The occurrence of giant mesenteric cyst and adrenal ganglioneuroma in a schizophrenic male patient presenting as pseudocyesis: A case report

Abstract

Mesenteric cysts (MCs) are rare benign lesions found in the abdomen with an incidence rate of 1 per 100 000 adults and 1 per 20 000 children. Although it can be found at all ages, it is more common among adults at the age of between 40 and 70 years and children under 10 years without any gender preference. While their typical sizes are up to 10 cm, they can emerge in larger sizes. However, very large mesenteric cysts are rare presentations of such benign tumors. 1,2 This lesion was first diagnosed and introduced by Benineni, an Italian anatomist, in an eight-year-old boy, in 1507. Afterward, in 1850, Paul Jules Tillaux successfully resected a mass of this type of cyst for the first time. Subsequently, marsupialization of the cyst was conducted by Pean in 1883. 3 The mesenteric cysts exhibit no signs in 40% of cases. They are usually diagnosed accidentally, while tumor expansion, mesenteric stretching, or pressure on surrounding organs may cause symptoms such as abdominal pain, intestinal obstruction, nausea, and vomiting. 1 Ganglioneuromas (GNs) are benign tumors in sympathic system, originating from neural crest cells. They are composed of ganglionic cells, Shawn cells, and neurites. Generally, this tumor is found in posterior mediastinum and retroperitoneum. In addition, there are a few rare cases of its formation in the adrenal medulla. GN tumors can be found at all ages. However, the rare cases of GN tumor of the adrenal gland are more common in children and young adults. GNs are often hormonally silent and present no symptom; hence, the clinical diagnosis is difficult and virtually in all cases accidental. 4