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Background: Arachnoid cysts (AC) are associated with a risk of rupture or haemorrhage following head impact and pose a potential predisposing factor for significant complications of sport-related concussion. Despite a recognised association between ACs and intracranial haemorrhage/cyst rupture, the risk profile of participating in contact sports with AC is not well defined. We report a retrospective case series of players presenting to the Birmingham Sports Concussion Clinic between 2017 and 2023 and underwent MRI head, with a comprehensive review of the prior literature. Results: 432 athletes underwent MRI of which 11 were identified to have AC (middle fossa n = 8; posterior fossa n = 2, intraventricular n = 1). Average maximal diameter was 4.1 ± 1.2 cm. 64% had a protracted recovery (≥ 3 months). 9% experienced an AC specific complication (cyst rupture, complete neurological recovery, maximal diameter 6.5 cm, Galassi II, 4 previous concussions). 91% of patients (mean maximal diameter 3.9 ± 1.0 cm) experienced no complications despite multiple previous accumulated sports-related concussions (mean 3.3, range 1–9). Case studies from the literature are summarised (n = 63), with 98% reporting complications, none of which resulted in adverse or unfavourable neurological outcomes. Across prospective and retrospective cohort studies, 1.5% had a structural injury, and (where outcome was reported) all had a favourable outcome. Conclusions: AC is an incidental finding in athletes, with the majority in our cohort having sustained serial concussions without AC complication. The single complication within this cohort occurred in the largest AC, and AC size is proposed as a tentative factor associated with increased risk of contact sports participation. Complications of AC appear to be a rare occurrence. This case series and review has not identified evidence to suggest that participation in sports with AC is of significant risk, though individualised assessment and discussion of the potential risks of contact sports participation should be offered. Key Points: Incidental arachnoid cysts were found to occur in 2.5% of athletes presenting after sports-related concussion. Of 11 athletes with AC and a history of concussion, one (9%) had experienced a prior complication of AC (cyst rupture) and made a full recovery. A comprehensive review of the prior literature suggests an overall risk of complications of 1.5%, with all reported outcomes from cases describing a full neurological recovery. Overall, complications of AC in athletes after sport-related concussion appear to be rare, with no recorded cases of significant neurological consequences. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the ability of the Assessment of Different NEoplasias in the adneXa (ADNEX) model and the International Ovarian Tumour Analysis (IOTA) two‐step strategy to predict malignancy in adnexal masses detected in an outpatient low‐risk setting, and to estimate the risk of complications in masses with benign ultrasound morphology managed using clinical and ultrasound follow‐up. Methods: This single‐center study was performed at Hospital Universitari Dexeus, Barcelona, Spain, using interim data from the ongoing prospective observational IOTA Phase‐5 (IOTA5) study. The primary aim of the IOTA5 study is to describe the cumulative incidence of complications during follow‐up of adnexal masses classified as benign on ultrasound examination. Consecutive patients with an adnexal mass detected between June 2012 and September 2016 in a private center offering screening for gynecological cancer were included and followed up until February 2020. Tumors were classified as benign or malignant based on histology (if patients underwent surgery) or the outcome of clinical and ultrasound follow‐up at 12 (range, 10–14) months. Multiple imputation was used when outcomes were uncertain. The ability of the ADNEX model without CA125 and of the IOTA two‐step strategy to distinguish benign from malignant masses was evaluated retrospectively using the prospectively collected data. We assessed performance with regard to discrimination (area under the receiver‐operating‐characteristics curve (AUC)), calibration, classification (sensitivity and specificity) and clinical utility (Net Benefit). In the group of patients with a mass judged to be benign who were selected for conservative management, we evaluated the occurrence of spontaneous resolution or any mass complication during the first 5 years of follow‐up by assessing the cumulative incidence of malignancy, torsion, cyst rupture and minor mass complications (inflammation, infection or adhesions) and the time to occurrence of an event. Results: A total of 2654 patients were recruited to the study. After application of exclusion criteria, 2039 patients with a newly detected mass were included for the model validation. Of those, 1684 (83%) masses were benign, 49 (2%) masses were malignant and, for 306 (15%) masses, the outcome was uncertain and therefore imputed. The AUC was 0.95 (95% CI, 0.89–0.98) for ADNEX without CA125 and 0.94 (95% CI, 0.88–0.97) for the two‐step strategy. Calibration performance could not be meaningfully interpreted because the small number of malignancies resulted in very wide confidence intervals. The two‐step strategy had better clinical utility than did the ADNEX model at malignancy risk thresholds < 3%. There were 1472 (72%) patients whose mass was judged to be benign based on pattern recognition by an experienced ultrasound examiner and were managed with clinical and ultrasound follow‐up. In this group, the 5‐year cumulative incidence was 66% (95% CI, 63–69%) for spontaneous resolution of the mass, 0% (95% CI, 0–0.2%) for torsion, 0.1% (95% CI, < 0.1–0.4%) for cyst rupture, 0.2% (95% CI, 0.1–0.6%) for a borderline tumor and 0.2% (95% CI, 0.1–0.6%) for invasive malignancy. Conclusions: The ADNEX model and IOTA two‐step strategy performed well to distinguish benign from malignant adnexal masses detected in a low‐risk population. Conservative management is safe for masses with a benign ultrasound appearance in this population. © 2024 International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Background: Hydatid disease, also known as echinococcosis, is a zoonotic parasitic infection caused by the larvae of the Echinococcus tapeworm. It is endemic in various regions worldwide, particularly in rural areas of countries in southern South America, Central Asia, China, parts of Africa, the Mediterranean, and parts of the Middle East. The disease primarily affects the liver (60–70% of cases) and the lungs (10–25% of cases), but it can involve any organ, including the brain, bones, and rarely the pelvic region, as seen in our case report. Hydatid disease typically follows an asymptomatic course in the early stages of the primary infection and may remain so potentially for years or even permanently. If symptoms occur, they depend on various factors, such as the number, size, and location among other factors. Typically, hydatid disease presents with nonspecific symptoms. Common symptoms include abdominal pain, hepatomegaly, as well as anaphylaxis in case of cyst rupture. Extrahepatic intra-abdominal isolated hydatic cyst is a rare finding (6–11%). Case presentation: In our case, a 70 year-old Asian white male presented with right thigh pain radiating to the lower leg, which is an atypical presentation for an extrahepatic intraabdominal hydatid cyst. Primary intraabdominal hydatid cysts involving the pelvic region are relatively rare, and such cases pose diagnostic and management challenges. Conclusion: This case report underscores the challenges in diagnosing and managing extrahepatic intraabdominal hydatid cysts, particularly in atypical presentations. A combination of clinical evaluation, serological studies, and imaging techniques facilitates accurate diagnosis. [ABSTRACT FROM AUTHOR]

