1
|
Lin YT, Tsai JH, Ko ME, Hsu C, Sheen JY, Sheu BC, Chang WC. Uterine mesothelial cysts mimicking ovarian cysts in a primipara patient with a history of Cesarean section: A case report and review of the literature. Taiwan J Obstet Gynecol 2024; 63:414-417. [PMID: 38802210 DOI: 10.1016/j.tjog.2023.09.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2023] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVE We describe a rare case of uterine mesothelial cysts mimicking ovarian cysts in a primipara patient with a history of Cesarean section. CASE REPORT A 39-year-old female patient with history of Cesarean section presented with dysmenorrhea. Sonography revealed that a hypoechoic and anechoic multicystic complex, which was located on the right side of the pelvic cavity, had infiltrated the adjacent posterior wall of the uterus, and it was preoperatively misdiagnosed as ovarian cysts with suspected endometrioma. Laparoscopic surgery revealed multiple cystic lesions filled with clear yellow fluid on the posterior uterine wall instead of the adnexa. Laparoscopic uterine cystectomy was performed, and the patient's recovery was uneventful. Pathohistological and immunohistochemical examinations confirmed the diagnosis of uterine mesothelial cysts. CONCLUSION Uterine mesothelial cysts should be considered in the differential diagnosis of pelvic lesions. Increasing the awareness of this rare disease can contribute to improved evaluation, decision-making, and disease management.
Collapse
Affiliation(s)
- Yu-Ting Lin
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Jia-Huei Tsai
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Pathology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Mu-En Ko
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ching Hsu
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Jiun-Yi Sheen
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Bor-Ching Sheu
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Wen-Chun Chang
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
| |
Collapse
|
2
|
Lumlertgul D, Tinroongroj N, Lumlertgul S, Siwapitak P, Tungkanakorn R, Kaewpanya S. Rescue plan for CAPD peritonitis: Using ultrasonography as a guide on when to remove the catheter. Ther Apher Dial 2023; 27:1113-1124. [PMID: 37632328 DOI: 10.1111/1744-9987.14042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 07/05/2023] [Accepted: 08/03/2023] [Indexed: 08/27/2023]
Abstract
INTRODUCTION Ultrasound has been found to facilitate early identification of peritonitis in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). METHODS A retrospective analysis was carried out to evaluate the effectiveness of ultrasonography-guided removal of the Tenckhoff catheter in reducing complications like a shift to hemodialysis or death in CAPD patients. RESULTS The "peritonitis rescue plan" supported timely decision-making for the removal of the infected catheter and resulted in a lower peritonitis episode per patient per month ratio (from 1:36 to 1:122) in 2021, a lower death rate (from 19% to 6.6%) and lower incidences of shifts to hemodialysis (from 2%-9% to 0%) as compared to that before the implementation of the plan in 2019. CONCLUSION The implementation of the "peritonitis rescue plan" and the removal of the infected catheter within 3 days of peritonitis being detected was successful in improving the standard of care for patients undergoing CAPD.
Collapse
Affiliation(s)
- Dusit Lumlertgul
- CAPD Institute, Chiangmai Kidney Clinic, Chiangmai, Thailand
- Faculty of Medicine, Chiangmai University, Chiangmai, Thailand
- Renal Disease Unit, Pan Hospital, Chiang Rai, Thailand
- Renal Disease Unit, Fang Hospital, Chiangmai, Thailand
| | - Nantawan Tinroongroj
- CAPD Institute, Chiangmai Kidney Clinic, Chiangmai, Thailand
- Bangkok Hospital, Chiangmai, Thailand
| | - Suthaporn Lumlertgul
- CAPD Institute, Chiangmai Kidney Clinic, Chiangmai, Thailand
- Department of Emergency Medicine, Chulalongkorn Hospital, Bangkok, Thailand
| | | | | | | |
Collapse
|
3
|
Barahmeh S, Shrateh ON, Hamarsheh L, Tanib I. The clinical significance of laparoscopy in the differentiation of inclusion cysts from ovarian masses: A case report and literature review. Int J Surg Case Rep 2023; 113:109043. [PMID: 37976723 PMCID: PMC10685012 DOI: 10.1016/j.ijscr.2023.109043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 11/02/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Peritoneal inclusion cysts (PICs) are infrequently encountered cysts within the abdominal and pelvic regions, typically observed in perimenopausal women. They frequently pose a diagnostic challenge as they can be clinically misinterpreted as ovarian-related lesions, owing to their resembling clinical presentations and radiological features. CASE PRESENTATION A 30-year-old female patient without significant medical or surgical history sought medical attention for mild left lower abdominal discomfort lasting two days. Initial evaluation ruled out pregnancy, and further tests showed no abnormalities in her blood work. Pelvic ultrasound revealed a 4.5 cm cystic mass in her left ovary while her right ovary and uterus appeared normal. A laparoscopic ovarian cystectomy was planned. During the procedure, it was discovered that the mass was not connected to the left ovary but was, in fact, a peritoneal inclusion cyst. CLINICAL DISCUSSION: previous intraperitoneal surgeries performed within a timeframe ranging from 6 months to 20 years, intraperitoneal inflammation, pelvic inflammatory disease, peritoneal tuberculosis, leiomyoma, tubo-ovarian abscess, among others. However, the absence of these predisposing factors does not minimize the possibility of PICs. CONCLUSION This case highlights the diagnostic challenges and the value of laparoscopy in accurately identifying and differentiating such cystic cases.
Collapse
Affiliation(s)
- Samer Barahmeh
- Department of Obstetrics and Gynecology, Al-Istishari Arab Hospital, Ramallah, Palestine.
| | - Oadi N Shrateh
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine.
| | - Lyudmila Hamarsheh
- Department of Obstetrics and Gynecology, Al-Istishari Arab Hospital, Ramallah, Palestine.
| | - Iyas Tanib
- Department of Obstetrics and Gynecology, Al-Istishari Arab Hospital, Ramallah, Palestine
| |
Collapse
|
4
|
Guo QH, He JL, Gong XZ, He WF, He GL. Traditional Chinese medicine treatments in a woman with a recurrent peritoneal inclusion cyst: a case report. J OBSTET GYNAECOL 2023; 43:2171775. [PMID: 36744838 DOI: 10.1080/01443615.2023.2171775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Qing-Hua Guo
- Department of Gynaecology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jing-Ling He
- Department of Gynaecology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiao-Zhen Gong
- Nursing Department, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wen-Fang He
- Department of Respiratory and Digestive Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Guang-Lian He
- Department of Gynaecology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| |
Collapse
|
5
|
Lupinelli M, Sbarra M, Kilcoyne A, Venkatesan AM, Nougaret S. MR Imaging of Gynecologic Tumors: Pearls, Pitfalls, and Tumor Mimics. Radiol Clin North Am 2023; 61:687-711. [PMID: 37169432 DOI: 10.1016/j.rcl.2023.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
MR imaging is the modality of choice for the pre-treatment evaluation of patients with gynecologic malignancies, given its excellent soft tissue contrast and multi-planar capability. However, it is not without pitfalls. Challenges can be encountered in the assessment of the infiltration of myometrium, vagina, cervical stroma, and parametria, which are crucial prognostic factors for endometrial and cervical cancers. Other challenges can be encountered in the distinction between solid and non-solid tissue and in the identification of peritoneal carcinomatosis for the sonographically indeterminate adnexal mass.
Collapse
Affiliation(s)
- Michela Lupinelli
- Department of Radiology, Morgagni-Pierantoni Hospital, Via Carlo Forlanini 34, 47121, Forlì, Italy.
| | - Martina Sbarra
- Unit of Diagnostic Imaging, Fondazione Policlinico Universitario Campus Bio-medico, Via Alvaro Del Portillo, 200, Roma 00128, Italy
| | - Aoife Kilcoyne
- Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA; Harvard Medical School, Boston, MA, USA
| | - Aradhana M Venkatesan
- Department of Abdominal Imaging, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, TX 77030, USA
| | - Stephanie Nougaret
- Department of Radiology, IRCM, Montpellier Cancer Research Institute, Montpellier 34090, France; INSERM, U1194, University of Montpellier, Montpellier 34295, France
| |
Collapse
|
6
|
AlTamimi JO, Alzahrani EA, Fallatah A, Alhakami LA, Bokhari BE. Peritoneal Inclusion Cyst in a Young Patient With a Long History of Abdominal Surgeries: A Case Report. Cureus 2023; 15:e35230. [PMID: 36968891 PMCID: PMC10032648 DOI: 10.7759/cureus.35230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2023] [Indexed: 02/22/2023] Open
Abstract
Peritoneal inclusion cysts (PICs) are reactive, fluid-filled lesions of the peritoneal lining, usually affecting women of reproductive age and with previous abdominal surgeries. Paraovarian cysts, hydrosalpinx, and low-grade cystic mesothelioma are usually considered in the differential diagnosis of PICs. In this case report, we present an 18-year-old female with a known case of bladder exstrophy and chronic urinary incontinence and a previous history of surgical bladder repair. She presented to the emergency department (ED) with urinary incontinence and lower abdominal pain. A computed tomography was ordered for her to rule out hydronephrosis, and incidentally, ovarian cysts were discovered that were then bilaterally excised via laparotomy. Our case report emphasizes the significance of considering such a diagnosis when coming across patients whose risk factors and symptoms match the diagnosis.
