M. Farina, R.El Gueddari, Y. Hanfaoui, Y. Bousbaa, A. Lachgar, K. Nouni, H. Elkacemi, T. Kebdani, K. Hassouni
Journal: Medpeer Publisher
ISSN: 3066-2737
Volume: 3
Issue: 10
Date of Publication: 2026/10/11
Introduction: Peritoneal inclusion cysts are benign fluid collections trapped between intraperitoneal adhesions, usually after abdominopelvic surgery in women of reproductive age. In patients treated for cancer, they may mimic a postoperative complication or recurrent disease.
Case presentation: A 61-year-old postmenopausal woman underwent total hysterectomy for grade 1 endometrioid adenocarcinoma with deep myometrial invasion and a p53-abnormal molecular profile, followed by bilateral salpingo-oophorectomy with pelvic lymph node dissection. Approximately three months after surgery, a large pelvic fluid collection was incidentally detected on the computed tomography simulation performed for radiotherapy planning. Magnetic resonance imaging showed a thin-walled, septated cystic lesion conforming to the pelvic cavity, without wall or septal enhancement, mural nodules, solid components, or diffusion restriction. The collection recurred repeatedly and required three image-guided percutaneous drainages; the final drainage yielded approximately 1.5 L of clear serous fluid, with negative cytology and sterile cultures. After recurrence had been excluded, the planned adjuvant chemotherapy and pelvic radiochemotherapy were delivered.
Discussion: Magnetic resonance imaging was essential for characterizing the lesion and excluding malignant recurrence, whereas drainage provided only temporary relief.
Conclusion: Peritoneal inclusion cyst should be considered in the differential diagnosis of a new pelvic fluid collection after surgery for gynecological cancer, including in postmenopausal women. Recognition of its imaging features may avoid unnecessary surgery and allow oncological treatment to proceed without delay.
Endometrial Neoplasms, Magnetic Resonance Imaging, Postoperative Complications, Drainage.
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