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Tay WC, Chia HY, Cheng SWN. Acquired lymphangioma circumscriptum of the vulva (secondary to lymphatic obstruction) occurring ten years after a hysterectomy and radiotherapy: A case report. Taiwan J Obstet Gynecol 2023; 62:184-186. [PMID: 36720539 DOI: 10.1016/j.tjog.2022.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2022] [Indexed: 01/30/2023] Open
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Massimi L, Bianchi F, Benato A, Frassanito P, Tamburrini G. Ruptured Sylvian arachnoid cysts: an update on a real problem. Childs Nerv Syst 2023; 39:93-119. [PMID: 36169701 PMCID: PMC9968703 DOI: 10.1007/s00381-022-05685-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/19/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE Sylvian arachnoid cysts (SACs) are the most common type of arachnoid cysts and the most prone to undergo a rupture. This event is considered rare but potentially severe. No definite information is available on its occurrence or management. The goal of the present article is to provide an update on the epidemiological, etiological, and clinical aspects and the management of this peculiar clinical condition. METHODS A comprehensive review of the English literature of the last 40 years on this topic has been realized. Moreover, a personal series of children investigated and treated in the last 20 years is presented. These patients were managed as follows: (1) treatment of the subdural collection; (2) identification of candidates for surgical treatment of the residual cyst (brain MRI, perfusion brain MRI, prolonged invasive ICP monitoring (selected cases), EEG, neuropsychological tests); (3) surgical treatment of the cyst in the patients with pathological perfusion MRI and/or ICP measurement and/or clear neurophysiological and neuropsychological correlations. RESULTS A total of 446 patients (430 from the literature and 16 from the personal series), mainly children, adolescents, and young adults, have been analyzed leading to the following results: (1) SAC rupture is rare but not negligible (yearly risk of rupture: 0.04%; overall risk up to 10% in children affected by SCAs). Prophylactic surgery in asymptomatic cases is not advisable. (2) The mechanism of rupture is not known but an impact of SAC against the sphenoid wing and/or a direct injury on SAC through a thinned temporal bone, with possible laceration of the cyst wall vessels and/or tear of the bridging veins, can be hypothesized. A head injury is often not reported (may be misdiagnosed). (3) Subdural collection (hygroma > chronic hematoma) is the most common finding followed by intracystic bleeding, extradural hematoma, and other types of bleeding. Signs or symptoms of raised intracranial pressure are the most frequent ones. (4) The complication of the rupture is usually treated in emergency or in the acute period by burr hole or craniotomic evacuation of the subdural collection, although a conservative management is possible in some cases. Following the rupture, the majority of SACs are treated (70%), often at the same time of the complication, but no specific investigations are routinely performed to select candidates. According to our protocol, only 43.7% of SACs needed to be treated. CONCLUSIONS The "spontaneous" or posttraumatic rupture of SACs is a rare but potentially significant complication followed by a generally good outcome. The course of the cyst is independent from the outcome of the complication, consequently requiring specific investigations for individuating those lesions interfering with CSF dynamics and/or cerebral blood flow.
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Affiliation(s)
- L Massimi
- Pediatric Neurosurgery, Fondazione Policlinico Universitario, A. Gemelli IRCCS, Rome, Italy.
- Catholic University of the Sacred Heart, Rome, Italy.
