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Improvement in Radicular Symptoms but Continued Facet Arthropathy and Axial Back Pain Following Rupture of a Facet Joint Synovial Cyst  [PDF]
Bryan J. Kratz, Troy Buck, Daniel Cramer
Neuroscience & Medicine (NM) , 2018, DOI: 10.4236/nm.2018.91006
Abstract: Lumbar synovial cysts are benign fluid collections thought to form in a background of facet joint degeneration, allowing for fluid to leak from the joint capsule and form cysts in the synovium. Although often asymptomatic, patients with symptomatic synovial cysts will present with low back pain and possibly an associated radiculopathy. Clinicians can consider conservative management, epidural steroid injection, surgical intervention, or facet joint block with aspiration and rupture. This case describes a 59-year-old male facilities manager with intermittent low back pain for one year with worsening right-sided radicular symptoms secondary to a lumbar facet joint synovial cyst in the context of severe facet arthropathy and microinstability. The patient’s low back pain and radicular symptoms were refractory to conservative treatment. Imaging demonstrated a lumbar synovial cyst and subsequent management included transforaminal epidural steroid injection and facet joint block with cyst aspiration and rupture. The patient’s radicular pain resolved but axial lumbar pain returned after 3 weeks of relief. Follow-up imaging demonstrated decreased cyst size with fluid accumulation and joint space widening. Although the cyst was successfully decompressed with resolution of radicular pain, the underlying facet arthropathy remains contributing to persistent axial low back pain and potential for continued degenerative changes including cyst recurrence.
Bacteriological examination of radicular cysts contents
Hrva?anin Slobodanka O.
Medicinski Pregled , 2002, DOI: 10.2298/mpns0202041h
Abstract: Radicular cysts are, most often, oral tissue cysts. The basis for their development are the remains of Hertwig's epithelial sheath, which is stimulated to proliferate by infectious agents, mostly periapical granuloma or pulp necrosis. The cyst contents can be liquid, either clear or milky-white, or thick and yellowish-caseous pus. Bacteriological and histopathological researches have shown that development of radicular cysts from periapical lesions is a consequence of penetration of normal bacterial flora of the oral cavity. Material and methods The study has bacteriologically examined contents of 50 radicular cysts. They were operated between 1993 and 1995 at the Department of Oral Surgery of the Outpatient Health Care Centre Banjaluka. Pathological substrate of the cyst was punctured by a sterile needle and bacteriologically examined at the Microbiological Laboratory of the Clinical Centre in Banjaluka. Discussion and conclusion Radicular cysts contents most often consisted of alpha-hemolytic streptococcus, Streptococcus pneumoniae, Staphyilococcus epidermidis, Streptococcus group B and alpha-hemolytic Streptococcus. It is concluded that normal oral cavity flora is present in the cysts contents the infection penetrated through the root canal to periapex, where, due to the course of time, radicular cyst develops from periapical granuloma.
An Unusual Case of Hydatid Cyst  [cached]
SA Mirhoseini,J Ahmadi
Journal of Research in Medical Sciences , 2005,
Abstract: Hydatidosis is a parasitic disease in all over the world which is caused by a Cestode (tape worm). Liver, lung, and brain are the most Common involved organs and involvement of muscles and bones is unusual. We report a 32years old man who had low back and radicular leg pain. He had a paravertebral mass with involvement of Spinal column. This patient was operated with differential diagnosis of tumor or hydatid cyst. The final diagnosis was hydatidosis of paravertebral muscles and vertebral column. Keywords: hydatidosis, p aravertebral muscle hydatid cyst, spinal column hydatid cyst
Localization of a Peripheral Residual Cyst: Diagnostic Role of CT Scan
Anshuman Jamdade,Gopakumar R. Nair,Madhur Kapoor,Neeta Sharma,Arya Kundendu
Case Reports in Dentistry , 2012, DOI: 10.1155/2012/760571
Abstract: The term residual cyst is used most often for retained radicular cyst from teeth that has been removed. Residual cysts are among most common cysts of the jaws. The location of all odontogenic cysts is usually intraosseous. The peripheral (extraosseous) presentations are rare. The peripheral presentation of residual cyst has never been reported in the literature. In this article, the role of CT in diagnosing an unusual peripheral presentation of a residual cyst is discussed.
