Mesenteric pseudocyst of the transverse colon: unusual presentation of more common pathology

Abstract

A 72-year-old man presented to the hospital with a cyst in the abdominal cavity as the main finding obtained by abdominal CT. The cyst measured 13.5×9 cm and was located near the proximal wall of the body of the stomach. Endoscopic ultrasonography revealed that, the size of the cyst was 8.6×8.8 cm and that most of it was anechoic. However, partially heterogeneous and hypoechoic solid portions and a septum were detected. This cystic lesion was separated from the stomach wall and pancreas. Surgical resection was performed. The final histopathological test results showed that the cystic mass originated from the mesentery of the transverse colon, and the cyst was diagnosed as mesenteric pseudocyst because the cystic wall was composed of granulation tissue without lining epithelial cells.

Laparoscopic Resection of a Jejunal Mesenteric Pseudocyst

“…As most mesenteric cysts have no symptoms, they are frequently discovered by chance on ultrasonography or CT; it is difficult to detect them on physical examination or by hematological testing [ 5 ]. The symptoms of mesenteric cysts are usually nonspecific.…”

Mucinous mesenteric cyst of the sigmoid mesocolon: a rare entity

“…Mesenteric cyst is a rare cystic disease that occurs within the abdominal cavity, with a prevalence of 1/100 000 to 250 000 among adult hospitalised patients 6. This cyst is a rare cause of abdominal pain.…”

“…Cyst of lymphatic origin Simple lymphatic cystLymphangiomasCysts of mesothelial origin Simple mesothelial cystsBenign cystic mesotheliomasMalignant cystic mesotheliomasCysts of enteric origin Enteric duplication cystsEnteric cystsCysts of urogenital originNon-pancreatic pseudocysts Cysts of traumatic originCysts of infectious originNon-neoplastic cysts HydatidTuberculous cystMucinous cystic neoplasmsMucinous cystadenoma Borderline malignant mucinous cystic neoplasmMucinous cyst adenocarcinomaMiscellaneous neoplasmsAs most mesenteric cysts have no symptoms, they are frequently discovered by chance, on USG or CT, and their detection is unlikely on a physical examination or by haematological tests 6. Sometimes, they may manifest with symptoms such as diffuse abdominal pain, sensation of fullness or pressure in the abdomen, or due to other complications such as torsion, rupture, haemorrhage of cysts, herniation of bowel into abdominal defect and obstruction.…”

“…Surgical excision is the mainstay of treatment for both, benign and malignant cysts. The surgical procedure differs according to the range of the lesion and extent of intrusion into the surrounding organs 6. Enucleation is adequate in the majority of mesenteric cysts but, sometimes, bowel resection may be necessary in cases where cysts are close to bowel structures or involving blood vessels that supply the bowel 9.…”

“…Although mesenteric cysts are rare and difficult to diagnose prior to surgery, attributable to absence of symptoms, in most cases, they must be considered in the differential diagnosis of a cystic lesion within the abdominal cavity 6. Although most are benign, surgical resection needs to be considered because these cysts have the possibility of malignant transformation 6…”