Case:
A 27-yr-old African woman presented with a 2 year history of an
abdominal mass that waned in size. It was associated with abdominal
bloatedness, postpandrial vomiting, lethargy and difficulty in
performing her daily activities. On examination she was clinically well
but exhausted from the weight of the abdominal mass. Physical
examination revealed a large circumscribed mobile abdominal mass of
~ 20cm d, extending across the upper abdomen that did
not move with respiration. There were no hepatosplenomegaly nor ascites.
Ultrasonography suggested a retroperitoneal mesenteric mass with no
lymphadenopathy. Blood tests were within the normal range. Laparotomy
revealed a circumscribed retroperitoneal mass in the stomach bed
protruding into the lesser sac and adherent to the transverse colon,
mesocolon and posterior surface of stomach with dilated gastroepiploic
veins. There was mucinous exudate from the cystic mass but no evidence
of metastases. A difficult mobilization of the mass allowed entry into
the lesser sac. There was no cleavage plane between the posterior
stomach wall and thus the posterior stomach wall was excised en bloc
with the mass (figure 1). The stomach defect was closed and the
mesenteric defect closed to prevent an internal hernia. Postoperative
recovery was unremarkable. Histology confirmed a benign cystic teratoma
(figure 2).