| | - F Bianchi
- Pediatric Neurosurgery, Fondazione Policlinico Universitario, A. Gemelli IRCCS, Rome, Italy
| | - A Benato
- Pediatric Neurosurgery, Fondazione Policlinico Universitario, A. Gemelli IRCCS, Rome, Italy
| | - P Frassanito
- Pediatric Neurosurgery, Fondazione Policlinico Universitario, A. Gemelli IRCCS, Rome, Italy
| | - G Tamburrini
- Pediatric Neurosurgery, Fondazione Policlinico Universitario, A. Gemelli IRCCS, Rome, Italy
- Catholic University of the Sacred Heart, Rome, Italy
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Al-Karaja L, Ibdah MG, Tos SM, Giacaman N, Yousef AMA, Salhab R. Rapidly enlarging axillary cystic hygroma in a 6-year-old male patient: A case report and literature review. Int J Surg Case Rep 2022; 102:107806. [PMID: 36502657 PMCID: PMC9758516 DOI: 10.1016/j.ijscr.2022.107806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/25/2022] [Accepted: 11/27/2022] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Cystic hygromas are relatively uncommon tumors of lymphatic origin, it appears most of the time, approximately 90 % before age of 2 years, and it is caused by abnormal development of lymphatic vessels. CASE PRESENTATION Here we report a case of axillary cystic hygroma in a 6-year-old healthy boy, which presented with the rapid development of a right axillary mass during 3 days, without any predisposing factor. DISCUSSION Cystic hygromas occur due to complete or partial obstruction of lymphatic vessels, which leads to lack of communication with the venous system, this results in the accumulation of lymphatic fluid and swelling, it occurs in the cervicofacial region most of the time 75 %, but it can arise anywhere in the body, it classically presents as painless, soft mass, diagnosis can be done using ultrasound, CT, MRI, each of which has its advantages, surgical treatment is routinely favored, but other options are also available. CONCLUSION Axillary cystic hygromas are quite rare, few cases have been reported in fetuses and adults, but only one case in the pediatric age group, thus, in light of these cases, cystic hygromas should be considered in the differential diagnosis of any cystic axillary swelling.
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Affiliation(s)
- Layth Al-Karaja
- Al-Quds University, College of Medicine, Palestine,Corresponding author at: Al-Quds University, Main Campus, Abu Dis, P.O. Box 89, Palestine.
| | | | - Salem M. Tos
- Al-Quds University, College of Medicine, Palestine
| | | | | | - Rafiq Salhab
- General Surgery Department, Al Ahli Hospital, Hebron, Palestine
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Andersson J, Wikström J, Högberg U, Wester K, Thiblin I. External Hydrocephalus as a Cause of Infant Subdural Hematoma: Epidemiological and Radiological Investigations of Infants Suspected of Being Abused. Pediatr Neurol 2022; 126:26-34. [PMID: 34736060 DOI: 10.1016/j.pediatrneurol.2021.09.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 09/15/2021] [Accepted: 09/25/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Acute subdural hematoma (ASDH) and chronic subdural hematoma (CSDH) in infants have been regarded as highly specific for abuse. Other causes of CSDH have not been investigated in a large population. PURPOSE The purpose of this study was to investigate to what extent external hydrocephalus is present in infants with ASDH and CSDH undergoing evaluation for abuse. MATERIAL AND METHODS Eighty-five infants suspected of being abused, with ASDH (n = 16) or CSDH (n = 69), were reviewed regarding age, risk factor profiles, craniocortical width (CCW), sinocortical width (SCW), frontal interhemispheric width (IHW), subarachnoid space width (SSW), and head circumference (HC). In infants with unilateral subdural hematoma (SDH), correlations between contralateral SSW and ipsilateral CCW and SDH width were investigated. RESULTS Infants with CSDH had significantly lower mortality, were more often premature and male, and had significantly higher CCW, SCW, IHW, and SSW than infants with ASDH (P < 0.05). Ipsilateral CCW (R = 0.92, P < 0.001) and SDH width (R = 0.81, P < 0.01) correlated with contralateral SSW. Increased HC was more prevalent in infants with CSDH (71%) than in infants with ASDH (14%) (P < 0.01). Forty-two infants, all with CSDH, had at least one of CCW, SCW, or IHW ≥95th percentile. Twenty infants, all with CSDH, had CCW, SCW, and IHW >5 mm, in addition to increased HC. CONCLUSION A substantial proportion of infants with CSDH who had been suspected of being abused had findings suggesting external hydrocephalus.
