We describe the clinical and pathological features of a case of mesent
eric cyst which was incompletely excised, recurred over several years,
and eventually underwent malignant transformation. A review of the li
terature shows how mesenteric cysts are still poorly understood clinic
al entities, often difficult to classify even after histopathological
evaluation. This is the first reported case of transformation of a ben
ign mesenteric cyst into adenocarcinoma. Complete excision of all mese
nteric cysts should be carried out, to prevent recurrence and possible
malignant transformation.