MELANOSIS PERITONEI ASSOCIATED WITH ENTERIC DUPLICATION CYST - A CASE-REPORT

Melanosis peritonei is extremely rare, and only five cases have been r eported in the English literature, four in association with ovarian de rmoid cysts, and one with a peritoneal cyst. We describe an additional case occurring in a girl two years of age who also had an enteric cys t. This is the first reported case of melanosis peritonei not associat ed with an ovarian teratoma, but with an enteric duplication cyst. Mel anophages were present focally in the submucosa, superficial muscle la yer, and ulcer bases of the cyst and extensively as small nodules on t he peritoneal surface and in the omentum. The tendency of perivascular nodular aggregation of melanophages favors a hematogenous (or lymphat ic) spread rather than implantation. Although clear evidence of melano cytic aggregation is lacking, are speculate that the melanin originate d from the esophageal-like squamous mucosa of the cyst.