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Brain tumors represent the second most frequent etiology in patients with focal seizure onset before 18 years of age and submitted to epilepsy surgery. Hence, this category of brain tumors, herein defined as low-grade, developmental, epilepsy-associated brain tumors (LEAT) is different from those frequently encountered in adults as (A): 77% of LEAT occur in the temporal lobe; (B): the vast majority of LEAT are of low malignancy and classified as WHO I°; (C): LEAT are often composed of mixed glial and neuronal cell components and present with variable growth patterns including small cysts or nodules; (D): LEAT do not share common gene driving mutations, such as IDH1 or 1p/19q co-deletions. Characteristic entities comprise the ganglioglioma (GG), the dysembryoplastic neuroepithelial tumor (DNT), the angiocentric glioma (AG), the isomorphic diffuse glioma (IDG) and the papillary glio-neuronal tumor (PGNT), representing 73.2% of 1680 tumors collected in a large German series of 6747 patients submitted to epilepsy surgery. In the realm of exciting discoveries of genetic drivers of brain tumors new genes have been also reported for LEAT. BRAF V600E mutations were linked to GG with CD34 expression, FGFR1 mutations to DNT, MYB alterations to AG and also IDG and PRKCA fusions to PGNT, suggesting the possibility to also develop a genetically driven tumor classification scheme for LEAT. Rare availability of LEAT in a single center is a challenging obstacle, however, to systematically unravel the neurobiological nature and clinical behavior of LEAT. Other challenges in need of clarification include malignant tumor progression of LEAT entities, seizure relapse in patients following bulk tumor resection and the controversial issue of associated focal cortical dysplasia as additional pathomechanism. In order to advance our understanding and promote reliable diagnostic work-up of LEAT, we recommend, therefore, international collaboration to achieve our goals.

Background Jaw cysts are a diverse group of intraosseous lesions commonly encountered in oral and maxillofacial pathologies. Several studies have addressed their distribution and clinicopathological features; however, further large-scale analyses using standardized classification systems may enhance cross-regional comparability and diagnostic consistency. We aimed to evaluate the demographic and anatomical characteristics of jaw cysts over an almost 50-year period. Methods We retrospectively reviewed 19,352 histologically confirmed jaw cysts diagnosed between 1975 and 2024. Each case was reclassified according to the 2022 WHO classifications for head and neck tumors. Patient age, sex, cyst type, and anatomical location data were collected and descriptively analyzed to identify trends across different cyst categories. Results Odontogenic cysts comprised the majority of cases. Radicular cysts were the most common, followed by dentigerous cysts and odontogenic keratocysts. Non-odontogenic cysts mainly consisted of surgical ciliated cysts and nasopalatine duct cysts. Bone cysts (simple bone cysts and aneurysmal bone cysts), which lack an epithelial lining and were therefore analyzed separately, were infrequent. A male predominance was observed overall, with sex- and age-related patterns differing according to cyst type. Mandibular involvement was more common than maxillary involvement, and several cysts showed specific anatomical predilections. These findings highlight distinct demographic and anatomical characteristics across cyst categories. Conclusions This large retrospective study provides a detailed epidemiological profile of jaw cysts. The findings revealed distinct patterns according to cyst type, age, sex, and anatomical site, providing a valuable reference for diagnostic refinement and future comparative studies of oral and maxillofacial pathology.

