-Case Reports-

A Case of a Mesenteric Cyst in the Sigmoid Colon of a 3-year-old Girl

Shinya Iida¹, Kiyonori Furukawa^1,2, Yoshie Terada¹, Yuichi Sugisaki³, Kazuyasu Yoshimura⁴ and Takashi Tajiri¹

¹Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School
²Department of Surgery, Nippon Medical School Chiba Hokusoh Hospital
³Department of Diagnostic Pathology, Nippon Medical School Hospital
⁴Department of Surgery, Hakuji-kai Memorial Hospital, Tokyo

Mesenteric cysts are rare. In this paper we present a case of a mesenteric cyst in the sigmoid colon of a 3-year-old girl. On the first visit to our department, a smooth-surfaced soft mass approximately 15 cm in diameter was noticed in the right lower abdomen. Although the patient complained of lower abdominal pain, there was no tenderness or guarding. Laboratory tests indicated no abnormality except a slightly increased level of C-reactive protein (2.3 mg/dL). A plain abdominal X-ray film revealed displacement of colonic gas from the right lower abdomen, and abdominal ultrasonography and computed tomography revealed a smooth cystic mass measuring 9.5 × 8.7 × 4.7 cm that contained many internal septa. Because the patient had several symptoms, we performed a surgical operation under general anesthesia. We found a light-red cystic mass, 8.5 × 8.0 × 3.0 cm in size, in the mesentery of the sigmoid colon and surrounding the sigmoid colon, without adhesion to any other organ. We approached the cystic mass from the sigmoid colon and the mesentery of sigmoid colon and completely resected it without complications. The content of the cystic mass was a pale-yellow serous fluid. A cytological examination revealed mainly lymphocytes with reactive mesothelial cells. The resulting pathological diagnosis was a multi-lobular mesenteric cyst. Immunohistochemical staining with D2-40 antibody was positive value along the wall of the cyst, indicating that the cyst was derived from a lymphatic vessel.

J Nippon Med Sch 2009; 76: 247-252

Keywords
mesenteric cyst, colon, lymphatic vessel

Correspondence to
Shinya Iida, Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
shinya1s@nms.ac.jp

Received, June 22, 2009
Accepted, August 17, 2009