Tumor markers such as carbohydrate antigen 19-9 (CA19-9) are generally useful in ruling out malignancy of hepatic cysts. The patient was a 72-year-old man who had a ruptured liver cyst in the right liver, which had been noted since he was 67 years old at another hospital. The initial laboratory tests demonstrated elevated CA19-9 (193 784.3 U/mL). We made the diagnosis with a simple ruptured liver cyst from magnetic resonance imaging and cytological examination of ascites, and laparoscopic fenestration with drainage of the abdominal fluid was performed. Pathological diagnosis of the resected wall cyst was non-parasitic simple hepatic cyst with acute inflammation and hemorrhage. The patient's serum levels of CA19-9 were 164.0 U/mL on postoperative day 23. The follow-up abdominal computed tomography scan performed 2 months later did not any finding of tumor. [ABSTRACT FROM AUTHOR]

Epidermoid cyst of the spleen is a rare disease, and relatively few cases were reported by literatures. Most published case reports provided inadequate information on the impact of splenic epidermoid cyst on tumor markers. A 32-year-old woman with a giant splenic epidermoid cyst was reported, for whom the serum concentration of a collection of tumor markers (CA19-9, CEA, CA125, CA242, and CA50) increased abruptly accompanied by left upper abdominal pain for 5 days. After comprehensive preoperative examination and multidisciplinary team discussion, we ruled out any concurrent malignancy and a laparoscopic total splenectomy was performed, during which the splenic cyst spontaneously ruptured unexpectedly. After surgery, the elevated serum tumor marker levels decreased sharply until reaching normal range 3 months later. Learning from the case, we conclude that interval monitoring of serum tumor markers is of critical value for patients with splenic epidermoid cyst. Abrupt elevation of tumor marker levels and abdominal pain may serve as signs of cyst rupture, which is strongly indicative of surgical intervention as soon as possible. Total removal of the splenic cyst is strongly suggested considering the recurrence and malignant potential of the splenic epidermoid cyst. [ABSTRACT FROM AUTHOR]

Abstract Background Arachnoid cysts (AC) are associated with a risk of rupture or haemorrhage following head impact and pose a potential predisposing factor for significant complications of sport-related concussion. Despite a recognised association between ACs and intracranial haemorrhage/cyst rupture, the risk profile of participating in contact sports with AC is not well defined. We report a retrospective case series of players presenting to the Birmingham Sports Concussion Clinic between 2017 and 2023 and underwent MRI head, with a comprehensive review of the prior literature. Results 432 athletes underwent MRI of which 11 were identified to have AC (middle fossa n = 8; posterior fossa n = 2, intraventricular n = 1). Average maximal diameter was 4.1 ± 1.2 cm. 64% had a protracted recovery (≥ 3 months). 9% experienced an AC specific complication (cyst rupture, complete neurological recovery, maximal diameter 6.5 cm, Galassi II, 4 previous concussions). 91% of patients (mean maximal diameter 3.9 ± 1.0 cm) experienced no complications despite multiple previous accumulated sports-related concussions (mean 3.3, range 1–9). Case studies from the literature are summarised (n = 63), with 98% reporting complications, none of which resulted in adverse or unfavourable neurological outcomes. Across prospective and retrospective cohort studies, 1.5% had a structural injury, and (where outcome was reported) all had a favourable outcome. Conclusions AC is an incidental finding in athletes, with the majority in our cohort having sustained serial concussions without AC complication. The single complication within this cohort occurred in the largest AC, and AC size is proposed as a tentative factor associated with increased risk of contact sports participation. Complications of AC appear to be a rare occurrence. This case series and review has not identified evidence to suggest that participation in sports with AC is of significant risk, though individualised assessment and discussion of the potential risks of contact sports participation should be offered.

Background: In recent years, with the continuous expansion of the application scope of Tranexamic acid (TXA), its usage has surged. Despite numerous studies demonstrating its powerful efficacy, concerns regarding its adverse reactions persist, necessitating comprehensive safety assessment. This study analyzed realworld data from the U.S. Food and Drug Administration to investigate TXA-related adverse events, aiming to elucidate its safety and optimize patient treatment. Methods: The adverse drug event data concerning TXA from 2004 Q1 to 2023 Q3 were collected. Following data standardization, a variety of signal quantification techniques, including the reporting odds ratios, proportional reporting ratios, Bayesian confidence propagation neural network, and empirical Bayes geometric mean were used for analysis. Results: After analyzing 16,692,026 adverse event reports, a total of 1,574 cases of adverse events related to TXA were identified, spanning 23 system organ classes and 307 preferred terms. In addition to the common thrombosis-related Vascular disorders (n = 386) and Cardiac disorders (n = 377), adverse reactions in the Nervous system disorders category were also observed (n = 785), including Myoclonus (n = 70), Status epilepticus (n = 43), and Myoclonic epilepsy (n = 17). Furthermore, this study uncovered adverse effects such as Renal cortical necrosis, Hepatic cyst rupture, and Vascular stent stenosis, which were not previously mentioned in the instructions. Although these occurred infrequently, they exhibited high signal strength. Both Retinal artery occlusion and Vascular stent thrombosis disorder were frequent and exhibited high signal strength as well. It is worth noting that 78 cases of adverse reactions were caused by confusion between incorrect product administration. Conclusion: Our research suggests that TXA has some adverse reactions that are being overlooked. As a cornerstone medication in hemorrhage treatment, it's crucial to monitor, identify, and address these adverse reactions effectively. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate success rates of computed tomography (CT)-guided lumbar facet synovial cyst (LFC) rupture. Materials and methods: We retrospectively reviewed all LFC ruptures performed by a single musculoskeletal radiologist with > 10 years of experience, using posterior facet approach and/or direct puncture by ipsilateral/contralateral interlaminar, or transforaminal approach. All patients also received a corticosteroid injection. Rupture rates were calculated, and clinical success rate was determined through medical record review. Pre-procedure magnetic resonance imaging (MRI) images and CT procedure images were also reviewed for LFC and facet joint imaging features that may predict rupture. Results: There were 37 patients, 17 (46%) female and 20 (54%) male, ages 62 ± 12 (range 39–87) years. Thirty-four (92%) of LFC were successfully ruptured, 17 (50%) by facet approach and 17 (50%) by direct cyst puncture. At least one direct puncture approach was possible in 35 (95%) patients. No MRI or CT LFC or facet joint features predicted cyst rupture. Thirty-one (91%) of patients reported immediate pain relief, and 19 (53%) did not have further intervention for LFC-related pain. Sixteen (84%) of these patients remained pain-free for an average follow-up time period of 28 months. Fourteen (39%) of patients required surgical intervention. There were no complications. Conclusion: Our systematic approach to CT-guided LFC rupture is safe and has high technical and clinical success rates similar to prior studies. Since there are no definitive imaging features that determine rupture success, this procedure can almost always be attempted as a first-line treatment for LFC. [ABSTRACT FROM AUTHOR]