Collapse
|
7
|
Late-onset peritoneal inclusion cysts (PIC) in adolescents undergoing major gastrointestinal surgery. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2023. [DOI: 10.1016/j.epsc.2023.102592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
|
8
|
Kaya MT, Kuruca N, Kanat M, Akca FB, Gulbahar MY. Uterine Serosal Inclusion Cysts with Greater Omentum Involvement in a Cat. J Comp Pathol 2022; 199:37-42. [DOI: 10.1016/j.jcpa.2022.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 06/29/2022] [Accepted: 09/17/2022] [Indexed: 11/16/2022]
|
9
|
Diao Y, Chen L, Liu Z. Ultrasonographic misdiagnosis of multicystic mesothelioma of the omentum: A case report. Medicine (Baltimore) 2022; 101:e30441. [PMID: 36086679 PMCID: PMC10980464 DOI: 10.1097/md.0000000000030441] [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: 05/16/2022] [Accepted: 07/28/2022] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Multicystic Mesothelioma (MM) is very rare and preoperative diagnosis is difficult. PATIENT CONCERNS We report a case of a 34-year-old man with solid abdominal cystic echo mass. Physical examination showed that the patient had a flat and soft abdomen without tenderness or rebound pain, no fluid wave tremor, and no obvious abdominal mass was touched. The patient complained of repeated abdominal distention with nausea for 5 days. Sonographic examination suspected pseudomyxoma peritoneum. DIAGNOSIS Conventional ultrasound examination showed a cystic solid echo mass in the right abdominal cavity of the patient, with uneven internal echo and honeycomb change, and clear boundary with surrounding organs. Color Doppler suggested that the blood flow in the mass was not obvious. Contrast-enhanced computed tomography of the abdomen revealed hypodensity foci in hepatic and renal crypts and right paracolic sulcus. INTERVENTIONS Laparoscopic resection of the mass was performed, and the postoperative pathological findings were polycystic mesothelioma (greater omentum). OUTCOMES After mass resection, all laboratory tests and abdominal ultrasound were normal, and abdominal distension and nausea disappeared. LESSONS Improved ultrasound diagnosis of MM is useful for clinical decision-making.
Collapse
Affiliation(s)
- Yuhong Diao
- Department of Ultrasonography, First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Li Chen
- Department of Ultrasonography, First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Zhixing Liu
- Department of Ultrasonography, First Affiliated Hospital of Nanchang University, Nanchang, China
| |
Collapse
|
10
|
Kiyokawa T. Peritoneal Pathology Review: Mullerian, Mucinous and Mesothelial Lesions. Surg Pathol Clin 2022; 15:259-276. [PMID: 35715161 DOI: 10.1016/j.path.2022.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This review provides an overview of the pathology of selected benign and malignant lesions of the female peritoneum and their often-encountered differential diagnoses. It includes endometriosis and its related lesions, endosalpingiosis, pseudomyxoma peritonei (PMP) and related ovarian/appendiceal pathology, and malignant and benign mesothelial tumors. The current terminology associated with PMP is also discussed.
Collapse
Affiliation(s)
- Takako Kiyokawa
- Department of Pathology, The Jikei University School of Medicine, 3-25-8 Nishishimbashi Minato-ku, Tokyo 105-8461, Japan.
| |
Collapse
|
11
|
Oshikiri H, Ozawa Y, Suzuki O, Usuda M, Miyata G. Benign multicystic peritoneal mesothelioma occurring in bilateral inguinal canals metachronously: a case report. Surg Case Rep 2022; 8:44. [PMID: 35292863 PMCID: PMC8924337 DOI: 10.1186/s40792-022-01399-5] [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: 12/30/2021] [Accepted: 03/07/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Benign multicystic peritoneal mesothelioma (BMPM) is a benign tumor that usually occurs in middle-aged females. Although several published studies have reported the occurrence of this tumor in the abdominal cavity, few have documented its development in the inguinal region. CASE PRESENTATION We present a case of a 48-year-old female presenting with a bulge in her left inguinal region. Physical examination revealed a golf ball-sized nodule in the left inguinal region that could not be pushed back into the abdominal cavity. Contrast-enhanced computed tomography showed a multicystic tumor; therefore, the patient was diagnosed with inguinal hernia or hydrocele of the Nuck's canal. We performed surgical resection and hernia repair using the mesh plug method. The resected specimen was 80 mm in length and contained a multicystic tumor. Pathological examination showed that the cyst wall was lined by a single layer of cuboidal to single layer squamous epithelium. Immunohistochemistry revealed positivity for calretinin in the epithelial cells, for which a diagnosis of BMPM was established. The patient returned to our hospital after 5 years with symptoms similar to the previous episode, but this time in the right inguinal region. Imaging studies showed a tumor in the right inguinal region with the same characteristics as the previous one. The patient underwent tumor resection and hernia repair using the same technique. The resected tumor was 45 mm in length and had characteristics similar to the previously resected tumor. The presence of calretinin and D2-40 on immunohistochemistry led to the diagnosis of BMPM. There was no recurrence of BMPM for 33 months after the secondary surgery. CONCLUSIONS Here we present the first report of metachronous BMPM occurring in bilateral inguinal canals. Although the pathogenesis of BMPM remains unclear, reactive changes have been suggested to cause tumors originating from the groin. The treatment of choice for BMPM is surgical resection. For diagnosis, pathological examination with immunostaining can be useful. The most appropriate postoperative follow-up for inguinal BMPM is controversial, and the accumulation of more inguinal BMPM cases is needed.
Collapse
Affiliation(s)
- Hiroyuki Oshikiri
- Department of Digestive Surgery, Iwate Prefectural Central Hospital, 1-4-1, Ueda, Morioka, Iwate, 020-0066, Japan. .,Department of Surgery, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
| | - Yohei Ozawa
- Department of Surgery, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - On Suzuki
- Department of Digestive Surgery, Iwate Prefectural Central Hospital, 1-4-1, Ueda, Morioka, Iwate, 020-0066, Japan
| | - Masahiro Usuda
- Department of Digestive Surgery, Iwate Prefectural Central Hospital, 1-4-1, Ueda, Morioka, Iwate, 020-0066, Japan
| | - Go Miyata
- Department of Digestive Surgery, Iwate Prefectural Central Hospital, 1-4-1, Ueda, Morioka, Iwate, 020-0066, Japan
| |
Collapse
|
12
|
McGahan W, Lah K, Iyengar K, Naidu S. Benign multi-cystic peritoneal mesothelioma discovered at the time of acute appendicitis: a rare pathology in association with a common disease. ANZ J Surg 2022; 92:3055-3057. [PMID: 35170836 DOI: 10.1111/ans.17524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 01/20/2022] [Indexed: 11/28/2022]
Affiliation(s)
- William McGahan
- Department of General Surgery, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Kevin Lah
- Department of General Surgery, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Krishnan Iyengar
- Department of Anatomical Pathology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Sanjeev Naidu
- Department of General Surgery, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| |
Collapse
|
13
|
Chandramohan A, Shah N, Thrower A, Carr NJ, Mittal R, Mohamed F, Moran B. Communicating imaging findings in peritoneal mesothelioma: the impact of 'PAUSE' on surgical decision-making. Insights Imaging 2021; 12:174. [PMID: 34817720 PMCID: PMC8613330 DOI: 10.1186/s13244-021-01118-y] [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] [Received: 08/05/2021] [Accepted: 10/27/2021] [Indexed: 12/26/2022] Open
Abstract
The peritoneal cavity is the second commonest site of mesothelioma after the pleural cavity. There are five histological types of peritoneal mesothelioma with variable symptomatology, clinical presentation and prognosis. Cystic mesothelioma is a borderline malignant neoplasm with a favourable prognosis, well-differentiated papillary mesothelioma is generally a low-grade malignancy, and all other varieties such as epithelioid, sarcomatoid and biphasic mesothelioma are highly malignant types of peritoneal mesothelioma with poor prognosis. Malignant peritoneal mesothelioma was considered inevitably fatal prior to the introduction of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in selected cases where long-term survival and cure could be achieved. However, the survival benefits following CRS and HIPEC mainly depend on completeness of cytoreduction, which come at the cost of high morbidity and potential mortality. Using the acronym 'PAUSE', we aimed at describing the key imaging findings that impact surgical decision-making in patients with peritoneal mesothelioma. PAUSE stands for peritoneal cancer index, ascites and abdominal wall disease, unfavourable sites of involvement, small bowel and mesenteric disease and extraperitoneal disease. Reporting components of 'PAUSE' is crucial for patient selection. Despite limitations of CT in accurately depicting the volume of disease, describing findings in terms of PAUSE plays an important role in excluding patients who might not benefit from CRS and HIPEC.
