Retroperitoneal enterogenous cyst combined with teratoma

Area of Science:

• Gastroenterology
• Surgical Pathology

Background:

• Enterogenous cysts (ECs) are rare congenital anomalies, often found in the mediastinum or abdomen.
• Their presentation can be varied, sometimes mimicking other intra-abdominal pathologies.

Observation:

• A 63-year-old male presented with acute left abdominal pain, distention, and melena after stress and exercise.
• CT revealed a large cystic mass, a teratoma, and a duodenal diverticulum.
• Surgical resection of the cyst was performed.

Findings:

• Pathology confirmed the cyst wall's composition of mucinous glandular epithelium and smooth muscle, resembling normal intestinal tissue.
• The cyst lining featured ciliated columnar epithelium, establishing the diagnosis of an isolated enterogenous cyst (EC).

Implications:

• This case highlights the importance of considering ECs in the differential diagnosis of abdominal masses, especially with gastrointestinal symptoms.
• The management decision not to resect the co-existing teratoma due to vascular proximity underscores surgical risk assessment.