Peritoneal inclusion cysts in female children: pathogenesis, treatment, and multimodality imaging review

Area of Science:

• Radiology
• Pediatric Surgery
• Gynecologic Imaging

Background:

• Peritoneal inclusion cysts (PICs) are uncommon, fluid-filled masses that can form in the peritoneal cavity.
• Adolescent females with a history of abdominal surgery are a specific demographic where PICs may arise.
• Previous literature has focused more on clinical and pathological aspects rather than imaging characteristics.

Purpose of the Study:

• To highlight the multimodality imaging findings of peritoneal inclusion cysts in adolescent females.
• To emphasize the diagnostic utility of Magnetic Resonance Imaging (MRI) for PICs.
• To increase awareness of PICs as a differential diagnosis for pelvic cystic masses in surgically treated patients.

Main Methods:

• Retrospective review of imaging studies (ultrasound, CT, MRI) in two adolescent females with confirmed peritoneal inclusion cysts.
• Detailed analysis of imaging features across different modalities.
• Review of relevant literature on pathology, pathophysiology, diagnosis, and treatment.

Main Results:

• Demonstration of characteristic imaging findings of PICs on ultrasound, CT, and MRI.
• MRI proved particularly advantageous in delineating the cystic nature and relationship to surrounding structures.
• The patients presented with pelvic cystic masses, and a history of prior abdominal surgery was noted.

Conclusions:

• Multimodality imaging, particularly MRI, is crucial for diagnosing peritoneal inclusion cysts in adolescent females with a history of abdominal surgery.
• Clinicians should consider PICs in the differential diagnosis of pelvic cystic masses, even with a remote surgical history.
• Understanding the imaging features can lead to timely diagnosis and appropriate management.