Intraspinal Extradural Degenerative Cervical Cyst Treated by Anterior Cervical Discectomy and Fusion: A Surgical Alternative to the Posterior Approach, about One Case.

Introduction: Intraspinal extradural arthrosynovial cysts, which belong to the spectrum of degenerative spinal diseases are mainly located at lumbar level and their location at cervical level joint is therefore unusual. The most common surgical approach for symptomatic arthrosynovial cervical cyst remains a direct resection of the cyst by a cervical hemilaminectomy with or without a posterior arthrodesis. However, another surgical approach may also be discussed when considering the cyst as a result of a local spinal instability or hypermobility. Case Report: We report in this work the case of a patient with cervical radiculopathy due to intraspinal extradural compressive arthrosynovial cervical cyst which was treated by anterior discectomy and fusion without direct resection of the cyst. The post-operative radiological control performed at 3 months showed a complete regression of the cyst with a patient pain-free. To the best of our knowledge, this is the first case of intraspinal cervical degenerative cyst at C7-T1 level treated by anterior approach and fusion without direct cyst resection. Conclusion: For the treatment of a joint spinal cervical cyst, the anterior approach is a relevant option that gives the advantages to respect the posterior cervical muscles and articular structures.

Quiste cervical del conducto torácico: reporte de un caso y revisión de la literatura

El quiste del conducto torácico en su porción cervical es una patología infrecuente con escasos casos reportados en la literatura mundial. Habitualmente, se presenta como un aumento de volumen blando e indoloro en la fosa supraclavicular izquierda, el cual puede generar sintomatología compresiva variable de las estructuras adyacentes. Presentamos el caso de una mujer de 76 años remitida a la consulta de otorrinolaringología por evidencia de una lesión quística en la fosa supraclavicular izquierda con estudio posterior concordante con quiste cervical del conducto torácico.

The cervical thoracic duct cyst is an infrequent entity, with only a few cases reported in the international literature. It usually presents as a painless swelling on the left supraclavicular fossa, that can generate symptoms due to compression of adjacent structures. We present the case of a 76-year-old women that was referred to otolaryngology due to a supraclavicular cyst, with subsequent diagnosis of cervical thoracic duct cyst.

Case Report: Giant Pelvic Cystic Appearance-An Unusual Feature of Uterine Cervical Adenocarcinoma.

Cervical adenocarcinoma can present as a solid, mixed solid, cystic, or multiple cystic cervical mass in the endocervical canal. In this report, we present an extremely rare case of cervical adenocarcinoma with giant cystic lesions. A 37-year-old Chinese woman with a regular menstrual cycle presented to her local doctor complaining of mild abdominal distension. Abdominal ultrasonography suggested an ovarian cyst, whose mean diameter increased from 3 to 8 cm in 3 months. Thereafter, she was referred to our hospital. She had no abnormal vaginal bleeding or discharge. Transvaginal ultrasonography revealed a 95 × 80 mm cyst below the back of the uterus. Computed tomography revealed a 9.8 × 8.5 cm multilocular cyst between the cervix and right ovary. Human papillomavirus (HPV)-E6 and -E7 mRNA tests revealed HPV-16 positivity. The thin-layer, liquid-based cytological test of the cervix showed negative results. No tumor lesions were observed on the cervical biopsy histopathology. The lesion was misdiagnosed as an ovarian cyst prior to the surgery. Intraoperatively, a cyst of the size of a child's head was observed extending from the low posterior wall of the uterus to the posterior lip of the cervix, and the cervical cysts were resected. Histological examination revealed cervical adenocarcinoma. Subsequently, she underwent extensive hysterectomy, bilateral salpingectomy, and pelvic lymphadenectomy. The final diagnosis was stage IB3 cervical adenocarcinoma. After 21 months of follow-up, no clinical or radiological evidence of recurrence has been found.

Cervical Thymic Cyst - A Rare Diagnosis.

Cervical thymic cysts are rare cysts which are seen in the first decade of life in males on the left side. The following is a case of a young female with a painless swelling on the right side of the neck. She was evaluated and underwent exploration of the neck and excision of the swelling.

Diagnostic Approach to Congenital Cystic Masses of the Neck from a Clinical and Pathological Perspective.

