mesenteric cyst

肠系膜囊肿
  • 文章类型: Case Reports
    淋巴管瘤是罕见的良性囊性肿瘤。手术切除是主要的治疗方法,旨在完全移除。诊断依赖于影像学和组织学确认。恶性转化异常罕见。我们报告了一名25岁的男子,他因脐周腹痛和腹部肿块而入院。影像学显示多房性腹膜囊性形成伴邻近肠系膜脂肪浸润。实验室发现并不显著,并进行剖腹探查术。发现了源自肠系膜的大量囊性肿块,需要肠处死才能完全切除。术后即刻恢复顺利。病理分析证实诊断为肠系膜囊性淋巴管瘤。在三年的随访中,患者的预后良好,没有肿瘤复发。我们强调完全手术切除对预防与囊性淋巴管瘤相关的并发症和降低复发风险的重要性。
    Lymphangiomas are rare benign cystic tumors. Surgical excision is the primary treatment, aiming for complete removal. Diagnosis relies on imaging and histological confirmation. Malignant transformation is exceptionally rare. We report a 25-year-old man admitted for peri-umbilical abdominal pain and an abdominal mass. Imaging revealed multilocular peritoneal cystic formations with infiltration of adjacent mesenteric fat. Laboratory findings were unremarkable, and exploratory laparotomy was performed. A voluminous cystic mass originating from the mesentery was discovered, requiring intestinal sacrifice for complete resection. Immediate postoperative recovery was smooth. Pathological analysis confirmed the diagnosis of mesenteric cystic lymphangioma. The patient had a favorable outcome with no tumor recurrence at a three-year follow-up. We emphasize the significance of complete surgical removal to prevent complications associated with cystic lymphangioma and reduce the risk of recurrence.
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  • 文章类型: Case Reports
    背景:囊性淋巴管瘤是由淋巴系统畸形引起的罕见良性肿瘤。肠系膜位置更不常见。
    方法:我们报告了一例63岁的绝经女性,她表现为骨盆的持续性疼痛明确肿块。关于超声波和计算机断层扫描,肿块表现为厚壁单眼同质囊肿,有利于卵巢囊腺瘤。在剖腹手术中,由于发现肿瘤包埋在回肠肠系膜,因此误诊。随后的组织病理学检查证实了良性囊性淋巴管瘤的诊断。
    结论:肠系膜囊性淋巴管瘤是成人罕见的腹膜肿瘤。临床上,它经常伪装成其他腹盆腔肿块,如卵巢囊肿。由于重叠的临床腹部表现和放射学特征,鉴别诊断通常具有挑战性。组织病理学是诊断肠系膜囊性淋巴管瘤的金标准。手术是主要治疗手段,如果手术切缘阴性,复发率较低。
    结论:肠系膜囊性淋巴管瘤通常模仿更频繁和潜在的恶性病变。在评估腹盆腔囊性肿块时,外科医生必须对这种诊断的可能性保持警惕。
    BACKGROUND: Cystic lymphangioma is rare benign tumor that results from a lymphatic system malformation. The mesenteric location is even more uncommon.
    METHODS: We report the case of a menopausal 63-year-old woman who presented with a persistent painful well-defined mass of the pelvis. On ultrasound and computed tomography, the mass appeared as thick-walled unilocular homogenous cyst in favor of an ovarian cystadenoma. During laparotomy, the misdiagnosis was confirmed as the tumor was found to be embedded in the mesentery of the ileum. Subsequent histopathological examination confirmed the benign cystic lymphangioma diagnosis.
    CONCLUSIONS: Mesenteric cystic lymphangioma is rare peritoneal tumor of the adult. Clinically, it often masquerades as other abdominopelvic masses like ovarian cysts. Differential diagnosis is often challenging because of the overlapping clinical abdominal presentation and radiological features. Histopathological is the gold standard in diagnosing mesenteric cystic lymphangioma. Surgery is the mainstay treatment, and the recurrence rate is low if negative surgical margins are achieved.
    CONCLUSIONS: Mesenteric cystic lymphangioma often mimics more frequent and potentially malignant lesions. It is essential for surgeons to remain vigilant for the possibility of this diagnosis when evaluating abdominopelvic cystic masses.
