Giant benign mesenteric cysts (mesothelioma and lymphangioma): A report of two cases

Our plain-English summary of Giant benign mesenteric cysts (mesothelioma and lymphangioma): A report of two cases, by J.E. Prior-Rosas, B. Mejía-Ruíz, B.A. Magdaleno-Becerra, et al (International Journal of Surgery Case Reports, 2024).

The study

• Authors: J.E. Prior-Rosas, B. Mejía-Ruíz, B.A. Magdaleno-Becerra, C.G. Nava-Tenorio, S.M. Alonso-Domínguez, G.E. Botello-Ortiz
• Journal: International Journal of Surgery Case Reports
• Published: 2024;125:110587
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Introduction And Importance: Mesenteric cysts are a rare group of intra-abdominal tumors located in the mesentery or omentum, most of this lesion are asymptomatically but occasionally presents with non-specific symptoms, which makes diagnosis difficult.

Case Presentation: We present two cases of giant mesenteric cyst in our Institution, the first case is a women of 23 years with previous gynecologic surgery with chronic abdominal pain and large abdominal mass CT showed a giant intraabdominal 30 × 25 × 15 cm, the patient went to laparotomy and a large mesenteric tumor found. The Histopathology reported a Benign cyst mesothelioma (BCM). The second case is a 47 year male with intermittent abdominal pain and abdominal CT shows a 20x21x15 cm tumor. Laparotomy was performed. Histopathology reported a large lymphangioma.

Clinical Discussion: BCM tumors are rare intrabdominal lesions often diagnosed in premenopausal women. Its etiopathogenesis is still unclear, associated risk factors are endometriosis, pelvic inflammatory disease and previous pelvic surgery. Lymphangiomas are an infrequent cyst tumors. It results from a failure in the evolutionary development of the lymphatic system, often localized in the head and neck and its localization in the abdomen is even rare. The definitive diagnosis is made by histopathology.

Conclusion: Mesenteric cysts diagnosis if often challenge due to nonspecific symptoms and significant overlap in imaging appearance between the different entities, its diagnosis should be in mind when encounter a cystic abdominal tumor, surgical complete removal of this tumors is the optimal treatment to prevent recurrence and complications.

Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.

In plain English

This article is a case series of two patients with very large benign cysts in the mesentery, the tissue that holds the intestines. They were treated at a regional hospital of the Mexican Social Security Institute (IMSS) in the State of Mexico. The first patient, a 23-year-old woman with a previous uterine curettage, had months of abdominal swelling and pain. A CT scan showed a cyst measuring 28 × 25 × 15 cm, with a volume of 5775 cc. At open surgery the cyst, attached to the ileum mesentery, was completely removed; it held 5.5 L of yellow fluid. Pathology reported a benign cyst mesothelioma. The second patient, a 47-year-old man, had intermittent pain and a growing mass. CT showed a cyst of 20.73 × 21 × 15 cm, thought to arise from the omentum; surgery found it attached to the ileum mesentery, and pathology reported a lymphangioma. Neither patient showed recurrence at 6 months. The article does not mention asbestos or report any occupational or environmental exposure for either patient. The authors concluded that diagnosis requires histology and that complete surgical removal is the treatment to prevent recurrence.

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 series (two case reports)
• Who was studied: Two patients at General Regional Hospital No 72, State of Mexico, IMSS, Mexico: a 23-year-old woman and a 47-year-old man; dates of treatment not given
• Exposure: No asbestos or other occupational or environmental exposure is reported for either patient. The first patient's surgical history was a uterine curettage 3 years earlier for missed abortion.
• Main results:
  • Case 1 (23-year-old woman): CT showed a large cyst with a volume of 5775 cc (28 × 25 × 15 cm on CT; about 30 × 25 cm at surgery), attached to the ileum mesentery
  • Case 1: the cyst was completely resected and contained 5.5 L of yellow fluid
  • Case 1: histopathology reported a benign cyst mesothelioma
  • Case 1: at 6-month follow-up the patient was free of pain with no signs of recurrence
  • Case 2 (47-year-old man): CT showed a large cystic tumor of 20.73 cm × 21 cm × 15 cm, about 3 L in volume
  • Case 2: based on CT, the preoperative diagnosis was a large cyst of suspected omental origin
  • Case 2: at laparotomy the cyst was found attached to the ileum mesentery
  • Case 2: pathology reported a lymphangioma cyst
  • Case 2: no recurrence at 6-month follow-up
• The authors' conclusion: The authors concluded that mesenteric cysts lack well-defined symptoms or imaging findings, that definitive diagnosis requires histology, and that treatment is complete surgical removal to prevent recurrence.

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Mesentery, Omentum, Laparotomy, Histopathology.

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• Benign cystic mesothelioma in a boy: An uncommon case mimicking a lymphangioma — P. Fernandez Eire, M.X. Lemos Bouzas, et al. (2015)
• Benign multicystic mesothelioma and peritoneal inclusion cysts: are they the same clinical and histopathological entities? A systematic review to find an evidence-based management — A.M.C. Rapisarda, A. Cianci, et al. (2018)
• Peritoneal, benign, cystic mesothelioma with free-floating cysts, re-examined by new methods. A case report — O.H. Iversen, T. Hovig, et al. (1988)
• A rare case of benign multicystic peritoneal mesothelioma misdiagnosed as hydatid cyst found in the liver parenchyma and abdomen cavity of a male with asbestos exposure — A.B. Kelarji, M.S. Alshutaihi, et al. (2021)

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