A huge mesenteric teratoma in reproductive age woman: a case report

The incidence of dermoid ovarian cyst is 15-20% of all ovarian neoplasm, which is a common entity. Mesenteric cyst are one of the very rare entities with incidence of 1 in 2, 50, 000. Dermoid cysts rarely present as mesenteric cysts. Mesenteric dermoid cyst have good prognosis. Here, we report a rare abdominal tumor which was initially diagnosed clinically as an ovarian dermoid cyst but operative and histology revealed it to be mesenteric dermoid cyst. A 36 year-old, multiparous presented with abdominal mass, gradually increasing in size since 1 year with recent onset of abdominal pain. Physical examination revealed abdominal mass of 22×20 cm size, globular, non-tender, mobile, and cystic to solid in consistency. Contrast-enhanced computed tomography (CECT) showed 23×21×14.4 cm heterogeneous enhancing mass lesion with areas of fat density and calcifications within, suggestive of neoplastic mass lesion, likely teratoma. Tumor markers were within normal limit. Patient was managed surgically. Laparotomy findings revealed a huge solid mesenteric mass (22×20 cm) weighing 6.5 kgs. Histopathology showed mature cartilage, osteoid formation, fibro-adipose connective tissue, focal lymphoid aggregates, congested blood vessels and focal mature neuronal component and no immature elements seen, confirming dermoid cyst. Mesenteric cyst are rare intra-abdominal tumor found most commonly in ileum (60%) next is ascending colon (40%). However, if a mesenteric cyst locates within the pelvic cavity, as in this case, it may be misdiagnosed as an ovarian cyst.

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Sonographic and histopathological findings in ovarian dermoid cyst

Journal of Patan Academy of Health Sciences ◽

10.3126/jpahs.v4i2.24581 ◽

2017 ◽

Vol 4 (2) ◽

pp. 27-32

Author(s):

Pooja Jaiswal ◽

Shital Bhandary ◽

Shreejana Shrestha ◽

Yogita Dwa ◽

Binod Parmar ◽

...

Keyword(s):

Dermoid Cyst ◽

Ovarian Cyst ◽

Wide Spectrum ◽

Reproductive Age ◽

Age Group ◽

Ovarian Mass ◽

Abdominal Sonography ◽

Histopathological Findings ◽

Ovarian Dermoid Cyst ◽

Reproductive Age Group

Introductions: Ovarian dermoid cyst occurs most commonly in reproductive age group. It consists all three layers of germ cells, in variable composition resulting in wide spectrum of USG findings. This study aimed to find the association between sonographic and histopathological findings of dermoid cyst. Methods: This was a retrospective study consisting of 55 cases of complex ovarian cysts with features of dermoid cyst, during two years 2013-2015. The diagnostic accuracies of trans-abdominal sonography findings were compared with post-operative histopathology reports. Results: Among 55 cases of complex ovarian cyst with sonographic features of dermoid, histopathology was benign in 52 (94.5%) and malignant in 3 (5.5%). In 52 benign cysts, 25 (48.0%) were teratoma and 27 (51.9%) were other benign masses. Conclusions: The accuracy of ultrasound was 95% in the diagnosis of ovarian cyst and is the modality of choice for initial workup of ovarian mass.

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Huge Ovarian Cyst Imitating Pregnancy

Nepal Journal of Obstetrics and Gynaecology ◽

10.3126/njog.v13i1.21622 ◽

2018 ◽

Vol 13 (1) ◽

pp. 61-63

Author(s):

Nishma Bajracharya ◽

Aruna Karki ◽

Ganesh Dangal ◽

Hema Pradhan ◽

Ranjana Shrestha ◽

...

Keyword(s):

Case Report ◽

Dermoid Cyst ◽

Young Women ◽

Respiratory System ◽

Ovarian Cyst ◽

Slow Rate ◽

Ovarian Neoplasms ◽

Reproductive Age ◽

Ovarian Cysts ◽

Genitourinary System

Ovarian cysts are common findings in females of reproductive age. Mostly, they are non-neoplastic and hormonally dependent as follicular, simple, and corpus luteum cysts. Ovarian cysts are rarely grown to reach huge size without raising any symptoms. Most of the cases that have huge cysts present with pressure symptoms over the genitourinary system leading to urinary complaints or the respiratory system lead to respiratory embarrassment.Dermoid cysts account for 10–20% of all ovarian neoplasms. They are common in young women, especially at the age of 30 years.In most of cases, they are asymptomatic and can be discovered accidentally on clinical examination or ultrasonographic scan. They are usually indolent tumors with very slow rate of growth about 1.8 mm per year. Giant dermoid cysts have been infrequently reported in the literature.This is a case report of huge dermoid cyst weighing 25 kgs in a 42-year old perimenopausal lady that remained relatively asymptomatic. She underwent Laparotomy with ovarian cystectomy.

