A colic mesothelial cyst, mimicking an appendicular mucocoele in an elderly patient: A case report and a literature review

Our plain-English summary of A colic mesothelial cyst, mimicking an appendicular mucocoele in an elderly patient: A case report and a literature review, by H. Sekkat, J. El Hamzaoui, K.S.K. Armel, et al (Journal of Minimal Access Surgery, 2024).

The study

• Authors: H. Sekkat, J. El Hamzaoui, K.S.K. Armel, J. Naddouri, A. Jahid, I. Elouarith, Y. El Bakali, M. Raiss, F. Sabbah, A. Hrora, M.M. El Alaoui
• Journal: Journal of Minimal Access Surgery
• Published: 2024;20(2):229-232
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Benign cystic mesothelioma is a very rare and uncommon lesion, first reported by Plaut in 1928. It affects young women of reproductive age. It is usually asymptomatic or has non-specific symptoms. Diagnosis remains difficult despite the evolution of imaging, and the histopathological study is the key examination to make the diagnosis. Surgery remains the only curative treatment, regardless of significant rate of recurrence, and until today, no consensus on the therapeutic strategy is established.

Copyright © 2023 Copyright: © 2023 Journal of Minimal Access Surgery.

In plain English

This was a case report from Ibn Sina University Hospital in Rabat, Morocco, followed by a short discussion of earlier published reports. A 64-year-old diabetic woman had pain in the lower right abdomen for 4 months. Ultrasound and CT scans showed a fluid-filled cyst of 67 mm by 49 mm beside the caecum, suggesting an appendicular mucocoele (a mucus-filled swelling of the appendix). During keyhole (laparoscopic) surgery, surgeons found a 5 cm cyst on a fatty appendage of the right colon; the appendix looked normal. The cyst was removed, her gallbladder was also taken out, and she went home 24 hours later. Laboratory tests confirmed a mesothelial cyst, which the authors call benign cystic mesothelioma, with no abnormal-looking cells. There was no recurrence after 6 months. The article did not say whether the patient had any asbestos or other exposure. The authors concluded that this location is exceptional, that diagnosis before surgery is difficult, that laparoscopy is the best approach, and that close follow-up is needed because recurrence can reach 50%.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case report of one patient, with a brief narrative discussion of published literature
• Who was studied: One 64-year-old diabetic woman treated at Ibn Sina University Hospital, Rabat, Morocco, with 4 months of right iliac fossa pain
• Exposure: The article does not mention any asbestos, fiber or occupational exposure history for this patient. The discussion cites earlier work saying dust, inflammation, fibres and mechanical trauma can cause changes in mesothelial cells. It does not name asbestos or any fiber type.
• Main results:
  • Ultrasound and CT showed a fluid-density cyst measuring 67 mm × 49 mm in contact with the caecum, suggesting an appendicular mucocoele
  • At laparoscopy, the cyst measured 5 cm and grew on a fatty appendage (appendix epiploica) of the right colon; the appendix looked normal
  • The mass was removed and the gallbladder was also removed; the patient left hospital 24 hours later
  • Under the microscope, the cyst was lined by a single layer of cubic cells without atypia. Staining (positive for calretinin, negative for CD31) confirmed its mesothelial nature.
  • The patient had no recurrence and no symptoms after 6 months of follow-up
• The authors' conclusion: The authors concluded that appendicular and colic location of benign cystic mesothelioma is exceptional and that diagnosis before surgery remains difficult. They judged laparoscopy the best approach and said close follow-up is needed because recurrence can reach 50%.

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma.

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