Laparoscopically resected mesothelial cyst mimicking a urachal cyst

Atsuko Sakakibara, Tadayoshi Nagano, Mari Ujita, Yusuke Butsuhara, Hiromi Miyata, Hiroko Yoshikawa, Natsuki Tsuji, Erika Kumakura, Koichi Terakawa, Yoshiaki Yuba
In: JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY · 2012 · vol. 28(1) , pp. 398–402 · doi:10.5180/jsgoe.28.398 · W2314639693
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This report describes a rare case of a laparoscopically resected mesothelial cyst mimicking a urachal cyst, which may extend into the extraperitoneal space through a peritoneal defect caused by endometriosis.

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This paper reports a rare case of a laparoscopically resected mesothelial cyst in the lower abdominal extraperitoneal space that clinically and radiologically mimicked a urachal cyst in a 43-year-old nulligravid woman with 6 months of lower abdominal pain. Imaging showed a large cystic tumor alongside a uterine leiomyoma and an ovarian endometriotic cyst, and laparoscopy found the mesothelial cyst extending into the extraperitoneal space and adherent to the ovarian endometriotic cyst. Pathology confirmed the tumor as a mesothelial cyst, and the authors note a limitation that this is a single case report. The paper’s discussion explicitly links mesothelial cysts in reproductive-aged women to endometriosis and suggests spread into the extraperitoneal space via a peritoneal defect caused by endometriosis, making it directly relevant to endometriosis.

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Abstract

Objective: To report a rare case of a mesothelial cyst in the lower abdominal extraperitoneal space, mimicking a urachal cyst.Case: A 43-year-old nulligravid female complained of lower abdominal pain, ongoing for about 6 months. Physical examination revealed a pelvic mass reaching the height of the umbilicus. Magnetic resonance imaging showed a 15 × 6 cm cystic tumor in addition to a uterine leiomyoma and an ovarian endometriotic cyst. Laparoscopic surgery revealed that the huge cystic tumor extended into the lower abdominal extraperitoneal space, similar to a urachal cyst, and was adherent to the ovarian endometriotic cyst. The resected tumor was diagnosed pathologically as a mesothelial cyst.Conclusion: Mesothelial cysts occur most frequently in the peritoneal cavity of reproductive-aged women and are often accompanied by endometriosis. Endometriosis is often associated with pelvic peritoneal defects. This report suggests that a mesothelial cyst may extend into the lower abdominal extraperitoneal space through a peritoneal defect caused by endometriosis.
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Abstract

Objective: To report a rare case of a mesothelial cyst in the lower abdominal extraperitoneal space, mimicking a urachal cyst. Case: A 43-year-old nulligravid female complained of lower abdominal pain, ongoing for about 6 months. Physical examination revealed a pelvic mass reaching the height of the umbilicus. Magnetic resonance imaging showed a 15 × 6 cm cystic tumor in addition to a uterine leiomyoma and an ovarian endometriotic cyst. Laparoscopic surgery revealed that the huge cystic tumor extended into the lower abdominal extraperitoneal space, similar to a urachal cyst, and was adherent to the ovarian endometriotic cyst. The resected tumor was diagnosed pathologically as a mesothelial cyst.

Conclusion

Mesothelial cysts occur most frequently in the peritoneal cavity of reproductive-aged women and are often accompanied by endometriosis. Endometriosis is often associated with pelvic peritoneal defects. This report suggests that a mesothelial cyst may extend into the lower abdominal extraperitoneal space through a peritoneal defect caused by endometriosis. Case: A 43-year-old nulligravid female complained of lower abdominal pain, ongoing for about 6 months. Physical examination revealed a pelvic mass reaching the height of the umbilicus. Magnetic resonance imaging showed a 15 × 6 cm cystic tumor in addition to a uterine leiomyoma and an ovarian endometriotic cyst. Laparoscopic surgery revealed that the huge cystic tumor extended into the lower abdominal extraperitoneal space, similar to a urachal cyst, and was adherent to the ovarian endometriotic cyst. The resected tumor was diagnosed pathologically as a mesothelial cyst.

Conclusion

Mesothelial cysts occur most frequently in the peritoneal cavity of reproductive-aged women and are often accompanied by endometriosis. Endometriosis is often associated with pelvic peritoneal defects. This report suggests that a mesothelial cyst may extend into the lower abdominal extraperitoneal space through a peritoneal defect caused by endometriosis. © 2012 Japan Society of Gynecologic and Obstetric Endoscopy and Minimally Invasive Therapy Favorites & Alerts Recently viewed articles

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endometriosis

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