A Mesothelial Inclusion Cyst Presenting in a 40-Year-Old Woman as Abdominal Pain and Bloating – A Rare Diagnosis.

European Journal of Case Reports in Internal Medicine 2020 January 24 [Link]

Canadas S, Fernandes R, Almeida H, Correia JS

Abstract

Cystic mesotheliomas (also called mesothelial inclusion cysts) are rare benign neoplasms that occur more often in young women. Symptoms are usually non-specific, demanding a thorough work-up. We report a case of a 40-year-old female patient with 2 prior caesarean sections presenting with a 3-month history of abdominal pain. Laboratory tests revealed microcytic hypochromic anaemia and an elevated tumour marker CA-125. An investigation identified a large cystic abdominal mass, mostly in the left side of the abdomen. A laparotomy was performed with total resection of the lesion. Histological assessment resulted in a diagnosis of a mesothelial inclusion cyst. The patient had no recurrence after 3 years.

LEARNING POINTS:

Peritoneal mesotheliomas are rare conditions, and with benign features are even rarer.Mesothelial inclusion cysts, also known as benign cystic mesothelioma, occur more often in young to middle-aged women with excellent prognosis, although there are high rates of local recurrence.Investigation unmasks large abdominal lesions. A timely diagnosis is of the utmost importance, to prevent a dramatic change in outcome if severe complications develop.