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Human cystic echinococcosis (CE) is a parasitic infection caused by the larval stage of the tapeworm Echinococcus granulosus sensu lato, primarily affecting the liver and lungs. Although the heart is affected in only 0.02–2% of all CE cases, a considerable number of cases have been, and continue to be, published. However, due to the rare occurrence of cardiac CE and the resulting lack of clinical trials, knowledge about various aspects of the disease remains limited. To obtain a clearer picture of anatomical, clinical, diagnostic as well as therapeutic aspects of cardiac CE, we systematically reviewed the literature published between 1965 and 2022. The anatomical pattern of the affected cardiac structures follows the extension of the supplying capillary bed. The majority of patients (82.7%) are symptomatic and present with prolonged non-specific symptoms such as dyspnoea, chest pain and palpitations. Acute complications generally derive from cyst rupture, occur in 18.3% of cases and manifest as embolism, pericardial tamponade, or anaphylactic reaction in 83.2%, 17.8% and 10.9% of these cases, respectively. As for CE cysts localized in other organs, the diagnosis of cardiac CE is made by imaging. Serology plays a minor role due to its limited sensitivity. Unlike abdominal CE cysts, cardiac CE cysts are usually resected independent of their stage (active/inactive), because their presence impairs cardiac performance and carries the risk of long-term sequelae. More than 80% of patients are treated with a single surgical intervention. We found a disease-related case fatality rate of 11.1%. Since local recurrence was reported up to 108 months and secondary CE up to 72 months after surgery, patients should be followed up for a minimum of 10 years. Author summary: Human cystic echinococcosis (CE) is a parasitic infection caused by the larva of the dog tapeworm Echinococcus granulosus, which primarily affects the liver and lungs. Although the heart is rarely affected (≤2% of cases), a considerable number of case reports continue to be published. While the diagnostic and clinical management of cardiac CE has greatly benefited from the increasingly widespread availability of diagnostic imaging techniques as well as from advances in heart surgery, the overall picture of cardiac CE remains patchy and several aspects remain poorly understood. To overcome this, we systematically reviewed the last five decades of published literature on cardiac CE, and analyzed and summarized the existing data. [ABSTRACT FROM AUTHOR]

Patient: Female, 33-year-old Diagnosis: Hydatid cyst Symptoms: Abdomenal pain Procedure: CT abdomen and pelvis Specialty: Surgery Objective: Unusual clinical course Background: Hydatid disease is a common parasitic infection in many areas of Asia, South America, and Africa. It can affect any organ, most commonly the liver. The hydatid is often asymptomatic and the diagnosis is made when complications arise. The most common complication of this disease is opening in the bile ducts, which is a lifethreatening condition causing serious acute cholangitis. We report a case of acute cholangitis caused by hydatid cyst rupture into the right bile duct. Report: A 33-year-old woman, with no medical or surgical history, presented to our Emergency Department with abdominal pain, jaundice, and fever for 3 days prior to admission. The patient was hemodynamically stable. In the examination, we noticed right upper-quadrant tenderness with guarding, icterus sclera, and negative Murphy sign. A CT scan showed a liver hydatid cyst of the 4th and 8th of segments, with intrahepatic and extrahepatic biliary duct dilation. The cyst communicated with the right hepatic bile duct via a large fistula. A diagnosis of acute cholangitis was made and she underwent conservative treatment with external drainage of the pericystic cavity through the biliary duct. The postoperative course was uncomplicated and she was discharged 15 days later. Conclusions: The surgical approach to hepatic hydatid must be customized based on the specific characteristics of the cyst and associated complications. Acute hydatid cholangitis is a rare but serious complication of a hydatid cyst, which requires early diagnosis and adequate surgical management. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the clinicopathological characteristics and surgical outcomes of patients with Wolfring gland ductal cysts (WGDCs). Methods: A retrospective, consecutive, interventional comparative case series was performed over a period of 7 years. Data on demographic and clinical characteristics, pathological findings and outcomes of surgically excised cysts were collected. A comparison between the transconjunctival and transcutaneous approaches was also assessed. Results: Forty-eight patients (48 eyelids) were included in the final analysis. The most common presenting symptom was painless eyelid swelling (81.3%). The median symptom duration was 11.5 months (IQR, 18.25). The upper eyelid was involved in 31 (64.6%) patients, 29/31 of whom had cysts in a medial or centromedial location. Forty-five (93.8%) cysts were bluish gray and transilluminable with clear contents on lid eversion and a median largest dimension of 22 mm (IQR, 8). A transverse conjunctival fibrotic band was observed along the proximal tarsal border in the cyst area in all patients. Signs of chronic trachoma were noted in 38 (79.2%) patients. Preoperative significant ptosis was present in 28/31 (90.3%) of the upper eyelid cysts. Thirty cysts (62.5%) were excised through the skin, and 18 cysts (37.5%) were excised transconjunctivally. Intraoperative cyst rupture, the need for conjunctival grafting and postoperative residual upper lid ptosis were significantly greater in the transconjunctival group (p = 0.009, p < 0.001, and p = 0.016, respectively). Conclusion: The present study highlights the clinicopathological characteristics of a relatively large series of surgically excised WGDCs. Transcutaneous excision of WGDCs has proven to be an effective treatment with fewer adverse sequelae than the transconjunctival approach. [ABSTRACT FROM AUTHOR]

Racemose neurocysticercosis (RNC) is a malignant form of Taenia solium infection. It carries high mortality due to widespread intraparenchymal invasion, mass effect, and cyst rupture. Cerebellar RNC is unusual and constitutes a surgical challenge. Scarce applications of ultrasound (US) -guided resection have been reported for RNC of the posterior fossa. We report the case of a 66-year-old woman who presented with ataxia and dysmetria. Her past medical history was relevant for seizures and hydrocephalus secondary to neurocysticercosis. Because of the increasing cyst invasion and threatening mass effect in the posterior fossa, the patient underwent US-guided resection of lesions. Postoperative computed tomography (CT) demonstrated complete excision of cysts, and a 2-year follow-up magnetic resonance imaging (MRI) showed no recurrence. On neurological examination, the patient had persistent ataxia without new-onset neurological deficits. The present case study illustrates the feasibility and cost-effective approach of US-guided resection to provide enhanced operative visualization and achieve complete cyst resection. [ABSTRACT FROM AUTHOR]

