Abstract

We report the case of a 52-year-old patient. She was overweight and thought at first she was gaining weight. She presented to our department with a gradually increasing huge abdomen after 11 months of clinical evolution. She was not febrile and had normal vital signs on general assessment. No icterus or edema was present. On examination of the abdomen, there was widespread distension and a dull tone on percussion. The liver and spleen could not be felt. A large abdominal echogenic tumor filled the whole abdomen and pelvic cavity, according to the CT scan (Figure 1). Despite their rarity, peritoneal cystic mesothelioma and abdominal cystic lymphangioma should be suspected in the presence of such a pelvic mass. The huge cyst was confirmed on an abdomino-pelvic Magnetic Resonance Imaging (MRI) and measured 65 x 52 cm, supero-laterally displacing the liver and spleen. The kidneys were located in the back, and the bowel loops were located in the front. The ovaries were not visible. There was fluid in the peritoneal cavity (Figures 2 and 3). Tumor markers (CEA, a-fetoprotein and CA-125) were within normal limits. The hydatid cyst serology was positive.

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