Objectives To assess changes and factors influencing in buccolingual width and cyst cavity depth at the stoma site during marsupialization with cyst plug decompression for jaw cystic lesions. Materials and methods Data were collected from patients who underwent marsupialization and cyst plug decompression for mandibular cystic lesions. A total of 15 cases were analyzed, including 10 odontogenic keratocysts (OKC), 1 unicystic ameloblastoma (UA), and 4 dentigerous cysts (DC). Cone beam computed tomography (CBCT) scans were conducted pre-surgery (T 0 ), three months post-surgery (T 1 ) and at the end of marsupialization (T 2 , > 2 months post-T 1 ). Three-dimensional models were created to analyze bone dimensional changes in buccolingual width, vertical depth, and cyst volume. Results The Friedman two-way rank analysis and subsequent pairwise comparisons demonstrated the cyst volume significantly decreased from T 0 to T 1 , T 1 to T 2 , respectively ( p  < 0.05). The buccolingual width remained basically unchanged from T 0 to T 1 ( p  = 0.423), but gradually decreasing from T 1 to T 2 ( p  < 0.001). Meanwhile, the cyst cavity depth consistently decreased throughout the study ( p  < 0.05). The Spearman rank correlation coefficient test indicated the final change in buccolingual width positively correlated with the initial width of the stoma site ( p  < 0.001). Conclusions Buccolingual width remains stable before decreasing, whereas cyst cavity depth and cyst volume decreases continuously. The larger the initial width of the stoma site, the greater change in width at the end of marsupialization. Clinical relevance During marsupialization, cyst plug modifications should align with bone remodeling patterns in jaw cystic lesions. Initially, only the plug’s depth is adjusted, while in later stages, both stoma width and depth are gradually reduced. This understanding can contribute to the digital prefabricated series of cyst plugs by integrating clinical insights to develop more minimally invasive treatment strategies and to appropriately lengthen the decompression period during marsupialization.

The authors present cystic epithelial masses in the suprasellar region which on histopathology revealed 4 mixed tumors having simple cuboidal epithelium of Rathke's Cleft Cyst (RCC) elements trapped within pituitary adenoma, epidermoid cyst, dermoid cyst, and papillary craniopharyngioma respectively. To highlight the developmental theory of ectodermal continuum in the realm of suprasellar epithelial cystic lesions and examines the cardinal aspects that distinguish RCC from its confounder, ciliary craniopharyngioma. The authors performed a medical chart review on 4 patients who had coexisting RCC with craniopharyngioma, pituitary adenoma, suprasellar dermoid, and epidermoid cysts. This series of unique suprasellar lesions elucidate the spectrum of cases from Rathke's cyst to other suprasellar epithelial cysts including a recently identified clinical entity called ciliary craniopharyngioma, which authors feel is a misnomer. The authors also report the first case of ruptured dermoid cyst admixed with elements of Rathke's cyst elements and xanthogranuloma in neurosurgical literature. We propose that the new entity of ciliary craniopharyngioma could be just another variant of RCC elements nested within a typical papillary or adamantinomatous lesion. Further study is warranted to understand the implications of natural history with tumors containing RCC elements.

A significant factor contributing to reproductive failure in dairy cattle that raised the possibility of culling was ovarian cysts. Its etiology and pathogenesis remained a puzzle, but investigation of the associated tissue modulation, particularly those of the ovaries, oviduct, and uterus, might shed some light on its development. Therefore, the current study aimed to assess changes induced by follicular and luteal cyst formation in the ovary, oviduct, and uterus. In addition, the aims also involved the effect of these cyst formations on the interstitial glands and mast cell distribution in the ovaries of dairy cows. Genital organs of healthy, non-pregnant buffalo-cows ( n  = 45) were collected from the abattoir. According to the ovarian status, buffalo-cows were divided into three equal groups (15 for each): one normal healthy group was the control group (Ctrl group) and two diseased groups. The first diseased group was the group of buffalo-cows with follicular cysts (FC group), while the second one was the group with luteal cysts (LC group). Blood and tissue samples were collected to determine progesterone levels and do histological investigations of the reproductive organs. Hematoxylin and eosin, Alcian blue-PAS, and Alcian blue-safranin-O stains were used for investigating ovarian tissues, interstitial glands (IGs), and mast cells (MCs), respectively. Results showed that significantly reduced thickness of the ovarian cortex and medulla, loss of ovarian folliculi, hemorrhage, and dilated blood vessels were observed in the FC and LC groups compared to the Ctrl group. In addition, the cystic ovaries significantly reduced interstitial gland count that was characterized by histopathological alterations that included atrophied and apoptotic cells and fragmentation, fading, and pyknotic nuclei. Likewise, in cystic ovaries, mast cell counts were found significantly reduced compared to the Ctrl group. The ovarian cysts significantly reduced the length and diameter of oviductal mucosal villi that were characterized by severe histopathological fluctuation in the ciliated cells and protruding and non-protruding secretory cells. For the uterus, the average thickness of the myometrium and endometrium in the ovarian cyst groups was significantly reduced compared to the Ctrl group. Furthermore, histopathological changes in the uterine glands, including severe apoptotic alterations, fading, pyknotic, and fragmented nuclei, were observed. In conclusion, the current study indicated that follicular and luteal cyst formations in the ovary induced various changes in the reproductive organs, interstitial glands, and mast cell distribution in the ovarian stroma, providing insights into the potential pathogenesis of cyst formation.

