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Special Feature
March 2001

Radiological Case of the Month

Arch Pediatr Adolesc Med. 2001;155(3):414. doi:10.1001/archpedi.155.3.413

Figure 1. An abdominal computed tomographic scan revealed a large cystic mass displacing the bowel superiorly.

Figure 2. Surgically resected specimen revealing a thin-walled, bilobed cyst containing clear amber fluid.

Based on the findings of the abdominal computed tomographic scan, surgery was planned. A large, bilobed mesenteric cyst was found, involving the ileum. The cyst was removed, and segmental intestinal resection with primary anastomosis was necessary. The pathologist identified the cyst as a cystic lymphangioma of the mesentery.

Mesenteric cysts are rare, benign, intra-abdominal tumors, and fewer than 1000 cases are reported since Benevieni's original description in 1505.1,2 One third of reported cases involve children younger than age 10 years.3,4 The incidence of mesenteric cysts in children ranges from 1 per 11 250 to 1 per 34 000 hospitalizations.2,5 Most are considered congenital in origin. Proposed mechanisms of development include sequestration or obstruction of lymphatic vessels and ectopic lymphatic tissue.6-8 Mesenteric cysts may arise from trauma, infection, or neoplasm.6 They are grouped with omental and retroperitoneal cysts because of a common origin and histologic features.9