Collapse
Affiliation(s)
| | - Nehal Shah
- Department of Radiology, Basingstoke Hospital, Aldermaston Road, Basingstoke, RG24 9NA, UK
| | - Andrew Thrower
- Department of Radiology, Basingstoke Hospital, Aldermaston Road, Basingstoke, RG24 9NA, UK
| | - Norman John Carr
- Peritoneal Malignancy Institute, Basingstoke Hospital, Aldermaston Road, Basingstoke, RG24 9NA, UK
| | - Rohin Mittal
- Christian Medical College, Vellore, 632004, India
| | - Faheez Mohamed
- Peritoneal Malignancy Institute, Basingstoke Hospital, Aldermaston Road, Basingstoke, RG24 9NA, UK
| | - Brendan Moran
- Peritoneal Malignancy Institute, Basingstoke Hospital, Aldermaston Road, Basingstoke, RG24 9NA, UK
| |
Collapse
|
14
|
Ruiz-Riera E, Nofrarias M, Martí-Garcia B, Domingo M, Segalés J, Vidal E. A case of uterine inclusion cysts in a sow. Porcine Health Manag 2021; 7:58. [PMID: 34724992 PMCID: PMC8559359 DOI: 10.1186/s40813-021-00237-8] [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] [Received: 08/13/2021] [Accepted: 10/19/2021] [Indexed: 12/04/2022] Open
Abstract
Background Serosal inclusion cysts are thin walled-structures located on the peritoneal surface of the uterus, frequently observed as multiple cystic structures in aggregates or grape-like clusters containing a clear, non-viscous fluid. In human and veterinary medicine, they are thought to be developed under hormonal effects, or after manipulation or inflammation of the reproductive tract. However, they have not yet been described in swine. Case presentation A uterus of a 3-year-old crossbreed sow was condemned at slaughter due to the presence of multiples cystic cavities attached to the serosal surface. Microscopically, multiple cystic dilations emerging from the serosa were lined by a simple and flattened epithelium (cytokeratine positive and vimentin negative on immunohistochemistry) supported by a subepithelial layer of collagen. Grossly and histologically, they were diagnosed as serosal inclusion cysts. Conclusion To the authors’ knowledge, this report represents the first description of serosal inclusion cysts in sows. These lesions should be taken into consideration within the differential diagnostic list of cystic peritoneal lesions such as cystic neoplasms, congenital cysts, and parasitic diseases.
Collapse
Affiliation(s)
- Elisa Ruiz-Riera
- Servei de Diagnòstic de Patologia Veterinària (SDPV), Departament de Sanitat i d'Anatomia Animals, Universitat Autonòma de Barcelona, 08193, Bellaterra (Cerdanyola del Vallès), Barcelona, Spain
| | - Miquel Nofrarias
- OIE Collaborating Centre for the Research and Control of Emerging and Re-Emerging Swine Diseases in Europe (IRTA-CReSA), Bellaterra, Barcelona, Spain.,IRTA, Centre de Recerca en Sanitat Animal (CReSA, IRTA-UAB), Campus de la Universitat Autònoma de Barcelona,, 08193, Bellaterra (Cerdanyola del Vallès), Barcelona, Spain
| | - Bernat Martí-Garcia
- Servei de Diagnòstic de Patologia Veterinària (SDPV), Departament de Sanitat i d'Anatomia Animals, Universitat Autonòma de Barcelona, 08193, Bellaterra (Cerdanyola del Vallès), Barcelona, Spain
| | - Mariano Domingo
- Servei de Diagnòstic de Patologia Veterinària (SDPV), Departament de Sanitat i d'Anatomia Animals, Universitat Autonòma de Barcelona, 08193, Bellaterra (Cerdanyola del Vallès), Barcelona, Spain.,UAB, Centre de Recerca en Sanitat Animal (CReSA, IRTA-UAB), Campus de la Universitat Autònoma de Barcelona, Barcelona, Spain.,OIE Collaborating Centre for the Research and Control of Emerging and Re-Emerging Swine Diseases in Europe (IRTA-CReSA), Bellaterra, Barcelona, Spain
| | - Joaquim Segalés
- Servei de Diagnòstic de Patologia Veterinària (SDPV), Departament de Sanitat i d'Anatomia Animals, Universitat Autonòma de Barcelona, 08193, Bellaterra (Cerdanyola del Vallès), Barcelona, Spain.,UAB, Centre de Recerca en Sanitat Animal (CReSA, IRTA-UAB), Campus de la Universitat Autònoma de Barcelona, Barcelona, Spain.,OIE Collaborating Centre for the Research and Control of Emerging and Re-Emerging Swine Diseases in Europe (IRTA-CReSA), Bellaterra, Barcelona, Spain
| | - Enric Vidal
- OIE Collaborating Centre for the Research and Control of Emerging and Re-Emerging Swine Diseases in Europe (IRTA-CReSA), Bellaterra, Barcelona, Spain. .,IRTA, Centre de Recerca en Sanitat Animal (CReSA, IRTA-UAB), Campus de la Universitat Autònoma de Barcelona,, 08193, Bellaterra (Cerdanyola del Vallès), Barcelona, Spain.
| |
Collapse
|
15
|
Kalampokas E, Giannis G, Kalampokas T, Eleftheriades M, Panoulis K, Vlahos N. Laparoscopic removal of a mesenteric cyst: A case report. Int J Gynaecol Obstet 2021; 156:583-584. [PMID: 34719031 DOI: 10.1002/ijgo.14002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 10/04/2021] [Accepted: 10/29/2021] [Indexed: 11/10/2022]
Affiliation(s)
- Emmanouil Kalampokas
- Unit of Gynecologic Oncology, Second Department of Obstetrics and Gynecology, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Giannis
- Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Theodoros Kalampokas
- Unit of Obstetrics and Gynecology, Second Department of Obstetrics and Gynecology, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Makarios Eleftheriades
- Unit of Obstetrics and Gynecology, Second Department of Obstetrics and Gynecology, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Panoulis
- Unit of Obstetrics and Gynecology, Second Department of Obstetrics and Gynecology, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Vlahos
- Unit of Obstetrics and Gynecology, Second Department of Obstetrics and Gynecology, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
16
|
Shinmura H, Matsushima T, Fukami T, Takeshita T. Successful treatment of peritoneal inclusion cysts with dienogest: two case reports. J OBSTET GYNAECOL 2021; 42:530-532. [PMID: 34379551 DOI: 10.1080/01443615.2021.1943339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Hiroki Shinmura
- Department of Obstetrics and Gynecology, Nippon Medical School Musashikosugi Hospital, Kanagawa, Japan
| | - Takashi Matsushima
- Department of Obstetrics and Gynecology, Nippon Medical School Musashikosugi Hospital, Kanagawa, Japan
| | - Takehiko Fukami
- Department of Obstetrics and Gynecology, Nippon Medical School Musashikosugi Hospital, Kanagawa, Japan
| | - Toshiyuki Takeshita
- Department of Obstetrics and Gynecology, Nippon Medical School Hospital, Tokyo, Japan
| |
Collapse
|
17
|
Miles S, Mansuria S. Multilocular Peritoneal Inclusion Cysts Throughout the Pelvis. J Minim Invasive Gynecol 2021; 28:1559-1560. [PMID: 33892187 DOI: 10.1016/j.jmig.2021.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/12/2021] [Accepted: 04/13/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Shana Miles
- Department of Obstetrics, Gynecology and Reproductive Sciences, UPMC Magee-Womens Hospital, Pittsburgh, Pennsylvania (all authors)..
| | - Suketu Mansuria
- Department of Obstetrics, Gynecology and Reproductive Sciences, UPMC Magee-Womens Hospital, Pittsburgh, Pennsylvania (all authors)
| |
Collapse
|
18
|
Damaskos C, Garmpis N, Garmpi A, Liakea A, Mantas D. Peritoneal Pseudocyst Causing Acute Abdomen as a Complication of Cronh's Disease. ACTA MEDICA (HRADEC KRÁLOVÉ) 2021; 64:55-59. [PMID: 33855961 DOI: 10.14712/18059694.2021.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Peritoneal pseudocysts (PPs) in patients who are diagnosed with Crohn's disease (CD), is a rarely diagnosed entity with unknown epidemiology, etiology and pathogenesis. We present the case of a 30-year old male with known CD who presented with an acute abdomen because of a PP. PPs are developed as a complication caused in patients, suffering from mainly thee conditions. Firstly, PPs appear in patients with continuous ambulatory peritoneal dialysis (CAPD), they are also developed in patients with peritoneal trauma and finally in CD patients. Our case belongs to these three reported cases in our literature review, since it refers to a CD patient that developed PPs. He underwent emergency laparotomy and excision of the cyst, with good postoperative results. A literature review of 22 publications show that PPs often represent a diagnostic and therapeutic problem as it has a variable presentation and there are no data on what the best treatment option is - surgical excision or aspiration.
