Peritoneal inclusion cysts: a review

To provide a comprehensive review of peritoneal inclusion cysts in the female patient population. To define the optimal diagnostic modalities and review the medical and surgical options for management, enabling the gynecologist to individualize treatment for patients.

We searched the MEDLINE database for articles with keywords "peritoneal inclusion cyst" and "benign (multicystic) mesothelioma." Our search was limited to the English language. All reports included a tissue-confirmed diagnosis, except 1. Case reports and case series with adolescent and adult patients were reviewed.

We evaluated all studies meeting our criteria for clinical features, histologic criteria for diagnosis, imaging and laboratory studies, and treatment modalities.

Fifty-two descriptive studies and 1 prospective cohort study meet criteria for review. Eleven articles focused on imaging modalities. Nineteen articles depicted histopathology. Eight addressed treatment modalities.

This is a comprehensive review of peritoneal inclusion cysts. We specifically focus on the method of diagnosis and management. There is no standard algorithm by which the patients are evaluated, treated, or followed up. Peritoneal inclusion cysts have minimal mortality but high morbidity. Diagnosis is made by clinical history, ultrasound imaging, and CA-125 correlation. Magnetic resonance imaging is useful if ultrasound is unclear. Tissue sample is necessary for definitive diagnosis. Prior studies have suggested that cure is only accomplished with surgical resection; however, patients have a 50% risk of recurrence. We suggest that the goal for such a chronic disease should not be cure, but symptomatic relief through individualization of treatment.

Obstetricians & Gynecologists, Family Physicians.

After completion of this article, the reader should be able to summarize imaging characteristics of peritoneal inclusion cysts, explain the epidemiology and risk factors for the development of peritoneal inclusion cysts, and describe possible treatment options for peritoneal inclusion cysts.