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Affiliation(s)
- Jacob Andersson
- Forensic Medicine, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
| | - Johan Wikström
- Neuroradiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Ulf Högberg
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden & Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Knut Wester
- Department of Clinical Medicine K1, University of Bergen, Bergen, Norway
| | - Ingemar Thiblin
- Forensic Medicine, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
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Deora H, Mishra A, Gupta R, Konar S, Vazhayil V, Shashidhar A, Dwarakanath S. Paediatric chronic subdural haematoma: what are the predisposing factors and outcomes in management of these cases? Childs Nerv Syst 2022; 38:123-132. [PMID: 34487204 DOI: 10.1007/s00381-021-05341-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 08/21/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Chronic subdural hematoma (cSDH) is a disease of the elderly population. Incidence in paediatric population is relatively uncommon. Child abuse, birth trauma, coagulopathy and shunt surgeries represent major causes. Major impact of the disease on life of patient due to recurrence and repeat surgical procedure is significant, not to mention the burden on health care system. MATERIAL AND METHODS We retrospectively reviewed our institute data for chronic sub-dural cases for the past 10 years (2008-2018) and collected data on the demography, clinical features, metabolic workup, mode of treatment, recurrence rates, predisposing factors, laterality, hematoma characteristics and factors associated with recurrence in all cases with less than or equal to 18 years of age. RESULTS A total of 30 such cases were found in a period of 10 years (2008-2018). The mean patient age was 7.3 years (range 2 months-17 years), with 20 males (66.67%) and 10 females (33.33%). Raised intracranial pressure (n = 9) was the commonest presenting symptom in 30% of cases followed by seizures in 26.67% (n = 8). The previous shunt was the commonest predisposing factor seen in 43.33% (n = 13). cSDHs were unilateral in 56.67% cases (n = 17) and bilateral in 43.33% (n = 13). Burr hole craniostomy was done in 27 cases (90%), and conservative management was done in three cases (10%). Follow up was available for 27 cases (90%) with a mean follow up duration of 24 months. Recurrence rate was 30% (n = 9). Shunt surgery contributed to 77% of bilateral disease (p = 0.009). Child abuse was not reported in our series. CONCLUSION Presence of paediatric cSDH is alarming, and the physician should be alerted to look for underlying cause and rule out child abuse. Detailed metabolic, skeletal workup is required. Treatment of primary pathology should be the goal as CSF diversion is not the solution to all problems, but can definitely be the cause of all the problems.
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Affiliation(s)
- Harsh Deora
- Neurosurgery, NIMHANS, Hosur Road, Bangalore, Karnataka, India
| | - Ajit Mishra
- Neurosurgery, NIMHANS, Hosur Road, Bangalore, Karnataka, India
| | - Rahul Gupta
- Neurosurgery, NIMHANS, Hosur Road, Bangalore, Karnataka, India
| | - Subhas Konar
- Neurosurgery, NIMHANS, Hosur Road, Bangalore, Karnataka, India
| | - Vikas Vazhayil
- Neurosurgery, NIMHANS, Hosur Road, Bangalore, Karnataka, India
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Ko K, Evers J, Smith T, Morshuis WJ, Geuzebroek GSC. Perigraft hygroma mimicking recurrent angiosarcoma of the right atrium. Gen Thorac Cardiovasc Surg 2021; 70:184-189. [PMID: 34787734 DOI: 10.1007/s11748-021-01737-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 11/05/2021] [Indexed: 11/28/2022]
Abstract
Primary cardiac angiosarcoma is extremely rare, has a poor prognosis and has no specific clinical manifestation. A 31-year-old pregnant woman presented to the emergency department with signs of pericardial tamponade. Transesophageal echocardiography (TEE) showed a mass within her right atrium. Extensive surgical resection was performed with subsequent pericardial patch reconstruction of the right atrium. Histological examination showed the presence of an angiosarcoma. A reoperation was performed 18 months after the initial operation, because of concerns of radicality. Three years later she was re-admitted with a superior caval vein syndrome. A stent was placed to relieve symptoms. Because of the suspicion of a recurrent tumor, a second reoperation followed. During this operation, a perigraft hygroma was found pressing against the previously reconstructed superior caval vein. Histological examination after both reoperations showed no signs of a recurrent angiosarcoma. Until today, 8 years after her first surgery, the patient is still alive without any signs of recurrent tumor.
