A case of cystic hemangioma in mesentery

Abstract

A nine-year-old, otherwise healthy girl presented with abdominal pain. On exam, there was a palpable cystic tumor in the left abdomen. According to imaging examinations, we tentatively diagnosed the tumor as lymphangioma of mesentery with bleeding. We planned to perform laparoscopic surgery to remove the tumor. On laparoscopy, cyst aspiration was performed to reduce the volume of the cysts, and the aspirated fluid was found to contain red blood cells. Due to technical difficulties, laparoscopic surgery was converted to open surgery. RBCs were detected in the cyst fluid at the sigmoid colon and intestinal mesentery. Resection of the cystic tumor and sigmoidectomy were performed. On pathologic examination of the tumor, there were multiple cysts but there was no cavernous part. The largest cyst was 6 × 5 × 3 cm. Simple squamous epithelium cells were found along parts of the inner lining of enlarged luminal cysts. On immunohistochemical staining, the tumor was positive for CD31 and CD34, and negative on D2-40 antibody staining. Therefore, we diagnosed this specimen as hemangioma with giant cysts at the mesentery. We conclude that bleeding into cysts of a hemangioma of mesentery might lead to the development of giant cysts and, in turn, a cystic tumor in the abdomen.