Massive acromioclavicular ganglionic cyst treated with excision and allograft patch of acromioclavicular region

Skedros, John G.; Knight, Alex N.

doi:10.1016/j.jse.2011.07.033

Cited by 17 publications

(26 citation statements)

References 19 publications

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“…They used a human dermis allograft patch to seal the AC region in a patient suffering from a similar condition. Their result concerning cyst recurrence was likewise satisfying, as no recurrence was noted at the 1-year follow-up 18. Assumptions about a possible pinch valve effect have been made in previous reports, and acromioplasty in addition to rotator cuff debridement and cyst excision was suggested to eliminate it, thus preventing cyst recurrence 1 2 4 6 7 10–13.…”

Section: Discussionmentioning

confidence: 71%

Acromioclavicular joint cyst formation in a patient with rotator cuff-tear arthropathy: a rare cause of shoulder discomfort

et al. 2018

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We report a case of a 77-year-old man who presented to our shoulder department with a soft tissue mass on his right acromioclavicular (AC) joint. Previously attempted puncture aspiration had revealed serous fluid retention which recurred after each of several drainage attempts. Conventional radiography and MRI of the affected shoulder joint demonstrated a progressed cuff-tear arthropathy with an irreparable tear of the supraspinatus tendon, static superior migration of the humeral head, opening of the AC joint capsule and a superior joint-fluid ‘eruption’ and accumulation called ‘Geyser sign’. Given that the patient’s cuff-tear arthropathy was very well compensated, arthroscopic rotator cuff debridement and open cyst excision were performed. Closure of the superior aspect of the AC joint capsule was performed by the aid of a collagen matrix with additional closure of the deltotrapezial fascia. One year postoperatively, no cyst recurrence was noted.

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Section: Discussionmentioning

confidence: 71%

Acromioclavicular joint cyst formation in a patient with rotator cuff-tear arthropathy: a rare cause of shoulder discomfort

et al. 2018

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“…The nature of the ACJ cysts is typically benign, being either synovial or ganglionic in origin. 30 Nevertheless, malignant tumours should be considered in the differential diagnosis, because they can grow to significant sizes. 6,33 Synovial cysts are synovium-lined structures containing articular fluid that comes from the adjacent joint.…”

Section: Discussionmentioning

confidence: 99%

“…In this review, 9 cases (15.8%) are ganglion cysts related to rotator cuff tear and 1 (1.7%) presented as an isolated ganglion with ACJ degeneration. 4,9,16,18,19,22,24,26,30,32 Regardless of the underlying pathology and mechanism, these cysts are located in the subcutaneous tissue. 29 We found only 3 studies (5.3%) that reported intramuscular extension of the cyst 19,31,34 and 1 (1.7%) describing it communicating with the epidermis.…”

Section: Discussionmentioning

confidence: 99%

“…In 1 case, there was a previous shoulder trauma on the affected side. [2][3][4][5][6][7]9,10,[12][13][14][16][17][18][19][20][21][22][23][24][25][27][28][29][30][31][32][33][34] Based on the patient's age, general condition, symptoms, and shoulder functionality, the treatment may be conservative or surgical. 21 In this review, 20 patients (35.1%) were treated conservatively with cyst aspiration, steroid injection, or no intervention at all, whereas 36 patients (63.2%) were surgically managed.…”

Section: Discussionmentioning

confidence: 99%

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Gigantic acromioclavicular joint cyst: presentation and mini review

Christodoulou

Kakagia

Galanis³

et al. 2021

Journal of Shoulder and Elbow Surgery

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Acromioclavicular joint (ACJ) cyst is an uncommonly documented condition of the shoulder, first described by Craig. 5 According to Hiller's classification, 13 there are 2 types of cysts, based on the various etiologies that generate them. Type I cysts are caused by degenerative changes of the ACJ due to injury, metabolic/infectious disease, or excessive use and are therefore restricted to the joint, with an intact rotator cuff. Gradually, these changes can inflame the synovium, leading to the overproduction of fluid and cyst formation superficial to the ACJ. Type II cysts are associated with rotator cuff tears, partial or complete, and subsequent cuff tear arthropathy, including superior migration of the humeral head and irritation of the inferior ACJ capsule. Synovial fluid from the glenohumeral joint (GHJ) escapes through the subacromial/subdeltoid bursa (Geyser sign) into the ACJ, with the deteriorated capsule acting like a 1-way valve that prevents the fluid from returning, leading to the formation of a cyst. 6 We report a massive cyst over the right ACJ in an 80-yearold man, followed by a short literature review. PubMed database search was carried out using the terms acromioclavicular joint cyst, acromioclavicular joint ganglion cyst, ACJ cyst, and ACJ ganglion cyst. No date criteria were placed. All articles reporting the cyst's size and its underlying pathology, as well as the applied treatment methods and the recurrence rate, were included. The inclusion criteria were (1) full-text studies and (2) English language or official English translation provided. The initial research query provided 166 records. Eleven were excluded as duplicates, and 79 were irrelevant by reviewing the title. In addition, 2 cases describing a juxtaarticular myxoma and chondromyxoid fibroma, respectively, were excluded. From the remaining 76 reports, 10 were rejected by reviewing their abstracts, because of apparent irrelevancy. We tried to retrieve the full text of the remaining 66 articles. For 10 of them, the whole text could not be obtained; therefore, they were excluded. No official English translation was provided for 8 articles, which were also not included. A total number of 48 cases were thoroughly reviewed. Six were rejected because of irrelevant data and 6 because of a low level of evidence. A total of 34 studies finally entered the review, reporting 57 cases of ACJ cysts (Table I). A right-handed 80-year-old man was admitted to the hospital with a mass located above his right ACJ. His medical history was free, with the exception of pulmonary echinococcosis, diagnosed 40 years ago. The patient, a retired manual laborer, denied any previous shoulder trauma or any prior surgeries on the affected side, but complained of chronic right shoulder discomfort and mild pain during daily life activities, because of a gradually increasing shoulder lump. On physical examination, the mass measured 6.5 cm in diameter, 8 cm in length, 5 cm in Institutional review board approval was not required for this case report. This patient provid...

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“…Interestingly in this hemiarthroplasty case series, no operative procedure was directed on the ACJ and the cyst demonstrated a complete resolution at mean follow-up of 27 months [ 12 ]. Furthermore, Skedros et al managed their patient primarily with resection of the ACJ cyst only without addressing the end-stage rotator cuff arthropathy [ 16 ]. This resulted in their patient to have unresolved shoulder pain and restricted ROM postoperatively to approximately 90 degrees forward flexion.…”

Section: Discussionmentioning

confidence: 99%

Reverse Total Shoulder Replacement with Minimal ACJ Excision Arthroplasty for Management of Massive ACJ Cyst - A Case Report

Shaarani

Mullett

2014

TOORTHJ

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Massive acromioclavicular ganglionic cyst treated with excision and allograft patch of acromioclavicular region

Cited by 17 publications

References 19 publications

Acromioclavicular joint cyst formation in a patient with rotator cuff-tear arthropathy: a rare cause of shoulder discomfort

Acromioclavicular joint cyst formation in a patient with rotator cuff-tear arthropathy: a rare cause of shoulder discomfort

Gigantic acromioclavicular joint cyst: presentation and mini review

Reverse Total Shoulder Replacement with Minimal ACJ Excision Arthroplasty for Management of Massive ACJ Cyst - A Case Report

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