Retroperitoneal benign cystic peritoneal mesothelioma

Abstract

A 53-YEAR-OLD,OTHERWISEHEALTHYWOMAN was involved in a motor vehicle accident when an automobile crashed through the window of her workplace and struck her. She was brought to an outside hospital and her only complaint was left ankle pain associated with an open left ankle fracture. Evaluation for associated injuries included an abdominal computed tomography scan that demonstrated a large cystic lesion apparently arising from the retroperitoneum (Fig 1). Other than a possible increase in abdominal girth over the previous several months, the patient denied abdominal complaints. On review of systems, she denied nausea, vomiting, constipation, or constitutional symptoms. Past medical history was unremarkable, and there was no history of previous abdominal surgery or gynecologic disorders. Family history was notable only for a renal cell carcinoma in her maternal grandmother. Physical examination was remarkable only for a soft, moderately distended abdomen. There were no discretely palpable masses or peritoneal signs. The patient underwent open reduction and fixation of her ankle fracture. Subsequent work-up of the cystic abdominal mass included endoscopic retrograde cholangiopancreatography, because there was some concern for the possibility of a traumatic pancreatic injury with resultant pseudocyst formation. The result of study was unremarkable. After discharge, the patient was referred to our institution for further evaluation and treatment. After the pertinent history and radiologic study results were reviewed, the patient was scheduled for exploratory laparotomy with resection of the large