A giant peritoneal simple mesothelial cyst: a case report

Abstract

IntroductionA peritoneal simple mesothelial cyst is a very rare mesenteric cyst of mesothelial origin. The size of this lesion usually ranges between a few centimeters and 10 cm. It is usually asymptomatic, but occasionally presents with various, non-specific symptoms, which makes correct pre-operative diagnosis difficult. We present a case of a giant peritoneal simple mesothelial cyst that was successfully managed by complete surgical excision which is the treatment of choice.Case presentationA 21-year-old Caucasian Moroccan woman with vague abdominal discomfort and associated distention, during the previous 2 years, without other symptoms, presented to our hospital. Her past medical history was unremarkable. On physical examination, a mobile, painless and relatively hard abdominal mass was palpated. The laboratory examination and abdominal radiograph were unremarkable. Abdominal radiologic imaging showed a cystic mass of 35 × 20 × 10 cm that occupied the entire anterior and right abdominal cavity. Radical excision of the cyst was performed by midline laparotomy without any damage to the adjacent abdominal organs. The histopathological diagnosis was simple mesothelial cyst. The postoperative course was uneventful with no recurrence.ConclusionA peritoneal simple mesothelial cyst is a quite rare abdominal tumor, that must always be considered in differential diagnosis of pelvic cystic lesions and other mesenteric cysts. The treatment of choice is the complete surgical excision of the cyst.

Mesenteric tumors: Diagnosis and treatment

“…CT shows a simple unilocular cyst with no discernable wall thickness. Histologically, the cyst has serous content and the internal wall consists of mesothelial cells overlying acellular fibrous tissue with no muscular or lymphatic components [14,15].…”

Diagnostic et traitement des tumeurs mésentériques

“…Histologiquement, il s'agit d'un kyste à contenu séreux dont la paroi interne est constituée de cellules mésothéliales, supportée par du tissu fibreux sans cellules musculaires ou lymphatiques [14,15]. C'est une lésion rare plus souvent diagnostiquée chez l'enfant ou le jeune adulte.…”

Infarcted mesothelial cyst: A case report

“…Mesenteric and omental mesothelial cysts are responsible for only 1 in 100,000 of adult hospital admissions [3], and are thus left low on the list of differential diagnoses for abdominal pain. Small symptomatic cysts are often only detected on CT imaging as nonspecific masses.…”

“…The pathogenesis of a mesothelial cyst involves failed coalescence of mesothelial-lined surfaces, typically involving the small bowel, mesentery, or mesocolon [3]. Imaging usually demonstrates a fluid-filled cavity without a readily identifiable wall.…”