Introduction: Renal artery aneurysm rupture is a rare but morbid diagnosis, often requiring emergency surgery and nephrectomy. Clinical presentation can mimic more common pathology in non-pregnant women such as ruptured ovarian cyst. Case Report: We present a case of a woman with a prior history of ovarian cyst presenting with a ruptured renal artery aneurysm. Prompt computed tomography (CT) imaging revealed a left renal artery aneurysm rupture with hemoperitoneum and renal infarct. She underwent emergency laparotomy and nephrectomy and was ultimately discharged in good condition. Conclusion: While ovarian cyst rupture is the most common cause of spontaneous hemoperitoneum in non-pregnant women of childbearing age, renal artery aneurysm rupture should be considered and prompt CT imaging obtained, particularly in cases of hemodynamic instability, to ensure prompt treatment. [ABSTRACT FROM AUTHOR]

A choledochal cyst is a rare condition that requires surgical treatment to prevent complications, such as obstructive jaundice, cyst rupture, cholangitis, and the risk of malignancy. Complete cyst excision is considered the best option, as it reduces the risk of inflammation and the development of cholangiocarcinoma. Therefore, cholecystectomy and complete cyst resection followed by reconstruction with a Roux-en-Y hepaticojejunostomy is the treatment of choice. We present a case (with video) that shows the complete resection of a type I choledochal cyst with Roux-en-Y reconstruction of two separate ducts since the right posterior duct reached the cyst independently. The laparoscopic approach offers all the advantages of mini-invasive surgery and better visualization of the structures; however, biliary reconstruction to fine ducts implies a surgical challenge that requires high training in mini-invasive surgery. [ABSTRACT FROM AUTHOR]

Background: Co-infection with other microorganisms such as parasites in patients with COVID-19 can affect the clinical outcome and require prompt diagnosis and appropriate therapy. Case Presentation: We present a case of an adult male with chest pain, dyspnea, cough, diplopia, and anorexia who was confirmed to have acute COVID-19 pneumonia. 2 weeks prior to admission, a hydatid lung cyst was identified on examination, but the patient refused surgery. Thoracoabdominal computed tomography (CT) revealed a rupture of the lung hydatid cyst and co-infection with COVID-19. The patient has prescribed a treatment protocol for COVID-19 and albendazole. Despite measures taken to manage severe inflammation and decreasing blood oxygen levels, the patient required admission to the intensive care unit (ICU) and intubation. After approximately 3 weeks of hospitalization, the patient was successfully extubated and discharged uneventfully from the hospital. Oral albendazole was prescribed for follow-up treatment. Conclusion: Our case highlights the importance of considering hydatid cysts in the differential diagnosis of patients with COVID-19, especially those living in endemic areas. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Hydatid cysts, primarily found in the liver (70%), are caused by parasitic infections and can lead to severe complications such as cyst rupture. This case report describes a unique instance of a hydatid liver cyst occupying the right lobe with a communicating part with the biliary tree that ruptured showing a concurrent superinfection. Hydatid cysts are a clinical pathology resulting from parasitic infections. They may occur in different organs of the body. However, these are mostly found in the liver (70%). This can cause significant complications including cyst rupture. Several case reports have described various hydatid cyst ruptures; however, only a few have reported an intra‐biliary hydatid cyst rupture. A 24‐year‐old male patient presented with right upper quadrant pain, jaundice, dark urine, and pale stool. Imaging studies, including Magnetic resonance cholangiopancreatography (MRCP) and computed tomography (CT), revealed a beavertail liver, cystobiliary communication and intrahepatic biliary tree‐ruptured hydatid cysts. The cyst was in the right liver lobe, which is the most common site for hydatid cysts. Surgical intervention involving laparoscopic de‐roofing and cyst removal resulted in a smooth recovery without complications. Several case reports have described various hydatid cyst ruptures; however, only a few have reported originally placed intra‐biliary hydatid cyst ruptures. This case report describes a unique instance of a hydatid liver cyst occupying the right lobe with a communicating part with the biliary tree that ruptured showing a concurrent superinfection. [ABSTRACT FROM AUTHOR]

Hydatid cyst, a common ailment affecting both humans and animals, has the potential to develop in various anatomical locations, with the lungs and liver being the primary sites where this happens. Individuals in endemic regions, particularly those involved in livestock farming, face an increased risk of exposure to this parasitic disease. The cysts can concurrently manifest in multiple areas of the body, highlighting the intricate nature of their presentation. Despite often being asymptomatic, early detection of hydatid cysts is crucial for effective intervention. Diagnostic tools such as ultrasound, CT scans, and serological tests play a pivotal role in identifying these cysts, even without overt symptoms. The insidious progression of hydatid cysts allows them to persist asymptomatically over prolonged periods, posing a latent threat. However, the rupture of these cysts, whether spontaneous or triggered by external factors, can result in severe consequences, potentially leading to fatality. This study reports a compelling case involving a 41-year-old woman investigating the causes of infertility. Through comprehensive examinations, multiple hydatid cysts were serendipitously discovered in her liver, spleen, and kidneys. This case underscores the diverse anatomical locations these cysts can occupy and emphasizes the significance of vigilant diagnostic approaches, even in individuals initially presenting with unrelated concerns such as infertility. Diagnostic findings including elevated levels of specific biomarkers and radiological assessments provided detailed visualization of the cystic lesions, aiding in the formulation of a treatment strategy. The therapeutic regimen comprised albendazole therapy and surgical intervention, resulting in promising progress and enhanced overall well-being for the patient while supporting the patient after surgery. [ABSTRACT FROM AUTHOR]

Toxoplasma gondii is an obligate intracellular parasite existing in three infectious life stages—tachyzoites, bradyzoites, and sporozoites. Rupture of tissue cysts and re-conversion of bradyzoites to tachyzoites leads to reactivated toxoplasmosis (RT) in an immunocompromised host. The aim of this study was to apply ImageJ software for analysis of T. gondii brain cysts obtained from a newly established in vivo model of RT. Mice chronically infected with T. gondii (BGD1 and BGD26 strains) were treated with cyclophosphamide and hydrocortisone (experimental group—EG) or left untreated as infection controls (ICs). RT in mice was confirmed by qPCR (PCR+); mice remaining chronically infected were PCR−. A total of 90 images of cysts were analyzed for fractal dimension (FD), lacunarity (L), diameter (D), circularity (C), and packing density (PD). Circularity was significantly higher in PCR+ compared to IC mice (p < 0.05 for BGD1, p < 0.001 for the BGD26 strain). A significant negative correlation between D and PD was observed only in IC for the BGD1 strain (ρ = −0.384, p = 0.048), while fractal parameters were stable. Significantly higher D, C, and PD and lower lacunarity, L, were noticed in the BGD1 compared to the more aggressive BGD26 strain. In conclusion, these results demonstrate the complexity of structural alterations of T. gondii cysts in an immunocompromised host and emphasize the application potential of ImageJ in the experimental models of toxoplasmosis. [ABSTRACT FROM AUTHOR]