Collapse
Affiliation(s)
| | - Nikolaos Garmpis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Anna Garmpi
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Aliki Liakea
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Mantas
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
19
|
Kozasa K, Takemoto Y, Goto T, Kobayashi M, Sakaguchi H, Fujiwara S, Ichikawa F, Kuroda M, Komura N, Tanaka A, Masuda K, Otsuka H, Yokoi T. Two cases of giant peritoneal inclusion cysts requiring treatment after total laparoscopic hysterectomy. J Surg Case Rep 2020; 2020:rjaa506. [PMID: 33365120 PMCID: PMC7748126 DOI: 10.1093/jscr/rjaa506] [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: 10/27/2020] [Revised: 11/02/2020] [Accepted: 12/10/2020] [Indexed: 11/24/2022] Open
Abstract
Peritoneal inclusion cysts (PICs) often develop in post-operative patients. Since the incidence of adhesions is lower with laparoscopic surgery than with open surgery, PICs are less likely to occur in the former. Although post-operative adhesions or PICs rarely develop after laparoscopic surgery (such as total laparoscopic hysterectomy: TLH), we encountered two cases of giant PICs with abdominal pain after TLH. In Case 1, strong adhesion was already present when TLH was performed. Therefore, this case may have been predisposed to the development of adhesions in the abdominal cavity. However, no adhesions were observed during TLH in case 2, and there were no risk factors, such as pre-operative adhesions and endometriosis. Therefore, adhesions and PICs may develop even after TLH, and approaches need to be considered for their prevention.
Collapse
Affiliation(s)
- Katsumi Kozasa
- Department of Obstetrics and Gynecology, Kaizuka City Hospital, Osaka, Japan
| | - Yuki Takemoto
- Department of Obstetrics and Gynecology, Kaizuka City Hospital, Osaka, Japan
| | - Takeshi Goto
- Department of Obstetrics and Gynecology, Kaizuka City Hospital, Osaka, Japan
| | - Mariya Kobayashi
- Department of Obstetrics and Gynecology, Osaka University, Osaka, Japan
| | - Hitomi Sakaguchi
- Department of Obstetrics and Gynecology, Osaka University, Osaka, Japan
| | - Sho Fujiwara
- Department of Obstetrics and Gynecology, Kaizuka City Hospital, Osaka, Japan
| | - Fuyuki Ichikawa
- Department of Obstetrics and Gynecology, Kaizuka City Hospital, Osaka, Japan
| | - Misako Kuroda
- Department of Obstetrics and Gynecology, Kaizuka City Hospital, Osaka, Japan
| | - Naoko Komura
- Department of Obstetrics and Gynecology, Kaizuka City Hospital, Osaka, Japan
| | - Asuka Tanaka
- Department of Obstetrics and Gynecology, Kaizuka City Hospital, Osaka, Japan
| | - Kumi Masuda
- Department of Obstetrics and Gynecology, Kaizuka City Hospital, Osaka, Japan
| | - Hirofumi Otsuka
- Department of Obstetrics and Gynecology, Kaizuka City Hospital, Osaka, Japan
| | - Takeshi Yokoi
- Department of Obstetrics and Gynecology, Kaizuka City Hospital, Osaka, Japan
| |
Collapse
|
20
|
Padmanabhan N, Ishibashi H, Nishihara K, Sako S, Katayama K, Wakama S, Kamada Y, Yonemura Y. Multicystic peritoneal mesothelioma treated with complete cytoreductive surgery, peritonectomy and hyperthermic intra-peritoneal chemotherapy-A case report. Int J Surg Case Rep 2020; 74:152-157. [PMID: 32846277 PMCID: PMC7452569 DOI: 10.1016/j.ijscr.2020.07.074] [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: 04/26/2020] [Revised: 07/26/2020] [Accepted: 07/26/2020] [Indexed: 02/07/2023] Open
Abstract
Multicystic Peritoneal mesothelioma is a distinct type of peritoneal mesothelioma with borderline malignant potential and tendency to recur after tumor debulking. Morphologically MCPM has grapelike cysts filled with clear fluid and microscopically it has cystic spaces lined by cuboidal epithelium. There are areas of increased proliferative activity in the background of benign cyst representing potential for aggressiveness. Peritoneal free floating cysts can be formed from disintegration of main mass and deposit in other areas to form metastatic deposits. Comprehensive treatment – Complete cytoreduction, involved peritonectomy and HIPEC is required for treatment of macroscopic tumor and microscopic residue.
Background Multicystic Peritoneal mesothelioma is a rare and distinct variety of peritoneal mesothelioma with borderline malignant potential. Conventional Tumor bulking has been associated with recurrence of 45–50 %. Hence a comprehensive treatment with Complete cytoreductive surgery with involved field peritonectomy (CRS) and Hyperthermic Intra-peritoneal chemotherapy (HIPEC) is being increasingly adopted for MCPM. Case presentation A 47 year old lady evaluated for peri-menopausal disturbance was diagnosed to have a multicystic lesion in the pelvis. With a preoperative suspicion of diagnosis of pseudomyxoma peritonei, CRS with HIPEC was planned. On exploration a diffuse multicystic mass was found in omentum and pouch of douglas with typical morphological features of MCPM. Complete cytoreduction was achieved with anterolateral and sub-diaphragmatic peritonectomy, omentectomy and panhystrectomy. HIPEC was performed with cisplatin 50 mg/m2 for 40 min. Pathological examination revealed MCPM of omentum and uterine surface with focal clusters of mesothelial proliferation. However there was low proliferative activity 1–2 %. Discussion MCPM presents with wide spread peritoneal spread but with relative sparing of visceral invasion. Literature review suggests the disease spread is similar to PMP and treatment with CCRS and HIPEC has yielded long term survivals in MCPM. Conclusions This patient with voluminous disease burden in abdomen required surgical management and HIPEC for her condition. Whether CCRS alone without HIPEC can be an alternative for limited disease will be interesting research for future clinical reports.
Collapse
Affiliation(s)
- Naveen Padmanabhan
- Department of Surgical Oncology, Apollo Cancer Insitutes, Chennai, India; NPO to Support Peritoneal Surface Malignancy Treatment, Japanese/Asian School of Peritoneal Surface Oncology, Kyoto, Japan; Department of Regional Cancer Therapies, Peritoneal Surface Malignancy Center, Kishiwada Tokushukai Hospital, Kishiwada, Japan
| | - Haruaki Ishibashi
- NPO to Support Peritoneal Surface Malignancy Treatment, Japanese/Asian School of Peritoneal Surface Oncology, Kyoto, Japan; Department of Regional Cancer Therapies, Peritoneal Surface Malignancy Center, Kishiwada Tokushukai Hospital, Kishiwada, Japan
| | - Kazurou Nishihara
- NPO to Support Peritoneal Surface Malignancy Treatment, Japanese/Asian School of Peritoneal Surface Oncology, Kyoto, Japan; Department of Regional Cancer Therapies, Peritoneal Surface Malignancy Center, Kishiwada Tokushukai Hospital, Kishiwada, Japan
| | - Shouzou Sako
- NPO to Support Peritoneal Surface Malignancy Treatment, Japanese/Asian School of Peritoneal Surface Oncology, Kyoto, Japan; Department of Regional Cancer Therapies, Peritoneal Surface Malignancy Center, Kishiwada Tokushukai Hospital, Kishiwada, Japan
| | - Kanji Katayama
- NPO to Support Peritoneal Surface Malignancy Treatment, Japanese/Asian School of Peritoneal Surface Oncology, Kyoto, Japan; Department of Regional Cancer Therapies, Peritoneal Surface Malignancy Center, Kishiwada Tokushukai Hospital, Kishiwada, Japan
| | - Satoshi Wakama
- NPO to Support Peritoneal Surface Malignancy Treatment, Japanese/Asian School of Peritoneal Surface Oncology, Kyoto, Japan; Department of Regional Cancer Therapies, Peritoneal Surface Malignancy Center, Kishiwada Tokushukai Hospital, Kishiwada, Japan; Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yasuyuki Kamada
- NPO to Support Peritoneal Surface Malignancy Treatment, Japanese/Asian School of Peritoneal Surface Oncology, Kyoto, Japan; Department of Regional Cancer Therapies, Peritoneal Surface Malignancy Center, Kishiwada Tokushukai Hospital, Kishiwada, Japan; Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yutaka Yonemura
- NPO to Support Peritoneal Surface Malignancy Treatment, Japanese/Asian School of Peritoneal Surface Oncology, Kyoto, Japan; Department of Regional Cancer Therapies, Peritoneal Surface Malignancy Center, Kishiwada Tokushukai Hospital, Kishiwada, Japan; Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
| |
Collapse
|
21
|
Chand MT, Edens J, Lin T, Anderson I, Berri R. Benign multicystic peritoneal mesothelioma: literature review and update. AUTOPSY AND CASE REPORTS 2020; 10:e2020159. [PMID: 33344293 PMCID: PMC7703464 DOI: 10.4322/acr.2020.159] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Benign multicystic peritoneal mesothelioma (BMPM) is a rare peritoneal tumor diagnosed predominantly in pre-menopausal women. Associated risk factors include endometriosis and pelvic inflammatory disease in women, and prior abdominal surgery in both genders. To date, the pathogenesis of this disease remains controversial with possible etiologies, including a neoplastic versus a reactive process. Given the risk factors, some authors believe that this disease is secondary to a reactive process. However, because some studies describe cases where there is no prior surgical history or inflammatory milieu present, and because of this entity’s predilection for recurrence, some authors believe the origin to be neoplastic. Some genetic and familial associations have also been reported. Malignant transformation is extremely rare, with only two cases reported in the literature, despite the recurrence potential. Like the etiology, the name of this entity is also controversial. Some authors prefer the term “peritoneal inclusion cyst (PCM)” instead of “benign cystic mesothelioma” and argue that the term mesothelioma should only be used when there is evidence of atypia. Most cases of BMPM are discovered incidentally. Others reflect sequela of tumor mass effect. It appears intra-operatively as large, multi-focal, cystic lesions in the peritoneal and pelvic cavity. Diagnosis is achieved through surgical sampling with histopathological examination. Immunobiologically, BMPM exhibits multiple small cystic spaces with flattened lining containing calretinin positive cells without atypical features, mitotic figures, or tissue invasion. Treatment includes cytoreductive surgery. Here we present a case of BMPM in a 60-year-old male – a rare disease in an uncommon patient population.
