scholarly journals Mesothelial Cyst in a Young Female: Case report and literature review

Author(s):  
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Mesenteric cysts are rare intra-abdominal benign tumors (1 in 100,000 cases in adults) with various clinical presentations. [1,2] They commonly originate from the small bowel mesentery, although a proportion has been found to originate from the mesocolon, and retroperitoneum. [1,3] The formation of mesenteric cysts depends on the histologic origin, where they could be classified into cysts of lymphatic origin, cysts of mesothelial origin, cysts of enteric origin, cysts of urogenital origin, dermoid cysts and pseudocysts. [4,5] Diagnosis is extremely difficult since. The Mesenteric cyst is usually asymptomatic, but if symptomatic, abdominal pain (82%), nausea and vomiting (45%), constipation (27%) are the most common presenting symptoms. [2,3] The clinical finding of abdominal mass is encountered in more than 61% of the patients. [2,3]. As this condition is very rare and its symptomatology can resemble any other abdominal diseases, diagnosis is extremely difficult and incorrect preoperative diagnosis is often made. Hence, performing physical examination and conducting radiological investigations such as ultrasonography (USG) and computed tomography (CT) are important in making a correct diagnosis. [2,3] As well as cases of mesothelial cysts, they are typically asymptomatic but occasionally, their symptoms are vague and non-specific. [6,7] As mentioned above, imaging modalities such as USG, CT and magnetic resonance imaging (MRI) are great in identifying the character, size, location, surrounding tissues and the wall and content of the cysts. [7] Surgery is the treatment of choice, as a complete resection with negative borders is curative and often prevents recurrence. [3] We report a case of a young female patient who presented with a vague abdominal symptoms and a large cystic mass in lower abdomen. After proper evaluation, surgical exploration revealed a large simple mesothelial cyst.

2018 ◽  
Vol 5 (4) ◽  
pp. 1217
Author(s):  
Ahmed M. Gafar ◽  
Mohamed Y. Batikhe

Background: Mesenteric cysts are exceptional abdominal lesions of childhood. Presentation may vary with broad spectrum of symptoms from asymptomatic mass and nonspecific complaints to an acute abdomen. Objectives of this study were to present a series of patients with mesenteric cysts and to analyze our experience with emphasis on the presentation, management, and outcome.Methods: This observational study included thirteen children were diagnosed and treated for mesenteric cysts. All cases subjected to clinical evaluation, laboratory investigations and radiological studies. The diagnosis was confirmed on laparotomy. Ethics committee approval was obtained. The main data which extracted and analyzed included demographic data, operative finding, postoperative complications and duration of hospital stay. Data were analyzed using SPSS for Windows software and P value of ≤ 0.05 was considered significant.Results: There were 13 patients with mesenteric cyst, 5 girls and 8 boys. The ages ranged from neonate to 8 years. Abdominal mass and pain was the main presenting symptoms. Prenatal diagnosis established in two cases. Laparotomy performed in all cases. Small bowel mesentery is the commonest site. Two patients required urgent surgery. Surgical procedures included cyst excision with or without intestinal resection. Chylolymphatic cyst was documented in 4 cases. Post-operative complications reported in 2 cases.Conclusions: Mesenteric cysts are unusual in children with variable clinical presentation. Complete excision was feasible in nearly all cases, bringing a favorable outcome. The possibility of this disease entity should be considered as the cause of acute abdomen.


2007 ◽  
Vol 15 (3-4) ◽  
pp. 91-93 ◽  
Author(s):  
Dragoslav Miljkovic ◽  
Dragojlo Gmijovic ◽  
Milan Radojkovic ◽  
Jasmina Gligorijevic ◽  
Zoran Radovanovic

Mesenteric cysts are rare abdominal findings. Due to absent or unspecific clinical presentation, very low incidence, and lack of adequate classification these cysts may sometimes represent a diagnostic and therapeutic challenge. We report a case of 37-year-old man with vague palpatory tenderness in left hypochondrium and paraumbilically and with palpable large intra-abdominal mass in whom mesenteric cyst was diagnosed using US and CT imaging. He was operated and cyst was extirpated in toto. Histopathological examination revealed a thick fibrous cyst wall with the signs of chronic inflammation and without inner epithelial lining, which suggested its traumatic origin. Considering the possibility of malignancy mesenteric cysts should be radically resected (with resection of adjacent organs if necessary) due to their strong relapsing potential and a tendency for sudden, progressive local enlargement if not removed in toto.


