Taieb Ahmed Hadj, Chaouch Mohamed Ali, Zayati Mohamed, Beltaifa Ramzi, Gafsi Besma, Noomen Faouzi
Department of Visceral and Digestive Surgery, Monastir University Hospital, Monastir, Tunisia.
Department of Visceral and Digestive Surgery, Monastir University Hospital, Monastir, Tunisia.
Int J Surg Case Rep. 2025 Jan;126:110792. doi: 10.1016/j.ijscr.2024.110792. Epub 2024 Dec 26.
Peritoneal inclusion cysts (PICs), also known as peritoneal mesothelial cysts, are rare, benign cystic lesions primarily occurring in the abdominopelvic cavity of premenopausal women with histories of pelvic surgery or inflammation. These cysts can present with nonspecific symptoms and may mimic other abdominal pathologies, making diagnosis challenging.
A 41-year-old male with no significant medical history, who experienced progressive nonspecific abdominal pain over several months. Clinical examination revealed a poorly defined mass in the right hemi-abdomen. Imaging studies, including CT and MRI, identified an elongated subhepatic cystic lesion, suggesting a peritoneal inclusion cyst or mesenteric cyst. Surgical intervention was decided following multidisciplinary team consultation. Intraoperative findings revealed a 13 cm intraperitoneal cyst with clear fluid content in the right hemi-abdomen, adherent to adjacent structures. Monobloc cystectomy was performed, and a histopathological examination confirmed the diagnosis of a peritoneal inclusion cyst.
PICs are rare and typically affect females, with only limited cases reported in males. These cysts can be asymptomatic or present with non-specific symptoms such as abdominal pain or distension, often requiring imaging and, occasionally, surgical exploration for diagnosis. The differential diagnosis includes other cystic abdominal lesions, emphasizing the need for thorough clinical and imaging assessment. The preferred management of PICs is surgical excision, as it provides histological confirmation and minimizes recurrence risk.
This case highlights a rare presentation of a PIC in a male patient, underscoring the importance of considering PICs within the differential diagnosis of abdominal cystic lesions regardless of patient gender. Surgical resection remains the primary management approach, but further research is needed to establish standardized guidelines for diagnosis and treatment.
腹膜包涵囊肿（PICs），也称为腹膜间皮囊肿，是罕见的良性囊性病变，主要发生在有盆腔手术或炎症病史的绝经前女性的腹腔盆腔内。这些囊肿可能表现为非特异性症状，并且可能与其他腹部病变相似，这使得诊断具有挑战性。
一名41岁男性，无重大病史，数月来经历了进行性非特异性腹痛。临床检查发现右半腹有一个边界不清的肿块。包括CT和MRI在内的影像学检查发现肝下有一个细长的囊性病变，提示为腹膜包涵囊肿或肠系膜囊肿。经过多学科团队会诊后决定进行手术干预。术中发现右半腹有一个13厘米的腹腔内囊肿，内含清亮液体，与相邻结构粘连。进行了整块囊肿切除术，组织病理学检查证实为腹膜包涵囊肿。
PICs罕见，通常影响女性，男性病例报道有限。这些囊肿可能无症状，或表现为腹痛或腹胀等非特异性症状，通常需要影像学检查，偶尔还需要手术探查来诊断。鉴别诊断包括其他腹部囊性病变，强调需要进行全面的临床和影像学评估。PICs的首选治疗方法是手术切除，因为它能提供组织学确诊并将复发风险降至最低。
本病例突出了PICs在男性患者中的罕见表现，强调了在腹部囊性病变的鉴别诊断中考虑PICs的重要性，无论患者性别如何。手术切除仍然是主要的治疗方法，但需要进一步研究以建立标准化的诊断和治疗指南。
