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Case Reports in Women's Health Jun 2024Mature cystic teratomas (MCTs) arise from totipotent cells. While the ovaries are the most common sites, extragonadal teratomas are very rare. This case report describes...
Mature cystic teratomas (MCTs) arise from totipotent cells. While the ovaries are the most common sites, extragonadal teratomas are very rare. This case report describes the clinical details of a 20-year-old woman who was found to have a large pelvi-abdominal mass on clinical and imaging studies and elevated levels of CA-125. Because of the uncertainties of the origin of the mass, a multidisciplinary team suggested exploratory laparotomy with a mesenteric cyst as a differential diagnosis. Laparotomy showed both ovaries to be normal and revealed a large omental MCT, which was excised. Histopathology confirmed the diagnosis.
PubMed: 38855718
DOI: 10.1016/j.crwh.2024.e00619 -
International Journal of Surgery Case... Jun 2024Cystic lymphangioma is rare benign tumor that results from a lymphatic system malformation. The mesenteric location is even more uncommon.
INTRODUCTION
Cystic lymphangioma is rare benign tumor that results from a lymphatic system malformation. The mesenteric location is even more uncommon.
CASE REPORT
We report the case of a menopausal 63-year-old woman who presented with a persistent painful well-defined mass of the pelvis. On ultrasound and computed tomography, the mass appeared as thick-walled unilocular homogenous cyst in favor of an ovarian cystadenoma. During laparotomy, the misdiagnosis was confirmed as the tumor was found to be embedded in the mesentery of the ileum. Subsequent histopathological examination confirmed the benign cystic lymphangioma diagnosis.
DISCUSSION
Mesenteric cystic lymphangioma is rare peritoneal tumor of the adult. Clinically, it often masquerades as other abdominopelvic masses like ovarian cysts. Differential diagnosis is often challenging because of the overlapping clinical abdominal presentation and radiological features. Histopathological is the gold standard in diagnosing mesenteric cystic lymphangioma. Surgery is the mainstay treatment, and the recurrence rate is low if negative surgical margins are achieved.
CONCLUSION
Mesenteric cystic lymphangioma often mimics more frequent and potentially malignant lesions. It is essential for surgeons to remain vigilant for the possibility of this diagnosis when evaluating abdominopelvic cystic masses.
PubMed: 38824741
DOI: 10.1016/j.ijscr.2024.109846 -
Clinics and Practice Apr 2024: Intra-abdominal cystic formations represent heterogeneous pathologies with varied localization and clinical manifestation. The first challenge of a giant...
: Intra-abdominal cystic formations represent heterogeneous pathologies with varied localization and clinical manifestation. The first challenge of a giant intra-abdominal cystic lesion is identifying the organ of origin. The clinical presentation of intra-abdominal cystic lesions varies from acute manifestations to non-specific symptoms or accidental discovery. : A 2-year-old girl presents to the emergency unit with a fever of 38.5 Celsius, loss of appetite, and apathy. The investigations showed a gigantic intra-abdominal mass whose organ belonging could not be specified. Postoperatively, a giant mesenteric lymphangioma was evident, which was completely excised. : Giant cystic formations modify the anatomical reports and become space-replacing formations, and the starting point is even more challenging to assess preoperatively. Nevertheless, the careful evaluation of the characteristics of the formation, the effect on the adjacent organs, the age of the patient, and the clinical picture can provide elements of differential diagnosis. The stated purpose of this work is to systematize intra-abdominal lesions according to the organ of origin and to make the preoperative diagnosis of an intra-abdominal cystic lesion in the pediatric patient easy to perform starting from the presented case.
PubMed: 38804391
DOI: 10.3390/clinpract14030059 -
Cureus Apr 2024Mesenteric cysts are mostly congenital cysts of varied etiology. They occur twice as often in females than in males. They have varied clinical presentations. Most of...
Mesenteric cysts are mostly congenital cysts of varied etiology. They occur twice as often in females than in males. They have varied clinical presentations. Most of them are asymptomatic, and a few present with abdominal mass, abdominal pain, nausea, and vomiting. Ultrasonography and computed tomography (CT) are essential in their diagnosis. These cysts may get complicated due to hemorrhage, torsion, rupture, or infection and may become life-threatening with features of acute abdominal pain and peritonitis. This is a case presentation of a 22-year-old Indian female who came with abdominal pain and was found to have an infected mesenteric cyst on laparotomy.
PubMed: 38800183
DOI: 10.7759/cureus.58975 -
BMC Pediatrics May 2024To compare the clinical characteristics, surgical management and prognosis of mesenteric lymphatic malformations (ML) and omental lymphatic malformations (OL) in...
PURPOSE
To compare the clinical characteristics, surgical management and prognosis of mesenteric lymphatic malformations (ML) and omental lymphatic malformations (OL) in children.
METHODS
This retrospective study included 148 ML patients and 53 OL patients who underwent surgical treatment at two centers between January 2016 and December 2022. Details about the patients' clinical characteristics, cyst characteristics, preoperative complications, surgical methods, and prognosis were retrieved and compared.
RESULTS
No significant differences in sex ratio, prenatal diagnosis, or age of diagnosis were noted between ML and OL patients. Vomiting was more common in ML patients than in OL patients (46.6% vs. 22.6%, P = 0.002), but OL patients were more likely to be misdiagnosed (35.8% vs. 18.9%, P = 0.012). The size of the cysts in OL patients was significantly larger than that in ML patients (14.0 [4.0-30.0] vs. 10.0 [2.0-50.0] cm, P<0.001), and cysts with turbid fluid were more common in OL patients (38.0% vs. 20.6%, P<0.001). More OL patients than ML patients had preoperative hemorrhage or infection of cysts (41.5% vs. 31.8%, P<0.016). Cyst excision was performed in 137 (92.6%) ML patients and 51 (96.2%) OL patients, and the incidence of postoperative complications was lower (12.6% vs. 4.2%, P = 0.165) among OL patients. The main postoperative complications included adhesive ileus and recurrence of cysts. Additionally, more OL patients than ML patients were treated with laparoscopic surgery (69.8% vs. 39.2%, P<0.001).