2005 ◽  
Vol 71 (7) ◽  
pp. 571-573 ◽  
Author(s):  
Mohammed Hassan ◽  
Nick Dobrilovic ◽  
Joel Korelitz

The case is a 33-year-old white female presenting with a 3-day history of abdominal pain. On initial examination, she was found to have significant right lower quadrant tenderness. Workup included computed tomography, which demonstrated a large cystic mass appearing to be of ovarian origin. The patient required an exploratory laparotomy, at which time she was found to have a large cyst involving the lesser curvature of her stomach. The cyst was successfully resected, and the patient had a rapid postoperative recovery with complete resolution of symptoms. Histopathologic evaluation of the specimen identified a mesenteric cyst. Mesenteric cysts are uncommon; gastric involvement is exceedingly rare. A review of the literature is presented.


2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Maria Isaia ◽  
Maria Erodotou ◽  
Georgios Nakos ◽  
Nikolaos Nikolaou

Mesenteric cysts are rare benign abdominal tumors, and they can appear anywhere in the mesentery of the gastrointestinal tract, from the duodenum to the rectum. They are generally asymptomatic and may present as an incidental finding. The diagnosis is confirmed by the laparotomy findings and the results of the histopathological examination. Complete surgical (open or laparoscopic) enucleation of the cyst is the treatment of choice. We present a case of a female patient who presented with abdominal pain and a giant palpable abdominal mass. The patient underwent a surgical exploration which showed a giant mesenteric cyst. A complete surgical enucleation of the cyst was successfully performed without the need of bowel resection. The histopathological examination of the cyst was compatible with the diagnosis of chylous mesenteric cyst.


2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Vygintas Aliukonis ◽  
Marius Lasinskas ◽  
Algirdas Pilvelis ◽  
Audrius Gradauskas

Introduction. Both mesenteric cysts and cystic lymphangiomas are scarce and clinically and radiologically almost identical derivatives, but their histological structure is fundamentally different. Case Presentation. A 52-year-old woman was consulted by a surgeon for a derivative felt in her abdomen. The patient said she felt a growing derivative in the abdomen about a month ago. After consulting and testing, a sigmoid colon mesenteric cyst ( 13   cm × 11   cm × 10   cm ) was found. Complete excision of the cyst within healthy tissues was performed through laparotomy. The surgery had no complications. The initial pathological answer was a simple mesothelial cyst (a rare histological finding). However, immunohistochemical tests were performed that showed that diagnosis was mesenteric cystic lymphangioma (ML). Cystic lymphangiomas that have a link to the mesentery have been described less than 200 times. Conclusions. Final differential diagnosis between different cystic derivatives is possible only based on histopathological examinations. Mesenteric lymphangioma is most common at a very young age, but in rare cases, it also occurs in adults. All clinicians should increase their awareness of the disease.


