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EP1115 Parametrium tumor (lymphocyst) after adnextomy on the same side: case report
  1. AZ Tolkos1,
  2. T Theodoridis1,
  3. EG Klonos1,
  4. L Zepeiridis2 and
  5. GF Grimbizis2
  1. 1Aristotele University of Thessaloniki
  2. 2Aristotle University of Thessaloniki, Thessaloniki, Greece


Introduction/Background Lymphocyst is rare disease,and mainly reported in some case reports.Occurrence of lymphocyst has been described in relation to surgery in a wide variety of other areas including the mediastinum, axila, neck, aorta and peripheral vasculature.The pathophysiology is based in insufficient lymphatic stasis with gross postoperative lymph leakage which cannot be absorbed in the peritoneum.

Methodology A 46-year-old woman, was admitted to the emergency department, with abdominal pain. The pain was located to the abdomen.Her vital signs were non-reassuring.A mass was palpated arising from the pelvis on the left side.Her medical history included aleft oophorectomy due to a cyst form about 13 centimeters. The tumor makers were within normal range. Moreover, an abdominal MRI scan was carried out, that described the presence of a cyst measured 10 x 8 cm in the left parametrium.She was scheduled for surgery a few days later. The cyst was above the division of iliac vessels cling to left ureter and left uterine artery. The operation was uncomplicated and her post-operative period was uneventful. Histology showed lymphocyst, without any signs of malignancy

Fifteen days later after a routine check, an entrenched retention of fluid was found in the pouch of Douglas 5 cm which was aspirated by needle under guidance of Computed Tomografy. The cytological examination showed lymphpocytes as an inflammatory response.

Results In 5 to 10% of patients, the lymphocyst become symptomatic, manifesting fever, pain, constipation, prolonged ileus, urinary frequency, obstructive uropathy, leg edema, erythema of overlying skin or deep vein thrombosis.

Conclusion Most lymphocysts are asymptomatic and are only diagnosed accidentally. A symptomatic lymphocyst may compress adjacent structures, for example, ureter, the urinary bladder, rectum or the iliac vein. Pelvic lymphocysts may be treated conservatively or surgically, by laparoscopy or laparotomy as well as using the methods of intervention radiology.

Disclosure Nothing to disclose

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