Cysts: Symptoms And Treatment

Write a short note on the cyst.

Answer. Cyst is defined as “A pathological cavity having flid, semifluid or gaseous contents and which is not created by the accumulation of pus.” Kramer (1974)

True cysts are lined by epithelium while false cysts are not lined by epithelium.

General Examination Of Cyst

1. Location: Most of the congenital cystic swellings have a typical location wherein diagnosis can be made with fair accuracy.
A few examples are:

Branchial cyst: Anterior triangle partly covered by the upper one-third of the sternomastoid
Dermoid cyst: Midline, outer or inner canthus ofthe eye

2. Shape: Majority of the cystic swellings are round or oval.

For example sub hyoid bursitis: Transverse oval cystic swelling in the midline of the neck
Thyroglossal cyst: Vertically placed oval swelling in the midline of the neck
Sebaceous cyst: Hemispherical swelling

3. Surface: Almost all the cystic swellings in the skin and subcutaneous tissue have smooth surface.

4. Consistency: Fluctuation is positive in all cystic swellings.
However, depending on the contents the flctuation may be diffrent, which an experienced surgeon can diagnose.

Soft cystic: Thyroglossal cyst, meningocele, lymph cyst.
Tensely cystic: Ganglion.
Putt or toothpaste: Sebaceous cyst

5. Transillumination Test: Cystic swelling which contains clear flid show positive transillumination.

6. Mobility: Almost all cystic swellings in skin, subcutaneous tissue or in deep plane are freely mobile.
At times, this is not true due to various anatomical factors:

Branchial cyst: Restricted mobility is due to its adherence to the sternomastoid muscle.
Thyroglossal cyst: Transverse mobility is absent because cyst is tethered by remnant of thyroglossal duct.

7. Sign of compressibility: Swelling which has communication with the cavity or with tissue spaces gives a positive sign of compressibility.

8. Pulsations: Aneurysms are characterized by expansile pulsations and when the swelling pushes the vessel anteriorly transmission pulsation is obtained.

Complications Of Cyst

Infection: For example sebaceous cyst
Calcification: For example hematoma, hydatid cyst
Pressure effects: Ovarian cyst pressing iliac veins
Hemorrhage: In thyroid cyst.