This article explores the rate of spontaneous regression of Rathke's cleft cysts (RCCs), which are benign fluid-filled cysts that develop in the pituitary gland. The study describes three cases of patients with spontaneous RCC regression and conducts a systematic review of the literature to assess the incidence of regression in patients managed conservatively. The results show that approximately 25.5% of patients with RCCs demonstrated regression. The article suggests that conservative management and routine surveillance of RCCs may be appropriate for patients without significant symptoms, and surveillance should continue for at least 5 years to demonstrate cyst stability. [Extracted from the article]

Arachnoid cysts are usually asymptomatic, benign lesions commonly occurring in the middle cranial fossa. However, the cysts may rupture in rare cases causing intracystic or subdural hemorrhages with significant mass effect. We report two cases of middle cranial fossa arachnoid cyst with subdural hemorrhage with very different clinical course. The first case presented with significant mass effect with cerebral herniation and had significant neurological morbidity post-surgery. The second case had minimal symptoms and was managed conservatively with offer of elective surgery. The report underscores the importance of prompt diagnosis and appropriate surgical intervention in managing arachnoid cysts with hemorrhage, highlighting the potential for diverse clinical presentations and outcomes. [ABSTRACT FROM AUTHOR]

This article discusses a rare case of a 9-year-old girl with a left ventricular echinococcus cyst, which is a parasitic infection caused by the Echinococcus granulosus worm. The girl, who had previously been diagnosed with hepatic cystic echinococcosis, underwent abdominal CT which revealed the presence of a fluid-filled mass in her left ventricle. The diagnosis was confirmed through echocardiography, cardiac CT, and MRI. The girl underwent successful surgical removal of the cyst and continued treatment with albendazole. The article emphasizes the importance of thorough diagnostics, interdisciplinary planning, and close follow-up to prevent recurrences and complications. [Extracted from the article]

Background: Hydatid cyst is a parasitic infection, often caused by Echinococcus granulosus. Although it is classified as a benign disease, cyst ruptures in the abdomen can be fatal. Ruptures occur spontaneously or after trauma. We aimed to report data from patients who underwent emergency surgery due to spontaneous intra-abdominal hydatid cyst rupture. Methods: Upon a retrospective review of the records at Department of General Surgery, Faculty of Medicine, Harran University, Şanlıurfa, Turkey, we found that 34 cases were operated on due to hydatid cyst rupture between January 2012 and October 2022. All patients were operated on in an emergency, and partial cystectomy, intra-abdominal irrigation, and drainage were performed using laparotomy. The patients were evaluated in terms of age, sex, symptoms, radiological findings, laboratory results, intraoperative findings, and postoperative follow-ups. Results: Twenty-two (64.7%) female and 12 (35.3%) male patients were enrolled. The mean age was 39.1 (±17.58) years. All patients experienced spontaneous rupture. The ruptured cyst was found in the liver in 32 patients (94%), the spleen in 1 patient (3%), and the pelvis in 1 patient (3%). The diagnosis was determined using ultrasonography in 12 (35.3%) patients, computed tomography in 21 (61.8%) patients, and magnetic resonance imaging in 1 (2.9%) patient. All patients exhibited acute abdomen and leukocytosis. The average length of hospital stay was 5.14 (±1.37) days. Conclusion: Hydatid cyst rupture should be considered in cases of acute abdomen, particularly in regions where the disease is endemic, as in our region. The ruptured hydatid cyst was primarily observed in the liver (94.11% of cases). [ABSTRACT FROM AUTHOR]

Key message Pulmonary hydatid disease remains a global public health issue. Symptoms often result from cyst rupture, causing fever, cough, and hemoptysis. Radiographs may show homogeneous masses, air‐fluid levels, or the pathognomonic “water lily” sign. Surgical removal is the primary treatment, with early diagnosis crucial to prevent acute hypersensitivity reactions and death.

This article discusses a case of a trichilemmal cyst (TC) that presented as a dermatofibroma on the lower back, which is an atypical site for this type of cyst. The patient, a 54-year-old male, had a slightly painful and occasionally itchy swelling on his lower back. The clinical features led to a complete excision biopsy, and the histopathology confirmed the diagnosis of a TC. TCs are rare, benign cysts that typically occur on the scalp, but can also occur in other areas. The treatment of choice is complete surgical excision to prevent recurrence. [Extracted from the article]

This article discusses the rare occurrence of spontaneous rupture of arachnoid cysts (ACs), which are benign collections of cerebrospinal fluid. ACs are typically detected incidentally or when investigating symptoms after rupture. The incidence of ACs is about 1% of all intracranial masses, and their reporting has increased with advanced imaging techniques. The article highlights the rarity of spontaneously ruptured ACs and the limited literature available on their management. Conservative treatment and surgical interventions have been attempted, but further studies are needed for targeted approaches to treatment. [Extracted from the article]

Early detection of the etiologic agent is important in patients who present to the emergency department due to anaphylaxis, especially if the anaphylaxis is resistant. Even if there is no history of trauma in resistant anaphylaxis of unknown origin, hydatid cyst rupture should be considered since it is known that the hydatid cyst can rupture spontaneously. A 15-year-old female patient presented to the emergency department of our hospital with complaints of widespread hot flashes, abdominal pain, and confusion during kickboxing training. Treatment of the patient was started with a preliminary diagnosis of anaphylaxis. Adrenaline infusion was started because of the refractory hypotension and lack of improvement in the clinical findings. The patient's history was taken in more detail because of the resistant anaphylaxis. Abdominal ultrasonography was performed with the suspicion of hydatid cyst rupture due to the patient's history of abdominal trauma while kickboxing. It was observed that the cysts were ruptured in the liver. This case report emphasizes that hydatid rupture should be among the rare causes of anaphylaxis, especially in regions where hydatid disease is endemic. Ruptured hydatid cyst causing anaphylaxis requires timely diagnosis, treatment, and urgent intervention. [ABSTRACT FROM AUTHOR]

Echinococcal liver cysts are predominantly located in the right lobe of the liver and are mostly asymptomatic. A frank intra-biliary rupture (IBR) of hydatid cyst is uncommon, having variable clinical presentation and treatment options. We present a case of a 60-year-old male patient who presented with pain in the upper abdomen associated with vomiting but without jaundice. On investigations, he was diagnosed to have a left lobe hepatic hydatid cyst (HHC) with IBR for which left hepatectomy with bile duct exploration was performed. It highlights the benign nature of the disease for which seldom major hepatectomies have to be performed. [ABSTRACT FROM AUTHOR]

