Peritoneal inclusion cysts as a diagnostic and treatment challenge.

Peritoneal inclusion cysts (PICs) are benign multilocular cysts that consist of fluid localized between intraperitoneal adhesions. They usually present in women in the third and fourth decades of life with a history of prior pelvic or abdominal surgery, especially months to 20 years ago. PICs have low mortality and the potential for high morbidity. Transvaginal ultrasound with color Doppler has an important role in the differential diagnosis. Also, a very important role is played by CA 125 plasma level or use of the ROMA algorithm. But thanks to laparoscopy and the possibility of biopsy from suspicious lesions the correct diagnosis can be established. Treatment of PICs depends individually on the patient's condition, symptoms, other diseases, and desire for procreation. Among other contemplated are hormonal oral contraceptive, an image-guided aspiration, minimally invasive or open surgery. The issue of diagnosis and treatment of PICs requires the continuation of multicentre, randomized clinical trials to find and standardize effective, personalized treatments for PICs.