BACKGROUND: neck cysts are frequently encountered in pediatric medicine and can present a diagnostic dilemma for clinicians and pathologists. Several clinical items enable to subclassify neck cyst as age at presentation, anatomical location, including compartments and fascia of the neck, and radiological presentation. SUMMARY: this review will briefly describe the clinical, imaging, pathological and management features of (I) congenital and developmental pathologies, including thyroglossal duct cyst, branchial cleft cysts, dermoid cyst, thymic cyst, and ectopic thymus; (II) vascular malformations, including lymphangioma. Key Messages: pathologists should be familiar with the diagnostic features and clinicopathologic entities of these neck lesions in order to correctly diagnose them and to provide proper clinical management.

Bronchogenic Cyst in the Cervical Region: A Rare Entity - A Case Report and Review of the Literature.

Bronchogenic cysts originate from the tracheobronchial bud, which arises from the embryonic foregut. Congenital bronchogenic cysts in the cervical region, especially in the thyroid or perithyroidal area, are extremely rare. Moreover, distinguishing them from other cervical cystic lesions such as thyroglossal duct and branchial cleft cysts and metastatic cervical lymph nodes is difficult preoperatively. In this report, we discuss a case of a 41-year-old woman who presented to us with a history of anterior neck swelling for two weeks with occasional palpitations and bilateral flank pain. On workup, she was diagnosed as a case of multiple neuroendocrine neoplasm type 2A for which she underwent adrenalectomy first followed by total thyroidectomy with central neck dissection and parathyroidectomy. On the final histopathology specimen, an incidental bronchogenic cyst was diagnosed. A bronchogenic cyst is a rare entity, especially in the head and neck region, and can be confused with a metastatic lymph node. Diagnosis is made based on the histopathological examination, which requires surgical excision. The bronchogenic cyst should be considered in the differential diagnosis for midline and lateral neck masses.

Quiste dermoide latero cervical / Dermoid cyst of the lateral neck

Resumen Introducción: Los quistes dermoides son lesiones de origen ectodérmico poco frecuentes. Solo un 1,6% de ellos, se presenta en el piso de la boca y de éstos, solo un 6% lateralmente en el espacio submandibular. Objetivo: Reporte de caso y revisión de la literatura. Caso clínico: Se presenta un caso de una paciente de 32 años, con un cuadro de 1 año de evolución caracterizado por una lesión de crecimiento lento pero sostenido. Se le realizó la resección de la lesión junto con una submandibulectomía ipsilateral resultando compatible con un quiste dermoide. Discusión: La localización de esta lesión es muy infrecuente. En el estudio histopatológico son lesiones con epitelio pluriestratificado cornificado y anexos cutáneos. El estudio de imágenes orienta a una lesión quística, siendo la resonancia nuclear hoy en día el mejor examen para caracterizar esta lesión. Es una lesión benigna, sin recidivas reportadas cuando la resección ha sido completa.

Introduction: Dermoid cysts are uncommon lesions from ectodermic origin. Only 1.6% arise in the floor of the mouth, and at this site only 6% arise laterally in the submandibular region. Aim: Case report and review of the literature. Clinical Case: 32 years old patient, with a slow growing lesion during 1 year. Complete resection with an ipisilateral submandibulectomy was performed. The pathologic report showed a dermoid cyst. Discussion: The localization of this lesion is very uncommon. In the pathologic report are lesion with pluri stratified cornified epthitelium with skin attachments. Image studies show a cystic lesion being the magnetic resonance the best study to characterize this lesions. Are benign lesions, without recurrence reported when the lesion has been fully excised.

Large pelvic mass arising from the cervical stump: A case report.

BACKGROUND: A large cervical cyst with a cervical high-grade squamous intraepithelial lesion arising from the cervical stump is rare. After supracervical hysterectomy, there is a risk of various lesions occurring in the cervical stump. We review the types and characteristics of cervical stump lesions and compare total hysterectomy with subtotal hysterectomy. Gynecologists should choose the most suitable surgical method based on both the patient's condition and wishes. If the cervix is retained, patients require a close follow-up. CASE SUMMARY: A 57-year-old woman was admitted to the Gynecology Department for a large pelvic mass. Her chief complaint was abdominal distention for two months. She had undergone subtotal supracervical hysterectomy for leiomyoma 14 years prior. Abdominal ultrasonography detected a 9.1 cm × 8.5 cm × 8.4 cm anechoic mass with silvery fluid in the pelvic cavity and high-risk human papilloma virus 53 (HPV53) was positive. The admission diagnosis we first considered was a pelvic mass mimicking carcinoma of the cervical stump. We performed a laparotomy and a rapid frozen biopsy was suggestive of a fibrous cyst wall coated with a high squamous intraepithelial lesion. The pelvic mass was removed, and a bilateral adnexectomy was implemented. Final pathology confirmed that the pelvic mass was a large inflammatory cyst with a cervical high-grade squamous intraepithelial lesion. After successful intervention, the patient was discharged one week after surgery and there was no recurrence of the vaginal stump at 43 mo. CONCLUSION: When addressing benign uterine diseases, gynecologists should pay adequate attention to retaining the cervix. If the cervix is retained, patients require a close follow-up.