Background: Cysts, primarily epidermal and trichilemmal, are commonly seen in clinical practice. Rupture, infection, inflammation, and rarely malignant transformation may complicate the cysts. This study aims to analyze the clinicohistological features of cutaneous cysts. Materials and Methods: A retrospective review of patients with the diagnosis of cyst confirmed on histopathology over the past two years (2020–2021) was performed. Clinical details comprised of age, gender, site of involvement, size, duration, and associated symptoms. Histological examination included cyst wall lining, type of keratinization, complications like rupture, inflammation, foreign body giant cell reaction, calcification, and malignant change. Results: A total of 324 cases with mean age of 37.9 years and equal gender distribution were identified. Most frequent diagnosis was epidermal cyst in 89.8%, followed by trichilemmal cyst in 8.9% of cases. Rare types included follicular hybrid cyst, verrucous cyst, vellus hair cyst, and steatocystoma. Most common complication was cyst rupture in 54.3% of epidermal cysts. Proliferating epidermal and proliferating trichilemmal cysts were noted in one and two cases, respectively. Two cases revealed malignancy arising in the wall of epidermal cyst. Limitations: The retrospective study design and non-availability of follow-up data, especially for proliferating cysts and cysts with malignant transformation were the main limitations of this study. Conclusion: Histopathologic examination of excised cutaneous cysts is paramount in reaching accurate diagnosis of the type of cyst and associated secondary changes to enable appropriate management. [ABSTRACT FROM AUTHOR]

Background: Alveolar adenoma is a rare benign tumour, usually presenting as a peripherally located solid mass, sometimes mimicking malignancy. Case presentation: A 37-year-old woman presented with chronic intermittent vague chest discomfort. The chest x-ray showed a simple cyst in the left lower lung field, and serial computed tomography (CT) over the following 2-year period showed rapid growth of the cyst, from 3.5 to 9.0 cm in diameter. The CT scan suggested bronchiolar communication, which was suspected to be the cause of growth, via check-valve mechanism. Thoracoscopic surgery was performed, and we found a thin-walled cyst in the lingular segment. Wedge resection was performed and the pathology was an unexpected alveolar adenoma which had grown on the terminal bronchiole, causing the alveolus to rupture and the cyst to grow. In 48 months of follow-up, there was no evidence of recurrence and the patient's symptoms resolved. Conclusions: Rapidly growing pulmonary cysts can lead to complications including rupture with pneumothorax and haemothorax, and surgery is always indicated. Abnormally rapid growth may indicate an underlying pathology such as alveolar adenoma. Surgical resection is the treatment of choice and there have been no reported cases of recurrence. Here we present a rare form of alveolar adenoma, which was a form of rapidly growing pulmonary cyst. [ABSTRACT FROM AUTHOR]

Background: Arachnoid cysts (ACs) account for about 1% of all intracranial mass lesions. The Sylvian fissure is the most common site of ACs which are usually asymptomatic. Traumatic rupture of arachnoid cysts complicated with subdural hygroma is a relatively rare entity in adults especially in females. There is no consensus on their management and each case could add to previous experiences leading to more uniform therapeutic measurements. This case encompasses a combination of watchful strategy, limited surgery and ultimately successful cyst fenestration which highlights a good outcome without complications by adopting a stepwise procedure. Case presentation: Here, the case of a 51-year-old Persian woman being presented with a 2-month history of a localized headache which had begun 4 days after a minor head trauma. Early brain computed tomography (CT) obtained in another center at 4th day of post-injury which misinterpreted as an old infarct. Repeated CT in our center revealed a large AC of Sylvian fissure complicated with subdural hygroma. Initially a conservative management pursued but due to worsening of the symptoms, a burr-hole craniotomy performed for hygroma evacuation that subsequently followed by cyst fenestration about 1-month later. Conclusion: Previous awareness about radiographic characteristics of ACs as well as employing appropriate imaging modality are necessary for correct and timely diagnosis of symptomatic patients after minor head trauma because incidentally found ACs might be the underpinning causes of symptoms. Also, following a multistage therapeutic process along with the involvement of patients in decision-making are of paramount importance. [ABSTRACT FROM AUTHOR]

Facet joint (FJ) disease is a common cause of axial low back pain with many minimally invasive image-guided treatment options. This article discusses fluoroscopic and CT-guided intraarticular FJ injections, medial branch (MB) radiofrequency ablation (RFA), and lumbar facet synovial cyst (LFSC) aspiration, rupture, or fenestration. Additionally, the article will highlight medial branch blocks (MBBs) utilized to diagnose facet-mediated pain and to predict outcomes to RFA. [ABSTRACT FROM AUTHOR]

This article discusses a rare case of an intradural extramedullary persistent neuroenteric canal with an intramedullary component. The authors present the first instance of this condition, which was successfully managed using a transpedicular corridor. Neuroenteric cysts are uncommon congenital anomalies, and the intramedullary subtype is even rarer. The article provides details of the surgical procedure and includes a video link for further reference. The document describes a surgical procedure to remove an intramedullary neuroenteric cyst with a persistent neuroenteric canal. The surgery involved carefully separating the cyst from the spinal cord and removing it, as well as repairing the dural defect. The patient experienced improvement in lower limb strength and complete resolution of myelopathy after the surgery. The document also discusses the importance of preoperative imaging, the surgical approach used, and the potential complications and pitfalls of the procedure. [Extracted from the article]

Intracranial dermoid cysts (IDC) are rare cystic lesions that are present from birth. After rupture of these cysts, patientsmay present to the hospital with ischemic cerebral symptoms, headaches, seizures, syncope, and meningitis. Brain magnetic resonance imaging (MRI) is the most sensitive radiologic method in the diagnosis of IDC rupture, which has a high mortality rate. Patients should be rapidly evaluated for surgery if a symptomatic and ruptured cyst is detected. In this presentation, we aimed to describe the diagnosis and treatment of IDC in a 23-year-old male patient brought to the emergency department after syncope. [ABSTRACT FROM AUTHOR]

This article discusses a case of saccular limited dorsal myeloschisis (LDM), a type of closed dysraphism (CD) in which the patient experienced sudden signs of Chiari-II malformation due to cyst rupture during pregnancy. Fetal surgery was performed to repair the cyst and protect the neural tissue. The surgery involved a three-layer reconstruction and was successful in reversing the changes associated with Chiari-II malformation. This case highlights the importance of close monitoring for CD patients and the potential benefits of prenatal repair. [Extracted from the article]

Bakers cyst (BC) is a common condition and can be caused by both inflammatory and non-inflammatory disorders. Small BCs are usually asymptomatic and accidentally revealed. Large BCs present with pain and discomfort in the posterior knee as well as certain limitations of mobility. Large BCs may rupture resulting the fluid efflux down into the calf, which in turn presents with acute pain and number of potential thrombotic and neural complications. On another note, BC rupture requires differentiation with some urgent conditions such as venosus or arterial thrombosis, soft tissue infections etc. In this article we present some aspects of the etiopathogenesis, clinical signs and course of the BC. We also discuss the problematic issues of assessment and diagnostic work-up in case of BC ruptures.

