OBJECTIVES: In recent years, the incidence and detection rate of pancreatic cystic lesions (PCLs) have increased significantly. Endoscopic ultrasound (EUS) plays an indispensable role in the diagnosis and differential diagnosis of PCLs. However, evidence comparing the diagnostic performance of EUS-guided fine-needle aspiration (EUS-FNA) and fine-needle biopsy (FNB) remains limited. This study aims to compare the diagnostic yield, adequacy of tissue acquisition, and safety between EUS-FNA and EUS-FNB in evaluating PCLs to inform clinical practice. METHODS: A retrospective review was conducted on patients with PCLs who underwent either EUS-FNA or EUS-FNB between January 2014 and August 2021. The diagnostic yield, tissue acquisition adequacy, and incidence of adverse events were compared between the 2 groups. RESULTS: A total of 90 patients with PCLs were included (52 in the FNA group and 38 in the FNB group). The diagnostic yield was similar between the FNA and FNB groups (94.2% vs 94.7%, P>0.05). The adequacy of tissue acquisition was 71.2% in the FNA group and 81.6% in the FNB group (P>0.05). No statistically significant difference was observed in the incidence of adverse events between the 2 groups (P>0.05). CONCLUSIONS Both EUS-FNA and EUS-FNB demonstrate equally high diagnostic yields and tissue adequacy in PCLs, with excellent safety profiles. Both methods are safe and effective diagnostic tools for evaluating PCLs.
Humans ; Endoscopic Ultrasound-Guided Fine Needle Aspiration/adverse effects* ; Retrospective Studies ; Female ; Male ; Pancreatic Cyst/diagnostic imaging* ; Middle Aged ; Biopsy, Fine-Needle/adverse effects* ; Aged ; Pancreatic Neoplasms/diagnosis* ; Adult ; Endosonography/methods* ; Pancreas/pathology* ; Diagnosis, Differential

Objective:To explore the clinical manifestations, recurrence factors, and outcomes of revision surgery for recurrent thyroglossal duct cysts and fistulas in children. Methods:A retrospective study was conducted on the clinical manifestations, the relationship between cysts/ fistulas and residual hyoid bone of 10 patients with recurrent thyroglossal cysts and fistulas admitted to our hospital from July 2015 to July 2023, as well as the methods and effects of revision surgery. Results:The recurrence time after the initial surgery was between 7 months and 6 years, with an average of 2 years and 1 month.Clinical manifestations: 50%（5 cases） of patients have recurrent cysts near the incision, 40%（4 cases） had recurrent infections at the incision and eventually form fistulas, and 10%（1 case） experienced sleep snoring and pharyngeal trouble, were diagnosed with lingual thyroglossal duct cyst through laryngoscopy. All cysts or fistulas are connected to residual hyoid bodies, and three cases have intact hyoid bodies.Revision surgery: Nine cases underwent modified Sistrunk surgery, removing cysts, fistulas, and residual hyoid bodies. Suspension laryngoscopy and coblation were employed to treat the lingual thyroglossal duct cyst. After the revision surgery, follow-up was conducted for 8 months to 3 years, and no recurrence was found. Conclusion:All recurrences of thyroglossal duct cysts in this study were associated with residual hyoid bodies. Therefore, for thyroglossal duct cysts or fistulas, whether it is the first surgery or a revision surgery, it is recommended to choose the optimized Sistrunk operation, with the key point being complete resection of the hyoid body. Cases with lingual thyroglossal duct cyst can be treated with suspension laryngoscopy by coblation. Whether to remove the residual hyoid body requires further observation.
Humans ; Thyroglossal Cyst/surgery* ; Retrospective Studies ; Recurrence ; Reoperation ; Fistula/surgery* ; Child ; Hyoid Bone/surgery* ; Male ; Female ; Treatment Outcome ; Laryngoscopy ; Child, Preschool

Objective:To explore the clinical efficacy of the coblation resection of lingual thyroglossal duct cysts under self-retaining laryngoscopy. Methods:A retrospective analysis was conducted on the clinical data of 22 patients with lingual thyroglossal duct cysts admitted to our hospital from December 2016 to December 2023. There were 16 males and 6 females, aged 2 years to 12 years and 3 months（mean: 4 years 1 month; median: 3 years 3 months）. The lingual thyroglossal duct cysts were removed by coblation under self-retaining laryngoscopy. If the cysts could not be removed completely, the epithelial cells of the remaining cysts would be ablated. Results:There were 22 cases of lingual thyroglossal duct cysts，13 cases （59.1%） of lingual thyroglossal duct cysts had laryngeal stridor and dyspnea. The postoperative follow-up period is 3 months to 7 years. 11 cases （50.0%） underwent secondary laryngoscopic evaluation.There were 4 cases of recurrence （18.2%）, with no laryngeal obstruction,bleeding, or nerve damage. Conclusion:Laryngeal stridor and dyspnea are the main clinical symptoms of lingual thyroglossal duct cysts in children. The coblation resection of lingual thyroglossal duct cysts under self-retaining laryngoscopy is safe and effective. Cyst recurrence correlates strongly with residual cyst walls, emphasizing the need for enhanced intraoperative visualization and refined surgical precision.
Humans ; Thyroglossal Cyst/surgery* ; Male ; Female ; Child ; Retrospective Studies ; Child, Preschool ; Laryngoscopy/methods* ; Treatment Outcome ; Catheter Ablation/methods*