An Uncommon Case of Cervical Thymopharyngeal Duct Cyst.

Thymopharyngeal duct cyst is one of the most uncommon benign cervical lesions encountered in the paediatric population. Due to its rarity, it almost always escapes a correct preoperative diagnosis and is usually misdiagnosed as a branchial cyst or lymphangioma. Furthermore, although located at the neck it may present with retrosternal or mediastinal extension. In this case report here we present a case of a young boy with a right cervical mass, diagnosis of thymopharyngeal duct cyst was confirmed during histopathological examination of the excised specimen. Furthermore, preoperative ultrasonography and MRI did not detect the thin cord and the lower part of the lesion, which rendered operative treatment more demanding. Apropos to these findings, we reflect on the crucial points of awareness that affect the diagnostic and surgical process of this lesion.

Unusually rapid development of a lateral neck mass: Diagnosis and treatment of a branchial cleft cyst. A case report.

INTRODUCTION: Branchial cleft cysts are benign lesions caused by anomalous development of the branchial cleft. Cases that arise in the lateral neck region are often misdiagnosed, resulting initially in inappropriate management. CASE PRESENTATION: We describe a 32-year-old woman with a swelling on the right side of her neck and no pain during palpation or neck motion. DISCUSSION: The patient was evaluated using fine-needle aspiration cytology (FNAC), ultrasound, and magnetic resonance imaging (MRI) scans. The MRI showed a right-sided cervical mass with hyperintense content, well-defined margins, and no evidence of infiltration into surrounding structures, while FNAC found a yellow, pus-like fluid, keratinised anuclear cells, squamous epithelium, and a matrix of amorphous debris. CONCLUSION: Based on the images and the patient's symptoms, a surgical intervention was performed.

Experiencia en el manejo de la patología del conducto tirogloso: serie de casos / Experience in thyroglossal duct pathology: clinical case series

La patología del conducto tirogloso constituye la segunda anomalía cervical benigna más frecuente en la infancia. El diagnóstico es principalmente clínico. Sistrunk fue quien describió la técnica quirúrgica considerada de elección para el tratamiento definitivo de esta patología. Estudio descriptivo retrospectivo. Entre junio de 2008 y agosto de 2015 se realizaron 54 procedimientos en 45 pacientes (39 casos primarios). La mediana de edad fue de 4,7 años; 14/39 pacientes (31,1%) presentaron infección preoperatoria. Todos los pacientes fueron evaluados inicialmente por ecografía. Todos fueron tratados mediante la técnica de Sistrunk. La recidiva global fue de 17,8%.

The thyroglossal duct cyst pathology represents the second cause of bening cervical anomalies in childhood. Diagnosis is mainly clinical. Sistrunk (1920) proposed a surgical technique that is still considered the gold standard for definitive treatment of this condition. A retrospective study was made including patients who underwent surgery for thyroglossal duct cyst pathology in our department between June 2008 and August 2015. In this period, we performed 54 procedures in 45 patients (39 primary cases). Median age was 4.7 years; 14/39 patients (31.1%) had pre-operative infection. All patients were studied with neck ultrasound. A Sistrunk's procedure was performed in all cases. The global recurrence rate was 17.8% (8/45).

[Experience in thyroglossal duct pathology: clinical case series]. / Experiencia en el manejo de la patología del conducto tirogloso: serie de casos.

The thyroglossal duct cyst pathology represents the second cause of bening cervical anomalies in childhood. Diagnosis is mainly clinical. Sistrunk (1920) proposed a surgical technique that is still considered the gold standard for definitive treatment of this condition. A retrospective study was made including patients who underwent surgery for thyroglossal duct cyst pathology in our department between June 2008 and August 2015. In this period, we performed 54 procedures in 45 patients (39 primary cases). Median age was 4.7 years; 14/39 patients (31.1%) had pre-operative infection. All patients were studied with neck ultrasound. A Sistrunk's procedure was performed in all cases. The global recurrence rate was 17.8% (8/45).

