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Case Reports
. 2018 Oct 17;12(1):317.
doi: 10.1186/s13256-018-1716-x.

Ideal treatment strategy for chylous mesenteric cyst: a case report

Daniel Paramythiotis  1 , Petros Bangeas  2 , Anestis Karakatsanis  1 , Alexandros Iliadis  3 , Georgia Karayannopoulou  3 , Antonios Michalopoulos  1
Affiliations
Case Reports

Ideal treatment strategy for chylous mesenteric cyst: a case report

Daniel Paramythiotis et al. J Med Case Rep. .

Abstract

Background: A mesenteric chylous cyst is defined as a cyst occurring in the mesentery of the gastrointestinal tract anywhere from the duodenum to the rectum and is diagnosed most often during the fifth decade of life.

Case presentation: In our case report, we describe a case of 38-year-old Greek woman who presented at our Emergency Department complaining of abdominal pain without any other symptoms. Her medical and family histories were clear and she had never had any abdominal interventions. During an imaging examination with ultrasound of her abdomen, an anechoic lesion in her upper left abdomen was revealed. In a further investigation with computed tomography, a well-defined hypodense cystic 7.08 × 6.05 cm mass with mild enhancement was noted. The mass was excised by open laparotomy within healthy borders and the specimen was sent for pathological examination. The histopathological findings were found to be most consistent with a simple lymphatic (chylous) cyst of the mesentery. A review of the literature considering this rare entity was also performed to evaluate our treatment strategy and the result was analyzed.

Conclusions: Chylous cysts represent a diagnostic challenge and they should be considered when a physician encounters an intraabdominal mass. Physical examination and imaging do not always provide a diagnosis and surgical management should be advised due to the potential complications that may develop.

Keywords: Chylous mesenteric cyst; Computed tomography; Laparotomy; Lymphatic cyst; Ultrasound.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the investigational review board (IRB) of AHEPA University Hospital, Thessaloniki, Greece. Moreover, all methods were carried out in accordance with the relevant guidelines and regulations.

Consent for publication

Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
PRISMA Chart with the exclusion articles
Fig. 2
Fig. 2
Computed tomography showed a well-defined hypodense cystic 7.08 × 6.05 cm chylous cyst with mild enhancement
Fig. 3
Fig. 3
Intraoperative image of mesentery cyst with well-defined wall
Fig. 4
Fig. 4
Final specimen
Fig. 5
Fig. 5
Cyst wall with lymphoid aggregates, hematoxylin and eosin × 100 (a) and CD31+ vessels, immunohistochemical × 200 (b)
Fig. 6
Fig. 6
Foreign-body giant cell in the lumen, hematoxylin and eosin × 200 (a) as well as CD68+, foamy macrophages, immunohistochemical × 40 (b)
See this image and copyright information in PMC

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