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Author Spotlight: Advancements in Retroperitoneal Approach for Necrotizing Pancreatitis

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A diaphragmatic retroperitoneal cyst.

F P Robertson, D Tsironis¹, B R Davidson

¹Division of Surgery and Interventional Science, Royal Free Campus, University College London , UK.

Annals of the Royal College of Surgeons of England

|August 13, 2015

Summary

A diaphragmatic cyst can mimic cancer, even with elevated tumor markers and imaging findings. This case highlights that benign epidermoid cysts may present falsely suggestive of neoplasia.

Keywords:

CA19–9 Computed tomography Epidermoid cyst Positron emission tomography

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Area of Science:

Medical imaging and diagnostics
Surgical pathology
Gastroenterology

Background:

Diaphragmatic lesions are often congenital bronchogenic cysts.
Benign cysts can sometimes present with concerning clinical and imaging features.

Observation:

A patient with a known diaphragmatic cyst developed right upper quadrant pain.
Imaging revealed cyst enlargement, elevated CA19-9 levels (312 iu/ml), and increased PET-CT uptake in the cyst wall.

Findings:

Surgical excision and histological examination confirmed a benign epidermoid cyst.
This presentation falsely suggested neoplasia, a phenomenon previously noted in splenic cysts but not typically in diaphragmatic epidermoid cysts.

Implications:

Benign diaphragmatic epidermoid cysts can exhibit features mimicking malignancy.
Careful pathological evaluation is crucial for accurate diagnosis and management of diaphragmatic lesions.