Thymic cyst in the neck. Apropos of a case

Accidents are the most common cause of death in children over one year of age. Prevention remains a high priority. We have reviewed the current epidemiology of childhood accidents and their prevention, and made recommendations for the future. In 1992, 559 children died in United Kingdom as a result of an accidents--240 from road traffic accidents and 100 from burns and scalds. Every year 50 children drown. Accidents cause significant disability to children. Many children, up to one in four of the population in urban areas, attend accident and emergency departments, and 5-10% of these are admitted to hospital. Accident risk factors include low social class, psychosocial stress, an unsafe environment, and child developmental disorders. Research has shown that prevention is best achieved by making the child's environment safer, often through legislation. Insufficient resources have been put into both research into childhood injuries and preventive work in communities. Collaboration between health authorities, NHS trusts, local authorities and community networks is vital if success is to be achieved. A national safety agenda for children would focus the attention that this problem deserves.     

Spinal aneurysmal cyst with medullary compression. Apropos of a case with preoperative embolization

The authors report the case of a vertebral aneurysmal bone cyst, at the thoracic level, with spinal cord compression. 16 months after operation, the initial neurological signs reappeared. Selective angiography pointed out a good picture, through not specific, of the lesion; the embolisation, then performed, provided considerable relief for the complete removal of the important vascular bone formation. The diagnostic, therapeutic and pathogenic problems of the vertebral aneurysmal bone cysts are discussed.     

Hydatid cyst of the psoas muscle. Apropos of a case

The authors report a rare case of hydatid cyst of the psoas muscle in a 28-year-old woman, operated for vertebrospinal hydatid cyst. The patient presented with a left iliac fossa mass. Ultrasonography and computed tomography contributed to the preoperative diagnosis, despite negative hydatid serology. A retroperitoneal approach by left lumbotomy with partial pericystectomy was performed. In the light of this case, the authors discuss the diagnostic and therapeutic problems raised by hydatid cyst of the psoas muscle.     

Intraorbital conjunctival cyst after a penetrating orbital injury: a case report

We report a case of intraorbital conjunctival cyst following a penetrating orbitocranial injury. The patient was a 28-year-old male who was hospitalized with exophthalmos, retrobulbar pain and upper gaze disturbance of his left eye. When he was 4 years old, a thin iron rod had penetrated intracranially through the inner angle of his left orbit. He was hospitalized and treated conservatively for about two weeks. The left eye ball was intact and visual acuity was normal, although bloody fluid had continuously flowed out from the left inner angle of the conjunctival wound for a few days. He had been febrile to 39 degrees C and complained of headache for one week. Subsequentry, the symptoms gradually improved through conservative therapy. When he was a junior high school student, he noticed exophthalmos of his left eye. However, he had never been examined closely, until he was 28 years old. We suspect that he had suffered from meningitis caused by the penetrating orbitocranial injury, and had fortunately improved under the conservative therapy. On admission to our hospital, a craniogram showed fracture of the left orbital roof, and coronal and three-dimensional computed tomography (CT) scans clearly demonstrated the orbital fracture. CT revealed a cystic mass in the retrobulbar space, and a porencephalic cyst in the medial basal frontal lobe. On magnetic resonance imaging (MRI) scans, both cysts were of low intensity on T1-weighted imaging, and of high intensity on T2-weighted images. Coronal and sagittal MRI scans showed that the two cysts were connected with each other through the fracture in the orbital roof. We diagnosed therefore that the orbital cyst was a herniated porencephalic cyst of the frontal lobe. Surgery was performed by a transcranial approach. The porencephalic cyst adhered to the fractured lesion of the frontal base but did not extend into the orbita. The intraorbital cyst was totally removed by opening the orbital roof including the fractured lesion. The cyst contained milky fluid. Postoperatively, the exophthalmos, retrobulbar pain and upper gaze disturbance showed gradual improvement. On histological examination, the cyst was found to be lined by non-keratinized stratified squamous epithelium and was diagnosed as a conjunctival cyst. This case was considered to be one of traumatic conjunctival cysts caused by a penetrating orbitocranial injury. Orbital conjunctival cysts have been reported to comprise about 10% of orbital epidermoid and dermoid cysts. Of these cysts, traumatic conjunctival cysts are rare, and only a few cases have been described. The etiology and therapy of orbital conjunctival cysts are discussed.     

Syringomyelia associated with posterior fossa cyst: a case report

We report a case of a 47-year-old woman with a posterior fossa cyst associated with syringomyelia and hydrocephalus. Her birth was traumatic and she had suffered a fractured skull. About 10 years prior to coming to our department she had occipitalgia and a pain had developed over a month from her right shoulder to hand. Shortly before presenting occasional electric-like shocks were felt in her right hand associated with coughing and hiccuping. Magnetic resonance imaging (MRI) revealed a large midline posterior fossa cyst, hydrocephalus and syrinx (C1-Th11). Cisternography could not demonstrate communication between the cyst and the subarachnoid space and the 4th ventricle was present but without communication with the cyst. The cyst was tentatively diagnosed as an arachnoid cyst. One week after placement of a cyst-peritoneal shunt, CT scans showed a decrease in cyst and ventricle size and 2 months later a follow-up MRI revealed resolution of the syringomyelia. We suspected that cyst-peritoneal shunt was effective for this patient who had syringomyelia associated with incommunicated posterior fossa cyst.     

