Abstract:Benign cystic mesothelioma (BCM) is a rare tumor of unknown origin, most frequently encountered in women of reproductive age and with unknown etiology. Most patients have a history of previous pelvic operation, endometriosis, or pelvic inflammatory disease. Preoperative diagnosis is difficult. We report the cases of three patients, with one case complicated by pregnancy, and discuss the diagnostic evaluation and treatment of this rare disease. Complete surgical resection is recommended if feasible. However, re… Show more
“…Owing to this pattern it has been suggested that the cysts are at least in part hormonally driven, likely by oestrogen. Given this, it is surprising that there are very few reports of mesothelial cyst occurrence during pregnancy 6. One report described the incidental finding of a mesothelial cyst in the right iliac fossa during a caesarean section.…”
The case of a healthy 33-year-old woman who underwent an elective caesarean section with incidental finding of small free-floating cysts within the pelvic peritoneum is presented. Gross examination could not identify the specimens. Histopathological investigation was necessary to classify the specimens as benign mesothelial cysts. The patient had no medical or surgical history and no other risk factors. The presented case is particularly interesting as the cysts were non-adherent to any pelvic or abdominal structure, as is commonly described. Similarly, there are few descriptions of mesothelial cyst diagnosis during pregnancy.
“…Owing to this pattern it has been suggested that the cysts are at least in part hormonally driven, likely by oestrogen. Given this, it is surprising that there are very few reports of mesothelial cyst occurrence during pregnancy 6. One report described the incidental finding of a mesothelial cyst in the right iliac fossa during a caesarean section.…”
The case of a healthy 33-year-old woman who underwent an elective caesarean section with incidental finding of small free-floating cysts within the pelvic peritoneum is presented. Gross examination could not identify the specimens. Histopathological investigation was necessary to classify the specimens as benign mesothelial cysts. The patient had no medical or surgical history and no other risk factors. The presented case is particularly interesting as the cysts were non-adherent to any pelvic or abdominal structure, as is commonly described. Similarly, there are few descriptions of mesothelial cyst diagnosis during pregnancy.
“…They pertain to the peritoneum, can have mass effect, are filled with fluid and can include haemorrhagic components. The classic appearance on ultrasound is a spider web or honeycomb pattern 11 17. However, PICs can present as very complex lesions on the ovarian surface, hence mimicking an ovarian malignancy 12.…”
A cystic pelvic mass detected during pregnancy is not uncommon, but can be a diagnostic challenge. Most of these pelvic masses are benign ovarian cysts and resolve spontaneously. However, rare non-ovarian causes can complicate the diagnostic and therapeutic management. In this report an unusual case is presented of a 27-year-old pregnant woman with an atypical multicystic lesion in the pelvis, seen on routine first trimester ultrasound. A laparoscopic exploration was performed to rule out ovarian malignancy, and after histological analysis she was diagnosed with peritoneal inclusion cysts. The diagnostic and therapeutic challenges inherent to this rare non-ovarian disease are addressed in this case report.
“…Some cases have also been described in vaginal tunic [5]. Most papers about the disease are case reports [1,5,8] and clinical series, the largest with 17 patients [8].…”
Section: Discussionmentioning
confidence: 99%
“…Finally, abnormalities in the development could lead to formation of cysts in the mesothelial [5,10]. This injury has no association with exposure to amianto [8].…”
Section: Discussionmentioning
confidence: 99%
“…It is a rare disease that occurs most often in women of reproductive age and is associated with a history of prior abdominal surgery, endometriosis or inflammatory pelvic disease [6]. There are even cases reports in men [7] (ratio of 5 women:1 man) [8] and children [9].…”
Benign multicystic peritoneal mesothelioma (BMPM) is a rare tumor of slow growth, with low malignant potential and which is part of the differential diagnosis of pelvic cysts. We described a case report: 55 years old woman, asymptomatic, with ultrasonographic findings of multicystic pelvic image, submitted to exploratory laparotomy and, at the inventory of the cavity, multiple cysts were present, adhered to the omentum. Omentectomy and resection of the cysts was performed followed by complete hysterectomy and bilateral oophorectomy and salpingectomy. Macroscopic examination of the surgical specimen revealed a cystic lesion with translucent content and histological features compatible with BMPM. In the immediate postoperative period, the patient developed vasomotor symptoms secondary to hypoestrogenism, which ceased spontaneously. She underwent a new surgical approach for recurrence after two years. Since the pathogenesis and etiology of BMPM are not well defined, it is very important to describe clinical practices, to better understand the diagnosis, prognosis and management of this disease.
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