Collapse
Affiliation(s)
- Momal Tara Chand
- Ascension St. John Hospital, Anatomical & Clinical Pathology. Detroit, MI, USA
| | - Jacob Edens
- Ascension ST John Hospital, Department of Pathology. Detroit, MI, USA
| | - Tayson Lin
- Ascension Providence Hospital, Department of Internal Medicine. Southfield, MI, USA
| | - Ian Anderson
- Ascension ST John Hospital, Department of Pathology. Detroit, MI, USA
| | - Richard Berri
- Ascension ST John Hospital, Department of Surgery. Detroit, MI, USA
| |
Collapse
|
22
|
Wolf J, Jackson A, Herzog T, Kendler A, Wahab SA, Billingsley C. A case of a unique presentation of a primary vaginal endometrioid adenocarcinoma arising in the setting of a recurrent peritoneal inclusion cyst fistulized to the vagina. Gynecol Oncol Rep 2020; 33:100585. [PMID: 32462072 PMCID: PMC7243260 DOI: 10.1016/j.gore.2020.100585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/05/2020] [Accepted: 05/13/2020] [Indexed: 11/25/2022] Open
Abstract
Primary vaginal endometrioid adenocarcinoma is a rare cancer that is often associated with chronic endometriosis. We present the case of a 72-year-old female who underwent right salpingo-oophorectomy followed by hysterectomy with benign pathology 25 years prior to her cancer diagnosis. She had an extensive surgical history in the intervening years and several complicating factors including a history of endometriosis as well as a recurrent peritoneal inclusion cyst treated with ethanol sclerotherapy, followed by formation of a peritoneal-vaginal fistula. Endometriosis is associated with malignant transformation to endometrioid adenocarcinoma through genomic alteration, oxidative stress, inflammation, and hyperestrogenism. Frequency of surveillance examinations and imaging prior to diagnosis were based on patient symptoms, and ultimately a vaginal cuff mass was detected with invasion of the rectosigmoid colon, bladder and levators at time of diagnosis, necessitating infralevator total pelvic exenteration for removal.
Collapse
Affiliation(s)
- Jennifer Wolf
- University of Cincinnati Department of Obstetrics & Gynecology, 231 Albert Sabin Way MSB 4408, Cincinnati, OH 45267, USA
| | - Amanda Jackson
- University of Cincinnati Department of Obstetrics & Gynecology: Division of Gynecologic Oncology, 234 Goodman Street, Cincinnati, OH 45219, USA
| | - Thomas Herzog
- University of Cincinnati Department of Obstetrics & Gynecology: Division of Gynecologic Oncology, 234 Goodman Street, Cincinnati, OH 45219, USA
| | - Ady Kendler
- University of Cincinnati Department of Pathology and Laboratory Medicine, 234 Goodman Street Suite 110, Cincinnati, OH 45219, USA
| | - Shaun A Wahab
- University of Cincinnati Department of Radiology, 234 Goodman Street, PO Box 670761, Cincinnati, OH 45219, USA
| | - Caroline Billingsley
- University of Cincinnati Department of Obstetrics & Gynecology: Division of Gynecologic Oncology, 234 Goodman Street, Cincinnati, OH 45219, USA
| |
Collapse
|
23
|
Chua HA, Goh SC, Upamali V, Seet MJ, Wong PA, Phoon WJ. Subserosal adenomyotic cysts and peritoneal inclusion cysts - Unusual differential diagnoses of multicystic pelvic masses: A review of two cases. Case Rep Womens Health 2020; 27:e00193. [PMID: 32292709 PMCID: PMC7150504 DOI: 10.1016/j.crwh.2020.e00193] [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] [Received: 02/02/2020] [Revised: 03/15/2020] [Accepted: 03/23/2020] [Indexed: 11/17/2022] Open
Abstract
Background Multiloculated pelvic cysts are commonly misdiagnosed as ovarian tumors or malignancies. We report 2 patients diagnosed with subserosal adenomyotic cysts and peritoneal inclusion cysts, mimicking multiloculated pelvic tumors. We discuss their clinical presentation, investigations, operation findings, and histopathology, present a literature review. Cases Case 1 was a 44-year-old patient with abnormal uterine bleeding. Imaging showed an enlarging multiloculated cystic structure over the right uterine wall. She underwent a diagnostic laparoscopy and right salpingo-ophorectomy. Intra-operatively, she was found to have multiple subserosal uterine cysts, diagnosed as adenomyotic cysts on histology. Case 2 was a 50-year-old patient with history of laparoscopic cystectomy done 20 years ago. She was incidentally found to have a multiloculated cystic lesion in the pelvis. The lesion was located midline, anterior and superior to the uterus and bladder. She underwent a total abdominal hysterectomy, bilateral salpingo-ophorectomy, and bladder peritonectomy. Intra-operatively, multiple cystic lesions were noted over the anterior and fundus of uterus, bladder peritoneum, and pelvic side walls. The condition was confirmed to be peritoneal inclusion cysts on histology. Conclusion Subserosal adenomyotic cysts are a rare presentation of adenomyosis. They typically occur in premenopausal women. Treatment is usually by hormonal medications or surgical excision. Many patients with peritoneal inclusion cysts have a history of peritoneal insults. Surgical excision is the most commonly described management as they often mimic malignancy. Both conditions are unusual presentations of multiloculated pelvic masses. A high recurrence rate is found, hence long-term follow-up with imaging is essential. Adenomyotic cysts can present as multiple cystic lesions found within the uterine myometrium, submucosal or subserosal layers, lined with endometrial epithelium and stroma. Patients with adenomyotic cysts commonly present with dysmenorrhoea or dysfunctional uterine bleeding. These cysts are usually excised surgically or treated with hormonal methods. Peritoneal inclusions cysts are benign aggregate masses of variable sized, fluid-filled, mesothelial lined cysts of the pelvis and abdomen, commonly with a history of previous insult to the peritoneum Surgical excision of the peritoneal inclusion cysts is the most common treatment option, often for histological diagnosis as it mimics malignancy. Recurrence is common for both conditions, hence long term follow ups with imaging should be considered.
Collapse
|
24
|
Napoe GS, Rardin CR. Case report of a peritoneal inclusion cyst presenting as pelvic organ prolapse. J OBSTET GYNAECOL 2019; 40:1036-1037. [PMID: 31607189 DOI: 10.1080/01443615.2019.1650262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Gnankang Sarah Napoe
- Division of Urogynecology and Reconstructive Pelvic Surgery, Women and Infants Hospital of Rhode Island/Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Charles R Rardin
- Division of Urogynecology and Reconstructive Pelvic Surgery, Women and Infants Hospital of Rhode Island/Warren Alpert Medical School of Brown University, Providence, RI, USA
| |
Collapse
|
25
|
Rapid Growth of Pelvic Cyst during Pregnancy: A Case Report. Case Rep Obstet Gynecol 2019; 2019:3120921. [PMID: 31214368 PMCID: PMC6535882 DOI: 10.1155/2019/3120921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 04/24/2019] [Accepted: 05/02/2019] [Indexed: 11/19/2022] Open
Abstract
We describe a patient with bilateral cystic tumors of the pelvis. The left one rapidly grew during pregnancy and combined with the right one, whose clinical course made diagnosis difficult. A pregnant woman with a history of laparotomy was referred to us due to suspected bilateral pelvic cysts. The left-sided cyst had rapidly grown to 27 cm in diameter and merged with the right cyst, forming a large cyst occupying the entire pelvic cavity in the third trimester. Considering this rapid growth, cesarean section and resection of the cyst were performed at 37th week. The resected cyst consisted of two components: a large unilocular cyst containing serous fluid and a multilocular cyst suggestive of ovarian mucinous cystadenoma in the right ovary. The wall of the former largely lacked lining epithelium, but it was partly continuous with the latter mucinous epithelium. Immunohistochemically, estrogen and progesterone receptors were focally positive in the cyst wall, suggesting that pregnancy-associated sex-hormones may have contributed to the rapid growth of the cyst. We diagnosed this condition as a peritoneal inclusion cyst margining with a right ovarian mucinous cystadenoma. Peritoneal inclusion cyst should be considered in the differential diagnosis of a rapidly growing pelvic mass during pregnancy.
