A Case of Mucinous Cystadenoma of the Mesentry Associated with Increased Serum Levels of CEA and CA19-9

Abstract

A 39-year-old woman presented with lower abdominal pain. An abdominal contrast-enhanced CT scan showed a 7-cm unilocular cystic lesion in the right lateral abdominal region, with the enhanced cystic wall. We diagnosed the case as cystic tumor arisen in the mesentery. Blood examinations revealed increased levels of CEA and CA19-9. As a possibility of continuity with the intestine could not be ruled out, laparoscopic ileectomy was performed. It revealed that there were no points of contact between the tumor and the uterus/bilateral appendages of uterus. No communication between the cystic wall and the intestine was also demonstrated by pathologic study. The inside of the cystic wall was composed of short monolayer columnar epithelia associated with moderate degree of nuclear atypia. Immunohistology resulted in the tumor cells to be positive for CK7 and CK20 and negative for CDX2. We finally diagnosed the case as mucinous cystadenoma arising in the ileocecal mesentery. Furthermore, CEA and CA19-9 were positive. Her postoperative course was uneventful, her symptoms disappeared, and the tumor marker levels declined within the normal ranges. No recurrence has occurred as of 6 months after the operation. We present this case of mucinous cystadenoma arisen in the mesentery due to its rarity.