Mesenteric cysts - Toward less confusion?

Objective: Mesenteric cysts are rare intra-abdominal masses generally omite d or briefly reported in textbooks, Their rarity had fostered a lack of inf ormation and difficulty in classification. The goal of the study is to pres ent a simple, comprehensive, and reproducible classification of mesenteric cysts. Methods: A large review of the literature with particular attention to recent series was performed in order to identify and characterize the di fferent groups of mesenteric cysts. Results: Although cysts of lymphatic an d mesothelial origin are those most frequently encountered, they were confo unded or omitted in previous classifications. However, their distinction is important because their incidence and mode of presentation differ. Lymphan giomas predominate in male children, may cause acute abdominal pain, and fr equently require resection of adjacent structures. In contrast, cysts of me sothelial origin such as benign cystic mesothelioma are seen more frequentl y in young and middle-aged women, usually present with more indolent sympto ms, and often recurs. Conclusions: A new classification based essentially o n histopathological features should include the 6 following groups: (1) cys ts of lymphatic origin (simple lymphatic cyst and lymphangioma); (2) cysts of mesothelial origin (simple mesothelial cyst, benign cystic mesothelioma, and malignant cystic mesothelioma); (3) cysts of enteric origin (enteric c yst and enteric duplication cyst); (4) cysts of urogenital origin; (5) matu re cystic teratoma (dermoid cysts), and (6) pseudocysts (infectious and tra umatic cysts). Copyright (C) 2000 S. Karger AG. Basel.