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Mesentrial Cyst Lymphangioma in 3-Year-Old Girls: A Case Report

Berkala Kedokteran ◽

10.20527/jbk.v16i2.9227 ◽

2020 ◽

Vol 16 (2) ◽

pp. 135

Author(s):

Hafni Zuchra Noor ◽

Nunik Agustriani

Keyword(s):

Differential Diagnosis ◽

Case Report ◽

Physical Examination ◽

Left Kidney ◽

Good Prognosis ◽

Pelvic Cavity ◽

Abdominal Tumor ◽

Type Iv ◽

Firm Boundary ◽

Postoperative Diagnosis

Abstract: Mesenterial cysts are rare tumors, incidence 1: 100,000-200,000. We report the case and the treatment. Case report, 3-year-old woman with complaints of a lump in the abdomen. Complaints in the last 1 year ago, sometimes she felt pain, physical examination showed a lump of cystic impression with a size of ± 5x10 cm in the epigastric region, mobile, firm boundary. It can be diagnosed with a suspected intra-abdominal tumor with a mesenterial cyst, differential diagnosis of teratoma. Surgery was performed and a mass was found in retroperitoneal with a size of ± 20x5 cm up to the pelvic cavity, cystic and mobile, the mass could not be taken at all, we decided to do marsupialization, and left kidney is not visible. Postoperative diagnosis is retroperitoneal (type IV) mesenterial cyst lymphangioma with agenesis ren sinistra. Mesenterial cyst Lymphangioma is a tumor that is very rarely found and is benign. For a good prognosis, it depends on the type and therapy that is performed. Keywords: Mesenterial cyst lymphangioma, a tumor in children, mesenterial tumor

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Laparoscopic Cystectomy of Huge Ovarian Cyst in Nulliparous Woman

Nepal Journal of Obstetrics and Gynaecology ◽

10.3126/njog.v13i3.23478 ◽

2018 ◽

Vol 13 (3) ◽

pp. 63-65

Author(s):

Amarnath Thakur ◽

Ganesh Dangal ◽

Aruna Karki ◽

Hema Kumari Pradhan ◽

Ranjana Shrestha ◽

...

Keyword(s):

Ovarian Cyst ◽

Abdominal Mass ◽

Mucinous Cystadenoma ◽

Nulliparous Woman ◽

Surface Epithelium ◽

Epithelioid Cells ◽

Brenner Tumor ◽

Laparoscopic Cystectomy

Mucinous cystadenoma arises from the totipotent surface epithelium of the ovary. Its association with Brenner tumor suggests its origin as mucinous metaplasia of the epithelioid cells. The chance of malignancy is 5–10 percent. Patients usually present with abruptly increasing abdominal mass. Cystectomy is the management of choice in these cases. It was managed by laparoscopy.

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Painless spontaneous haemoperitoneum secondary to a uterine leiomyoma/fibroid: unusual presentation of a life-threatening differential

BMJ Case Reports ◽

10.1136/bcr-2021-243465 ◽

2021 ◽

Vol 14 (10) ◽

pp. e243465

Author(s):

Chiamaka Maduanusi ◽

Sathiyaa Balachandran ◽

Sahathevan Sathiyathasan ◽

Kazal Omar

Keyword(s):

Uterine Leiomyoma ◽

Rare Complication ◽

Abdominal Mass ◽

Uterine Fibroids ◽

Reproductive Age ◽

Haemodynamic Instability ◽

Hypovolaemic Shock ◽

Important Differential Diagnosis ◽

Life Threatening ◽

Definitive Management

This is a case of a 47-year-old woman with a spontaneous haemoperitoneum secondary to uterine leiomyomas (fibroids), an important differential diagnosis in patients with uterine fibroids and hypovolaemic shock. Uterine fibroids are very common in women of reproductive age, yet little is taught about their potential to cause hypovolaemic shock. Although it is a rare complication, given the prevalence of fibroids, it is important to bear this life-threatening differential in mind to optimise the care for these women. Presentation typically involves abdominal pain, syncope, haemodynamic instability and an intra-abdominal mass. CT of the abdomen and pelvis can be helpful in identifying the source of the haemoperitoneum, but should not delay surgery, which is the definitive management.

