Imaging spectrum of renal masses on multi-slice computed tomography

Background: Multi-slice computed tomography (MSCT) is the mainstay for preoperative assessment of many complex renal masses in current clinical practice. Benign renal processes may simulate malignant renal tumors and could be defined correctly by CT. MSCT has also an important role in tumor staging. The purpose of this article is to understand the imaging spectrum of renal masses on MSCT and assess the usefulness of CT in surgical planning and management.Methods: Studied 500 patients with suspected renal lesions who underwent MSCT during the period July 2017 to July 2020 at state-of-art imaging center. CT imaging was done in those patients in whom clinical examination and ultrasonography (USG) revealed possibility of diagnosis of renal masses for further detailed evaluation and deciding management.Results: Out of 500 total subjects, the common age group in this study is 51 to 60 years (25%). Male preponderance (59%) was noted. The most common presentation was pain (84%) followed by lump (29.4%) and haematuria (17.8%). Malignant masses (51%) were more common followed by benign (39%) and inflammatory masses (10%) respectively. Renal cell carcinoma has more incidence (30%) followed by simple cyst (20%). Calcification (19.6%), perinephric extension (78%) and vascular invasion (21.5%) are more common in malignant masses. Conclusion: MSCT is the modality of choice for the diagnosis of renal masses and deciding management approach in current practice. Detection of tumoral spread, invasion of surrounding organs and vascular structure are better with CT. MSCT also has a role in postoperative follow-up of renal masses.

Resección de quiste mesentérico gigante en adulto mayor: Reporte de un caso / Case Report: Gigantic mesenteric cyst in a senior citizen

Los quistes mesentéricos son poco frecuentes y representan menos de 1 de cada 100,000 ingresos hospitalarios. Fueron descritos por primera vez en 1507, y en 1880 Tillaux fue el primer cirujano que extirpó uno en forma exitosa. El presente reporte de caso se trata de una paciente de 64 años de edad que presentaba un aumento de volumen progresivo a nivel de mesogastrio e hipocondrio izquierdo, acompañado de náusea y dolor punzante intermitente. Contaba con exámenes de laboratorio que incluían marcadores tumorales, los cuales se encontraban dentro de rangos normales. La tomografía axial computada (TAC) de abdomen mostraba una imagen quística de aproximadamente 10 x 10 cm y diagnóstico probable de quiste mesentérico. Se realizó intervención quirúrgica programada con el diagnóstico preoperatorio de probable quiste mesentérico y se encontró un tumor de 15 x 10 cm dependiente de mesenterio, firmemente adherido la raíz del mismo, que se pudo extirpar sin dificultad. El reporte histopatológico fue de quiste simple de mesenterio. La paciente cursó con buena evolución posquirúrgica; egresó al cuarto día y fue dada de alta del servicio al tercer mes en la consulta externa de cirugía general. Los quistes mesentéricos constituyen patologías raras, y las referencias bibliográficas continúan siendo pocas, es más frecuente en la edad pediátrica y su presentación clínica en adultos generalmente se presenta con dolores abdominales vagos y poco localizados y en ocasiones acompañado de náuseas. El tratamiento definitivo lo constituye generalmente la escisión quirúrgica, con preferencia la enucleación.

The mesenteric cysts are uncommon and represent less than one case out of 100 000 hospital admissions. The first time they were described was on 1507 and on 1880 Dr. Tillaux was the first surgeon which removed a mesenteric cyst successfully. The present case report is about a patient of 64 years old that had mesogastric and left quadrant volume mass together with nausea and throbbing along with labs results including tumor markers all being on average normal range. The abdomen CT report of the patient showed a cyst mass of about 10 x 10 cm with probable diagnose of mesentericcyst. The surgery was performed with such preop diagnosis finding a mass of 15x10cm strongly dependent to root mesentery which was able to be removed. The histopatologic report was a simple mesenteric Cyst. The patient followed good postop follow and got off on the fourth day after surgery and getting reviewed at clinic with good outcome. The mesenteric cysts are rare pathologies and the bibliography reviews are few being more often at pediatric time and at adult age being shown with vague abdominal pain, bad located together with nausea. The last treatment is always surgical remove.

Intratesticular Simple cyst lined by ciliated columnar epithelium: A Case Report / 영남의대학술지

An intratesticular simple cyst is a rare lesion. The pathogenesis of such lesions is uncertain. Clinically, an intratesticular simple cyst may be difficult to differentiate from a cystic neoplasm. However, preoperative diagnosis is possible using ultrasonography (US). Testis-sparing surgery with simple enucleation of the cyst has a favorable outcome. We report an intratesticular simple cyst in a 48-year-old male who had a non-tender cystic mass in the right testis for 2 years. The diagnosis was made by preoperative US. The patient underwent a testis-sparing surgery. After simple excision of the cyst, histological examination revealed a simple cyst lined by ciliated cuboidal and columnar epithelium.