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Affiliation(s)
- Kinsing Ko
- Department of Cardiothoracic Surgery, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands.
| | - Jort Evers
- Department of Cardiothoracic Surgery, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Tim Smith
- Department of Cardiothoracic Surgery, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Wim J Morshuis
- Department of Cardiothoracic Surgery, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Guillaume S C Geuzebroek
- Department of Cardiothoracic Surgery, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
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Gergelé L, Manet R, Kolias A, Czosnyka M, Lalou A, Smielewski P, Hutchinson PJ, Czosnyka ZH. External Hydrocephalus After Traumatic Brain Injury: Retrospective Study of 102 Patients. Acta Neurochir Suppl 2021; 131:35-38. [PMID: 33839814 DOI: 10.1007/978-3-030-59436-7_8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
INTRODUCTION External hydrocephalus (EH) refers to impairment of extra-axial cerebrospinal fluid flow with enlargement of the subarachnoid space (SAS) and concomitant raised intracranial pressure (ICP). It is often confused with a subdural hygroma and overlooked, particularly when there is no ventricular enlargement. In this study, we aimed to describe the epidemiology of EH in a large population of adults with traumatic brain injury (TBI). METHODS This observational, retrospective cohort study was conducted in adult patients who were admitted with TBI to the Department of Clinical Neuroscience at Addenbrooke's Hospital (Cambridge, UK) over a period of 3 years (2014-2017). Patients were included in the study if they had ICP monitoring and at least three CT scans within the first 21 days to assess SAS evolution. Patients who underwent a decompressive craniectomy were excluded. SAS was assessed individually on each CT scan by two independent investigators. ICP data were analysed with ICM+ software (Cambridge Enterprise Ltd., Cambridge, UK). Short-term and 6-month outcomes were examined. The groups of patients with and without EH were compared. RESULTS Of the 102 patients included in the study, 30.4% developed EH after a delay of 2.98 ± 2.4 days. The initial Glasgow Coma Scale (GCS) scores did not differ between patients with and without EH. Subarachnoid haemorrhage was found to be the main risk factor for EH. Patients with EH required a significantly longer period of mechanical ventilation (+6.9 days), were more likely to have a tracheostomy (55% versus 33%), and had a longer stay in the intensive care unit (+8.5 days). ICP was higher during the 48 h after diagnosis of EH than during the previous 48 h. EH survivors had a lower mean Glasgow Outcome Scale Extended (GOS-E) score (4.6 versus 5.9, P = 0.031) and were more likely to receive a permanent shunt for secondary hydrocephalus (17.4% versus 1.8%, odds ratio 7.1). CONCLUSION In adults with TBI, EH remains insufficiently understood and probably underdiagnosed. This study showed that it is a frequent complication of TBI, with significant clinical consequences.
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Affiliation(s)
- Laurent Gergelé
- Intensive Care Unit, Ramsay Santé
- , Hôpital Privé de la Loire, Saint Etienne, France. .,Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neuroscience, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK.
