Mesenteric lymphangioma presenting as adnexal torsion: Case report and literature review

Abstract

We report the case of a patient with a mesenteric chylous lymphangioma who presented with acute pelvic symptoms mimicking adnexal torsion. The cyst contents had no specific sonographic or CT characteristics, such as a fluid-fluid level, to aid the preoperative diagnosis; definitive diagnosis was made only upon histopathologic examination of the cyst, which was resected intact.

Mesenteric lymphatic malformation mimicking an adnexal source in a teenager

“…8 These imaging findings overlap with many other possible intraabdominal masses, so it can be difficult to make a definitive diagnosis based on imaging alone and not uncommonly, the diagnosis of a lymphatic malformation is not confirmed until histological specimens are examined after surgical intervention. 9 This case demonstrates the importance of keeping this diagnosis in the differential when an abnormal adnexal mass or pelvic abnormality is seen on CT or ultrasound. It also highlights the benefits of a multidisciplinary approach that may include Gynecology, General or Pediatric Surgery, Radiology, among other specialties.…”

Mesenteric Lymphangioma in Adult: A Case Series with a Review of the Literature

“…Mesenteric lymphangioma from the jejunal mesentery can infiltrate the ileal mesentery, leading to secondary volvulus of the ileum or kinking of this part of gut. In females, this can present as acute pelvic symptoms and sometimes mimic torsion of the adnexa [22]. Differentiation of this mesenteric lesion from a mesenteric cyst is important as it may prevent a proliferative and invasive course [23].…”

Cisto mesentérico: aspectos clínicos e anátomopatológicos

“…A excisão cirúrgica completa deve ser indicada em todos os casos de cisto mesentérico para evitar sua recorrência, possível transformação maligna e complicações como hemorragia, torção, obstrução, ruptura traumática e infecção 17,24,25 . Desde que foi descrita pela primeira vez em 1993 por Mackenzie, a cirurgia laparoscópica para o cisto mesentérico tem se mostrado como uma excelente opção de tratamento, se aproximando em eficiência da cirurgia aberta, com a vantagem de proporcionar menos dor no pós-operatório, recuperação precoce, menor tempo de internação hospitalar e melhor resultado estético 7,[26][27][28][29] . Os linfangiomas freqüentemente invadem os tecidos vizinhos, necessitando operações mais complexas que se fazem melhor por via laparotômica, para sua completa remoção, enquanto os cistos mesoteliais são facilmente enucleados por causa de suas frouxas conexões, permitindo a ressecção laparoscópica 30,31 .…”