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Concept: Ganglion cyst

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Intraspinal and extradural cysts in the cervical spine are rare disorders that may cause myelopathy or radiculopathy. A synovial cyst or ganglion derived from the facet joint and that from a ligamentum flavum have been reported. We report a surgical case of degenerative intraspinal cyst, causing cervical myelopathy. MRI of a case revealed cystic lesion at C4-5. Spinal cord was compressed by cyst and symptoms of myelopathy were also observed. The patient with cervical spinal canal stenosis underwent laminoplasty and excision of the cyst. The patient recovered well immediately after the surgery. Literature review showed that 133 patients have been reported, including the present case. Previous reports indicated that most cysts occurred in old patients and at the atlanto-axial or C7-T1 junction, and laminectomy or laminoplasty with excision of the cyst gave good results in most cases.

Concepts: Medical terms, Patient, Surgery, Vertebral column, Ovarian cyst, Spinal stenosis, Cyst, Ganglion cyst

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BACKGROUND: Intra-articular ganglion cysts of the knee are extremely rare within the pediatric population. To our knowledge, only seven case reports have been published in the medical literature identifying pediatric patients with intra-articular cysts of the anterior cruciate ligament (ACL). Intra-articular cysts of the knee are a rare cause of knee discomfort and mechanical symptoms such as locking of the knee. To our knowledge, up until now the youngest patient reported in the medical literature with an intra-articular ganglion cyst of the ACL was a 7-year-old boy. CASE REPORT: We describe a 6-year-old boy who presented with a unilateral intra-articular ganglion cyst of the ACL in the right knee. In addition to the diagnostic work-up of radiographs and MRI, the cyst was successfully treated with arthroscopic resection and debridement to decompress the cyst. CLINICAL RELEVANCE: We provide a review of the proposed pathogenesis, diagnostic modalities, differential diagnosis, treatment options, and complications of treatment for intra-articular cysts of the ACL. LEVEL OF EVIDENCE: Level V, case report.

Concepts: Medicine, Medical terms, Knee, Anterior cruciate ligament, Cyst, Ligament, Cruciate ligament, Ganglion cyst

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BACKGROUND CONTEXT: There are rare reports of intraosseous ganglion cysts in the cervical spine. However, to our knowledge, there are no previous reports of these cysts occurring in the lumbar spine. PURPOSE: To report a case of symptomatic lumbar spinal stenosis caused by an intraosseous ganglion cyst of the L4 lamina that communicated with the spinal canal. STUDY DESIGN: Case report. METHODS: An 86-year-old woman was referred to our spine service for a 2-year history of anterior thigh and leg pain. Magnetic resonance imaging revealed a benign-appearing intraosseous cyst in the left L4 lamina communicating with a posterior epidural cyst at L4-L5 causing marked spinal stenosis. The patient was treated successfully with a laminectomy and resection. RESULTS: The patient underwent partial laminectomies of L4 and L5 preserving the interspinous ligaments between L5-S1 and L3-L4. The cyst was removed en bloc without violation of the cyst wall. Histopathologic examination revealed focal myxoid changes without a cellular lining of the cyst wall, confirming the diagnosis of intraosseous ganglion cyst. CONCLUSIONS: This is the first report to describe an intraosseous ganglion cyst occurring in the lumbar spine. Although spinal stenosis is commonly a result of degenerative joint or disc disease, it occasionally may result from more obscure causes. This case illustrates a patient with an intraosseous ganglion cyst within the spinal lamina resulting in spinal stenosis, treated successfully with a laminectomy and resection.

Concepts: Causality, Lumbar vertebrae, Vertebral column, Magnetic resonance imaging, Bones of the torso, Cyst, Cervical vertebrae, Ganglion cyst

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Background Ganglion cysts in the temporomandibular joint are treated by resection; however, there has been insufficient discussion regarding the appropriate approach for surgical resection. Clinical presentation A 55-year-old man presented with a left preauricular swelling for one year. The examination revealed a moderately hard mass with a 30-mm diameter, tenderness, and restricted movement. Magnetic resonance imaging showed a cystic lesion with a 25 mm-long axis. Considering a diagnosis of temporomandibular cyst, separation of the cyst wall through a preauricular incision was attempted. However, the cyst ruptured due to strong adherence on the reverse side. Curettage followed by discectomy was performed. Histopathological diagnosis was of a ganglion cyst. Among 39 reported cases, 24 were excised via the preauricular approach, with 8 intraoperative cyst ruptures. Conclusion The parotidectomy approach should be employed when the cyst is large, at a low position, or adherent to the surrounding tissue, in order to achieve reliable excision.

Concepts: Ganglion, Surgery, Magnetic resonance imaging, Joint, Cyst, Dermoid cyst, Ganglion cyst, Carpometacarpal bossing

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A 60-year-old woman presented with a painless swelling in the right preauricular region. Physical examination revealed a soft, nontender, oval-shaped lump in this location. Computed tomography indicated an anterolateral cystic lesion that was attached to the condyle of the mandible and to the accessory parotid gland. Differential diagnoses included ganglion cyst, synovial cyst of the temporomandibular joint, and accessory parotid gland cyst. Surgical removal of the cyst was performed with the patient under general anesthesia. The specimen was 18 × 20 × 18 mm in size; it contained fluid that was clear, slightly yellow, and amylase positive. Hematoxylin and eosin staining revealed that a bilayer cuboidal epithelium lined the cyst wall. Immunohistochemical analyses of the cyst wall showed strong expression of cytokeratin and weak expression of vimentin. The final diagnosis was a salivary duct cyst. The postoperative course was uneventful except for a transient facial motor paresis.

Concepts: Medical diagnosis, Cranial nerves, Immunohistochemistry, Cyst, Parotid gland, Temporomandibular joint, Submandibular gland, Ganglion cyst

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Intraosseous ganglion cysts are rare entities, even rarer in the subchondral region of the distal tibia. A 20-year-old male presented to us with complaints of pain and limp in the right ankle joint, which was diagnosed as an intraosseous ganglion cyst of the right distal tibia and was successfully treated with curettage and bone cement with no recurrence seen even after a year.

Concepts: Ganglion, Cyst, Ankle, Ganglion cyst

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Peroneal intraneural ganglion cysts (IGCs) are nonneoplastic lesions. They are responsible for a small number of footdrop cases, which occur after additional nerve damage. The earliest patient symptom related to IGCs is knee pain.

Concepts: Ganglion, Cyst, Ganglion cyst

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To observe the effect of electroacupuncture (EA) on mechanical hyperalgesia threshold (MHTs) and thermal hyperalgesia threshold (THTs) and content of proteinase-activated receptors 2 (PAR 2) in dorsal root ganglia (DRG) in rats with inflammatory pain, so as to explore its peripheral mechanism underlying improvement of inflammatory pain.

Concepts: Inflammation, Nervous system, Ganglion, Dorsal root ganglion, Nociception, Data management, Ganglion cyst

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The intraoperative use of intravenous fluorescein is presented in a case of peroneal intraneural ganglion cyst. When illuminated with the operative microscope and yellow filter, this fluorophore provided excellent visualization of the abnormal cystic peroneal nerve and its articular branch connection. The articular (synovial) theory for the pathogenesis of intraneural cysts is further supported by this pattern of fluorescence. Further, our report presents a novel use of fluorescein in peripheral nerve surgery.

Concepts: Ganglion, Fluorescein, Cyst, Ganglion cyst