Case 146: Benign Multicystic Mesothelioma

Abstract

History A 27-year-old gravida 1, para 1 woman who had a history of pelvic inflammatory disease presented to the emergency department with lower abdominal pain, nausea, vomiting, and chills. She began menstruating the night before presentation and reported an acute exacerbation of her chronic abdominal pain, which typically worsened with her menses. Her surgical history included one caesarean section and laparoscopic excision of a tubo-ovarian abscess. She was afebrile. Physical examination revealed mild diffuse abdominal tenderness and tenderness of the cervix. Laboratory findings revealed a white blood cell count of 17 000 cells per cubic millimeter. (A normal white blood cell count is between 4800 and 11 000 cells per cubic millimeter.) Ultrasonography (US) of the pelvis was performed. A computed tomographic (CT) examination of the abdomen and pelvis was subsequently performed after intravenous administration of 125 mL of iohexol (Omnipaque; Amersham Health, Princeton, NJ). We acquired 5-mm axial sections and performed 3-mm coronal reconstruction.