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  • 文章类型: Case Reports
    肠系膜囊肿,通常是良性和无症状的,是腹部检查期间偶然发现的非特异性症状。它们通常起源于小肠的肠系膜,mesocolon,或者腹膜后.本文报道了一例罕见的22岁男性,肠系膜囊肿表现为右下腹部肿块。超声检查显示不均匀的集合,导致手术切除。组织病理学意外发现起源于肠系膜的性腺外卵黄囊瘤(YST),一种罕见的常被误诊为囊肿。YST,主要存在于性腺中,很少在性腺外报告。这项研究有助于原发性腹膜YST的有限文献,讨论临床病理参数并介绍详细病例。性腺外生殖细胞肿瘤的发病机制,包括YST,仍在辩论,胚胎发育过程中生殖细胞的迁移和停滞是一种普遍的理论。性腺外YST的组织病理学检查反映性腺YST,具有各种图案。免疫组织化学,对诊断至关重要,显示SALL-4,磷脂酰肌醇蛋白聚糖-3,PLAP,法新社,还有PANCK.SALL-4是性腺外YST最敏感的标记。该病例强调了准确的术后组织病理学和免疫组织化学在区分肠系膜YST和囊肿中的重要性。误诊会影响预后。性腺外YST的罕见性强调了在临床实践中需要全面理解和认识。这项研究为诊断和管理提供了宝贵的见解,揭示了外科病理学的挑战性方面。
    Mesenteric cysts, typically benign and asymptomatic, are incidental findings during abdominal investigations for nonspecific symptoms. Their origin is commonly in the mesentery of the small bowel, mesocolon, or retroperitoneum. This paper reports a rare case of a 22-year-old male with a mesenteric cyst presenting as a right lower abdominal mass. Ultrasonography revealed a heterogenous collection, leading to surgical excision. Histopathology unexpectedly revealed an extragonadal yolk sac tumor (YST) originating in the mesentery, a rarity often misdiagnosed as a cyst. YST, primarily found in gonads, is infrequently reported extragonadally. This study contributes to the limited literature on primary peritoneal YST, discussing clinicopathological parameters and presenting a detailed case. The pathogenesis of extragonadal germ cell tumors, including YST, remains debated, with migration and stagnation of germ cells during embryonic development proposed as a prevalent theory. Histopathological examination of extragonadal YST mirrors gonadal YST, featuring various patterns. Immunohistochemistry, crucial for diagnosis, reveals positive expression for SALL-4, glypican-3, PLAP, AFP, and panCK. SALL-4 emerges as the most sensitive marker for extragonadal YST. This case underscores the importance of accurate postoperative histopathology and immunohistochemistry in distinguishing mesenteric YST from cysts, as misdiagnosis can impact prognosis. The rarity of extragonadal YST emphasizes the need for comprehensive understanding and recognition in clinical practice. The study contributes valuable insights into diagnosis and management, shedding light on a challenging aspect of surgical pathology.
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  • 文章类型: Case Reports
    神经节神经瘤是一种罕见的,良性,分化良好的神经源性肿瘤最常见于后纵隔或腹膜后。巨神经节神经瘤甚至更不常见;这只是迄今为止文献中报道的第19例。我们介绍了一个5岁儿童的巨大腹膜后神经节神经瘤,成像模拟肠系膜囊肿,并在其管理中提出了各种挑战。组织病理学后来证实了我们的误诊,并发现肿瘤是神经节神经瘤。这种独特的病例为临床医生提供了一个教训,即在接受组织病理学诊断确认之前不要进行手术。
    Ganglioneuroma is a rare, benign, well-differentiated neurogenic tumor most commonly located in the posterior mediastinum or retroperitoneum. Giant ganglioneuromas are even less common; this is only the 19th reported case in literature to date. We present a case of a giant retroperitoneal ganglioneuroma in a five-year-old child, which on imaging mimicked a mesenteric cyst and posed various challenges in its management. Histopathology later confirmed our misdiagnosis and revealed the tumor to be a ganglioneuroma. This unique case serves as a lesson for clinicians to not operate before receiving histopathological confirmation of their diagnosis.