Fractura patológica de la mandíbula asociada a quiste radicular: Reporte de 3 casos clínicos
Bouguila,J.; Córdova Jara,L.; Zairi,I.; Adouani,A.;
Revista Espa?ola de Cirugía Oral y Maxilofacial , 2008, DOI: 10.4321/S1130-05582008000400008
Abstract: introduction. radicular cyst is the most common cyst of the oral cavity. it may range in size from a small periapical lesion to one that can obliterate the antral space or cause mandibular fracture. case reports. we report three cases of radicular cyst complicated by mandibular fracture that occurred after maxillofacial trauma. the diagnosis was strongly suggested by panoramic radiography and confirmed by pathology examination of the operative specimen. treatment consisted in cyst enucleation followed by immobilization of fragments by osteosynthesis or maxillomandibular fixation. the clinical and radiologic outcome was favorable. discussion. the particularities and treatment are discussed. conclusion. treatment success is dependent on adequate therapy, the principles of which are removing the lesion and providing stable fixation.
Expressions of bax, bcl-2 and Ki-67 in Odontogenic Keratocysts (Keratocystic Odontogenic Tumor) in Comparison with Ameloblastomas and Radicular Cysts  [cached]
Merva SOLUK TEKKE??N,Sevcihan MUTLU,Vakur OLGA?
Türk Patoloji Dergisi , 2012,
Abstract: Objective: The aim of the study was to determine the apoptotic features and proliferation potential of odontogenic keratocysts compared with ameloblastomas and radicular cysts by analysing the role of bax, bcl-2, and Ki-67.Material and Method: The study material consisted of 20 odontogenic keratocysts, 20 radicular cysts, and 20 ameloblastomas. Immunohistochemically, bax, bcl-2 and Ki-67 were applied. The positive cells were evaluated in both neoplastic/nonneoplastic odontogenic epithelium and connective tissue cells.Results: Ameloblastoma showed stronger bcl-2 expression than odontogenic keratocysts and radicular cysts. Bcl-2 expression in the whole thickness of epithelium and connective tissue of odontogenic keratocyst was significantly higher than radicular cyst. The expression of bax in the epithelium of radicular cyst was significantly higher than odontogenic keratocyst and ameloblastoma. The lining epithelium of odontogenic keratocyst showed stronger Ki-67 expression than ameloblastoma and radicular cyst.Conclusion: The proliferation potential of the epithelium and the overexpression of various anti-apoptotic proteins in odontogenic epithelial tumors are quite significant for their clinical behaviour. High expressions of bcl-2 and Ki-67 in odontogenic keratocysts accord with their aggressive clinical behaviour and a high recurrence rate.
Nasopalatine Duct Cyst  [PDF]
Pratik Dedhia,Shely Dedhia,Amol Dhokar,Ankit Desai
Case Reports in Dentistry , 2013, DOI: 10.1155/2013/869516
Abstract: The nasopalatine cyst is the most common epithelial and nonodontogenic cyst of the maxilla. The cyst originates from epithelial remnants from the nasopalatine duct. The cells may be activated spontaneously during life or are eventually stimulated by the irritating action of various agents (infection, etc.). It is different from a radicular cyst. The definite diagnosis should be based on clinical, radiological, and histopathological findings. The treatment is enucleation of the cystic tissue, and only in rare cases a marsupialisation needs to be performed. A case of a nasopalatine duct cyst in a 35-year-old male is reviewed. The typical radiologic and histological findings are presented. 1. Introduction The nasopalatine duct cyst (NPDC) was first ever described by Meyer in 1914 [1, 2]. Nasopalatine duct cyst, also termed as incisive canal cyst, arises from embryogenic remnants of nasopalatine duct, the communication between the nasal cavity and anterior maxilla in the developing fetus. Most of these cysts develop in the midline of anterior maxilla near the incisive foramen [3]. It is one of the most common nonodontogenic cysts of the oral cavity occurring in about 1% of the population [4]. NPDCs affect a wide age range; however, most present in the fourth through sixth decades of life, and most studies show a significantly higher frequency in men than woman, with the ratio being 2.5?:?1 [5–11]. Patients may be asymptomatic, with the lesion being detected on routine radiographs; however, many will present with one or more symptoms. Complaints are often found to be associated with an infection of a previously asymptomatic nasopalatine duct cysts and consist primarily of swelling, drainage, and pain [10, 12]. The vitality of nearby teeth should not be affected; however, it is not uncommon to see evidence of endodontic therapy because the nasopalatine duct cyst was previously clinically misdiagnosed as a periapical cyst or granuloma. The present case of NPDC is one such typical pathology with the classical presentation which could have been easily misdiagnosed as a periapical lesion. 2. Case Report 2.1. History A 35-year-old male reported to the dental clinic with the chief complaint of painless swelling over the palate and anterior maxilla. The swelling was gradually increasing in size for the past 3 months with associated displacement of maxillary central incisors. There was no associated history of trauma. On examination, a well defined firm nontender swelling was seen on the left side of anterior hard palate and crossing over the midline to the right
