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A rare presentation and recurrence of a retroperitoneal Müllerian cyst in a male patient: A case report.
Int J Surg Case Rep 2019; 65:301-304IJ

Abstract

INTRODUCTION

The retroperitoneal Müllerian cysts are extremely rare lesions seen mostly in female patients but their occurrence in males is quite possible. Their exact etiology stills unknown, its histological and immunohistochemical characteristics may serve as an evidence that reflects its origin.

CASE PRESENTATION

We present a case of a resected retroperitoneal Müllerian cyst that reoccurred severely after 3 months of the first laparotomy in a male patient with a significant history of testicular teratocarcinoma. Due to the cyst's localization and its proximity to vital retroperitoneal structures, total surgical resection couldn't be made and the recurrence was minimized by post-operative oral chemotherapy.

DISCUSSION

The retroperitoneal Müllerian cyst is a benign cystadenoma that could be confused with other retroperitoneal lesions, which makes the pathological examination with the immunohistochemical study of the cyst's wall essential to make the diagnosis. The immunopositivity to Cytokeratin 7 and the immunonegativity to Cytokeratin 20 is a key feature that confirm the diagnosis whenever the retroperitoneal Müllerian cyst is suspected. Due to its high vascularity, we highly recommend the administration of chemotherapy which targets the proliferative cyst's cells.

CONCLUSION

The RMCs are rare benign lesions that tend to reoccur if total surgical resection isn't made, when the total resection couldn't be achieved, the-unspecific anti-mitotic drugs may help in minimizing the recurrence and improve the life quality of the patient.

Authors+Show Affiliations

Faculty of Medicine of Damascus University, Syria. Electronic address: antoine.naem@gmail.com.Faculty of Medicine of Damascus University, Syria. Electronic address: ammar.dlewati@outlook.com.Faculty of Medicine of Damascus University, Syria. Electronic address: maryam.alhimyar1@gmail.com.Faculty of Medicine of Damascus University, Syria; Department of General Surgery of Al-Assad University Hospital, Syria. Electronic address: draousta@hotmail.com.Faculty of Medicine of Damascus University, Syria; Department of General Surgery of Al-Assad University Hospital, Syria. Electronic address: drbayan@gmail.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31760217

Citation

Naem, Antoine, et al. "A Rare Presentation and Recurrence of a Retroperitoneal Müllerian Cyst in a Male Patient: a Case Report." International Journal of Surgery Case Reports, vol. 65, 2019, pp. 301-304.
Naem A, Dlewati A, Alhimyar M, et al. A rare presentation and recurrence of a retroperitoneal Müllerian cyst in a male patient: A case report. Int J Surg Case Rep. 2019;65:301-304.
Naem, A., Dlewati, A., Alhimyar, M., Ousta, M. A., & Alsaid, B. (2019). A rare presentation and recurrence of a retroperitoneal Müllerian cyst in a male patient: A case report. International Journal of Surgery Case Reports, 65, pp. 301-304. doi:10.1016/j.ijscr.2019.11.001.
Naem A, et al. A Rare Presentation and Recurrence of a Retroperitoneal Müllerian Cyst in a Male Patient: a Case Report. Int J Surg Case Rep. 2019;65:301-304. PubMed PMID: 31760217.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A rare presentation and recurrence of a retroperitoneal Müllerian cyst in a male patient: A case report. AU - Naem,Antoine, AU - Dlewati,Ammar, AU - Alhimyar,Maryam, AU - Ousta,Mohamad Ali, AU - Alsaid,Bayan, Y1 - 2019/11/12/ PY - 2019/07/15/received PY - 2019/10/29/revised PY - 2019/11/01/accepted PY - 2019/11/25/pubmed PY - 2019/11/25/medline PY - 2019/11/25/entrez KW - Case report KW - Cystadenoma KW - Müllerian cyst KW - Paramesonephric cyst KW - Retroperitoneal SP - 301 EP - 304 JF - International journal of surgery case reports JO - Int J Surg Case Rep VL - 65 N2 - INTRODUCTION: The retroperitoneal Müllerian cysts are extremely rare lesions seen mostly in female patients but their occurrence in males is quite possible. Their exact etiology stills unknown, its histological and immunohistochemical characteristics may serve as an evidence that reflects its origin. CASE PRESENTATION: We present a case of a resected retroperitoneal Müllerian cyst that reoccurred severely after 3 months of the first laparotomy in a male patient with a significant history of testicular teratocarcinoma. Due to the cyst's localization and its proximity to vital retroperitoneal structures, total surgical resection couldn't be made and the recurrence was minimized by post-operative oral chemotherapy. DISCUSSION: The retroperitoneal Müllerian cyst is a benign cystadenoma that could be confused with other retroperitoneal lesions, which makes the pathological examination with the immunohistochemical study of the cyst's wall essential to make the diagnosis. The immunopositivity to Cytokeratin 7 and the immunonegativity to Cytokeratin 20 is a key feature that confirm the diagnosis whenever the retroperitoneal Müllerian cyst is suspected. Due to its high vascularity, we highly recommend the administration of chemotherapy which targets the proliferative cyst's cells. CONCLUSION: The RMCs are rare benign lesions that tend to reoccur if total surgical resection isn't made, when the total resection couldn't be achieved, the-unspecific anti-mitotic drugs may help in minimizing the recurrence and improve the life quality of the patient. SN - 2210-2612 UR - https://www.unboundmedicine.com/medline/citation/31760217/A_rare_presentation_and_recurrence_of_a_retroperitoneal_Müllerian_cyst_in_a_male_patient:_A_case_report L2 - https://linkinghub.elsevier.com/retrieve/pii/S2210-2612(19)30631-5 DB - PRIME DP - Unbound Medicine ER -