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Large mesenteric cyst mimicking an ovarian cyst in an 8-year-old: A case report

International Journal of Surgery Case Reports ◽

10.1016/j.ijscr.2021.106566 ◽

2021 ◽

pp. 106566

Author(s):

Rebekah Leigh ◽

Marla A. Sacks ◽

Mitchell M. Won ◽

Amarseen Mikael ◽

Donald Moores ◽

...

Keyword(s):

Case Report ◽

Ovarian Cyst ◽

Mesenteric Cyst

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Chemical peritonitis resulting from spontaneous rupture of a mature ovarian cystic teratoma: a case report

Acta medica Lituanica ◽

10.6001/actamedica.v26i4.4207 ◽

2020 ◽

Vol 26 (4) ◽

pp. 217-226

Author(s):

Diana Bužinskienė ◽

Matas Mongirdas ◽

Saulius Mikėnas ◽

Gražina Drąsutienė ◽

Linas Andreika ◽

...

Keyword(s):

Abdominal Pain ◽

Dermoid Cyst ◽

Ovarian Cyst ◽

Transvaginal Ultrasound ◽

Cystic Teratoma ◽

Normal Vaginal Delivery ◽

Ultrasound Scan ◽

Presenting Symptoms ◽

Abdominal Examination ◽

Chemical Peritonitis

Background. Mature cystic teratomas (dermoid cysts) are the most common germ cell tumours with 10–25% incidence of adult and 50% of paediatric ovarian tumours. The aetiology of dermoid cysts is still unclear, although currently the parthenogenic theory is most widely accepted. The tumour is slow-growing and in the majority of cases it is an accidental finding. Presenting symptoms are vague and nonspecific. The main complication of a dermoid cyst is cyst torsion (15%); other reported complications include malignant transformation (1–2%), infection (1%), and rupture (0.3–2%). Prolonged pressure during pregnancy, torsion with infarction, or a direct trauma are the main risk factors for a spontaneous dermoid rupture that can lead to acute or chronic peritonitis. The diagnosis of mature cystic teratoma is often made in retrospect after surgical resection of an ovarian cyst, because such imaging modalities as ultrasound, computer tomography, or magnetic resonance imaging cannot yet accurately and reliably distinguish between benign and malignant pathology. Materials and methods. We present a report of a clinical case of a 35-years-old female, who was referred to the hospital due to abdominal pain spreading to her feet for three successive days. She had a history of a normal vaginal delivery one month before. Abdominal examination revealed mild tenderness in the lower abdomen; no obvious muscle rigidity was noted. Transvaginal ultrasound showed a multiloculated cystic mass measuring 16 × 10 cm in the pelvis. In the absence of urgency, planned surgical treatment was recommended. The next day the patient was referred to the hospital again, with a complaint of stronger abdominal pain (7/10), nausea, and vomiting. This time abdominal examination revealed symptoms of acute peritonitis. The ultrasound scan differed from the previous one. This time, the transvaginal ultrasound scan revealed abnormally changed ovaries bilaterally. There was a large amount of free fluid in the abdominal cavity. The patient was operated on – left laparoscopic cystectomy and right adnexectomy were performed. Postoperative antibacterial treatment, infusion of fluids, painkillers, prophylaxis of the thromboembolism were administered. The patient was discharged from the hospital on the seventh postoperative day and was sent for outpatient observation. Results and conclusions. Ultrasound is the imaging modality of choice for a dermoid cyst because it is safe, non-invasive, and quick to perform. Leakage or spillage of dermoid cyst contents can cause chemical peritonitis, which is an aseptic inflammatory peritoneal reaction. Once a rupture of an ovarian cystic teratoma is diagnosed, immediate surgical intervention with prompt removal of the spontaneously ruptured ovarian cyst and thorough peritoneal lavage are required.

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A Wandering Abdominal Mass in a Neonate: An Enteric Duplication Cyst Mimicking an Ovarian Cyst

Case Reports in Pediatrics ◽

10.1155/2017/9209126 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Shigeo Iijima

Keyword(s):

Ovarian Cyst ◽

Abdominal Mass ◽

Duplication Cyst ◽

Resonance Imaging ◽

Urgent Surgery ◽

Enteric Duplication Cyst ◽

Antenatal Ultrasonography ◽

Enteric Duplication ◽

Magnetic Resonance Imaging Mri ◽

The Right

Enteric duplication cysts are rare congenital anomalies that are prenatally diagnosed through antenatal ultrasonography (US). In female patients, however, attention must be paid since these formations might be confused with ovarian cysts. Herein, we present a case of a low birth weight female infant with an enteric duplication cyst. A cystic lesion was detected in the right abdomen of the fetus on antenatal US and magnetic resonance imaging (MRI). Serial US and MRI examinations performed after birth showed a single cyst that wandered from side to side in the abdomen; the initial diagnosis was thought to be an ovarian cyst. During laparotomy, however, it was found to be an enteric duplication cyst with volvulus. To our knowledge, there has been no report of an enteric duplication cyst presenting as a wandering abdominal mass. Our experience indicates that early intervention is necessary for patients who have a wandering abdominal mass to avoid complications and urgent surgery, whether it is an ovarian cyst or an enteric duplication cyst.