Collapse
|
26
|
Tamai H, Kinugasa M, Nishio M, Miyake M. Peritoneal inclusion cysts treated with a levonorgestrel-releasing intrauterine system: A case report. Case Rep Womens Health 2019; 22:e00113. [PMID: 30993079 PMCID: PMC6449736 DOI: 10.1016/j.crwh.2019.e00113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 03/15/2019] [Accepted: 03/27/2019] [Indexed: 11/22/2022] Open
Abstract
Patients with peritoneal inclusion cysts (PICs) often suffer from progressive abdominal or pelvic pain. There is no established treatment. We present the case of a 42-year-old woman with PICs complaining of progressive abdominal pain and fullness who was initially treated with drainage and gonadotropin releasing hormone agonist (GnRHa). Despite the treatment, her symptoms worsened approximately one year later. She was again treated with drainage and GnRHa, and subsequently a levonorgestrel-releasing intrauterine system (LNG-IUS) was placed in her intrauterine cavity. Thereafter, her condition stabilized and no complications were reported. The LNG-IUS may be an effective management option for patients with PICs. Patients with peritoneal inclusion cysts often suffer from progressive pelvic pain. Hormonal treatment stabilizes the size of the cyst and controls symptoms. In this case, a levonorgestrel-releasing intrauterine system was effective. This treatment has fewer adverse effects and fewer contraindications, as the drug is locally administered. The treatment is more cost-effective than other interventions and patient compliance is greater.
Collapse
Affiliation(s)
- Hanako Tamai
- Department of Obstetrics and Gynecology, Amagasaki Co-op Hospital, 12-16-1 Minamimukonoso, Amagasaki 661-0033, Japan
| | - Masato Kinugasa
- Department of Obstetrics and Gynecology, Amagasaki Co-op Hospital, 12-16-1 Minamimukonoso, Amagasaki 661-0033, Japan
| | - Miho Nishio
- Department of Obstetrics and Gynecology, Amagasaki Co-op Hospital, 12-16-1 Minamimukonoso, Amagasaki 661-0033, Japan
| | - Mayu Miyake
- Department of Obstetrics and Gynecology, Amagasaki Co-op Hospital, 12-16-1 Minamimukonoso, Amagasaki 661-0033, Japan
| |
Collapse
|
27
|
Katz SI, Ramchandani P, Torigian DA, Siegelman ES. Hydrosalpinx in patients with hysterectomy without salpingo-oophorectomy referred for pelvic magnetic resonance imaging. Clin Imaging 2019; 55:95-99. [PMID: 30798017 DOI: 10.1016/j.clinimag.2018.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 12/11/2018] [Accepted: 12/27/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Women with ovarian-sparing hysterectomy before 2007 are more likely to have retained Fallopian tube remnants which can become fluid-filled, distended masses, potentially mistaken for a cystic adnexal neoplasm on imaging. Here we assess the prevalence and appearance of hydrosalpinx in women with ovarian-sparing hysterectomy prior to 2007 referred for pelvic MRI. METHODS A total of 3044 consecutive pelvic MRI exams performed over a two-year period (2003-2004) were selected from our radiology database and retrospectively reviewed. Examinations performed on male patients (N = 858), duplicate examinations on the same patient (N = 675) and examinations performed for MR guided biopsy (N = 1) were excluded from the study. From the remaining female pelvic MRI examinations (N = 1510), patients with hysterectomy without oophorectomy were identified. The frequency of hydrosalpinx in this population was then determined visually by two experienced radiologists and kappa analysis was then performed to assess for interobserver agreement. RESULTS Of the 3044 pelvic MRI examinations, 1510 were performed on females and 76 (5%) of these women had ovarian-sparing hysterectomy. Of these 76 women, 14 patients (18%) had hydrosalpinx (kappa = 0.8) of which 11 were unilateral and 3 bilateral. A total of 9 of the 14 cases positive for hydrosalpinx in patients with ovarian-sparing hysterectomy were referred to MRI for evaluation of cystic adnexal masses detected on other modalities. CONCLUSION Hydrosalpinx should be considered in the differential diagnosis of cystic adnexal lesions in women with prior hysterectomy and retained ovaries.
Collapse
Affiliation(s)
- Sharyn I Katz
- Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States of America.
| | - Parvati Ramchandani
- Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States of America
| | - Drew A Torigian
- Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States of America
| | - Evan S Siegelman
- Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States of America
| |
Collapse
|
28
|
Matsuoka H, Matsubara H, Sugimura A, Uchida T, Ichihara T, Nakazawa T, Nakajima H. Mesothelial cyst derived from chest wall pleura growing after thoracic surgery: a case report. J Med Case Rep 2019; 13:1. [PMID: 30611283 PMCID: PMC6321693 DOI: 10.1186/s13256-018-1944-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 12/06/2018] [Indexed: 12/12/2022] Open
Abstract
Background Intrathoracic mesothelial cysts almost always arise in the mediastinum, and extramediastinal mesothelial cysts are extremely rare. Here we describe a case of mesothelial cyst derived from the chest wall pleura growing after thoracic surgery. Case presentation A 63-year-old Japanese woman was referred to our department. She had undergone total hysterectomy for cervical carcinoma and two lung wedge resections for metastatic lung cancer on the upper and lower lobes of her right lung and lower lobe of her left lung. After the thoracic surgery, an intrathoracic chest wall mass was found, which grew gradually. Computed tomography demonstrated a 2.0 × 1.8 cm low-density mass without contrast effect. Magnetic resonance imaging demonstrated a low-intensity mass in T1-weighted imaging and a high-intensity mass in T2-weighted imaging. Thoracoscopic excision of the mass was performed. The cystic mass was thought to be derived from her chest wall and was pathologically diagnosed as mesothelial cyst. Five years after the surgery, she has no evidence of recurrence of the cyst or cervical carcinoma. Conclusions The genesis of extramediastinal mesothelial cysts may be related to inflammation. From this perspective, extramediastinal mesothelial cysts may have different characteristics from pericardial cysts and resemble peritoneal inclusion cysts. Although, extramediastinal mesothelial cysts are not established, their characteristics resemble peritoneal inclusion cysts; therefore, such interesting intrathoracic cysts should be carefully resected considering the risk.
Collapse
Affiliation(s)
- Hiroyasu Matsuoka
- Department of Surgery, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo City, Yamanashi, Japan.
| | - Hirochika Matsubara
- Department of Surgery, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo City, Yamanashi, Japan
| | - Aya Sugimura
- Department of Surgery, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo City, Yamanashi, Japan
| | - Tsuyoshi Uchida
- Department of Surgery, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo City, Yamanashi, Japan
| | - Tomofumi Ichihara
- Department of Surgery, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo City, Yamanashi, Japan
| | - Tadao Nakazawa
- Department of Pathology, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo City, Yamanashi, Japan
| | - Hiroyuki Nakajima
- Department of Surgery, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo City, Yamanashi, Japan
| |
Collapse
|
29
|
Rapisarda AMC, Cianci A, Caruso S, Vitale SG, Valenti G, Piombino E, Cianci S. Benign multicystic mesothelioma and peritoneal inclusion cysts: are they the same clinical and histopathological entities? A systematic review to find an evidence-based management. Arch Gynecol Obstet 2018; 297:1353-1375. [PMID: 29511797 DOI: 10.1007/s00404-018-4728-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 02/28/2018] [Indexed: 10/25/2022]
Abstract
PURPOSE Peritoneal mesothelial cysts (PMC) are a clinical dilemma because of their true pathogenic nature. Many definitions have been associated with PMC, including "benign multicystic mesothelioma", "cystic mesothelioma", "multilocular peritoneal inclusion cysts", ''inflammatory cysts of the peritoneum" or "postoperative peritoneal cyst". METHODS We herein performed a systematic review of the literature focusing on clinical and histopathological aspects of PMC, diagnosis, and therapies. Moreover, we described our experience with a case of PMC in a young female. RESULTS Since there is often a history of prior surgery or inflammatory disease, most authors consider PMC of reactive origin. However, in some cases they occur without any documentable signs of disease or injury. A variety of clinical findings can complicate the preoperative assessment and a multitude of histological pictures may potentially lead to a misdiagnosis. The absence of a uniform treatment strategy and lack of long-term follow-up often hinder the accurate definition leading to unnecessary or unnecessarily aggressive therapy. CONCLUSIONS PMC are more common than had previously been thought. Most authors consider them non-neoplastic; thus the designation of "peritoneal inclusion cyst" is preferable. The term "mesothelioma" should be used only in cases of histological evidences of atypia. The high rates of recurrence suggest that the goal of treatment should not be necessarily complete eradication, but symptomatic relief through individualized treatment. This is a topic of particular importance, especially in young female where recurrence rates could be lower than those reported in adults and where an improperly aggressive treatment could have repercussions on fertility.
