J Korean Soc Radiol.  2010 Feb;62(2):159-162. 10.3348/jksr.2010.62.2.159.

Benign Multicystic Mesothelioma in the Left Round Ligament: Case Report

• Bae SY
• Yi BH
• Lee HK
• Park SJ
• Cho GS
• Kwak JJ

• KMID: 2208957
• DOI: http://doi.org/10.3348/jksr.2010.62.2.159

Abstract

Benign multicystic mesothelioma is a rare mesothelial lesion that forms multicystic masses in the upper abdomen, pelvis, and retroperitoneum. Most cases have a benign course. We present the ultrasound and MR findings of benign multicystic mesothelioma in the left round ligament, which caused a left inguinal hernia in a 46-year-old woman.

MeSH Terms

Abdomen
Female
Hernia, Inguinal
Humans
Mesothelioma
Mesothelioma, Cystic
Middle Aged
Pelvis
Peritoneum
Round Ligament of Uterus

Figure

• 

  Fig. 1 A. Ultrasonography of left inguinal area shows a well defined 6×5 cm sized multiseptated cystic mass. The content of the cystic mass is anechoic without solid portion. B. T2 weighted axial image shows a septated cystic mass on left inguinal area (black arrow). Within the cystic mass, multiple thin septae are seen without fluid-fluid level. C. Gd-DTPA enhanced T1weighted MR image shows well enhanced cystic wall and septae, but enhancing solid portion is not depicted (black arrow). D. In operation field, we checks the round ligament on medial aspect of inguinal ligament (black arrow), and then find a cystic mass abutting the round ligament. E. Surgical specimen shows a gray brown mass with multiple variable sized cystic spaces, measuring 6.0×3.5×2.0 cm in size. F. Histologic specimen (H & E stain, ×40) shows multiple cystic spaces lined by flat mesothelial cells (black arrows), and on the immunohistochemical stain, the lining cells are positive in calretinin and D2-40 and negative in CD31, which indicated mesothelial origin.

Reference

1. Safioleas MC, Constantinos K, Michael S, Konstantinos G, Constantinos S, Alkiviadis K. Benign multicystic peritoneal mesothelioma: a case report and review of the literature. World J Gastroenterol. 2006; 12:5739–5742.

2. Choi YC, Choi HC, Chang TS, Kwon OJ, Kim BH. A Cystic Mesothelioma in the Right Colon: A case report. J Korean Surg Soc. 1998; 55:919–924.

3. Lim SC, Jeong YK, Lee MS, Kim YS, Park HJ, Choi SJ. Benign Cystic Mesothelioma. Korean J Pathol. 1997; 31:595–597.

4. Søreide JA, Søreide K, Körner H, Søiland H, Greve OJ, Gudlaugsson E. Benign peritoneal cystic mesothelioma. World J Surg. 2006; 30:560–566.

5. O'Neil JD, Ros PR, Storm BL, Buck JL, Wilkinson EJ. Cystic mesothelioma of the peritoneum. Radiology. 1989; 170:333–337.

6. Weiss SW, Tavassoli FA. Multicystic mesothelioma: an analysis of pathologic findings and biologic behavior in 37 cases. Am J Surg Pathol. 1988; 12:737–746.

7. Ryley DA, Moorman DW, Hecht JL, Alper MM. A mesothelial cyst of the round ligament presenting as an inguinal hernia after gonadotropin stimulation for in vitro fertilization. Fertil Steril. 2004; 82:944–946.

8. Kim SH, Seo IY, Cho HJ, Ku YM, Kim KH, Ahn CH, Kim JS, Yoo SJ, Lim KW, Kim JI. Hydrocele of the Canal of Nuck. J Korean Surg Soc. 2008; 74:396–398.

9. Walshe JM, Gal A, Murray DR, Premkumar A, Berman D, Hassan R. Malignant mesothelioma of the inguinal canal with an unusually long survival. Am J Clin Oncol. 2008; 31:306–307.