2014 ◽  
Vol 3 (4) ◽  
pp. 17-24
Author(s):  
Sushna Maharjan

This prospective study was conducted at College of Medical Sciences-Teaching Hospital (CMS-TH) during December 2008 to May 2010. One hundred and fifty cases were analyzed. Age of the patients, parity, presenting symptoms, types of sur­gery, clinical diagnosis and complications were retrieved from case sheets. Surface epithelial tumors were more frequently observed above 30 years of age, (62.07%) cases. During 1st to 3rd decades of life, 62.8% germ cell tumors were seen; and sex cord tumors were seen in age group 41-60 years only. For all age groups, benign tumors were common than malignant tumors. There were 10.7% unmarried patients, 5.33% nulliparous, 35.55% of parity 1 to 2; 4% pregnant and 20 % postmeno­pausal women. There were 86.67% cases neoplastic, and 13.33% non-neoplastic ovarian lesions; 93.85% benign, 5.38% malignant and 0.77% borderline tumors. Surface epithelial tumors were the most common tumors (53.84%) followed by germ cell tumors (43.85%), constituted 46.7% and 38% among all ovarian lesions. The commonest benign tumors were serous cystadenomas and mature cystic teratomas, constituted 40% cases each. Dysgerminoma was the common malignant neoplasm (2.31%), all were seen in adolescents. Most of the other malignant neoplasms were observed above 40 years of age. Seventy percent (70%) of non-neoplastic lesions were hemorrhagic corpus luteum cysts. The commonest presenting symptom was pain in the lower abdomen (82%) followed by abdominal mass/ or distension (48.7%). Constitutional symp­toms were observed in malignant cases only. Grossly, majority of the ovarian lesions were of size ranging 5 to 15 cm; and 89.93% cystic lesions. There were 48.7% lesions in the right ovary and 45.3% in the left ovary; 6% bilateral ovarian lesions, all of which were observed in benign and non-neoplastic lesions. The common complication observed was torsion (6.7%) followed by rupture of the cysts (6%). Journal of Chitwan Medical College 2013; 3(4); 17-24 DOI: http://dx.doi.org/10.3126/jcmc.v3i4.9549


2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Cumhur Dulger ◽  
Ertan Adali ◽  
Serhat Avcu ◽  
Zehra Kurdoglu

Background. Intraabdominal lesions such as mesenteric cysts are uncommon disorders. Most are discovered incidentally during routine abdominal examinations.Methods. We report a patient with a mesenteric cyst masquerading as tuberculous peritonitis and ascites.Conclusion. Mesenteric cysts generally do not show typical clinical findings. They may also present with peritoneal tuberculosis findings such as low albumin gradient ascites with high ascitic adenosine deaminase levels. Surgery is used to remove a wide variety of mesenteric cysts. A correct diagnosis can be made by the combined use of radiographic and sonographic examinations in conjunction with the clinical signs.


2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S117-S118
Author(s):  
M Bourgeau ◽  
V Avadhani

Abstract Introduction/Objective Mesenteric cysts are rare intra-abdominal lesions in adults. However, with the advanced imaging techniques and laparoscopic techniques, they are more often being identified and resected when clinically significant. There is a lack of detailed information in histopathology (except as case reports) since mesentery is generally neglected in our organ-based textbooks. The aim of our study is to highlight the importance of identifying and classifying mesenteric cystic lesions; they are not all that simple. Methods We performed a retrospective search on all mesenteric cysts submitted as excisions in our electronic database from 2013-2019. We classified them as per the de Perrot (PMID: 11053936) classification with modification. Results Our search showed: A. Lymphatic origin-11 (lymphangioma-10, Lymphangioma hamartomatous-1, associated with LAM-0), B. Mesothelial origin-68 (Benign mesothelial cysts-57, multilocular mesothelial cyst-11), C. Enteric origin- 3, D. Urogenital origin (Urachal cyst, mullerian inclusion cyst)-9, E. Mature cystic teratom-2, F. Pseudocyst-12, G. Epithelial cyst (not urogenital)- 11 (a/w LAMN-3, MCN-4, Mucinous cystadenoma-4), H. Associated with carcinoma-2. Case illustration: A 61-year-old male presented with worsening dysphagia, emesis and hiccups. A CT scan showed a 21.2 cm cystic mass with at least one septation (Fig 1). The cyst was resected. On gross pathological examination, the cyst measured 18 cm in greatest dimension with a thick, rough, tan-brown capsule. Microscopic examination showed a fibrous capsule, and cyst wall composed of numerous lymphatic vessels (CD31 positive) and prominent smooth muscle proliferation (Desmin positive). Scattered lymphoid aggregates were also present throughout the cyst wall. No definite epithelial lining was identified and was suspected to have been denuded. HMB-45 immunostain was negative, ruling out association with LAM. The final diagnosis of a Lymphangiomyoma, hamartomatous was rendered. Conclusion Though most of the mesenteric cysts are benign, some of them are significantly important such as Lymphangiomyoma (esp secondary to LAM), MCN, those associated with LAMN etc. and identifying and differentiating from their mimics has distinct clinical implications.


