Giant Tarlov Cysts with Rare Pelvic Extension: Report of 3 Cases and Literature Review.
Adnexal mass
Cyst resection
Fistula
Giant Tarlov cyst with pelvic extension
Laparotomy
Pelvic cyst
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
05
02
2020
revised:
12
04
2020
accepted:
13
04
2020
pubmed:
29
4
2020
medline:
12
9
2020
entrez:
29
4
2020
Statut:
ppublish
Résumé
Giant presacral Tarlov cysts (TCs) with pelvic extension are extremely rare and have many special features that differ from normal TCs in examination, diagnosis, symptoms, and treatment. We report 3 rare cases of giant presacral TCs with pelvic extension and review the pertinent literature. We report 3 cases of giant presacral TCs with rare pelvic extension and analyzed the symptoms, diagnoses, and surgical procedures. Operations with the key point of blocking the inlet of the fistula from inside the dural sac were performed in all 3 cases. All 3 patients revealed alleviation of previous symptoms with no serious complications. Postoperative magnetic resonance imaging showed all the cysts were well blocked with no cyst recurrence. Giant TC with pelvic extension is extremely rare and often is discovered on gynecological ultrasound, where it might be misdiagnosed as adnexal mass. Different from patients with normal TCs, these patients also may present with abdominal symptoms like hydronephrosis, abdominal, or pelvic pain due to the cyst's ventral mass effect. Thus, patients with abdominal and back symptoms at the same time should be paid particular attention for lumbosacral magnetic resonance imaging examination to avoid misdiagnosis. Surgical procedures are recommended for symptomatic cases. However, cyst resection by laparotomy is doomed to postoperative recurrence because the fistula still exists. We describe a simple procedure with the key point of blocking the inlet of cyst fistula, which is more applicable and minimizes the probability of cyst recurrence.
Sections du résumé
BACKGROUND
Giant presacral Tarlov cysts (TCs) with pelvic extension are extremely rare and have many special features that differ from normal TCs in examination, diagnosis, symptoms, and treatment. We report 3 rare cases of giant presacral TCs with pelvic extension and review the pertinent literature.
CASE DESCRIPTION
We report 3 cases of giant presacral TCs with rare pelvic extension and analyzed the symptoms, diagnoses, and surgical procedures. Operations with the key point of blocking the inlet of the fistula from inside the dural sac were performed in all 3 cases. All 3 patients revealed alleviation of previous symptoms with no serious complications. Postoperative magnetic resonance imaging showed all the cysts were well blocked with no cyst recurrence.
CONCLUSIONS
Giant TC with pelvic extension is extremely rare and often is discovered on gynecological ultrasound, where it might be misdiagnosed as adnexal mass. Different from patients with normal TCs, these patients also may present with abdominal symptoms like hydronephrosis, abdominal, or pelvic pain due to the cyst's ventral mass effect. Thus, patients with abdominal and back symptoms at the same time should be paid particular attention for lumbosacral magnetic resonance imaging examination to avoid misdiagnosis. Surgical procedures are recommended for symptomatic cases. However, cyst resection by laparotomy is doomed to postoperative recurrence because the fistula still exists. We describe a simple procedure with the key point of blocking the inlet of cyst fistula, which is more applicable and minimizes the probability of cyst recurrence.
Identifiants
pubmed: 32344135
pii: S1878-8750(20)30819-6
doi: 10.1016/j.wneu.2020.04.112
pii:
doi:
Types de publication
Case Reports
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
505-511Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.