Zunyi Medical University Zhuhai Campus, Zhuhai, China.
Department of Radiology, the fifth affiliated hospital of Zunyi Medical University, Zhuhai, China.
Curr Med Imaging. 2024;20:e15734056303445. doi: 10.2174/0115734056303445240509061437.
This case report describes a case of Müllerian duct cyst that occurred in a male retroperitoneum. The cyst lesion is rare and complicated with diaphragmatic hernia. Müllerian duct-derived cyst is a rare developmental disorder that is more common in male pelvic tissues and rare in the retroperitoneum. We investigated the important role of computerized tomography (CT) and magnetic resonance imaging (MRI) in preoperative diagnosis and disease prediction of this condition.
A 25-year-old male was found to have an abnormal occupying lesion in the left diaphragm in imaging examinations, usually healthy with no obvious clinical symptoms. X-ray examination showed a circular, high-density shadow near the left diaphragm. CT scan showed a soft tissue density shadow resembling a tumor in the left adrenal area, irregularly protruding into the chest cavity, with uneven density. MRI examination showed an irregular elongated T1 and T2 signal shadow in the left adrenal area. T2 fat suppression showed high signal intensity with unrestricted diffusion. Robotic-assisted laparoscopic surgery showed left retroperitoneal tumor resection. The patient recovered well postoperatively and had no recurrence after discharge follow-up.
The preclinical symptoms of retroperitoneal Müllerian cysts complicated by diaphragmatic hernia in young men are difficult to distinguish, and it is difficult to diagnose other similar cysts with imaging. The method of combined CT and MRI diagnosis guides the endoscopic robot-assisted minimally invasive surgery for excision of cysts to achieve accurate diagnosis and treatment of such diseases.
本病例报告描述了一例发生于男性腹膜后腔的苗勒管囊肿。该囊肿病变罕见，且并发膈疝。苗勒管来源的囊肿是一种罕见的发育异常，在男性盆部组织中更为常见，腹膜后腔罕见。我们研究了计算机断层扫描（CT）和磁共振成像（MRI）在该疾病术前诊断和疾病预测中的重要作用。
一名 25 岁男性在影像学检查中发现左侧膈肌有异常占位病变，通常健康，无明显临床症状。X 射线检查显示左侧膈肌附近有一个圆形、高密度阴影。CT 扫描显示左肾上腺区软组织密度阴影，类似肿瘤，不规则突出至胸腔，密度不均匀。MRI 检查显示左肾上腺区不规则长形 T1 和 T2 信号阴影。T2 脂肪抑制显示高信号强度，弥散不受限制。机器人辅助腹腔镜手术显示左腹膜后肿瘤切除。术后患者恢复良好，出院随访无复发。
年轻男性腹膜后苗勒管囊肿并发膈疝的临床前症状难以区分，影像学难以诊断其他类似囊肿。联合 CT 和 MRI 诊断方法指导内镜机器人辅助微创手术切除囊肿，实现对该类疾病的准确诊断和治疗。
