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Xu J, Lv TF. Rupture of a giant jejunal mesenteric cystic lymphangioma misdiagnosed as ovarian torsion: A case report. World J Clin Cases 2024; 12:847-852. [PMID: 38322678 PMCID: PMC10841141 DOI: 10.12998/wjcc.v12.i4.847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/22/2023] [Accepted: 01/12/2024] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Cystic lymphangioma is a rare benign tumor that affects the lymphatic system. Mesenteric lymphangiomas in the small bowel are extremely uncommon. CASE SUMMARY We present a 21-year-old female patient who complained of abdominal pain. The diagnosis of ovarian torsion was suspected after abdominopelvic unenhanced computed tomography and ultrasound revealed a large cyst in contact with the bladder, ovary, and uterus. The patient underwent emergency laparotomy performed by gynecologists, but it was discovered that the cystic tumor originated from the jejunum. Gastrointestinal surgeons were then called in to perform a cystectomy. Pathological examination confirmed the diagnosis of cystic lymphangioma of the mesentery. The patient had an uneventful postoperative recovery. CONCLUSION Mesenteric lymphangiomas can cause abdominal pain, and imaging techniques can help determine their characteristics, location, and size. Complete surgical excision and pathological examination are considered the standard treatment and diagnostic method.
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Affiliation(s)
- Jing Xu
- Department of Hepatopathy, Hangzhou Xixi Hospital, Hangzhou 310023, Zhejiang Province, China
| | - Tie-Feng Lv
- Department of Hepatopathy, Hangzhou Xixi Hospital, Hangzhou 310023, Zhejiang Province, China
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Belkouchi L, Saouab R, Boualiten K, Aourarh B, Adioui T, Essaoudi MA, Kessab A. Large Cystic Mass of the Pancreatico-Duodenal Region Revealing Duodenal Lymphatic Malformation: A Case Report. Clin Med Insights Case Rep 2022; 15:11795476221091393. [PMID: 35418792 PMCID: PMC8998382 DOI: 10.1177/11795476221091393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 03/10/2022] [Indexed: 11/17/2022] Open
Abstract
Lymphatic malformations are benign tumors rarely located in the gastro-intestinal tract. They are usually asymptomatic; however, they can cause clinical discomfort when enlarged. Imaging leads to diagnosis, but the confirmation can only be done through histology findings. We report the case of a 59-year-old male patient, admitted in our ward for melena, to which esophago-gastroduodenoscopy showed budding formations in the second portion of the duodenum wall, with Magnetic Resonance Imaging features and histological examination confirming diagnosis of a duodenal lymphatic malformation.
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Affiliation(s)
- Lina Belkouchi
- Department of Radiology, Mohammed V Military Hospital, Mohammed V University, Faculty of Medicine and Pharmacy, Rabat, Morocco
| | - Rachida Saouab
- Department of Radiology, Mohammed V Military Hospital, Mohammed V University, Faculty of Medicine and Pharmacy, Rabat, Morocco
| | - Khadija Boualiten
- Department of Gastroenterology I, Mohammed V Military Hospital, Mohammed V University, Faculty of Medicine and Pharmacy of Rabat, Morocco
| | - Benayad Aourarh
- Department of Gastroenterology I, Mohammed V Military Hospital, Mohammed V University, Faculty of Medicine and Pharmacy of Rabat, Morocco
| | - Tarik Adioui
- Department of Gastroenterology I, Mohammed V Military Hospital, Mohammed V University, Faculty of Medicine and Pharmacy of Rabat, Morocco
| | - Mohamed Amine Essaoudi
- Department of Pathology, Mohammed V Military Hospital, Mohammed V University, Faculty of Medicine and Pharmacy of Rabat, Morocco
| | - Amine Kessab
- Department of Pathology, Mohammed V Military Hospital, Mohammed V University, Faculty of Medicine and Pharmacy of Rabat, Morocco
