Symptomatic mesothelial cyst of the diaphragm misdiagnosed as a hepatic hydatid cyst

Mesothelial cysts of the diaphragm are uncommon congenital lesions that can be easily misdiagnosed due to their resemblance to other cystic formations, particularly hepatic hydatid cysts. We present the case of a 19-year-old male with no significant past medical history who complained of dull, heavy...

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Main Authors: Imen Ben Ismail, MD, Mouna Mlika, MD, Marwen Sghaier, MD, Mohamed Boujemaa, MD, Hakim Zenaidi, MD, Saber Rebii, MD, Ayoub Zoghlami, MD
Format: Article
Language:English
Published: Elsevier 2025-04-01
Series:Radiology Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S1930043325000500
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author Imen Ben Ismail, MD
Mouna Mlika, MD
Marwen Sghaier, MD
Mohamed Boujemaa, MD
Hakim Zenaidi, MD
Saber Rebii, MD
Ayoub Zoghlami, MD
author_facet Imen Ben Ismail, MD
Mouna Mlika, MD
Marwen Sghaier, MD
Mohamed Boujemaa, MD
Hakim Zenaidi, MD
Saber Rebii, MD
Ayoub Zoghlami, MD
author_sort Imen Ben Ismail, MD
collection DOAJ
description Mesothelial cysts of the diaphragm are uncommon congenital lesions that can be easily misdiagnosed due to their resemblance to other cystic formations, particularly hepatic hydatid cysts. We present the case of a 19-year-old male with no significant past medical history who complained of dull, heavy pain in the right costovertebral region persisting for several weeks. Initial laboratory tests were within normal limits. A contrast-enhanced CT scan revealed a retrohepatic cystic lesion measuring 45 mm, closely associated with the right hemidiaphragm and liver, which was suggestive of a hydatid cyst. However, negative hydatid serology ruled out this diagnosis, leading to the decision for surgical intervention. During surgery via a right subcostal approach, a 4 cm cystic lesion was found tightly adherent to the diaphragm. Complete excision of the cyst along with repair of the diaphragmatic defect was performed without complications. Histopathological examination confirmed the diagnosis of a mesothelial cyst of the diaphragm, a rare benign entity. The patient had an uneventful postoperative course and was discharged on the third day. Follow-up over one year showed no recurrence of symptoms or lesions. This case highlights the diagnostic challenges associated with mesothelial cysts and emphasizes the importance of surgical excision for definitive diagnosis and symptom relief.
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spelling doaj-art-f008a8369a3c4c5a924492e49d5614b12025-02-06T05:11:28ZengElsevierRadiology Case Reports1930-04332025-04-0120422182221Symptomatic mesothelial cyst of the diaphragm misdiagnosed as a hepatic hydatid cystImen Ben Ismail, MD0Mouna Mlika, MD1Marwen Sghaier, MD2Mohamed Boujemaa, MD3Hakim Zenaidi, MD4Saber Rebii, MD5Ayoub Zoghlami, MD6Department of General Surgery, Trauma and Burns Center, University of Tunis El Manar, Ben Arous, Tunisia; Corresponding author.University of Tunis El Manar, Department of Pathology, Trauma Center Ben Arous, Ben Arous, TunisiaUniversity of Tunis El Manar, Department of Pathology, Trauma Center Ben Arous, Ben Arous, TunisiaDepartment of General Surgery, Trauma and Burns Center, University of Tunis El Manar, Ben Arous, TunisiaDepartment of General Surgery, Trauma and Burns Center, University of Tunis El Manar, Ben Arous, TunisiaDepartment of General Surgery, Trauma and Burns Center, University of Tunis El Manar, Ben Arous, TunisiaDepartment of General Surgery, Trauma and Burns Center, University of Tunis El Manar, Ben Arous, TunisiaMesothelial cysts of the diaphragm are uncommon congenital lesions that can be easily misdiagnosed due to their resemblance to other cystic formations, particularly hepatic hydatid cysts. We present the case of a 19-year-old male with no significant past medical history who complained of dull, heavy pain in the right costovertebral region persisting for several weeks. Initial laboratory tests were within normal limits. A contrast-enhanced CT scan revealed a retrohepatic cystic lesion measuring 45 mm, closely associated with the right hemidiaphragm and liver, which was suggestive of a hydatid cyst. However, negative hydatid serology ruled out this diagnosis, leading to the decision for surgical intervention. During surgery via a right subcostal approach, a 4 cm cystic lesion was found tightly adherent to the diaphragm. Complete excision of the cyst along with repair of the diaphragmatic defect was performed without complications. Histopathological examination confirmed the diagnosis of a mesothelial cyst of the diaphragm, a rare benign entity. The patient had an uneventful postoperative course and was discharged on the third day. Follow-up over one year showed no recurrence of symptoms or lesions. This case highlights the diagnostic challenges associated with mesothelial cysts and emphasizes the importance of surgical excision for definitive diagnosis and symptom relief.http://www.sciencedirect.com/science/article/pii/S1930043325000500Diaphragmatic mesothelial cystComputed tomographySurgical excisionHydatid cyst
spellingShingle Imen Ben Ismail, MD
Mouna Mlika, MD
Marwen Sghaier, MD
Mohamed Boujemaa, MD
Hakim Zenaidi, MD
Saber Rebii, MD
Ayoub Zoghlami, MD
Symptomatic mesothelial cyst of the diaphragm misdiagnosed as a hepatic hydatid cyst
Radiology Case Reports
Diaphragmatic mesothelial cyst
Computed tomography
Surgical excision
Hydatid cyst
title Symptomatic mesothelial cyst of the diaphragm misdiagnosed as a hepatic hydatid cyst
title_full Symptomatic mesothelial cyst of the diaphragm misdiagnosed as a hepatic hydatid cyst
title_fullStr Symptomatic mesothelial cyst of the diaphragm misdiagnosed as a hepatic hydatid cyst
title_full_unstemmed Symptomatic mesothelial cyst of the diaphragm misdiagnosed as a hepatic hydatid cyst
title_short Symptomatic mesothelial cyst of the diaphragm misdiagnosed as a hepatic hydatid cyst
title_sort symptomatic mesothelial cyst of the diaphragm misdiagnosed as a hepatic hydatid cyst
topic Diaphragmatic mesothelial cyst
Computed tomography
Surgical excision
Hydatid cyst
url http://www.sciencedirect.com/science/article/pii/S1930043325000500
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