PEDIATRICS ◽  
1962 ◽  
Vol 30 (6) ◽  
pp. 1018-1018

Cystic Fibrosis—NCFRF. 16 mm., color, sound, showing time 32 minutes. Produced in 1961 by Samuel L. Schulman for the National Cystic Fibrosis Research Foundation, medical supervision by Giulio J. Barbero, M.D. Philadelphia. Procurable on purchase from National Cystic Fibrosis Research Foundation, 521 Fifth Avenue, New York City 17. Procurable on loan from American Medical Association, Motion Picture Library, 535 N. Dearborn Street, Chicago 10. This film has been prepared to aid physicians in making a correct diagnosis and to instruct them in the techniques currently being used to prolong life in cases of cystic fibrosis. Following the introductoy remarks there is a good discussion of the presenting symptoms, the differential diagnosis, the multiple system involvement, hereditary aspects, therapy, and prognosis. The film brings out well the panexocrine involvement, the clinical variability, and the fact that the disease is not an all or none phenomenon but rather a disease of all grades of severity and is a disease in which no single test is applicable to the exclusion of others. The diagrams and patient demonstrations are good. Perhaps too much review of older methods of therapy and diagnosis is given, but this serves as a background for the newer recommended procedures. More emphasis could have been given to the tremendous burden, both financial and emotional, this disease is on parents. This is an excellent instructive film and it emphasizes the many problems of cystic fibrosis as related to the diagnostic tools available and to forms of therapy. The photography and sound are satisfactory. It is recommended for pediatricians, general practitioners, house staff, and medical students.


2021 ◽  
Vol 9 (2) ◽  
pp. 34-38
Author(s):  
Mehdi Ashik Chowdhury ◽  
- Asaduzzaman

Solid pseudopapillary neoplasm (SPN) of the pancreas, also referred to as Frantz's tumour, is a rare tumour and represents 1-3% of all pancreatic tumours, which typically affects young women without significant clinical symptoms. This cross-sectional study was done in the Department of Pathology, Bangabandhu Sheikh Mujib Medical Un iversity (BSMMU) between January 2009 and December 2015. A total of nineteen cases of solid pseudopapillary neoplasm (SPN) of pancreas were detected in patients and included in this study. In all the patients the diagnosis was confirmed by histopathology after the surgery. Tumours were nodular, cystic or solid-cystic, often encapsulated. Some of them were received as irregular fragmented pieces, as intact removal was not possible. Cut surfaces were partly grey-white and partly tan-brown with cystic degeneration. Areas of necrosis and hemorrhage were present in all the specimens.The age range was of 14-45 years (mean age 26.9±3.7 years) (Table-I). Among the tumours, 18 were found in female patients, while only 1 was from male patient. In all the cases, preoperative imaging contributed to diagnosis of an abdominal mass in the patients. 11 of these were reported as pancreatic mass, while 3 as pancreatic cystic mass, 2 as retroperitoneal mass, 2 as mesenteric mass and only 1 as adrenal mass. Tumour-size ranged from 6 to 19 cm (mean size 9.3±1.5 cm). 7 tumours were solid and cystic in nature, while 8 were solid and 4 were only cystic. Complete capsule was found in 17 specimens. Calcifications were found in only 5 specimens. Surgical resection was found generally curative. In our study, absence of metastasis suggests that these tumours hardly show aggressive clinical behaviour. However, follow-up is important to observe potential local recurrence and metastasis. CBMJ 2020 July: Vol. 09 No. 02 P: 34-38


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