Collapse
Affiliation(s)
| | - Antonio Cianci
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Salvatore Caruso
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Salvatore Giovanni Vitale
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy.
| | - Gaetano Valenti
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Eliana Piombino
- Department of Medical and Surgical Sciences and Advanced Technologies, G.F. Ingrassia, Azienda Ospedaliero-Universitaria "Policlinico-Vittorio Emanuele", Anatomic Pathology Section, School of Medicine, University of Catania, Catania, Italy
| | - Stefano Cianci
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy
| |
Collapse
|
30
|
Nickel B, Kraft B. [Unusual intraoperative cystic findings in laparoscopic hernioplasty (TAPP) for scrotal hernia]. Chirurg 2017; 89:237-239. [PMID: 29110041 DOI: 10.1007/s00104-017-0551-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- B Nickel
- Klinik für Allgemein- und Viszeralchirurgie, Kompetenzzentrum Minimalinvasive Chirurgie und Hernienchirurgie, Diakonie-Klinikum Stuttgart - Diakonissenkrankenhaus und Paulinenhilfe gGmbH, Rosenbergstraße 38, 70176, Stuttgart, Deutschland.
| | - B Kraft
- Klinik für Allgemein- und Viszeralchirurgie, Kompetenzzentrum Minimalinvasive Chirurgie und Hernienchirurgie, Diakonie-Klinikum Stuttgart - Diakonissenkrankenhaus und Paulinenhilfe gGmbH, Rosenbergstraße 38, 70176, Stuttgart, Deutschland
| |
Collapse
|
31
|
Sato K, Ota K, Maki J, Sato S, Masuda H, Tanaka M. Laparoscopic fenestration of a large peritoneal inclusion cyst: Description of a new surgical technique. Eur J Obstet Gynecol Reprod Biol 2017; 219:68-69. [PMID: 29055220 DOI: 10.1016/j.ejogrb.2017.10.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 10/12/2017] [Accepted: 10/15/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Kenji Sato
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Japan.
| | - Kuniaki Ota
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Japan
| | - Junko Maki
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Japan
| | - Suguru Sato
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Japan
| | - Hirotaka Masuda
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Japan
| | - Mamoru Tanaka
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Japan
| |
Collapse
|
32
|
Imaging appearance of benign multicystic peritoneal mesothelioma: a case report and review of the literature. Clin Imaging 2017; 42:133-137. [DOI: 10.1016/j.clinimag.2016.10.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 09/30/2016] [Accepted: 10/14/2016] [Indexed: 01/13/2023]
|
33
|
Abstract
Pelvic inflammatory disease (PID) is an ascending infection of the female genital tract caused by the spread of bacteria from the vagina to the pelvic reproductive organs and occasionally the peritoneum. The most common causative organisms are sexually transmitted. PID is a significant source of morbidity among reproductive age women both as a cause of abdominal pain and as a common cause of infertility. Its clinical presentation is often nonspecific, and the correct diagnosis may first come to light based on the results of imaging studies. MRI is well suited for the evaluation of PID and its complications due to its superior soft tissue contrast and high sensitivity for inflammation. MRI findings in acute PID include cervicitis, endometritis, salpingitis/oophoritis, and inflammation in the pelvic soft tissues. Acute complications include pyosalpinx, tuboovarian abscess, peritonitis, and perihepatitis. Hydrosalpinx, pelvic inclusion cysts and ureteral obstruction may develop as chronic sequela of PID. The pathophysiology, classification, treatment, and prognosis of PID are reviewed, followed by case examples of the appearance of acute and subclinical PID on MR images.
Collapse
|
34
|
Tuncer AA, Narcı A, Dilek FH, Embleton DB, Çetinkurşun S. Benign Cystic Mesothelioma in a Child: Case Report and Review of the Literature. Balkan Med J 2016; 33:232-4. [PMID: 27403396 DOI: 10.5152/balkanmedj.2015.15886] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Accepted: 05/12/2015] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Benign cystic mesothelioma (BCM) is a rare tumor with benign characteristic. There are only 8 child cases reported in the English literature. In this report, we present this rare entity a brief review of the literature. CASE REPORT A two year-old boy presenting with abdominal swelling was hospitalized. Physical examination revealed a mass filling the abdomen. Laboratory findings were not specific. Abdominal computerized tomography showed a 15×13×11 cm cystic mass extending from the bladder to the liver with no solid components and no infiltration to adjacent organs. Operation revealed a cystic mass filled with yellow-green serous fluid which was attached to the right lobe of the liver with a 1 cm thick peduncle. Total excision of the mass was performed by clamping and cutting the narrow attachment. Recovery was uneventful. Pathology revealed multiple cysts lined with mesothelial cells. No recurrence was seen after 5 years of follow-up. CONCLUSION BCM should be kept in mind as a rare cause of the abdominal mass in children, as it may lead to confusion in preoperative diagnosis. Although rare, patients should be followed throughout life because of the risk of recurrence and malignant degeneration.
Collapse
Affiliation(s)
- Ahmet Ali Tuncer
- Department of Pediatric Surgery, Yüksekova State Hospital, Hakkari, Turkey
| | - Adnan Narcı
- Department of Pediatric Surgery, Şifa University School of Medicine, İzmir, Turkey
| | - Fatma Hüsniye Dilek
- Department of Pathology, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Didem Baskın Embleton
- Department of Pediatric Surgery, Afyon Kocatepe University School of Medicine, Afyonkarahisar, Turkey
| | - Salih Çetinkurşun
- Department of Pediatric Surgery, Afyon Kocatepe University School of Medicine, Afyonkarahisar, Turkey
| |
Collapse
|
35
|
Tsui KP, Tsai HJ, Huang SH. Free-floating intra-peritoneal mesothelial cyst with histologic properties of amniotic epithelium in term pregnancy: Report of two cases. J OBSTET GYNAECOL 2015; 36:376-7. [PMID: 26467102 DOI: 10.3109/01443615.2015.1072806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- K-P Tsui
- a Department of Obstetrics and Gynecology , Kuang Tien General Hospital , Shalu Taichung , Taiwan
| | - H-J Tsai
- a Department of Obstetrics and Gynecology , Kuang Tien General Hospital , Shalu Taichung , Taiwan
| | - S H Huang
- b Department of Pathology , Kuang Tien General Hospital , Shalu Taichung , Taiwan
| |
Collapse
|
36
|
Mazziotti S, D'Angelo T, Racchiusa S, Salamone I, Blandino A, Ascenti G. Peritoneal inclusion cysts in patients affected by Crohn's disease: magnetic resonance enterography findings in a case series. Clin Imaging 2015; 40:152-5. [PMID: 26456117 DOI: 10.1016/j.clinimag.2015.09.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 08/14/2015] [Accepted: 09/10/2015] [Indexed: 11/26/2022]
Abstract
Peritoneal inclusion cystarises when fluid produced by ovary is trapped within peritoneal adhesions. In this article, we describe a case series of patients affected by Crohn's disease, undergoing to magnetic resonance enterography, in whom it was possible not only to monitor the pathological findings of small bowel but also to primarily diagnose the presence of peritoneal inclusion cysts. The current knowledge of peritoneal inclusion cyst concomitant to Crohn's disease is still limited, often leading radiologists to misdiagnose it.
Collapse
Affiliation(s)
- Silvio Mazziotti
- Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Policlinico "G. Martino" Via Consolare Valeria 1, 98100, Messina, Italy
| | - Tommaso D'Angelo
- Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Policlinico "G. Martino" Via Consolare Valeria 1, 98100, Messina, Italy.
| | - Sergio Racchiusa
- Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Policlinico "G. Martino" Via Consolare Valeria 1, 98100, Messina, Italy
| | - Ignazio Salamone
- Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Policlinico "G. Martino" Via Consolare Valeria 1, 98100, Messina, Italy
| | - Alfredo Blandino
- Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Policlinico "G. Martino" Via Consolare Valeria 1, 98100, Messina, Italy
| | - Giorgio Ascenti
- Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Policlinico "G. Martino" Via Consolare Valeria 1, 98100, Messina, Italy
| |
Collapse
|
37
|
Singh A, Sehgal A, Mohan H. Multilocular peritoneal inclusion cyst mimicking an ovarian tumor: A case report. J Midlife Health 2015; 6:39-40. [PMID: 25861208 PMCID: PMC4389384 DOI: 10.4103/0976-7800.153648] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Peritoneal inclusion cysts are uncommon abdominopelvic cysts seen in perimenopausal women. It is often misdiagnosed clinically as an ovarian tumor due to similar presentation and mimicking findings on radiology. We describe a perimenopausal woman presenting with pelvic mass. Her clinical finding on radiology suggested an ovarian tumor; however, biopsy revealed it as peritoneal inclusion cysts. We discuss the possible ways to avoid such mistakes.