Septo-optic dysplasia associated with bilateral complex microphthalmos

Examination of magnesium concentrations in the blood serum was carried out on a population of 246 patients 17-39 years old in pathologic/imminent abortion, imminent immature and premature labour and normal pregnancies as well as in first periods of parturition. In spite of considerable oscillations of magnesium concentrations in respective periods of normal and imminent pregnancies, the differences were statistically insignificant. A significant decrease of magnesium concentrations was found in the first period of parturition as compared with the imminent and normal pregnancies of the first and second trimester.     

Microphthalmos with orbital cyst: a clinicopathological report

The clinical and histopathological findings in a case of microphthalmos with orbital cyst is described. The clinical interesting feature of this case was the bilateral coloboma which represented interference in the development of the eye at different stages of embryonic life.     

A case of gliosarcoma associated with large cyst

A case of gliosarcoma with a large cyst is reported. A 22-year-old female was admitted to our hospital with complaints of blurred vision and headache. Plain skull x-ray films showed a radiolucent area in the right frontal area. Computed tomography (CT) revealed an iso-dense mass in the right frontal lobe with a large cyst. After administration of contrast medium, the solid part and cyst wall were well enhanced and the content of the cyst was slightly enhanced. CT number of the cyst fluid was increased from 64.2 to 83.5 Hounsfield units, after administration of the contrast medium. Axial T1-weighted magnetic resonance image (MRI) revealed an iso-intense mass with marked enhancement by Gd-DTPA in the same area. A large cyst was shown to be located in the dorsal part of the mass. A small round protrusion, 10 mm in diameter, was found on the anterior portion of the mass on this MRI. Right carotid angiogram showed a tumor stain fed by the frontopolar artery. Right frontal lobectomy including the tumor was carried out with a preoperative diagnosis of glioblastoma. The patient received radiation therapy of 60Gy (whole brain 40Gy; focal 20Gy) and chemotherapy postoperatively. Histologically, necrosis, hemorrhage and endothelial hyperplasia were revealed at the tumor lesion. The tumor was composed of proliferation of glial and mesenchymal elements. The glial element appeared as fibrillary astrocytoma and polar spongioblastoma. The mesenchymal element showed sarcoma. As mentioned above, this tumor was diagnosed as gliosarcoma. It was difficult to make a diagnosis of gliosarcoma preoperatively because of the complex findings similar to malignant gliomas in conventional neuroradiological imaging.(ABSTRACT TRUNCATED AT 250 WORDS)     

Tracheobronchopathia osteochondroplastica . Apropos a case

We present one case of osteochondroplastic tracheobronchopathy in a patient with right laterocervical tumoration as a manifestation of a normofunctional nodular goiter detected in a thyroid morphofunctional study, and tracheal stenosis secondary both to the goiter and the tracheobronchial process. The coincidence of these two processes, probably fortuitous, has never been described before.     

Melanosis peritonei associated with enteric duplication cyst. A case report

Melanosis peritonei is extremely rare, and only five cases have been reported in the English literature, four in association with ovarian dermoid cysts, and one with a peritoneal cyst. We describe an additional case occurring in a girl two years of age who also had an enteric cyst. This is the first reported case of melanosis peritonei not associated with an ovarian teratoma, but with an enteric duplication cyst. Melanophages were present focally in the submucosa, superficial muscle layer, and ulcer bases of the cyst and extensively as small nodules on the peritoneal surface and in the omentum. The tendency of perivascular nodular aggregation of melanophages favors a hematogenous (or lymphatic) spread rather than implantation. Although clear evidence of melanocytic aggregation is lacking, are speculate that the melanin originated from the esophageal-like squamous mucosa of the cyst.     

Multiple pilomatricoma. Apropos of a case

Pilomatricoma is a benign, solitary tumor. The histopathologic findings of viable basaloid cells in the periphery, shadow cells in the central part and foci of calcification are characteristic of pilomatricoma. The microscopic aspect of multiple pilomatricomas was not different from solitary pilomatricomas. Though, some consider them as a pathognomonic sign of myotonic dystrophy. Complete surgical excision is the best management.     

Pseudocystic ureteritis. Apropos of a case

The authors report one case of ureteritis cystica in a young adult. The diagnosis was made by intravenous urography and confirmed by histologic examination. The patient was treated surgically (nephro-ureterectomy). The etiopathogenic, clinical and therapeutic aspects are discussed with a review of literature.     

Odontoid bone. Apropos of a case

Reporting a clinical observation, the authors emphasize upon the extreme scarceness of this variety of so called "congenital" pseudarthrosis of the odontoid process. The congenital origin, due to a lack of fusion, or the acquired one by avascular necrosis following a trauma is explained. The diagnosis may be clinical, consisting either on a vertebral syndrome occurring in childhood, or on a neurological syndrome in the adult age. It is mainly radiological : A scanner investigation is presented here. Owing to the potential neurological severity of the disease, the posterior fusion has to be recommanded.     

Apropos of a rare case of bilateral orbital metastasis of malignant melanoma of the choroid

We report a case of bilateral orbital metastasis from an ocular choroidal melanoma which had required enucleation eight years earlier. This uncommon case was fully documented with clinical, radiological and pathological studies. Magnetic resonance imaging was particularly contributive showing very characteristic sequences. The patient was given focal palliative cobalt radiotherapy. We compared this case with previous reports in the litterature.     

Secreting retroperitoneal paraganglioma. Apropos of a case

A case of secreting, asymptomatic retroperitoneal paraganglioma is presented. Paragangliomas are rare neuroendocrine tumors and the malignant behaviour, higher than pheochromocytomas, is based on metastases or local recurrence. The treatment is complete surgical excision. Radiotherapy and chemotherapy may be used for palliation of symptoms.