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Gagliardi F, Lauro A, Tripodi D, Amabile MI, Palumbo P, Di Matteo FM, Palazzini G, Forte F, Frattaroli S, Khouzam S, Marino IR, D'Andrea V, Sorrenti S, Pironi D. Mesenteric Cyst with GI Symptoms: A Fluid Approach to Treatment-Case Report and Literature Review. Dig Dis Sci 2022; 67:786-798. [PMID: 35059952 DOI: 10.1007/s10620-021-07352-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/17/2021] [Indexed: 12/09/2022]
Abstract
Mesenteric cysts are defined as a heterogeneous group of intra-abdominal cystic lesions of the mesentery or omentum that may be found in any portion of the gastrointestinal tract from the duodenum to the rectum. The clinical condition is entirely asymptomatic in many patients, particularly with small cysts. The diagnosis is typically incidental and secondary to imaging performed for other purposes. In symptomatic patients, the clinical picture is characterized by nonspecific gastrointestinal signs and symptoms. Treatment may be surgical or via interventional radiology. We report the case of a 55-year-old female patient complaining of left-sided abdominal discomfort and constipation lasting three months. An abdominal ultrasound showed the presence of a 10 × 14 × 16 cm anechoic cystic mass filling the whole anterior and left abdominal cavity, confirmed by CT and MRI. The cyst, removed laparoscopically, was histologically a simple mesothelial cyst. We reviewed the international literature over the last 10 years of all cases with mesenteric cysts > 10 cm in evaluating gastrointestinal symptoms at diagnosis, histology, performed treatment, and outcome.
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Affiliation(s)
- Federica Gagliardi
- Department of Surgical Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Augusto Lauro
- Department of Surgical Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Domenico Tripodi
- Department of Surgical Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
| | - Maria Ida Amabile
- Department of Surgical Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Piergaspare Palumbo
- Department of Surgical Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Filippo Maria Di Matteo
- Department of Surgical Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Giorgio Palazzini
- Department of Surgical Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Flavio Forte
- Urology Department, M.G. Vannini Hospital, Rome, Italy
| | - Stefano Frattaroli
- Department of Surgical Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Simone Khouzam
- Department of Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Ignazio R Marino
- Department of Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Vito D'Andrea
- Department of Surgical Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Salvatore Sorrenti
- Department of Surgical Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Daniele Pironi
- Department of Surgical Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
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Barghash M, Nassif S, Alkurdi Y, Mansour M. Mesenteric Lymphangioma Presenting With Small Bowel Volvulus in an Adult. Cureus 2021; 13:e16771. [PMID: 34513383 PMCID: PMC8405412 DOI: 10.7759/cureus.16771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2021] [Indexed: 11/25/2022] Open
Abstract
Benign tumours of vascular and lymphatic origin are known as lymphangiomas. In this report, we present a case of a 26-year-old lady admitted with symptoms of small bowel obstruction. Her computed tomography (CT) scan showed a well-defined mass in the small bowel mesentery associated with small bowel volvulus. Segmental resection of the bowel, including the mass, was performed. Microscopic examination and immunohistochemistry of the specimen were consistent with lymphangioma of the small bowel mesentery.