Background This retrospective study aims to evaluate the relative representation of individual types of developmental odontogenic cysts (DOCs), especially from the perspective of syndromic and non-syndromic multiple DOCs in the Czech population. In addition, we also summarize the previous studies on the occurrence of multiple DOCs and provide a literature review of case reports and case series on non-syndromic multiple DOCs, particularly dentigerous cysts (DCs) and odontogenic keratocysts (OKCs). Methods The study included histologically confirmed DOCs retrieved between January 1, 2012, and August 8, 2023, at the Clinic of Maxillofacial Surgery, University Hospital Brno, Czech Republic. All specimens were re-classified according to the fifth edition of the World Health Organization Classification of Head and Neck Tumors, 2022. Patients with an uncertain histological diagnosis were excluded from the study. Results Of a total of 377 patients, 286 had DCs, 85 OKCs, 5 orthokeratinizing odontogenic cysts (OOCs), 1 botryoid cyst, and 1 calcifying odontogenic cyst. The proportion of patients with multiple DCs in our study (6.6%) was higher than usually reported in the literature. The study also found that 100% of patients with multiple DCs did not exhibit any syndromic associations. On the other hand, 66% of multiple OKCs were associated with the Naevoid Basal Cell Carcinoma Syndrome (NBCCS) and the proportion of OKC patients with NBCCS (7%) was relatively higher than in other studies. Recurrence of OKCs was also significantly associated with NBCCS ( p  < 0.05). Only one patient presented with bilateral OOCs, without any association with a syndrome. Conclusion Multiple OKCs are more likely to develop in syndromic patients, while none of the multiple DCs were associated with a syndrome. The incidence of multiple OOCs and other DOCs is extremely rare. Still, we conclude that patients with multiple DOCs should be carefully considered for examination by other specialists to rule out possible syndromic involvement.

Background Our aim was to determine whether the Apparent Diffusion Coefficient is able to predict the presence of a symptomatic pineal cyst by detecting cerebral edema. Methods We retrospectively analyzed MRIs of 45 patients with pineal cysts before and after resection and 51 patients without pineal cysts, comparing ADC values of thalamus, central, periventricular and subcortical white matter. Furthermore we evaluated cyst size and morphology and analyzed its correlation to ADC values in corresponding patients. Results Differences between patients with symptomatic pineal cyst and control group were not significant ( p  = 0.200 – 0.968). ADC ratios did not change significantly after resection of the cyst ( p  = 0.575 – 0.862). Cyst size showed no significant correlation to ADC ratios ( p  = 0.071 – 0.918). Raw data analyses revealed more significance, especially periventricularly and in central white matter, which resulted in significant interhemispheric differences in ADC ratios in both subgroups ( p  < 0.001 and p  = 0.031). MRI of 1.5T showed consistently higher values than 3T but mostly insignificant. Conclusion Our analysis revealed no evidence that pineal cysts lead to intracerebral edema caused by venous compression. Since variability was higher than the differences seen, ADC sequences do not appear to be an appropriate diagnostic tool for symptomatic pineal cysts.