La patología del conducto tirogloso constituye la segunda anomalía cervical benigna más frecuente en la infancia. El diagnóstico es principalmente clínico. Sistrunk fue quien describió la técnica quirúrgica considerada de elección para el tratamiento definitivo de esta patología. Estudio descriptivo retrospectivo. Entre junio de 2008 y agosto de 2015 se realizaron 54 procedimientos en 45 pacientes (39 casos primarios). La mediana de edad fue de 4,7 años; 14/39 pacientes (31,1%) presentaron infección preoperatoria. Todos los pacientes fueron evaluados inicialmente por ecografía. Todos fueron tratados mediante la técnica de Sistrunk. La recidiva global fue de 17,8%.

Embryology, Anatomy, and Radiology of Cervical Cysts and Cleft Lip/Palate: A Team-Based Learning Module for Medical Students.

INTRODUCTION: Current medical education promotes enhanced integration of various disciplines and early exposure to clinically relevant topics. Against this background, we have developed a team-based learning (TBL) module for medical students in the preclerkship period that integrates embryology, anatomy, and radiology of the head and neck region. METHODS: The module, which includes prereading assignments, readiness assurance tests, and an application exercise, focuses on the development of the head and neck region. Students were asked to consolidate their knowledge of the topic-acquired as part of their regular curriculum-and to apply this knowledge to cases of cervical cysts and cleft lip/palate. RESULTS: The TBL module was developed for a class of 234 students. The students performed well in the TBL module. Although many students perceived the session as time-consuming, the majority of students evaluated it as relevant for their understanding of the course material and a valuable adjunct to their course. DISCUSSION: To our knowledge, as of this writing, no TBL modules have been published that focus on the integration of complex embryological topics with anatomy and radiology and that are suitable for medical students at the beginning of their education. Therefore, the presented TBL module fills a gap in material available to educators in the field.

Recurrences after thyroglossal duct cyst surgery: Results in 207 consecutive cases and review of the literature.

BACKGROUND: A thyroglossal duct cyst is the most common form of congenital anomaly in the neck. Surgical removal is very effective. However, in some cases, a cyst recurs. The purpose of this study was to identify factors that predispose to recurrence of a thyroglossal duct cyst. METHODS: A retrospective study was conducted of consecutive patients who underwent surgical resection for histologically confirmed thyroglossal duct cysts between 1998 and 2013 in a tertiary referral center. RESULTS: Two hundred seven patients were included. The overall recurrence rate was 9.7%. The most important factor predicting recurrence was the type of resection: recurrence rate was 5.3% after the Sistrunk procedure, and 55.6% after plain excision (p < .001). The only other factor that was significantly associated with chance of recurrence was postoperative infection. CONCLUSION: The Sistrunk procedure is the treatment of choice for thyroglossal duct cysts because it yields low recurrence and morbidity. Postoperative infections, rather than preoperative infections, are associated with recurrence.

Quiste tímico cervical en un niño / Cervical thymic cyst in a child

Se presenta el caso clínico de un paciente de 7 años de edad con antecedentes de buena salud, quien fue ingresado a los 5 años en el Hospital Infantil Sur de Santiago de Cuba por presentar aumento de volumen en la región lateral izquierda del cuello, doloroso, sobre todo al ingerir alimentos, y fiebre de 38 °C. Luego del tratamiento indicado egresó a los 10 días, pero con seguimiento por consulta externa. Al cabo de los 2 años y medio acudió a la consulta de Cirugía con aumento de volumen en la región lateral derecha del cuello. Se realizó la exéresis del tumor y los resultados del estudio anatomopatológico confirmaron que se trataba de un quiste tímico cervical.

The case report of a 7 years patient is presented with a history of good health who was admitted when he was 5 years in the Southern Pediatric Hospital from Santiago de Cuba for presenting increase of volume mainly in the left lateral region of the painful neck, when ingesting foods, and fever 38 °C. After the prescribed treatment he was discharged 10 days later, but with follow up through out-patient department. After 2 and a half years he came to the Surgery Department with an increase of volume in the right lateral region of the neck. The exeresis of the tumor was carried out and the results of the pathological study confirmed that it was a thymic cervical cyst.