Objective:To investigate the safety, feasibility and efficacy of trans-oral robotic surgery in the treatment of lingual thyroglossal duct cyst. Methods:The clinical data of 21 patients with lingual thyroglossal duct cyst underwent trans-oral robotic surgery from May 2017 to March 2025 were analyzed retrospectively. Results:The cysts in all 21 patients were successfully excised by trans-oral robotic surgery. The mean robotic set-up and exposure time, operation time, estimated intraoperative blood loss and recovery time for oral intake were （14.3±7.2） min （[range 5.0-32.0]min）, （17.0±8.4） min （range[6.0-36.0]min）, （8.4±5.9） mL （range[2.0-25.0]mL） and （2.1±2.2） days （range[0-7]days）, respectively. No patients required tracheostomy, and no severe postoperative complications occurred. The patients were followed up for 2 to 96 months, with median follow-up time of 47 months, and 1 recurrence was observed. Conclusion:Excision of lingual thyroglossal duct cyst by trans-oral robotic surgery is safe and feasible, with rapid recovery and low recurrence rate, which is worth popularizing in clinical practice.
Humans ; Thyroglossal Cyst/surgery* ; Robotic Surgical Procedures/methods* ; Retrospective Studies ; Female ; Male ; Adult ; Treatment Outcome ; Middle Aged ; Adolescent

Laparoscopic management of a giant choledochal cyst (CC) in an infant is a technically demanding surgical endeavor that requires specialized training and meticulous planning. Laparoscopic CC surgery presents unique challenges due to the limited operative space, delicate anatomy, and technical demands of the procedure, being both excisional and reconstructive. These challenges are magnified when presented with an infant with a giant CC. In this report, we are going to present the challenges encountered and share the various steps that allowed our team to overcome these challenges.

Our patient is an 11-month-old female, 8.6 kg female who presented to our institution with a RUQ mass, jaundice, and a CT scan showing a large type 1 saccular choledochal cyst. After careful review, our team attempted and successfully performed a laparoscopic cholecystectomy with en bloc excision of the CC and hepaticoduodenostomy reconstruction.

The main challenge is the limited operative space. Once addressed, we felt confident we could complete the procedure laparoscopically. Operative time was 270 minutes. Feeding was resumed at postoperative day 5. Patient was discharged on postoperative day 7. There were no reported intraoperative and postoperative complications. The child remained well with no issues on postoperative reviews. Laparoscopic excision of a giant choledochal cyst in an infant is feasible, effective and safe with good outcomes. Preoperative planning, creative port placement, use of multichannel port, gauze, bipolar shears and needle cyst decompression are key in the successful performance of this elusive and challenging operation.

Thyroglossal duct cyst carcinoma is rare with majority being Papillary thyroid carcinoma. This is diagnosed after the final histopathology report following a Sistrunk procedure. Though with a good prognosis, surgical management has been controversial. Reported here is a case of a 30-year-old female who presented with an anterior neck mass. Pre-operative diagnosis was a thyroglossal duct cyst and patient underwent Sistrunk procedure with no untoward events. Final histopathology report of the excised mass revealed papillary thyroid carcinoma. This report draws attention to the rarity of papillary carcinoma in thyroglossal duct cyst and highlights the surgical options for such cases.

BACKGROUND AND OBJECTIVE

Choledochal cysts (CC) are rare congenital, cystic dilations of the biliary tree occurring predominantly in Asian populations and in females. Patients are usually children presenting with any of the following: abdominal pain, palpable abdominal mass, and jaundice. Its congenital nature hints at a potential genetic cause. A possible causal gene is TP53, a tumor suppressor with a germline variant called rs201753350 (c.91G>A) that changed from a G allele to an A allele, decreasing the cell proliferation suppressing activity of its functional protein. Currently, there is no information on the TP53 rs201753350 germline variant available for the Filipino population. This study determined the prevalence of rs201753350 and the association between the functional G allele, the rs201753350 germline variant A allele, and the occurrence of CCs in Filipino pediatric patients in a tertiary government hospital.