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Elevated serum CA 19-9 levels in dermoid cyst: a predictor of ovarian torsion and tissue necrosis?

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20192471 ◽

2019 ◽

Vol 8 (6) ◽

pp. 2571

Author(s):

Ruby Bhatia ◽

Simmanjit Kaur ◽

Sunita Mor ◽

Naazbir Kaur ◽

Ritika Gupta

Keyword(s):

Dermoid Cyst ◽

Ovarian Tissue ◽

Elevated Serum ◽

Cystic Teratoma ◽

Exploratory Laparotomy ◽

Carbohydrate Antigen ◽

Mature Cystic Teratoma ◽

Reproductive Age ◽

Tissue Necrosis ◽

Benign Condition

Dermoid cyst (mature cystic teratoma) with well differentiated derivatives of all the three-germ cell layer is a benign tumour with ovaries being the commonest site. Dermoid cyst accounts for more than half of ovarian tumours in girls below 20 years of age. 80% of dermoid cyst are seen in reproductive age group between 20-40 years. Size of dermoid cyst usually varies between 5-10 cm and it may be bilateral in 10% of cases. Malignant transformation is very rare occurrence only in 1-3% cases, however torsion may occur in 15% of dermoid cyst. Carbohydrate antigen or cancer antigen 19-9 is usually raised in gastrointestinal tumours, pancreatic malignancy, pseudocyst of pancreas. However, it may be raised in some other malignancies and benign condition like torsion of dermoid cyst. Authors report an unusual case of torsion large dermoid cyst with tissue necrosis along with significantly elevates levels of serum CA 19-9. A 30-year-old P1L1 female presented with chief complaint of heaviness and pain lower abdomen and loss of five kilogram weight for last three months. A provisional diagnosis of dermoid was made. Serum CA 19-9 level were 1126 IU significantly raised. An exploratory laparotomy done under regional anaesthesia. A large demoid cyst 12*10 cm with torsion and areas of gangrene in ovarian tissue was seen replacing left ovary. Large and small intestine, stomach, pancreas were explored to rule out any pathology. Histopathology confirmed diagnosis of mature cystic teratoma. There was significant fall in serum Ca 19-9 levels to 247 U/ml two weeks after surgery and levels returned to normal limit six weeks after surgery.

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Biphasic Malignant Testicular Sex Cord-Stromal Tumor in a Cotton-top Tamarin (Saguinus oedipus) with Review of the Literature

Veterinary Pathology ◽

10.1354/vp.45-6-922 ◽

2008 ◽

Vol 45 (6) ◽

pp. 922-927 ◽

Cited By ~ 4

Author(s):

J. H. Yearley ◽

N. King ◽

X. Liu ◽

E. H. Curran ◽

S. P. O'Neil

Keyword(s):

Granulosa Cell ◽

Abdominal Mass ◽

Granulosa Cell Tumor ◽

Needle Aspiration ◽

Cell Tumor ◽

Stromal Tumor ◽

Histologic Examination ◽

Saguinus Oedipus ◽

Abdominal Tumor ◽

Sex Cord Stromal Tumor

A 20–year old male cotton-top tamarin ( Saguinus oedipus) was presented with unilateral enlargement of an intrascrotal testicle. Fine-needle aspiration cytology demonstrated a neoplastic population with Call-Exner-like bodies and features of malignancy. The animal was castrated, and histologic examination revealed a biphasic sex cord-stromal tumor, with one region resembling Sertoli-cell tumor and one region resembling granulosa-cell tumor, with extensive microfollicular pattern and many Call-Exner bodies. Eight months after castration, the animal was euthanized on discovery of a caudal abdominal mass that displaced organs, was highly infiltrative, and extended into the paravertebral musculature with lysis of vertebral bone. Metastases to lymph node and lung were also present. Histologic examination of the abdominal tumor showed multifocal formation of Call-Exner bodies in an otherwise highly dedifferentiated population. Positive immunolabeling for alpha inhibin confirmed the sex cord-stromal origin of the abdominal and paravertebral tumor masses. This case has similarities to malignant testicular granulosa-cell tumor of humans.

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