| | - Romain Manet
- Department of Neurosurgery B, Hôpital P. Wertheimer, Hospices Civiles de Lyon, Lyon, France
| | - A Kolias
- Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neuroscience, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Marek Czosnyka
- Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neuroscience, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - A Lalou
- Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neuroscience, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Peter Smielewski
- Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neuroscience, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Peter J Hutchinson
- Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neuroscience, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Zofia H Czosnyka
- Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neuroscience, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
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Nguyen VN, Wallace D, Ajmera S, Akinduro O, Smith LJ, Giles K, Vaughn B, Klimo P. Management of Subdural Hemato hygromas in Abusive Head Trauma. Neurosurgery 2020; 86:281-287. [PMID: 31321424 DOI: 10.1093/neuros/nyz076] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 02/16/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The optimal management of nonacute subdural fluid collections in infantile abusive head trauma (AHT) remains controversial. OBJECTIVE To review the outcomes and costs of the various treatments for symptomatic subdural fluid collections in children with AHT at a single center. METHODS Our AHT database was queried to identify children requiring any intervention for hematohygromas. Demographic, hospital course, radiologic, cost, readmission, and follow-up information were collected. RESULTS From January 2009 to March 2018, the authors identified 318 children with AHT, of whom 210 (66%) had a subdural collection of any type (blood or cerebrospinal fluid). A total of 50 required some form of intervention specifically for chronic hematohygromas. The initial management consisted of transfontanelle percutaneous aspiration (n = 31), burr holes with (n = 12) or without (n = 3) external subdural drainage, and mini-craniotomy (n = 4). Of those who were initially managed with 1 or more needle aspiration, 23 (74%) required further intervention-12 subduroperitoneal shunts and 11 nonshunt procedures. No patient who underwent burr holes/external drainage required further intervention (n = 16). Overall, the average number of interventions needed in these 50 children for definitive treatment was 1.8 (range, 1-4). A total of 15 children ultimately required a subduroperitoneal shunt. Complications (infectious, hemorrhagic, and thrombotic) were significant and occurred in all treatment groups except burr holes without drainage (n = 3). The average hospital charge for the entire cohort was $166 300.25 (range, $19 126-$739 248). CONCLUSION Based on our experience to date, burr hole with controlled external subdural drainage is an effective and preferred treatment for traumatic hematohygromas; complications and need for additional intervention is low.
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Affiliation(s)
- Vincent N Nguyen
- Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - David Wallace
- College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Sonia Ajmera
- College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Oluwatomi Akinduro
- College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Lydia J Smith
- Neuroscience Institute, LeBonheur Children's Hospital, Memphis, Tennessee
| | - Kim Giles
- Neuroscience Institute, LeBonheur Children's Hospital, Memphis, Tennessee
| | - Brandy Vaughn
- Neuroscience Institute, LeBonheur Children's Hospital, Memphis, Tennessee
| | - Paul Klimo
- Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee.,Neuroscience Institute, LeBonheur Children's Hospital, Memphis, Tennessee.,Semmes Murphey, Memphis, Tennessee
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Macki M, Anand SK, Jaratli H, Dabaja AA. Penile Lymphangioma: review of the literature with a case presentation. Basic Clin Androl 2019; 29:1. [PMID: 30705756 PMCID: PMC6348653 DOI: 10.1186/s12610-018-0081-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 12/05/2018] [Indexed: 11/10/2022] Open
Abstract
Background Penile lymphangiomas are rare manifestations of lymphangiomas or lymphatic malformations which are more commonly found in the head or neck region of the body. Lymphangiomas are further categorized as lymphangioma circumscriptum, cavernous lymphangioma, cystic hygroma, or acquired lymphangiomas (also known as lymphangiectasia), based on their depth and etiology. Results A literature review revealed only 30 cases of penile lymphangioma between 1947 and March 30, 2018. Several causes were attributed to the acquired penile lymphangiomas, including trauma, phimosis, and infection. While penile lymphangiomas can be initially mistaken for an infection, a thorough history and physical examination is sufficient to clinically diagnose a lymphangioma of the penis. Historically, surgical excision has been the gold standard of treatment for this condition. When asymptomatic, patients may opt for conservative management with avoidance of mechanical trauma alone. Other physicians have revealed novel treatment plans to rid patients of their penile lymphangioma such as a staged laser procedure. Conclusion In this article, we elucidate the causes, symptoms, treatments, and outcomes associated with penile lymphangiomas found in the literature while also presenting the case of a 30-year-old African-American man diagnosed with acquired penile lymphangioma.