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Affiliation(s)
| | - Suad Nassif
- General Surgery, North Manchester General Hospital, Manchester, GBR
| | - Yazan Alkurdi
- General Surgery, North Manchester General Hospital, Manchester, GBR
| | - Moustafa Mansour
- General Surgery, North Manchester General Hospital, Manchester, GBR
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Tuan NA, Van Du N, Van Hiep P. Giant cystic lymphangioma of right mesocolon: A case report. Int J Surg Case Rep 2021; 86:106326. [PMID: 34481132 PMCID: PMC8416641 DOI: 10.1016/j.ijscr.2021.106326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/22/2021] [Accepted: 08/15/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction Cystic lymphangiomas are rare benign tumors of the lymph vessels and are usually found in children. However, abdominal cystic lymphangioma in mesocolon is extremely rare in adult patients. Presentation of case We reported a 15-year-old female with giant cystic lymphangioma of the right mesocolon. On examination, only abdominal pain was confirmed. Abdominal computed tomography (CT) showed a large multiseptated cystic mass. The patient underwent a total right mesocolic excision with the lesion. The patient recovered well on postoperative follow-up and was discharged on the fifth day. No evidence of recurrence had also been found in three months follow-up period. Discussion The diagnosis of intra-abdominal cystic lymphoma is often dismissed because the clinical symptoms are nonspecific. It is easy confusion because the ultrasound and CT scan images are relatively similar to the mesenteric and omental cysts. Sclerosing therapies may cause long-term consequences such as local recurrences with a very high proportion. Complete resection, including resection of the involved organs, is necessary. With tumors surrounding the colon, surgeons should consider performing removal block colon-lesion. Conclusion Complete tumor removal is the optimal choice for the management of intra-abdominal cystic lymphangioma. However, incomplete resection may lead to local recurrence. Intra-abdominal cystic lymphangiomas are rare benign tumors. The most common location in mesenteric small bowel, in mesocolon is extremely rare. Complete tumor removal is optimal choice for lymphangioma
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Affiliation(s)
- Nguyen Anh Tuan
- Department of Gastrointestinal tract Surgery, 108 Military Central Hospital, Hanoi 100000, Viet Nam
| | - Nguyen Van Du
- Department of Gastrointestinal tract Surgery, 108 Military Central Hospital, Hanoi 100000, Viet Nam.
| | - Pham Van Hiep
- Department of Gastrointestinal tract Surgery, 108 Military Central Hospital, Hanoi 100000, Viet Nam
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Kodera K, Abe K, Kanehira M, Futagawa Y, Okamoto T, Ikegami T. Retroperitoneal lymphangioma mimicking malignant tumor treated by pancreaticoduodenectomy. Clin J Gastroenterol 2021; 14:1791-1797. [PMID: 34386941 DOI: 10.1007/s12328-021-01492-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 07/26/2021] [Indexed: 11/26/2022]
Abstract
Lymphangiomas are classified as lymphatic malformations, which are more common in children and rare in adults. It frequently occurs in the cervical and axillary regions and uncommonly in the retroperitoneum. A 39-year-old woman presented to our department for the investigation for a 55 mm asymptomatic mass in the right anterior adrenal cavity. Abdominal ultrasound showed a tumor containing cysts in the right anterior adrenal cavity. Contrast-enhanced computed tomography showed that the tumor was poorly contrasted and ill-defined. Magnetic resonance imaging suggested that the tumor contained a small amount of fat. The tumor tended to grow, and the possibility of malignant diseases such as liposarcoma could not be excluded. Therefore, surgical resection was performed. Since intraoperative findings showed that the tumor tightly invaded to the duodenum and pancreatic head, a pancreaticoduodenectomy was selected. The entire tumor was removed without exposing the tumor. Macroscopic findings indicated that the specimen was 55 mm in size, indistinctly demarcated, yellow-white in color, and polycystic. Histologically, lymphovascular proliferation was observed with infiltration of the pancreatic head and the duodenal muscle layer. The diagnosis of lymphangioma was finally made. There was no recurrence 2 years after surgery.
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Affiliation(s)
- Keita Kodera
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, Japan
| | - Kyohei Abe
- Department of Surgery, The Jikei University Daisan Hospital, 4-11-1, Izumihoncho, Komae, Tokyo, Japan.
| | - Masaru Kanehira
- Department of Surgery, The Jikei University Daisan Hospital, 4-11-1, Izumihoncho, Komae, Tokyo, Japan
| | - Yasuro Futagawa
- Department of Surgery, The Jikei University Daisan Hospital, 4-11-1, Izumihoncho, Komae, Tokyo, Japan
| | - Tomoyoshi Okamoto
- Department of Surgery, The Jikei University Daisan Hospital, 4-11-1, Izumihoncho, Komae, Tokyo, Japan
| | - Toru Ikegami
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, Japan
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