Collapse
Affiliation(s)
- Anju Singh
- Department of Obstetrics and Gynaecology, Government Medical College and Hospital, Chandigarh, India
| | - Alka Sehgal
- Department of Obstetrics and Gynaecology, Government Medical College and Hospital, Chandigarh, India
| | - Harsh Mohan
- Department of Pathology, Government Medical College and Hospital, Chandigarh, India
| |
Collapse
|
38
|
Nomura H, Iwase H, Abe A, Yamamoto A, Omatsu K, Takeshima N. Multicystic peritoneal mesothelioma after fertility-sparing surgery for an ovarian tumor of borderline malignancy: A case report. Gynecol Minim Invasive Ther 2015. [DOI: 10.1016/j.gmit.2014.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
39
|
|
40
|
Hitzerd E, Jeurgens-Borst AJCM, Pijnenborg JMA. Peritoneal inclusion cysts in pregnancy, a diagnostic challenge. BMJ Case Rep 2014; 2014:bcr-2014-204963. [PMID: 24928933 DOI: 10.1136/bcr-2014-204963] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
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.
Collapse
|
41
|
Trehan A, Trehan AK. Peritoneal inclusion cyst with an unusual presentation treated by laparoscopic peritonectomy. J OBSTET GYNAECOL 2013; 34:112-3. [DOI: 10.3109/01443615.2013.835306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
42
|
Telli E, Oge T, Ozalp SS, Yalcin OT. Giant peritoneal inclusion cyst mimicking ovarian cyst. ASIAN PACIFIC JOURNAL OF REPRODUCTION 2013. [DOI: 10.1016/s2305-0500(13)60174-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
|
43
|
Passot G, Bakrin N, Isaac S, Decullier E, Gilly FN, Glehen O, Cotte E. Postoperative outcomes of laparoscopic vs open cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy for treatment of peritoneal surface malignancies. Eur J Surg Oncol 2013; 40:957-62. [PMID: 24209429 DOI: 10.1016/j.ejso.2013.10.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Revised: 09/16/2013] [Accepted: 10/02/2013] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are considered the only curative treatment for many peritoneal surface malignancies. The purpose of this study was to evaluate feasibility and safety of CRS combined with HIPEC by laparoscopy for patients with limited peritoneal disease and to compare postoperative outcomes with those for an open procedure. METHODS Between January 2011 and November 2012, all patients with low-grade pseudomyxoma peritonei (PMP) or multicystic mesothelioma (MM) and limited peritoneal disease (Peritoneal Cancer Index [PCI] less than 10) underwent CRS and HIPEC by a laparoscopic approach. The study cohort was matched with a historical cohort of patients with the same characteristics (completeness of cytoreduction, HIPEC agent, PCI ± 11 and age ± 20 years) treated with CRS and HIPEC by laparotomy. RESULTS Eight patients (five low-grade PMP and three MM) treated by a laparoscopic approach were compared to eight patients treated by laparotomy. All patients underwent complete cytoreductive surgery with HIPEC, and no conversion to laparotomy was needed. The median surgical length was 210 min (150-300) vs 240 (210-360), with a median hospital stay of 12 days (9-18) vs 19 (13-33). One patient had a postoperative complication (intraperitoneal haematoma treated by radiological drainage) vs four in the laparotomy group. CONCLUSION Laparoscopic CRS combined with HIPEC is feasible and safe for curative treatment of strictly selected patients with peritoneal surface malignancy and might reduce postoperative complications and length of hospital stay.
Collapse
Affiliation(s)
- G Passot
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud Pierre Bénite, Department of Oncologic and General Surgery, France; UMR 37-38 Université Lyon 1, Lyon, France
| | - N Bakrin
- UMR 37-38 Université Lyon 1, Lyon, France; Hospices Civils de Lyon, Centre Hospitalier Lyon Sud Pierre Bénite, Gynecology Department, France
| | - S Isaac
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud Pierre Bénite, Department of Pathology, France
| | - E Decullier
- Hospices Civils de Lyon, Pole IMER, Lyon, France; Health Information and Clinical Research, France
| | - F N Gilly
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud Pierre Bénite, Department of Oncologic and General Surgery, France; UMR 37-38 Université Lyon 1, Lyon, France
| | - O Glehen
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud Pierre Bénite, Department of Oncologic and General Surgery, France; UMR 37-38 Université Lyon 1, Lyon, France.
| | - E Cotte
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud Pierre Bénite, Department of Oncologic and General Surgery, France; UMR 37-38 Université Lyon 1, Lyon, France
| |
Collapse
|
44
|
Bharwani N, Crofton M. Peritoneal pseudocysts: aetiology, imaging appearances, and natural history. Clin Radiol 2013; 68:828-36. [DOI: 10.1016/j.crad.2013.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Revised: 02/27/2013] [Accepted: 03/06/2013] [Indexed: 12/21/2022]
|
45
|
Peritoneal inclusion cysts: clinical characteristics and imaging features. Eur Radiol 2012; 23:1167-74. [DOI: 10.1007/s00330-012-2695-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Accepted: 09/29/2012] [Indexed: 10/27/2022]
|
46
|
Stojsic Z, Jankovic R, Jovanovic B, Vujovic D, Vucinic B, Bacetic D. Benign cystic mesothelioma of the peritoneum in a male child. J Pediatr Surg 2012; 47:e45-9. [PMID: 23084231 DOI: 10.1016/j.jpedsurg.2012.06.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Revised: 05/07/2012] [Accepted: 06/04/2012] [Indexed: 10/27/2022]
Abstract
The benign cystic mesothelioma of the peritoneum is a rare lesion that occurs predominatly in women of reproductive age and has a high propensity for local recurrence. It is very rare in childhood, especially in boys, being reported in only 4 cases. A new case of benign cystic mesothelioma of the peritoneum in an 11-year-old boy is reported. The lesion occupied the entire left abdomen, arising from the transverse mesocolon, and it was accompanied by 4 small cysts. The patient had a coexistent right-sided renal agenesis. The mesothelial nature of the cysts epithelial lining cells was confirmed by immunopositivity for calretinin, cytokeratin 5/6, HBME1, and epithelial membrane antigen (EMA). No recurrence of the lesion was noted in the 7-month follow-up. Pathologists and clinicians should be aware of the existence of this rare entity in childhood to establish an accurate diagnosis and provide close follow-up after the surgery.
Collapse
Affiliation(s)
- Zorica Stojsic
- Institute of Pathology, Faculty of Medicine, University of Belgrade, 11 000 Belgrade, Serbia.
| | | | | | | | | | | |
Collapse
|
47
|
Eskander RN, Bristow RE. Adnexal Masses in Pediatric and Adolescent Females: A Review of the Literature. CURRENT OBSTETRICS AND GYNECOLOGY REPORTS 2011. [DOI: 10.1007/s13669-011-0001-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
|
48
|
|
49
|
Baratti D, Vaira M, Kusamura S, D'Amico S, Balestra MR, Cioppa T, Mingrone E, De Simone M, Deraco M. Multicystic peritoneal mesothelioma: outcomes and patho-biological features in a multi-institutional series treated by cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC). Eur J Surg Oncol 2010; 36:1047-53. [PMID: 20832234 DOI: 10.1016/j.ejso.2010.08.130] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2010] [Revised: 07/27/2010] [Accepted: 08/16/2010] [Indexed: 01/26/2023] Open
Abstract
AIM This retrospective multi-institutional study addresses the role of surgical cytoreduction and hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of multicystic peritoneal mesothelioma (MCPM). MCPM is an uncommon tumour with uncertain malignant potential and no current standard therapy. Additionally, poorly defined pathological and biological features of this disease were investigated. METHODS Twelve patients with MCPM underwent 14 procedures of cytoreduction and HIPEC in two Italian referral centres. Nine patients had recurrent disease after previous debulking (one operation in six patients, two in two, four in one). Biological markers related to mesothelioma origin and clinical features were assessed by immunohistochemical studies. RESULTS Median follow-up was 64 months (range 5-148). Optimal cytoreduction (residual tumour nodules ≤2.5 mm) was performed in all the procedures. One grade IV postoperative complication (NCI/CTCAE v.3.0) and no operative death occurred. All the patients are presently alive with no evidence of disease, including two patients who underwent the procedure twice, due to locoregional disease recurrence. Five- and ten-year progression-free survival was 90% and 72%, accounting for a. statistically significant difference (P = 0.0001) with progression-free survival following previous debulking surgery (median 11 months; range 2-31). All cases showed low proliferative activity assessed by mitotic rate and Ki-67 expression. CONCLUSIONS MCPM is a borderline tumour with a high propensity to local-regional recurrence. Definitive tumour eradication by means of cytoreduction and HIPEC seems more effective than debulking surgery in preventing disease relapse. Low mitotic rate and poor Ki-67 expression might be related to the peculiar behaviour of MCMP.
Collapse
Affiliation(s)
- D Baratti
- Department of Surgery, Istituto Nazionale per la Cura e lo Studio dei Tumori, Milan, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
50
|
|