An adult case of a retroperitoneal isolated enteric duplication cyst with the imaging changes over time

Abstract Background Adult cases of retroperitoneal isolated enteric duplication cyst (IEDC) are rare, with only 17 case reports in the relevant literature. We herein present a case, which was characterized by changes in intra-cystic density on computed tomography (CT), which was safely resected by l...

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Main Authors: Mayu Inomata, Kengo Kai, Takuto Ikeda, Akiko Ichihara, Rie Masuda, Takumi Kiwaki, Hiroyuki Tanaka, Hiroaki Kataoka, Atsushi Nanashima
Format: Article
Language:English
Published: Japan Surgical Society 2021-12-01
Series:Surgical Case Reports
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Online Access:https://doi.org/10.1186/s40792-021-01337-x
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author Mayu Inomata
Kengo Kai
Takuto Ikeda
Akiko Ichihara
Rie Masuda
Takumi Kiwaki
Hiroyuki Tanaka
Hiroaki Kataoka
Atsushi Nanashima
author_facet Mayu Inomata
Kengo Kai
Takuto Ikeda
Akiko Ichihara
Rie Masuda
Takumi Kiwaki
Hiroyuki Tanaka
Hiroaki Kataoka
Atsushi Nanashima
author_sort Mayu Inomata
collection DOAJ
description Abstract Background Adult cases of retroperitoneal isolated enteric duplication cyst (IEDC) are rare, with only 17 case reports in the relevant literature. We herein present a case, which was characterized by changes in intra-cystic density on computed tomography (CT), which was safely resected by laparoscopic surgery. Case presentation The patient was a 60-year-old male who received abdominal CT to investigate the cause of increased serum CA19-9 levels. CT revealed a unilocular cystic mass located in the lower right retroperitoneum. The size increased from 5 to 10 cm in three and a half years and the CT value decreased from 101 Hounsfield Units (HU) to 20 HU. We performed laparoscopic surgical resection, because the possibility that the enlargement of the lesion represented malignant transformation could not be denied. The large cystic mass firmly adhered to the appendix and its mesentery via the retroperitoneum, the appendix was resected en bloc with the cystic lesion. Microscopically, it had no communication with the appendix, and had an intestinal wall structure of muscularis mucosae and muscularis propria. The final pathological diagnosis was IEDC in the retroperitoneal space. There was no histological evidence of malignancy. Conclusion When we encounter a retroperitoneal cystic lesion, we should consider the possibility of malignancy to determine the treatment strategy and perform a careful operation without breaking the cyst wall, irrespective of the preoperative diagnosis.
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spelling doaj-art-e856579fe779480e997cf6aaab9c91ce2025-08-20T03:39:18ZengJapan Surgical SocietySurgical Case Reports2198-77932021-12-01711710.1186/s40792-021-01337-xAn adult case of a retroperitoneal isolated enteric duplication cyst with the imaging changes over timeMayu Inomata0Kengo Kai1Takuto Ikeda2Akiko Ichihara3Rie Masuda4Takumi Kiwaki5Hiroyuki Tanaka6Hiroaki Kataoka7Atsushi Nanashima8Department of Surgery, University of Miyazaki Faculty of MedicineDepartment of Surgery, University of Miyazaki Faculty of MedicineDepartment of Surgery, University of Miyazaki Faculty of MedicineDepartment of Surgery, University of Miyazaki Faculty of MedicineDepartment of Radiology, University of Miyazaki Faculty of MedicineSection of Oncopathology and Regenerative Biology, Department of Pathology, University of Miyazaki Faculty of MedicineSection of Oncopathology and Regenerative Biology, Department of Pathology, University of Miyazaki Faculty of MedicineSection of Oncopathology and Regenerative Biology, Department of Pathology, University of Miyazaki Faculty of MedicineDepartment of Surgery, University of Miyazaki Faculty of MedicineAbstract Background Adult cases of retroperitoneal isolated enteric duplication cyst (IEDC) are rare, with only 17 case reports in the relevant literature. We herein present a case, which was characterized by changes in intra-cystic density on computed tomography (CT), which was safely resected by laparoscopic surgery. Case presentation The patient was a 60-year-old male who received abdominal CT to investigate the cause of increased serum CA19-9 levels. CT revealed a unilocular cystic mass located in the lower right retroperitoneum. The size increased from 5 to 10 cm in three and a half years and the CT value decreased from 101 Hounsfield Units (HU) to 20 HU. We performed laparoscopic surgical resection, because the possibility that the enlargement of the lesion represented malignant transformation could not be denied. The large cystic mass firmly adhered to the appendix and its mesentery via the retroperitoneum, the appendix was resected en bloc with the cystic lesion. Microscopically, it had no communication with the appendix, and had an intestinal wall structure of muscularis mucosae and muscularis propria. The final pathological diagnosis was IEDC in the retroperitoneal space. There was no histological evidence of malignancy. Conclusion When we encounter a retroperitoneal cystic lesion, we should consider the possibility of malignancy to determine the treatment strategy and perform a careful operation without breaking the cyst wall, irrespective of the preoperative diagnosis.https://doi.org/10.1186/s40792-021-01337-xIsolated enteric duplication cystCT change of intra-cystic densityLaparoscopic surgery
spellingShingle Mayu Inomata
Kengo Kai
Takuto Ikeda
Akiko Ichihara
Rie Masuda
Takumi Kiwaki
Hiroyuki Tanaka
Hiroaki Kataoka
Atsushi Nanashima
An adult case of a retroperitoneal isolated enteric duplication cyst with the imaging changes over time
Surgical Case Reports
Isolated enteric duplication cyst
CT change of intra-cystic density
Laparoscopic surgery
title An adult case of a retroperitoneal isolated enteric duplication cyst with the imaging changes over time
title_full An adult case of a retroperitoneal isolated enteric duplication cyst with the imaging changes over time
title_fullStr An adult case of a retroperitoneal isolated enteric duplication cyst with the imaging changes over time
title_full_unstemmed An adult case of a retroperitoneal isolated enteric duplication cyst with the imaging changes over time
title_short An adult case of a retroperitoneal isolated enteric duplication cyst with the imaging changes over time
title_sort adult case of a retroperitoneal isolated enteric duplication cyst with the imaging changes over time
topic Isolated enteric duplication cyst
CT change of intra-cystic density
Laparoscopic surgery
url https://doi.org/10.1186/s40792-021-01337-x
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