CONCLUSIONS
There were differences in clinical characteristics, cyst characteristics and preoperative complications between ML and OL patients. Cyst excision was the most common surgical method that was used to treat both ML and OL patients, and laparoscopic surgery could be a feasible surgical approach for treating OL patients with a good prognosis.
TRIAL REGISTRATION
Retrospectively registered.
Topics: Humans; Retrospective Studies; Male; Female; Omentum; Infant; China; Child, Preschool; Lymphatic Abnormalities; Mesentery; Child; Postoperative Complications; Prognosis; Infant, Newborn
PubMed: 38783260
DOI: 10.1186/s12887-024-04808-w -
JPGN Reports May 2024This case report presents a rare complication of hepatic cystic echinococcosis in a 12-year-old Latino male, residing in a nonendemic region, who developed long-term...
This case report presents a rare complication of hepatic cystic echinococcosis in a 12-year-old Latino male, residing in a nonendemic region, who developed long-term sequelae of portal vein thrombosis accompanied by the emergence of a hyper-vascular sigmoid colon mass. Portal vein involvement in hepatic cystic echinococcosis is exceedingly uncommon, with limited documented cases. The presentation of the patient included intermittent hematochezia, abdominal pain, and fatigue. Imaging revealed liver cysts and chronic portal vein thrombosis with cavernous transformation, resulting in portal hypertension. Notably, the patient also exhibited mesenteric venous thrombosis, further complicating the clinical picture. The diagnosis was confirmed through echinococcus serology testing. Treatment involved a six month course of Albendazole, puncture-aspiration-injection-reaspiration procedure, splenectomy, and splenorenal shunt to alleviate portal hypertension. This case underscores the significance of considering portal hypertension secondary to hepatic cystic echinococcosis, even in nonendemic regions, particularly in pediatric patients with unique clinical presentations.
PubMed: 38756114
DOI: 10.1002/jpr3.12066 -
Cureus Mar 2024In the case of a 24-year-old woman experiencing depressive illness, weight loss, vomiting, and hypoglycemia, initial suspicion of gastroenteritis shifted to reveal...
In the case of a 24-year-old woman experiencing depressive illness, weight loss, vomiting, and hypoglycemia, initial suspicion of gastroenteritis shifted to reveal compensated metabolic acidosis and electrolyte imbalances. A subsequent CT scan revealed both superior mesenteric artery (SMA) syndrome and an incidental adnexal cyst, leading to treatment involving electrolyte correction and laparoscopic duodenojejunostomy, ultimately facilitating her recovery.
PubMed: 38681341
DOI: 10.7759/cureus.57073 -
Journal of the Belgian Society of... 2024Computed tomography is essential for timely diagnosing infected mesenteric cysts as a cause of acute abdomen, ultimately requiring complete excision to confirm...
Computed tomography is essential for timely diagnosing infected mesenteric cysts as a cause of acute abdomen, ultimately requiring complete excision to confirm diagnosis given the potential of malignant transformation.
PubMed: 38680722
DOI: 10.5334/jbsr.3555 -
Radiology Case Reports Jun 2024Mesenteric lymphangioma is a rare malformation of the lymphatic system. Misdiagnosis of mesenteric cystic lymphangioma can occur due to its rarity and resemblance to...
Mesenteric lymphangioma is a rare malformation of the lymphatic system. Misdiagnosis of mesenteric cystic lymphangioma can occur due to its rarity and resemblance to other cystic lesions and ascites. The authors report an acute presentation of a mesenteric lymphangioma in a 9-year-old child. Clinical, radiological, and surgical findings are illustrated accordingly. As authors, we aim to add to the limited data of acute presentations of mesenteric lymphangiomas.
PubMed: 38572275
DOI: 10.1016/j.radcr.2024.02.059 -
International Journal of Surgery Case... Apr 2024Mesenteric cysts are the rare benign intraperitoneal tumor, which are common in the mesentery of the terminal ileum. Though mesenteric cysts are frequently seen,...
INTRODUCTION
Mesenteric cysts are the rare benign intraperitoneal tumor, which are common in the mesentery of the terminal ileum. Though mesenteric cysts are frequently seen, chylolymphatic mesenteric cysts in children are rare entities.
CASE PRESENTATION
Our case is a case of a 3-year-old female child presenting to our center with a complain of abdominal pain. Ultrasonography (USG) of the abdomen revealed a cystic lesion in the right upper abdomen, and computed tomography (CT) scan showed a large homogenous fluid density lesion in the right upper abdomen, giving a provisional diagnosis of mesenteric cyst. She was managed surgically: the cyst was excised, the involved segment of bowel was resected and the remaining was anastomosed. On histopathology, the final diagnosis of a chylolymphatic mesenteric cyst was made.
DISCUSSION
Clinical presentations may vary from asymptomatic abdominal lump to features of acute abdomen. Imaging modalities like ultrasonography and computed tomography scans are the mainstay of investigations. Surgical management with excision of cyst, and resection of the involved bowel segment is the treatment of choice, as done in our patient. The final diagnosis is made after the histopathologic examination of the excised specimen.
CONCLUSION
Chylolymphatic mesenteric cysts are rare, and have varied clinical presentations. Although rare, chylolymphatic mesenteric cysts should be considered a differential diagnosis in patients presenting with cystic masses in the abdomen.
PubMed: 38458024
DOI: 10.1016/j.ijscr.2024.109480