Case Discussion
Case Takeaways
Case Summary
This is a case of a 9-year-old premenarchal female with a right lower quadrant abdominal cyst. The patient initially presented with pain and underwent multiple ultrasounds, which showed interval growth of the cyst. Labs were sent to rule out malignancy, including beta-HCG, AFP, CA19-9, and CA125, all of which were normal. The differential diagnosis included paratubal, ovarian, mesenteric, and enteric duplication cysts. The patient was consented for laparoscopic cyst resection, with the working diagnosis being a paratubal cyst. The surgery revealed a urachal cyst, which was successfully removed.
Left Preperitoneal Cyst Excision
The team performed a surgical procedure to remove a preperitoneal cyst located on the left side, separate from the bladder and uterus. They discussed the possibility of the cyst being a lymphatic malformation or potentially related to an umbilical artery remnant, though they were unsure of the exact cause. The cyst was thick-walled and adherent to surrounding tissue, requiring careful dissection. After removing the cyst and confirming normal creatinine levels in aspirated fluid, they considered but ruled out a possible connection to the bladder.
Off-Midline Urechal Cyst Case Discussion
The team discussed an off-midline urechal cyst in a pediatric patient. The pathology findings confirmed the diagnosis through immunohistochemistry and described the cyst's characteristics. The team debated the rarity of off-midline urechal cysts and considered potential differential diagnoses. They agreed that while this case was likely an incidental finding, it was important to keep an open mind about the location of such cysts in pediatric surgery.