Mesothelial Cyst in the Uterine Myometrium: A Rare Localization

Our plain-English summary of Mesothelial Cyst in the Uterine Myometrium: A Rare Localization, by G. Arslan, Y. Acar Sabir (Curēus, 2024).

The study

• Authors: G. Arslan, Y. Acar Sabir
• Journal: Curēus
• Published: 2024;16(12):e75158
• Type of article: Case report
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Mesothelial cysts in the uterus are exceedingly rare. A 41-year-old patient presented with complaints of abdominal pain, and transvaginal ultrasonography revealed an enlarged uterus with a hypoechoic intramural cystic mass measuring 7.2 × 3.3 × 3.6 cm in the posterior uterine corpus. Suspecting a degenerated leiomyoma, the patient underwent a total laparoscopic hysterectomy and bilateral salpingectomy. Intraoperatively, a cystic lesion approximately 7 cm in size was observed within the myometrium of the posterior uterine wall. Pathological examination, supported by immunohistochemical findings, confirmed the diagnosis of a mesothelial cyst. Mesothelial cysts can mimic various clinical and radiological entities, and definitive diagnosis is typically established through pathological evaluation following complete excision of the lesion.

Copyright © 2024, Arslan et al.

In plain English

This was a case report of one patient, written by authors from Kastamonu Training and Research Hospital in Turkey. A 41-year-old woman came to a gynecology clinic with abdominal pain. Ultrasound and computed tomography showed a cystic mass measuring 7.2 by 3.3 by 3.6 cm in the back wall of the uterus. Doctors thought it was a degenerated leiomyoma (a breaking-down fibroid), so the uterus and both fallopian tubes were removed by laparoscopic surgery. On examination the specimen held a 6 cm cyst filled with serous fluid inside the uterine muscle. It was lined by a single layer of benign mesothelial cells, which stained positive for calretinin, D2-40, WT-1, ER and PR. No fibroid tissue was found. The diagnosis was a uterine mesothelial cyst, and no problems were seen at follow-up, the length of which was not stated. The authors described this as the second reported mesothelial cyst within the uterine muscle. They concluded that diagnosis is typically made by pathology. The article does not mention asbestos.

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 (one patient)
• Who was studied: One 41-year-old woman with abdominal pain, seen at a gynecology clinic. The authors are from Kastamonu Training and Research Hospital, Turkey. Dates of care are not given.
• Exposure: No asbestos or other environmental or occupational exposure is reported. Her history included two pregnancies, one ending in cesarean delivery and one in curettage.
• Main results:
  • Ultrasound showed an enlarged uterus with a cystic mass measuring 7.2 × 3.3 × 3.6 cm in the posterior uterine corpus.
  • Because a degenerated leiomyoma was suspected, the patient underwent total laparoscopic hysterectomy and bilateral salpingectomy.
  • The removed uterus contained a 6 cm cyst with serous fluid in the posterior uterine wall.
  • Under the microscope, the cyst was lined by a single layer of benign cuboidal mesothelial cells within the myometrium. It was unrelated to the endometrium or serosa.
  • The cyst lining stained positive for calretinin, D2-40, WT-1, ER and PR.
  • Extensive sampling found no leiomyoma.
  • No pathology was observed during follow-up. The length of follow-up is not stated.
  • Based on their reading of the literature, the authors described this as the second reported mesothelial cyst developing within the myometrium.
• The authors' conclusion: The authors concluded that mesothelial cysts are extremely rare in the uterus and that definitive diagnosis is typically made by pathological examination.

Topics

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

Related studies

• Resection of mesothelial cyst of uterine round ligament by laparoscopic transabdominal preperitoneal procedure alone or combined with open surgery — D. Chen, P. Zhang, et al. (2019)
• Case Report: Uterine mesothelial cyst: a report of three cases and literature review — J. Huang, W. Yang, et al. (2026)
• A Mesothelial Inclusion Cyst Presenting in a 40-Year-Old Woman as Abdominal Pain and Bloating - A Rare Diagnosis — S. Canadas, R. Fernandes, et al. (2020)
• Diagnostic Journey From Suspected Ovarian Mass to Rare Mesothelial Cyst — G. Franzese, D.J. Koh (2024)
• A Rare Case of Multilocular Mesothelial Inclusion Cysts of the Pericardium: Diagnosis, Treatment, Follow Up, with Comprehensive Review of the Literature — A. Shadmanian, K. Patel, et al. (2025)
• Immunohistochemical evidence of the mesothelial histogenesis of a uterine adenomatoid tumor — Y. Satoh, M. Hiraguchi, et al. (1998)

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