Multiloculated mesothelial cyst presenting as a malignant mimic.

Area of Science:

• Gastroenterology
• Surgical Oncology
• Pathology

Background:

• Intra-abdominal masses can present with vague symptoms like pain and distension.
• Accurate diagnosis is crucial for appropriate management, especially when imaging is equivocal.

Observation:

• A 46-year-old woman presented with abdominal pain and distension due to an intra-abdominal mass.
• Initial imaging suggested an infiltrative tumor or mucinous ascites involving the small bowel, colon, and mesentery.

Findings:

• Laparoscopic evaluation revealed a benign-appearing, multiloculated omental cyst without bowel involvement.
• Complete laparoscopic resection was achieved.
• Pathology confirmed the diagnosis as a multiloculated peritoneal mesothelial cyst.

Implications:

• This case underscores the importance of considering benign cystic lesions, such as peritoneal mesothelial cysts, in the differential diagnosis of intra-abdominal masses.
• Laparoscopic resection is a feasible and effective treatment for such cysts.
• Accurate preoperative diagnosis can be challenging, necessitating intraoperative assessment and definitive pathological examination.