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.