Characterizing ovarian masses enables patients with malignancy to be appropriately triaged for treatment by subspecialist gynecological oncologists, which has been shown to optimize care and improve survival. Furthermore, correctly classifying benign masses facilitates the selection of patients with ovarian pathology that may either not require intervention, or be suitable for minimal access surgery if intervention is required. However, predicting whether a mass is benign or malignant is not the only clinically relevant information that we need to know before deciding on appropriate treatment. Knowing the specific histology of a mass is becoming of increasing importance as management options become more tailored to the individual patient. For example predicting a mucinous borderline tumor gives the opportunity for fertility sparing surgery, and will highlight the need for further gastrointestinal assessment. For benign disease, predicting the presence of an endometrioma and possible deeply infiltrating endometriosis is important when considering both who should perform and the extent of surgery. An examiner's subjective assessment of the morphological and vascular features of a mass using ultrasonography has been shown to be highly effective for predicting whether a mass is benign or malignant. Many masses also have features that enable a reliable diagnosis of the specific pathology of a particular mass to be made. In this narrative review we aim to describe the typical morphological features seen on ultrasound of different adnexal masses and illustrate these by showing representative ultrasound images.

Background Originating from odontogenic tissue, Odontogenic cysts are pathological cavities lined with epithelial cells and surrounded by fibrous connective tissue. This study investigated expression of CITED1 protein in different types of odontogenic cysts. Material and method 40 keratocysts, 40 radicular cysts, and 40 dentigerous cysts were excised and processed for routine paraffin wax embedding protocol. Macroscopic and panoramic radiographies images were used for diagnosis. Demographical properties and dental parameters were recorded. Cystic tissues were stained with hematoxylin-eosin dye and CITED1 antibody. Semi-quantitative analysis was performed for immune staining. The protein-protein interaction network, hub gene detection and KEGG analysis were conducted using Cytoscape software. Result Odontogenic keratocysts was imaged with 6–8 layered epithelial cells and fibrous cyst walls with inflammatory cells. Radicular cysts had stratified squamous epithelium with varying thickness, ciliated cells, and Rushton hyaline bodies. Dentigerous cysts presented hyperplastic non-keratinized epithelium, fibrous tissue, rete ridges, and inflammatory cells. CITED1 immunoexpression was highest in odontogenic keratocysts, followed by radicular cysts, and lowest in dentigerous cysts. Nuclear and cytoplasmic CITED1 expression was significantly elevated in odontogenic keratocysts compared to radicular and dentigerous cysts. The top five targets of CITED1 were identified, primarily showing enrichment in hormone and cancer related pathways. Conclusions Positive CITED1 expression in all three types of odontogenic cysts suggest a potential role for CITED1 in the pathogenesis of odontogenic cysts, particularly in keratocysts. Further investigations are needed to elucidate the exact mechanisms underlying the differential expression of CITED1 and its implications for the development and progression of odontogenic cysts.

Aim The aim of the study was to evaluate the trabeculation increase of treated mandibular cysts. Material and method The study included 26 female and 33 male patients (age mean: 38,4 years) with cysts larger than 3 cm in the posterior region of the mandible who were admitted to the same center. Two groups in treatment technique: marsupialization ( n  = 29) and enucleation ( n  = 30). Four groups in cyst types: dentigerous cyst ( n  = 21), keratocyst ( n  = 19), radicular cyst ( n  = 15) and residual cyst ( n  = 4). Cyst size was divided into two categories: smaller than 5.5 cm ( n  = 31) and larger than 5.5 cm ( n  = 28). Panoramic radiographs (PR) of the patients were analyzed at the beginning, 6. month and 12. month. Result At the end of the treatment, there was no statistically significant difference in terms of Fractal Analysis (FA) between patients treated with marsupialization and enucleation, but considering that the cysts in the marsupialization group were larger in size, a faster increase in FA was observed in the marsupialization group. When the cysts were grouped according to their size, it was observed that healing tissues in cysts smaller than 5.5 cm reached normal FA values faster, while healing in the middle of cysts larger than 5.5 cm took more time. Conclusions FA is a reproducible and reliable method. In large cysts, marsupialization results in a faster recovery, but FA values at the end of treatment are similar to the enucleation group. Cysts larger than 5.5 cm show a more rapid increase in Fractal Dimension (FD). The centre of the cysts is the area that heals the latest. Studies with larger sample sizes are needed to evaluate the difference in healing between cyst types. Clinical trial number Clinical trial number: Not applicable