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  • 文章类型: Case Reports
    肠系膜囊肿是罕见的腹内良性肿块,在儿童时期出现,有不同程度的临床表现,从无症状到表现为急腹症。诊断是在其他腹部病变(如急性阑尾炎)的检查过程中偶然做出的,肠梗阻,等。治疗主要是手术治疗,并根据病变的临床类型而有所不同。
    方法:一名26个月大的儿童因腹部包块被转诊至我院儿科外科。该患者先前抱怨便秘,并接受了泻药的对症治疗。超声检查报告经计算机断层扫描证实的卵巢囊肿(误诊为卵巢囊肿而不是肠系膜囊肿),在医院外的私人诊断中心做的.
    患者已做好手术准备,她被发现患有双重囊肿,大部分合并在横结肠系膜远端1/3的肠系膜。通过下中线剖腹切口摘除囊肿,不进行肠切除和吻合。标本的组织病理学分析证实为肠系膜囊肿。
    结论:肠系膜囊肿是儿童罕见的病变,在接近腹内包块时应考虑。除了需要肠切除和/或部分囊肿切除的罕见病例,所有肠系膜囊肿都可以切除,同时保留肠道完整性和血管供应。
    UNASSIGNED: Mesenteric cysts are uncommon intra-abdominal benign masses that appear in childhood with varying degrees of clinical manifestations, ranging from being asymptomatic to presenting as an acute abdomen. The diagnosis is made incidentally during the work-up for other abdominal pathologies such as acute appendicitis, bowel obstruction, etc. The treatment is mostly surgical and varies depending on the clinical type of the lesion.
    METHODS: A 26-month-old child was referred to our teaching hospital\'s pediatric surgery department with an abdominal mass. The patient had previously complained of constipation and been treated symptomatically with laxatives. Ultrasonography reported ovarian cysts confirmed by computerized tomography scanning (as a misdiagnosis report of an ovarian cyst instead of a mesenteric cyst), done outside the hospital in a private diagnostic center.
    UNASSIGNED: The patient was prepared for operation and during the surgical procedure, she was found to have a duplex cyst, which was mostly incorporated in the mesentery of the distal 1/3 of the transverse mesocolon. The cyst was enucleated through a lower midline laparotomy incision without bowel resection and anastomosis. The histopathological analysis of the specimen confirmed a mesenteric cyst.
    CONCLUSIONS: Mesenteric cysts are rare lesions in children and should be considered when approaching any intra-abdominal mass. Except for the rare cases where intestinal resection and/or partial cyst excision are required, all mesenteric cysts can be excised while preserving intestinal integrity and vascular supply.
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  • 文章类型: Journal Article
    未经证实:肠系膜囊肿(MC)是一种罕见的实体,引起腹部肿块生长和其他临床表现的良性病变。怀孕期间MC的出现频率甚至更低。
    方法:一名34岁的墨西哥妇女在妊娠第16周时出现肠系膜囊肿,接受剖腹抽吸术治疗;妊娠通过剖宫产解决,没有问题。然而,17个月后,病变复发.进行新的评估和完全切除的手术治疗,没有进一步复发的证据。
    UNASSIGNED:这种情况是必不可少的,因为妊娠与肠系膜囊肿之间的关联频率很低。不完全切除,抽吸,病变的袋状化有很高的复发风险。因此,妊娠期间应评估完整切除病灶和避免并发症的时机.
    结论:MC应被视为妊娠期囊性病变的鉴别诊断。影像学检查,完整的手术切除,组织学评估,和随访是必要的适当的治疗。
    UNASSIGNED: The mesenteric cyst (MC) is a rare entity, a benign lesion that causes the growth of an abdominal mass and other clinical presentations. The presentation of MC during pregnancy is even less frequent.
    METHODS: A 34-year-old Mexican woman presented with a mesenteric cyst treated with laparotomy aspiration during the 16th week of pregnancy; the pregnancy was resolved by cesarean section without problems. Nevertheless, 17 months later, the lesion recurred. New assessment and surgical treatment with complete excision are performed without evidence of further recurrence.
    UNASSIGNED: This case is essential due to the low frequency of association between pregnancy and mesenteric cyst. Incomplete resection, aspiration, and marsupialization of the lesion carry a high risk of recurrence. Therefore, the opportune moment to perform a complete resection of the lesion and avoid complications should be evaluated during pregnancy.
