|Year : 2021 | Volume
| Issue : 3 | Page : 195-196
A retroperitoneal cyst masquerading as a para-ovarian cyst in a postmenopausal woman
PG Paul, Anjana Annal, K Anusha Chowdary, George Paul
Centre for Advanced Endoscopy and Infertility Treatment, Paul's Hospital, Kochi, Kerala, India
|Date of Submission||04-Feb-2021|
|Date of Decision||09-Mar-2021|
|Date of Acceptance||11-Mar-2021|
|Date of Web Publication||3-Aug-2021|
Dr. P G Paul
Centre for Advanced Endoscopy and Infertility Treatment, Paul's Hospital, Vattekkattu Road, Kaloor, Kochi - 682 017, Kerala
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Paul P G, Annal A, Chowdary K A, Paul G. A retroperitoneal cyst masquerading as a para-ovarian cyst in a postmenopausal woman. Gynecol Minim Invasive Ther 2021;10:195-6
|How to cite this URL:|
Paul P G, Annal A, Chowdary K A, Paul G. A retroperitoneal cyst masquerading as a para-ovarian cyst in a postmenopausal woman. Gynecol Minim Invasive Ther [serial online] 2021 [cited 2022 Aug 15];10:195-6. Available from: https://www.e-gmit.com/text.asp?2021/10/3/195/322969
Peritoneal inclusion cysts are rare mesothelium-lined abdominopelvic cysts occurring in perimenopausal women, first described by Mennemeyer and Smith in 1979. They are commonly misdiagnosed as ovarian tumors.
A 56-year-old, P2L2, menopausal woman presented with lower backache and dysuria for 1 month. She had previous cesarean, with family history of breast cancer. Pelvic examination was unremarkable. Transvaginal and transabdominal ultrasound showed a large, anechoic cystic lesion of 10 cm close to the right adnexa, without solid components or color flow [Figure 1].
|Figure 1: Ultrasound showing a large anechoic cyst with adjacent normal right ovary|
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Total laparoscopic hysterectomy with bilateral salpingo-oophorectomy and excision of the right para-ovarian cyst was planned. Laparoscopy showed a normal uterus, Fallopian tube More Detailss, and ovaries with a large 10-cm retroperitoneal cyst over the right pelvic side wall [Figure 2]. The cyst was enucleated after isolating the right ureter, and the content was serous fluid [Figure 3]. Histopathology confirmed benign cystic mesothelioma [Figure 4]. One-year follow-up showed no evidence of recurrence.
|Figure 4: Histopathology showing fibrous-walled mesothelial cyst lined by flattened epithelium|
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Benign cystic mesothelioma is a rare tumor arising from the abdominal peritoneum. Mesothelial tumors can be benign cystic, adenomatoid, or malignant. Classically, they present as large multi-cystic masses. Typical symptoms are abdominal distention, tenderness, ascites, nausea, and constipation.,
It can mimic conditions such as ovarian malignancies and cystic lymphangioma and can pose a diagnostic challenge. Histopathology is confirmative. The presence of long slender apical microvilli and the hobnailed appearance of the cells are some of the distinguishing features.
Pathogenesis remains unclear. It may be associated with endometriosis, pelvic inflammatory disease, and previous abdominal surgeries. The treatment is usually surgical resection. Recurrence is possible, and therefore, follow-up after surgery is recommended.
These tumors may have local recurrence and can even occur many years later. It has been proposed that benign cystic mesothelioma behaves more like a borderline lesion. Rarely, it may transform into aggressive diffuse malignant mesothelioma. Therefore, periodic follow-up is warranted.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given her consent for her images and other clinical information to be reported in the journal. The patient understands that name and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Figure 1], [Figure 2], [Figure 3], [Figure 4]
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