Genomic DNA was extracted from blood samples of pediatric patients clinically diagnosed with CC. Controls were DNA samples collected from a previous study. The samples underwent PCR, electrophoresis, and sequencing.

A total of 109 participants (22 cases and 87 controls) were included in the study. The A allele (22.94%) occurs at a lower frequency than the G allele (77.06%) among both cases and controls. More individuals have a homozygous G/G genotype (54.13%) than a heterozygous A/G genotype (45.87%) while the homozygous A/A genotype was not observed. The estimated risk of choledochal cyst occurrence is significantly lower in individuals with the A allele (PR: 0.08, 95% CI: 0.01 – 0.55) and the A/G genotype (PR: 0.06, 95% CI: 0.01 – 0.40).

There is no significant evidence to suggest an association between the TP53 rs201753350 germline variant and the occurrence of choledochal cysts in Filipinos. It is recommended that other mutations within and beyond the TP53 gene be investigated for possible associations with choledochal cyst occurrence.

Objective: To report a case of lingual thyroglossal duct cyst in an elderly man, excised via combined Trotter procedure and hyoid osteotomy.

Methods:
Design: Case Report
Setting: Tertiary Government Training Hospital
Participant: An elderly retired male office worker with dysphagia

Results: The cyst was completely excised via median labiomandibular glossotomy, with hyoid osteotomy providing additional exposure. Our patient was discharged in two weeks after decannulation and remains asymptomatic.

Conclusion: The Trotter procedure with hyoid osteotomy may be a viable alternative to the Sistrunk procedure for large lingual TGDCs.

Parasitic dermoid cysts may form from autoamputation of the ovarian mass secondary to torsion or rupture. It may then reimplant in surrounding structures and undergo subsequent neovascularization and further growth. The true incidence of these cases is unknown, however, a study reported a 0.04% incidence among 1,007 cases of dermoid cysts. This report describes the case of a 30-year-old multigravida who presented with an ultrasound finding of an ovarian dermoid cyst, which, upon laparoscopic surgery, turned out to be a parasitic dermoid cyst adherent to the bladder, with grossly normal bilateral ovaries. Theories on the development of parasitic dermoid cyst are also presented.
Human ; Female ; Adult: 25-44 yrs old ; dermoid cyst ; laparoscopy

OBJECTIVE: To investigate efficacy between arthroscopic popliteal cyst drainage and arthroscopic popliteal cyst resection. METHODS: From January 2013 to June 2021, 54 patients with popliteal cyst (Rausching-Lindgren gradeⅠto Ⅲ) were treated with arthroscopic surgery. There were 24 males and 30 females. The age ranged from 44 to 72 years old, with a mean of (62.67±6.08) years old. The course of the disease ranged from 1 to 72 months, with a mean of(15±14) months. Twenty-four patients (group A) were underwent arthroscopic internal drainage of popliteal cyst. Thirty patients (group B) were underwent arthroscopic resection of popliteal cyst. Preoperative main symptoms included knee pain, swelling, walking pain, popliteal swelling, popliteal mass and so on. After 1, 3, 6 months and 1, 2 years of surgery, routine outpatient follow-up was conducted to observe and compare the surgical time, bleeding volume, preoperative and postoperative visual analog scale (VAS), knee Lysholm score, and complications between two groups. RESULTS: All incisions healed at one stage after operation. All 54 patients were followed up, and the duration ranged from 6 months to 2 years, with an average of (13.89±4.29) months. There was no intraoperative vascular or nerve injury. Operation time and intraoperative blood loss of the two groups:group A of (62.08±9.55) min and (8.00±1.69) ml, group B of (69.50±6.99) min and (8.70±2.00) ml. Popliteal pain, swelling, limitation of flexion and extension were significantly relieved after operation. VAS before and one month after operation between two groups:group A of 5.38±1.21 and 2.63±0.71, group B of 5.60±1.26 and 2.80±0.81. Lysholm scores of knee joint before and 6 months after operation:group A of 62.59±4.99 and 89.74±2.90, group B of 63.87±3.23 and 89.02±2.35. Knee joint function improved significantly in both groups. In group A, 4 cases had popliteal cyst at 3 months after operation, and 2 cases had small isolated cyst at 1 year after operation. There was no recurrence of cyst in group B. CONCLUSION The results between two arthroscopic treatments of popliteal cyst are satisfactory, and there is no significant difference in the amount of blood loss, safety, postoperative pain VAS score and knee function recovery. It is suggested that arthroscopic resection of the cyst wall should be performed when the technique is mature, especially for large cysts and septal cysts.
Female ; Male ; Humans ; Adult ; Middle Aged ; Aged ; Popliteal Cyst/surgery* ; Drainage ; Cysts ; Knee Joint/surgery* ; Pain