Localization of a Peripheral Residual Cyst: Diagnostic Role of CT Scan  [PDF]
Anshuman Jamdade,Gopakumar R. Nair,Madhur Kapoor,Neeta Sharma,Arya Kundendu
Case Reports in Dentistry , 2012, DOI: 10.1155/2012/760571
Abstract: The term residual cyst is used most often for retained radicular cyst from teeth that has been removed. Residual cysts are among most common cysts of the jaws. The location of all odontogenic cysts is usually intraosseous. The peripheral (extraosseous) presentations are rare. The peripheral presentation of residual cyst has never been reported in the literature. In this article, the role of CT in diagnosing an unusual peripheral presentation of a residual cyst is discussed. 1. Introduction The higher frequency of occurrence of cysts in the oro-facial region could be attributed to complex embryology and development of teeth and due to presence of odontogenic epithelial remnants. Radicular and residual cysts are by far the most common cyst comprising about 52.3% to 60% of all jaw cysts [1, 2]. Most radicular cysts (60%) are found in the maxilla, especially around incisors and canines [3]. The residual cyst can develop in a dental granuloma that is left after an extraction. They represent approximately 10% of all odontogenic cysts [4]. The radicular cyst does not recur if surgical removal is thorough. If the cystic sac is badly fragmented, leaving epithelial remnants, or if a periapical granuloma is incompletely removed with epithelial rests remaining, a residual cyst may develop in this area months or even years later. The residual cyst is usually asymptomatic and often discovered on routine radiographic examination of an edentulous area. However, they can cause expansion of cortical plates of the jaws and may invaginate into maxillary antrum or depress inferior alveolar canal. Sometimes become painful in case of secondary infection. Radiographically, it is a well-defined round-to-oval radiolucency with a corticated margin. The internal aspect of the cyst is typically radiolucent. Dystrophic calcification may be present in long-standing cyst, commonly with regressing one [3, 5]. However, an infection makes the cortex less apparent [6]. Unfortunately, very little study was carried out on proportion of regression versus growth of the residual cysts. The growing cyst can cause displacement or resorption of adjacent anatomical structure. However, in case of peripheral presentation of the same, it becomes difficult to diagnose exact location and extension of the lesion by conventional radiography. In maxilla, the peripheral residual cyst is a diagnostic dilemma whether it is originated from the alveolus/or the maxillary antrum. Residual cysts often occur centrally (within bone), mostly in the tooth-bearing region. In our case, on clinical examination, it was
Statistical Evaluation of Chronic Apical Periodontitis and Radicular Cysts
Baghaei-Naeini F,Hajloo R
Journal of Dental Medicine , 2000,
Abstract: Up to now, no complete study was carried out about the prevalence and location of periapical granuloma and radicular cysts from the point of view of clinical symptoms (e.g. pain and swelling fistula) in Iran. The data was collected from the files available in the Department of Pathology, faculty of Dentistry, Tehran University of Medical Sciences. With a consideration on different therapeutic methods. a proper method was selected. Radicular cyst occurred in 59.3 percent of 324 cases while 45.7 percent were granuloma. The most common incidence of these lesions was in the range of 24-25 years old. The most common location of lesions was the maxillary anterior. Sinus tracts occurred in 74 of all cases. 47.3 percent of these patients have been previously received root canal therapy. It is noticeable that 24 percent of all patients were treated endodontically before surgery. Higher incidence of granuloma occurred in small lesions while cysts were more common in large lesions. 232 of all cases showed one of the clinical symptoms, 16% pain, 35.8% swelling and 22.8% fistula. No symptoms were found in 92 cases.
Lumbar disc cyst with contralateral radiculopathy
Kishore Tourani,Belman Murali,Akshay Sahoo,Dandu Ravi Varma
Journal of Medical and Allied Sciences , 2012,
Abstract: Disc cysts are uncommon intraspinal cystic lesions located in the ventrolateral epidural space. They communicate with the nucleus pulposus of the intervertebral disc and cause symptoms by radicular compression. We report a unique case of lumbar disc cyst that was associated with disc herniation and contralateral radiculopathy. A 22 year old male presented with one month history of back-ache radiating to the left leg. Magnetic Resonance Imaging (MRI) showed L3-L4 disc herniation with annular tear and cystic lesion in the extradural space anterior to the thecal sac on right side, which increased in size over a period of 3 weeks. L3 laminectomy and bilateral discectomy and cyst excision was done with partial improvement of patients symptoms.
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