ABSTRACT
INTRODUCTION: A 22-year-old female presented with a large abdominal mass that was revealed to be a primary retroperitoneal mucinous cystadenoma. PRESENTATION OF CASE: A 22-year-old female presented with a two day history of bloating, mid-epigastric pain, and nausea without vomiting. A CT scan of her abdomen/pelvis showed a large left retroperitoneal mass, possibly a mesenteric cyst. The patient underwent laparoscopic surgery for mass excision. Once the cystic mass was completely dissected laparoscopically, it was placed in a large endobag. The fluid was then aspirated while in the bag to decompress and then completely taken out through a port site. She was discharged the following day. Final pathology revealed a benign mucinous cystadenoma/cystadenofibroma of mesenteric origin. DISCUSSION: Primary retroperitoneal mucinous cysts are rare occurrences and benign mucinous cystadenomas are the rarest subtype. We use an innovative laparoscopic technique with complete excision of the cyst without spillage of content, thus preventing possible seeding in case of malignancy. CONCLUSION: There is some previous caution in using a laparoscopic approach for cystic masses due to potential seeding intra-operatively, in case of fluid spillage of a possible malignant neoplasm. We show through our case that it is possible to efficiently and safely use such an approach.
ABSTRACT
INTRODUCTION: We report this large neck mass, located behind the sternocleidomastoid (SCM) within the posterior cervical space and anterior to the prevertebral fascia. The mass is displacing the carotid sheath and its neurovascular contents medially. It extends almost the whole length of the SCM muscle all the way down to the lung apex. CASE PRESENTATION: A 30-year-old female patient presented to our clinic with a left anterior neck mass for a few months with dysphagia. The lipoma was excised completely along with level II to IV lymphadenectomy. A very small volume chyle leak was noted intraoperatively. The drain was removed 2 weeks later only to recur in one month. A new drain was placed by interventional radiology, and the drainage resolved completely. DISCUSSION: The patient with mild dysphagia had a lipoma large enough to push vital structures away from their normal anatomical position. Due to the difficult location and the size of the lipoma, a meticulous formal lateral neck dissection was required. A 3D imaging like CT or MRI would be helpful to preoperatively plan the dissection. Substernocleidomastoid neck lipoma in our case is a rare benign tumor that was challenging to excise.