Radiographic Analysis of Simple Cyst of the Breast / 实用放射学杂志

Objective To make a further understanding of mammographic features of simple cyst of the breast (SCB).Methods Molybdenum target radiographic signs in 39 cases with SCB proved pathologically and were retrospectively analyzed. Results Of the 56 SCB in 39 cases, 23 were diagnosed rightly as SCB, 10 as fibroadenoma, 2 as cancer and the remaining 4 were undefined. The diagnostic accuracy and misdiagnosis were 59.0% and 41.0% respectively. Radiograph showed round in 12, ovoid in 38, mild lobed in 4 and comet tail form in 2. The borders of cyst were distinct and sharp in 26, distinct partly and indistinct partly in 27,indistinct completely in 3. The density was homogeneous in 54 with calcifications in 2. Of the 56 SCB, the length axes of cyst were upright to chest wall in 20 and towards nipple in 18. The cysts could be transformed with pressure in 4.Conclusion Careful analysis of radiographic features of SCB is helpful for diagnosing accurately this disease.

Solitary cystic lesions of the liver: Its diagnosis and Treatment / 한국간담췌외과학회지

BACKGROUND/AIMS: With the advances in imaging modalities, the incidental diagnoses of solitary cystic lesions of the liver are increasing. The aim of this study is to establish the strategy of differential diagnosis and treatment in the patients with solitary cystic lesions of the liver METHODS: Forty three solitary cystic lesions of the liver treated surgically at Seoul National University Hospital from January 1981 to December 1998 were reviewed retrospectively. The clinicopathologic features, postoperative courses and their long-term results were analysed. RESULTS: There were fifteen congenital nonparasitic cysts (simple cysts), 3 Caroli's diseases, 4 hydatid cysts, 2 traumatic cysts, 1 cystic hamartoma, 10 biliary cystadenomas, and 8 biliary cystadenocarcinomas. Twenty six hepatic resections, 12 excisions, 3 marsupializations, 1 cystojejunostomy, and 1 cystic wall biopsy were performed. There were 4 biliary leakages and 2 intraabdominal abscesses after surgery, and three out of them resulted from the communications with the biliary trees. Cystic fluid analysis or radiologic study could not offer the accurate diagonosis. Two patients who had biliary cystadenoma and biliary cystadenocarcinoma, respectively, and underwent marsupializations with preoperative misdiagnosis of simple cyst resulted in death due to recurrent tumors. CONCLUSION: In exploring every case of solitary cystic lesion of the liver, presence of biliary communication and cystic malignancy should be considered unless simple cyst is highly suggested.

Cystectomy and Hepatic Resection for Cystic Lesion of the Liver

PURPOSE: Cystic lesions of the liver are highly variable in respect to appearance and therapeutic approach. However, without cystectomy and hepatic resection, the patient is at risk for recurrent enlargement, infection, or progression of an unrecognized malignant neoplasm. The goal of this study was to discern the safest and most effective method, with special emphasis on a suitable therapeutic technique for various cystic lesions of the liver. METHODS: We reviwed the cystectomy and hepatic resection and outcome of patients with hepatic cysts from November, 1987 to April, 2000 at the Hanyang University Hospital. A retrospective study of 19 patients with various cystic lesions of the liver was performed. RESULTS: There were 8 simple cysts, 2 polycystic liver disease, 2 biliary cystadenoma, 4 biliary cystadenocarcinoma, 2 hydatid cysts, and 1 traumatic cyst. In examining the 6 cystectomies, 13 hepatic resections. (4 right lobectomies, 4 left lobectomies, 5 minor hepatic resections), there were no postoperative deaths in this series. Four patients (21.1%) developed operative complications. During the mean follow- up time of 78.2 months, symptomatic relief was complete and permanent in all of patients except the 1 biliary cystadenocarcinoma 1 of the 4 patients with biliary cystadenocarcinoma died of tumor recurrence (5.3%) approximately 27 months after hepatic resection. CONCLUSION: Cystectomy and hepatic resection is a more curative treatment for cystic lesions of the liver than other treatments. We recommend complete cystectomy and hepatic resection as the preferred therapy, particularly when the cyst is large, a malignancy cannot be ruled out, and a proper diagnosis is not confirmed.

A Case of Simple Intratesticular Cyst / 대한비뇨기과학회지

Simple cyst of the testis is a rare lesion. Clinically, testicular simple cyst may be difficult to differentiate from a cystic neoplasm. We report a simple intratesticular cyst which was found incidentally as a nontender, enlarged mass in the testicle of an eight- month- old infant. It was diagnosed by preoperative ultrasonography and operative finding and the patient underwent an organ-preserving operation.

A case of intratesticular simple cyst / 대한비뇨기과학회지

Simple cysts of the testis are rare benign lesions of uncertain etiology. A 3-month-old male infant presented with painful enlargement of the left testicle and was suspected for testicular torsion. On scrotal exploration, the diagnosis of intratesticular simple cyst was made intraoperatively and the patient treated with orchiectomy.

A case of simple cyst of the testis in an infant: ultrasonography and testicular preservation / 대한비뇨기과학회지

We report a very rare case of simple intra-testicular cyst, a 1.7 x l.2 cm sized round lesion fulfilling the criteria of a simple cyst on ultrasound in a 4-month-old male infant in whom the lesion was confirmed as a simple intra-testicular cyst on frozen section and subsequently underwent excision with successful preservation or the testis.

Intratesticular Simple Cyst: Report of a Case / 대한비뇨기과학회지

A 5-month-old male infant was referred by the pediatrician for nontender, left testicular enlarged mass. It was intratesticular round cyst 1.7 cm in diameter without internal echoes on ultrasonogram. After inguinal orchiectomy, pathologic report was intratesticular simple cyst. We report a rare case of intratesticularsimple cyst with a brief review of the literature.