A 2-year-old boy had a Wilms' tumor of the left kidney that appeared during physical examination as an abdominal mass and on gross examination as a multilocular cyst. Multilocular cyst of the kidney is a rare but distinctive congenital lesion. Its true biologic behavior is unknown. Although simple nephrectomy is sufficient for most lesions, more aggressive procedures are recommended for those lesions that contain Wilms' tumor (cystic Wilms' tumor).

Multilocular cyst of the kidney is an uncommon lesion. Approximately 70 cases are reported in the literature, with more than half occurring in children. The etiology and pathogenesis are not known, although the microscopic appearance in certain cases resembles that of Wilms' tumor. Three additional cases are presented and the literature is reviewed.

POST-TRAUMATIC bile cysts of the liver are extremely rare. A search of the literature reveals only 4 cases which have been recorded. 1 The nonparasitic bile cyst could properly be classified as a pseudocyst by comparing it with the pseudocyst of the pancreas, which does not have an epithelial lining. Nonparasitic cysts of the liver, which are not the direct result of trauma, are not so rare. Davis 2 reviewed the literature on nonparasitic cysts in 1937 and gathered 499 cases, of which 241 were classified as cases of cystic disease of the liver with multiple cysts, 187 as cases of solitary unilocular cysts and 20 as cases of solitary and monolocular cysts. The remaining 51 were not classified. Clagett and Hawkins 3 have recently reported the successful removal of a multilocular cyst by extirpation of the entire left lobe of the liver. REPORT OF A CASE A white girl

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An infant with multilocular cyst of the kidney studied angiographically is reported. Selective renal arteriography demonstrated an intrarenal mass lesion with “tumor” vessels, curvilinear blushes, and areas of relative avascularity. Whereas the differentiation of multilocular cyst from Wilms' tumor usually cannot be made from plain films and excretory urography, certain angiographic criteria are illustrated which suggest that it might be possible.

Solitary nonparasitic hepatic cysts are rare. Geist 4 collected 193 cases from the world literature up to 1954. Subsequently, 36 additional articles have appeared, making the total well over 200 cases. Others 1-3,5-9 have presented extensive reviews of the pathogenesis, diagnosis, and natural history, as well as treatment utilized in various forms of hepatic cystic disease. The present case of a solitary multilocular cyst is worthy of report, because the main cavity involved the whole of the left hepatic lobe, as well as the entire superior surface of the right lobe. The extent of involvement presented a difficult therapeutic problem at the time of surgery. In contrast to polycystic disease of the liver, which is commonly associated with cystic changes in other organs and frequently terminates fatally at an early age, solitary cysts often produce little or no disability. Characteristically, symptoms first appear in the fourth or fifth decade, with

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SUMMARY A case is described with a solitary, unilateral, multilocular renal cyst. This rare condition has now been reported eighteen times. Although anatomically a well-defined lesion, the clinical picture may be vague. Haematuria may be severe.