    CONCLUSIONS: MC should be considered a differential diagnosis in cystic lesions during pregnancy. Imaging studies, complete surgical resection, histological evaluation, and follow-up are necessary for adequate treatment.
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  • 文章类型: Case Reports
    肠系膜囊肿被定义为一组异质性的肠系膜或网膜的腹内囊性病变,可以在从十二指肠到直肠的胃肠道的任何部分中发现。许多患者的临床状况完全无症状,特别是小囊肿。诊断通常是偶然的,并且是为了其他目的而进行的成像的次要诊断。在有症状的患者中,临床表现以非特异性胃肠道体征和症状为特征。治疗可以是手术或通过介入放射学。我们报告了一名55岁的女性患者,抱怨左侧腹部不适和便秘持续三个月。腹部超声显示存在10×14×16厘米无回声囊性肿块,充满整个前腹腔和左腹腔,经CT和MRI证实。囊肿,腹腔镜切除,组织学上是一个简单的间皮囊肿.我们回顾了过去10年所有肠系膜囊肿>10厘米病例的国际文献,以评估诊断时的胃肠道症状。组织学,进行治疗,和结果。
    Mesenteric cysts are defined as a heterogeneous group of intra-abdominal cystic lesions of the mesentery or omentum that may be found in any portion of the gastrointestinal tract from the duodenum to the rectum. The clinical condition is entirely asymptomatic in many patients, particularly with small cysts. The diagnosis is typically incidental and secondary to imaging performed for other purposes. In symptomatic patients, the clinical picture is characterized by nonspecific gastrointestinal signs and symptoms. Treatment may be surgical or via interventional radiology. We report the case of a 55-year-old female patient complaining of left-sided abdominal discomfort and constipation lasting three months. An abdominal ultrasound showed the presence of a 10 × 14 × 16 cm anechoic cystic mass filling the whole anterior and left abdominal cavity, confirmed by CT and MRI. The cyst, removed laparoscopically, was histologically a simple mesothelial cyst. We reviewed the international literature over the last 10 years of all cases with mesenteric cysts > 10 cm in evaluating gastrointestinal symptoms at diagnosis, histology, performed treatment, and outcome.
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  • 文章类型: Case Reports
    The occurrence of a mesenteric cyst (MC) is common in adults while in children and in infants is rare. In adults mesenteric cysts are often asymptomatic and discovered incidentally; however, in children they commonly present with symptoms of abdominal pain or distension with fever and leucocytosis. We report on a rare case, in our experience, of Mesenteric Chylous cyst (MCC) in an infant with signs and symptoms of intestinal obstruction. Discussion of literature is also reported.
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  • 文章类型: Case Reports
    A lymphatic mesenteric cyst (LMC) is a rare clinical entity, of unclear etiopathogenesis, which can arise in the abdominal cavity or retroperitoneum without a clear origin. We describe a case of a 74-year-old male presenting with abdominal pain that was non-specific and non-responsive to medical therapy. Laboratory tests clinical examination were inconclusive while the abdominal computed tomography (CT) scan showed a cystic lesion of the ileal mesentery. We performed an open surgical excision of the lesion with the resolution of clinical symptoms. The lesion resulted to be an LMC at the histological examination. At the five-year CT scan follow-up, we did not record any recurrences. LMCs present without specific symptoms and imaging diagnostic techniques, such as ultrasound (US) or CT scan may define its features, location, or size. The preoperative diagnosis remains difficult, which is why the complete surgical excision is the gold standard treatment, aiming to prevent malignant transformation, complications, and recurrences.
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  • 文章类型: Case Reports
    Mesenteric cysts were first described in 1507 and since then remain as a rare intraabdominal pathology. The etiology of this kind of tumor is still unclear and the classification remains controversial. They are usually asymptomatic, but can also cause acute abdominal pain and sometimes need emergency surgical approach. Clinical history, physical exam and complementary tests do not always provide diagnosis, which in many cases is made after surgery. Surgical management with complete excision of the cyst is the gold standard treatment. Laparoscopy technique should be preferred whenever is possible. The knowledge of these rare tumors is important for considering the correct approach. The goals of this article is to describe a case report of mesenteric cyst presented with acute abdominal pain at the emergency and do a brief literature review about this entity.
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