Navin P, Meshkat B, McHugh S, Beegan C, Leen E, Prins H, Aly S
Department of Surgery, Connolly Memorial Hospital, Blachardstown, Dublin 15, Ireland.
Int J Surg Case Rep. 2012;3(10):486-8. doi: 10.1016/j.ijscr.2012.05.010. Epub 2012 May 26.
Primary retroperitoneal tumours of mucinous type are extremely rare and can be further sub-divided into benign, borderline or cystadenocarcinoma. Prompt diagnosis of retroperitoneal tumours is important as the majority are malignant.
Our case describes a 30year old woman, presenting with a 3month history of intermittent right iliac fossa pain. Abdominal examination demonstrated a mass palpable in the right iliac fossa. Ultrasonography of the abdomen demonstrated a cystic mass with a magnetic resonance imaging (MRI) scan of the pelvis further defining the lesion. Laparoscopy was performed to further evaluate and ultimately remove the retroperitoneal mass. Macroscopic and microscopic examination reported mucinous epithelium of endocervical type with no evidence of invasion. Findings were consistent with primary retroperitoneal mucinous cystadenoma.
This is the 19th reported case of a benign primary retroperitoneal mucinous cystadenoma in the English literature. The origin of mucinous cystadenomas in the retroperitoneum is widely debated with multiple theories suggested. Diagnosis of retroperitoneal tumours is important but difficult as serological investigations, ultrasonography, computed topography and magnetic resonance imaging, although useful, cannot allow a confident diagnosis.
Primary retroperitoneal mucinous cystadenoma is a benign tumour, however because of the malignant nature of the majority of mucinous retroperitoneal tumours they should be considered in the differential of chronic abdominal pain despite their rarity.
原发性腹膜后黏液性肿瘤极为罕见,可进一步细分为良性、交界性或囊腺癌。由于大多数腹膜后肿瘤是恶性的,因此及时诊断腹膜后肿瘤很重要。
我们的病例描述了一名30岁女性,有3个月间歇性右下腹疼痛病史。腹部检查发现右下腹可触及一个肿块。腹部超声显示为囊性肿块,盆腔磁共振成像(MRI)扫描进一步明确了病变。进行腹腔镜检查以进一步评估并最终切除腹膜后肿块。大体和显微镜检查报告为宫颈内膜样黏液上皮,无浸润证据。结果与原发性腹膜后黏液性囊腺瘤一致。
这是英文文献中第19例报告的良性原发性腹膜后黏液性囊腺瘤病例。腹膜后黏液性囊腺瘤的起源存在广泛争议,有多种理论提出。腹膜后肿瘤的诊断很重要但也很困难,因为血清学检查、超声、计算机断层扫描和磁共振成像虽然有用,但不能做出确切诊断。
原发性腹膜后黏液性囊腺瘤是一种良性肿瘤,然而,由于大多数腹膜后黏液性肿瘤具有恶性性质,尽管它们很罕见,但在慢性腹痛的鉴别诊断中仍应予以考虑。