The formation of multiple cysts in the liver occurs in a number of isolated monogenic diseases or multisystemic syndromes, during which bile ducts develop into fluid-filled biliary cysts. For patients with polycystic liver disease (PCLD), nonsurgical treatments are limited, and managing life-long abdominal swelling, pain, and increasing risk of cyst rupture and infection is common. We demonstrate here that loss of the primary cilium on postnatal biliary epithelial cells (via the deletion of the cilia gene Wdr35) drives ongoing pathological remodeling of the biliary tree, resulting in progressive cyst formation and growth. The development of cystic tissue requires the activation of transforming growth factor–β (TGFβ) signaling, which promotes the expression of a procystic, fibronectin-rich extracellular matrix and which itself is perceived by a changing profile of integrin receptors on the cystic epithelium. This signaling axis is conserved in liver cysts from patients with either autosomal dominant polycystic kidney disease or autosomal dominant polycystic liver disease, indicating that there are common cellular mechanisms for liver cyst growth regardless of the underlying genetic cause. Cyst number and size can be reduced by inhibiting TGFβ signaling or integrin signaling in vivo. We suggest that our findings represent a therapeutic route for patients with polycystic liver disease, most of whom would not be amenable to surgery. Editor's summary: Polycystic liver disease can result in severely reduced quality of life but has few available treatments. Waddell et al. show that loss of primary cilia in adult mouse biliary epithelia produces an integrin-rich cellular microenvironment that promotes pathological bile duct remodeling, resulting in the formation of morphologically abnormal cyst growth and fission-induced polycystic structures. Pharmacological inhibition of a specific integrin or TGFβ signaling reduced cyst size and number in the animals. Analysis of human liver samples suggested that this pathway may be a target in polycystic liver disease of varying genetic etiologies. —Catherine Charneski [ABSTRACT FROM AUTHOR]

Background: Human cystic echinococcosis (CE) is a zoonotic parasitic infection caused by the larval stage of the species belonging to the Echinococcus granulosus sensu lato (s.l.) complex. Parasitic cysts causing human CE are mainly localized in the liver and in the lungs. In a smaller number of cases, larvae may establish in any organ or tissue, including the central nervous system (CNS). Cerebral CE (CCE) is rare but poses serious clinical challenges. Methods: This study presents a case of CCE in a child living in the countryside near Rome (Italy), along with a comparative molecular analysis of the isolated cyst specimens from the patient and sheep of local farms. We also systematically searched the literature to summarize the most relevant epidemiological and clinical aspects of this uncommon localization. Findings: The comparative molecular analysis confirmed that the infection was caused by E. granulosus sensu stricto (s.s.) (G3 genotype), and most likely acquired in the family farm. The literature search identified 2,238 cases of CCE. In 80.51% of cases, brain was the only localization and single CCE cysts were present in 84.07% of cases. Mean patients' age was 20 years and 70.46% were children. Cyst rupture was reported in 12.96% and recurrence of CCE after treatment in 9.61% of cases. Permanent disability was reported in 7.86% of cases, while death occurred in 6.21%. In case series reporting all CE localization, CCE represented 1.5% of all CE cases. In the few reports that identified at molecular level the CCE cyst, E. granulosus s.s. was found in 40% and E. canadensis in 60% of cases. Conclusions: We report a rare case of CCE and evidenced the probable local origin of infection. The proportions of CE cases with uncommon localizations and with high impact on patients' lives have been globally neglected and should be included in the computation of the global burden of CE. Author summary: Human cystic echinococcosis (CE) is a parasitic zoonotic disease caused by cestode species belonging to Echinococcus granulosus s.l. complex. CE affects mainly pastoral and rural communities in both low-income and upper-middle-income countries, where the life cycle of the parasite is sustained between livestock and dogs. The larval parasite cysts causing human CE develop mainly in the liver and secondarily the lung, but in a smaller number of cases, larvae may develop in any organ or tissue, including the brain. We report here a case of cerebral CE (CCE) in a child living near Rome (Italy), which was attributed to probable household/backyard infection from the family farm by comparative molecular analysis of the patient's and sheep CE cyst specimens obtained from the family farm and another local farm. We also summarized the clinical characteristics of CCE cases retrieved through a literature review. When considering clinical centres reporting all anatomical sites of CE, liver represented 70%, lungs 19%, and unusual localizations 11% of all CE cases. The proportion of CCE among all CE cyst localizations represented 1.5% of all CE cases. These figures are important when calculating the global burden of disease, since CCE and other uncommon CE localizations, although more rare, are clinically more severe. [ABSTRACT FROM AUTHOR]

Intraventricular dermoid cyst are very rare benign tumour. Due to benign nature, it may go un-noticed for years and might present with sudden rupture. Ruptured cyst can cause chemical meningitis, hydrocephalus, seizures etc. Due to lack of data, there are no defined guidelines about its management. We are reporting an interesting case of ruptured intraventricular dermoid cyst and chemical meningitis, who was managed successfully and will review the literature. A 48 years male patient was brought with complaint of sudden mental deterioration, irritability, headache, vomiting for 3 days. He had history of seizures for 1 year. On examination, his higher mental functions were deteriorated, had neck rigidity and left lower limb weakness. CT/MRI brain confirmed diagnosis of right frontal horn ruptured dermoid cyst with scattered fat droplets, hydrocephalus and ventriculitis. Excision of cyst was done via right trans-sulcal (superior frontal sulcus) approach. Patient recovered well. Intraventricular dermoid cyst are a rare benign lesion. Due to potential of rupture, it must be surgically treated. Steroids should be used to treat chemical meningitis. Various individual case reports have shown good outcome after surgical management. We recommend early surgery, thorough ventricular wash with ringer lactate, post-operative extraventricular drain and steroid cover to manage ruptured cyst and chemical meningitis. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Hydatid disease is a zoonotic disease endemic in developing regions. It is usually caused by infection with the tapeworm Echinococcus granulosus due to contaminated food or drinks or by close contact with dogs. The lungs are the second most affected organ (25%) after the liver (>65%). Cyst rupture is the most frequent complication. Enlarging pulmonary cysts are more vulnerable to rupture, with rupturing in the bronchial tree being the most common (20%–40%). Hydropneumothorax is a consequence of complete cyst rupture into the pleural cavity and occurs in rare cases (2%–4%). Superinfection is a common complication of the ruptured cyst, which might lead to empyema. A 26‐year‐old male presented to our clinic with dyspnea that had progressed recently and made him unable to walk a few meters. He had a history of cough and exertional dyspnea and was examined by three different clinics without performing a chest X‐Ray. Physical examination revealed fever and a sick appearance. Chest X‐ray revealed complete pneumothorax with an air‐fluid level in the left hemithorax. Computerized tomography demonstrated two cysts, and one of them was ruptured, causing hydropneumothorax and empyema. The patient was treated with surgery, and follow‐up showed recovery with a fully re‐expanded lung. Rupture of pulmonary hydatid cyst is seen in the most of cases, the clinicians must be aware of such presentation and management of the pulmonary hydatid disease. [ABSTRACT FROM AUTHOR]