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Affiliation(s)
- Mohamed Macki
- Department of Neurosurgery, Henry Ford Hospital, 2799 West Grand Blvd, Detroit, MI 48202 USA
| | - Sharath Kumar Anand
- Department of Neurosurgery, Henry Ford Hospital, 2799 West Grand Blvd, Detroit, MI 48202 USA
| | - Hayan Jaratli
- Department of Pathology, Henry Ford Hospital, 2799 West Grand Blvd, Detroit, MI 48202 USA
| | - Ali A Dabaja
- 3Department of Vattikuti Urology Institute, Henry Ford Hospital, 2799 West Grand Blvd, Detroit, MI 48202 USA
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García Romero JC, Ortega Martínez R, Zabalo San Juan G, de Frutos Marcos D, Zazpe Cenoz I. Subdural hygroma secondary to rupture of an intracranial arachnoid cyst: description of 2cases and review of the literature. Neurocirugia (Astur) 2018; 29:260-264. [PMID: 29627291 DOI: 10.1016/j.neucir.2018.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 01/18/2018] [Accepted: 02/03/2018] [Indexed: 11/18/2022]
Abstract
The appearance of a subdural hygroma after the rupture of an arachnoid cyst wall is extremely rare, with very few cases described in the literature. Most cases are due to a traumatic cause. The therapeutic approach in symptomatic cases is controversial, with a current tendency toward conservative management initially. In those cases that require surgical treatment, multiple therapeutic options are available, with fenestration techniques being recommended as first-line treatment. We describe 2cases treated in our centre and review the literature.
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Affiliation(s)
| | | | | | | | - Idoya Zazpe Cenoz
- Servicio de Neurocirugía, Complejo Hospitalario de Navarra, Pamplona, España
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Malcolm JG, Miller BA, Grossberg JA, Pradilla G, Ahmad FU. Early urgent cranioplasty for symptomatic hygroma: Report of two cases. J Clin Neurosci 2016; 34:273-275. [PMID: 27523587 DOI: 10.1016/j.jocn.2016.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 08/01/2016] [Indexed: 10/21/2022]
Abstract
Following craniectomy, hygromas are relatively common. While many cases resolve spontaneously, some patients develop neurologic deficits. Management of symptomatic hygromas often involves shunting or drainage. We present two patients who three weeks after decompressive hemicraniectomy developed declining neurologic status secondary to enlarging hygroma. Failing conservative management, both were treated with urgent cranioplasty and returned to neurologic baseline. Early cranioplasty may be safe and effective for symptomatic collections.
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Affiliation(s)
- James G Malcolm
- Department of Neurological Surgery, Emory University, Atlanta, GA, United States
| | - Brandon A Miller
- Department of Neurological Surgery, Emory University, Atlanta, GA, United States
| | - Jonathan A Grossberg
- Department of Neurological Surgery, Emory University, Atlanta, GA, United States
| | - Gustavo Pradilla
- Department of Neurological Surgery, Emory University, Atlanta, GA, United States
| | - Faiz U Ahmad
- Department of Neurological Surgery, Emory University, Atlanta, GA, United States.
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Wad M, Pedersen BL, Lönn L, Sillesen H. Hygroma following endovascular femoral aneurysm exclusion: A case report. Int J Surg Case Rep 2013; 4:831-3. [PMID: 23959411 DOI: 10.1016/j.ijscr.2013.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 06/17/2013] [Accepted: 06/22/2013] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Endovascular treatment of aneurysms in the superficial femoral artery (SFA) and popliteal segments is a suggested alternative to open surgical repair. Careful selection of patients for endovascular treatment of SFA aneurysms is mandatory. PRESENTATION OF CASE A complication due to endovascular stent-graft treatment in an 80-year old male with a 6 cm aneurysm in the SFA is presented. Hygroma developed after a partially unintended extravascular placed stent-graft. Two consecutive explorations resulted in a femoro-popliteal Polytetrafluoro-ethylene (PTFE) by-pass graft as the final solution. DISCUSSION Several explanations for the patient's complications are suggested. CONCLUSION A primary femoral-femoral/popliteal by-pass might be the best solution in SFA aneurysms due to risk of stent complications.
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Affiliation(s)
- Morten Wad
- Department of Vascular Surgery, Rigshospitalet, National Hospital, Copenhagen University, Denmark.
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