Intra-abdominal cystic lymphangioma

Mesenteric Cyst in 22 Cases

BACKGROUND

The aim of this study is to retrospectively and multi-centerly examine the clinicopathological features of patients who were operated with the diagnosis of mesenteric cyst, which is a rare cause of intra-abdominal mass in the last 9 years, in the light of the literature.

METHODS

The patients were operated due to mesenteric cysts in the general surgery clinics of two Training and Research Hospital between 2010 and 2019; age, gender, preoperative clinical findings, computed tomography (CT) findings, localization of the mass, surgical procedure, morbidity, histopathological results, and follow-up period status were analyzed and reported electronically.

RESULTS

The patients generally applied with the complaints of abdominal pain, palpable abdominal mass, and abdominal distention. Fourteen (63.7%) of the cases were male and 8 (36.3%) were female. The mesenteric cysts were located in the small intestine in 18 cases and colon in 4 cases. In the histopathological examination of the surgical materials, simple cyst was detected in 17 cases, lymphangioma in 4 cases, colon adenocarcinoma, and simple cyst in 1 case. In the postoperative period, superficial surgical site infection developed in 3 patients and morbidity developed in 1 patient due to anastomotic leakage.

CONCLUSION

Although mesenteric cysts are rarely seen, although most of them are not histopathologically malignant, they can reach large sizes and require extensive surgical operation, and related morbidities can be seen. Therefore, mesenteric cysts should be followed carefully in the postoperative period as well as during the diagnosis and surgical treatment process.

Laparoscopic excision of a retroperitoneal mucinous cystic neoplasm: A case report

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Primary retroperitoneal mucinous cystic neoplasms are rare.

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Due to potential seeding intra-operatively, laparoscopic removal was avoided.

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Our case showed efficient and safe use of a laparoscopic approach.

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Surgeons must plan for every cyst to be malignant when planning for removal.

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With a laparoscopic approach, care is required when aspirating the cyst in vivo.

Introduction

A 22-year-old female presented with a large abdominal mass that was revealed to be a primary retroperitoneal mucinous cystadenoma.

Presentation of Case

A 22-year-old female presented with a two day history of bloating, mid-epigastric pain, and nausea without vomiting. A CT scan of her abdomen/pelvis showed a large left retroperitoneal mass, possibly a mesenteric cyst. The patient underwent laparoscopic surgery for mass excision. Once the cystic mass was completely dissected laparoscopically, it was placed in a large endobag. The fluid was then aspirated while in the bag to decompress and then completely taken out through a port site. She was discharged the following day. Final pathology revealed a benign mucinous cystadenoma/cystadenofibroma of mesenteric origin.

Discussion

Primary retroperitoneal mucinous cysts are rare occurrences and benign mucinous cystadenomas are the rarest subtype. We use an innovative laparoscopic technique with complete excision of the cyst without spillage of content, thus preventing possible seeding in case of malignancy.

Conclusion

There is some previous caution in using a laparoscopic approach for cystic masses due to potential seeding intra-operatively, in case of fluid spillage of a possible malignant neoplasm. We show through our case that it is possible to efficiently and safely use such an approach.

Subserous lymphangioma of the sigmoid colon: an uncommon cause of acute abdomen in pediatric patients

Lymphangioma is a rare, benign lesion derived from a malformation of the lymphatic system, which is more frequently found in the head, neck, and axilla. However, it may be present anywhere in the body, and the diagnosis involves adults as children with some distinct clinical features among them. In pediatric patients, abdominal cystic lymphangioma occurs mostly in the mesentery presenting abdominal pain, intestinal obstruction, or, more rarely, hemorrhage. The authors report the case of a child with a short-course history of fever, abdominal pain, and constipation. The physical examination disclosed the presence of an abdominal mass and signs of peritoneal irritation. Imaging was consistent with a cystic lesion compressing the sigmoid colon and laterally displacing the remaining loops. Exploratory laparotomy was undertaken, and a sigmoidectomy, followed by Hartman’s colostomy, was performed. Histological examination revealed the nature of the lesion as a cystic lymphangioma. The authors highlight the clinical features of this entity and call attention to this disease in the differential diagnosis of acute abdomen or abdominal pain, mainly in pediatric patients.

Spontaneous regression of a cystic retroperitoneal tumour in young women postpartum. Report of two cases

Retroperitoneal cystic tumours are rarely found, and of these, the most common lesion is a cystic lymphangioma. We present two postpartum patients with a cystic retroperitoneal tumour which showed spontaneous regression and a review of the literature.