Background: Liver hydatid cyst ruptures entering the biliary tree can lead to life-threatening conditions. This study investigates the frequency of biliary rupture and the most common magnetic resonance imaging findings. Methods: Patients with hydatid cyst within the last 5 years were screened. Demographic data, the hepatic segment location, number of lesions, lesion size, and type of cyst were recorded, and biliary communication was evaluated. In patients with biliary rupture, the presence of dilation bile ducts, the presence of structures consistent with cyst contents in the bile ducts, the presence of fistulous connections, and the frequency rates of these findings were evaluated. Results: Fifty-five cyst hydatid lesions from 50 patients (30 male and 20 female) were included. 4 (8%) patients had biliary rupture. Among them 4 (100%) patients had dilation in the intrahepatic and common bile ducts, 3 (75%) had deformation of cyst, 2 (50%) had structures consistent with cyst contents in the even ducts, and 1 (25%) had a fistulous connection shown by magnetic resonance imaging. Age and gender did not differ between patients with and without biliary rupture (P > .05). Patients with biliary rupture had larger cysts than those without (P < .05), and type 3 hydatid cysts were the most common. Conclusion: In conclusion, the frequency of intrabiliary rupture in our study was found to be 8%, and significant imaging findings can be obtained with magnetic resonance imaging in the evaluation of intrabiliary rupture. Bile duct dilation, cyst deformation, cyst contents in the bile ducts, and fistulous connection are the most common magnetic resonance imaging findings in patients with intrabiliary rupture. [ABSTRACT FROM AUTHOR]

Pancreatic pseudocysts can extend beyond the boundaries of the pancreas due to the enzymatic nature of the fluid they contain. However, the extension of a pseudocyst beyond the retroperitoneum, into the psoas muscle, and within the subcapsular space of the left kidney is extremely rare, with only a few documented cases in the medical literature. In this report, authors present a case of a 36-year-old male with chronic pancreatitis and atypical pseudocysts that were left untreated due to his negligence. Secondary infection led to the formation of a psoas abscess, perinephric abscess, and a renal abscess. Complications such as intracystic haemorrhage, infection, and rupture of a pseudocyst are uncommon and can be fatal, if treatment is delayed. Pseudocysts in atypical locations, complicated by a secondary infection, are extremely rare and must be timely and effectively managed. [ABSTRACT FROM AUTHOR]

This article reports on a case of a 73-year-old white Portuguese female farmer who presented with pain, numbness, and weakness in her left limb. A CT-scan revealed a non-calcified lesion suggestive of a hydatid cyst in the gluteal muscle. The patient was treated with albendazole and underwent partial surgical resection of the lesions. The article provides information on the parasite Echinococcus sp., its mode of transmission, and the rarity of hydatid cysts in muscle tissue. The case highlights the importance of diagnosing and managing cysts in this location due to the risk of rupture. [Extracted from the article]

This article discusses two cases of congenital epiglottic cysts, a rare form of cystic lesion that develops at the epiglottis. The symptoms of this condition include wheezing, dyspnea, feeding difficulties, and failure to thrive, and it can sometimes lead to airway obstruction. The article emphasizes the importance of individualized airway management for each case, as there is currently no established definitive treatment. The cases presented in the article highlight the challenges of securing the airway for intubation and the need for multidisciplinary care in managing congenital epiglottic cysts. [Extracted from the article]

Introduction: Hydatid disease is a parasitic infection caused by the tapeworm Echinococcus granulosus. Intracranial locations are rare and account for less than 3% of all cases. Typically, these cysts are found in the intracerebral spaces. However, this study presents an extremely rare intradural hydatid cyst. To our knowledge no similar case has been previously reported. Case presentation: This study presents the case of an 8-year-old boy presented with a 3-month history of headache and vomiting without any neurological deficit. Full radiological investigations were performed, the brain MRI showed a large cerebral hydatid cyst located within the dura layers between the periosteal and the endosteal layers. Surgery was performed without cyst rupture, confirming the intracerebral intradural location. Conclusion: Early diagnosis and treatment for intracranial hydatid cysts are crucial to prevent complications such as neurological deficits, seizures, and even death. In this case, the intracerebral intradural location of the cyst is extremely rare. [ABSTRACT FROM AUTHOR]

Hemorrhage into a juxtafacet cyst is rare and cyst rupture with hemorrhagic extension into the epidural space is even less commonly seen. We describe the case of a patient with a hemorrhagic synovial cyst with rupture associated to abundant bleeding in the epidural space. A 61-year-old man had a 5-month history of worsening low back pain radiating into the right leg with associated weakness and numbness. A magnetic resonance imaging scan showed the presence of a mild anterior spondylolisthesis of L5 on S1 with increased synovial fluid into both facet joints. A suspected synovial cyst of the right facet joint at level L5–S1, with signal characteristics consistent with hemorrhage was seen. Caudally, epidural blood was evident from S1 to S2 that involved spinal canal and right S1 and S2 foramens. These findings were confirmed at surgery. [ABSTRACT FROM AUTHOR]

I Purpose or Learning Objective: i Lumbar facet synovial cysts are seen in degenerative arthropathy and can cause disabling radiculopathy. We compared radiologic parameters of patients who presented with significant clinical improvement after CT-guided synovial cyst rupture with those who did not, to establish possible prognostic factors. A low-risk nonsurgical and minimally invasive management option includes computed tomography (CT)-guided injection of diluted contrast and anesthesia/corticosteroid for its rupture. [Extracted from the article]

Pulmonary hydatid cysts (PHC) and their complications are still a health concern in endemic countries. Here we described a 17‐year‐old male presented with a large PHC with a spontaneous rupture. He developed acute respiratory distress syndrome (ARDS) requiring mechanical ventilation. He was treated with albendazole, broad‐spectrum antibiotics, and corticosteroids. The patient's general condition did not allow any attempt for surgical resection of the cyst. He was discharged in stable condition after one month and referred to a thoracic surgeon for resection of the cyst. As far as we know ARDS after hydatid cyst rupture was rarely reported, and through this case report we aimed to raise awareness of this possible life‐threatening complication. [ABSTRACT FROM AUTHOR]