Giant lymphatic cyst of omentum: a case report
© Kumar et al; licensee BioMed Central Ltd. 2009
Received: 30 September 2008
Accepted: 07 January 2009
Published: 07 January 2009
Omental cysts are rare abdominal lesions and are difficult to diagnose. Mostly they are detected incidentally during imaging studies performed for unrelated reasons.
Presentation can be both acute and chronic. Acute presentations are usually due to complication in cyst. Imaging is helpful in excluding other causes of lump abdomen.
We encountered a case of giant lymphatic cyst presenting with abdominal swelling, clinically mimicking huge ovarian cyst.
The goal of surgical therapy is complete excision of the cyst, and Omental cysts can be removed without endangering the adjacent bowel.
Omental cysts are rare and are mostly derived from lymphatic tissue. They are present in the lesser or greater omentum and are lined by endothelium. Omental cyst occurs in all age groups, but most often presents in children and young adults . Gairdner published the first report of an omental cyst in 1852 . Omental cysts are thought to represent benign proliferations of ectopic lymphatics that lack communication with the normal lymphatic system. Other etiologic theories include (1) failure of the embryonic lymph channels to join the venous system, (2) failure of the leaves of the mesentery to fuse, (3) trauma, (4) neoplasm, and (5) degeneration of lymph nodes . Omental cysts can be simple or multiple, unilocular or multilocular, and they may contain hemorrhagic, serous, chylous, or infected fluid. Omental cysts can be discovered as an incidental finding during laparotomy for another condition, or they can manifest as a chronic or acute abdomen. Chronic symptoms include progressive abdominal distension and pain. The mass may be huge, simulating ascites . The most common mode of acute presentation is that of a small-bowel obstruction, which may be associated with intestinal volvulus  or infarction, hemorrhage into the cyst, infection, rupture, cystic torsion, and obstruction of the urinary and biliary tract. The imaging modality of choice is abdominal ultrasonography. Ultrasound demonstrates fluid-filled cystic structure, commonly with thin internal septations and sometimes with internal echoes from debris, hemorrhage, or infection. These can be confused with large ovarian cysts in females. Abdominal computed tomography (CT) scanning adds little additional information, although it can reveal that the cyst is not arising from another organ such as the kidney, pancreas, or ovary. The goal of surgical therapy is complete excision of the cyst . Omental cysts can be removed without endangering the adjacent bowel. Prognosis is excellent.
Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.
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