title: Peritoneal inclusion cysts in adolescent females: a clinicopathological characterization of four cases.
abstract: OBJECTIVE
  To identify adolescent females with peritoneal inclusion cysts and characterize the clinicopathologic features.
  
  
  METHODS
  Observational and chart review along with immunohistochemical studies.
  
  
  METHODS
  University pediatric and adolescent clinic.
  
  
  RESULTS
  Medical records of all subjects, ages 10-18 years, diagnosed with peritoneal inclusion cysts over a 4-year period were retrospectively reviewed. Four patients, ages 11-16 years (mean, 13.8 yrs) were identified. Pelvic pain was the most common presenting symptom. No palpable abdominal or pelvic masses were detected. However, pelvic lesions were identified by radiographic studies in three of the four patients. Half experienced tenderness on examination. With one exception, all had a prior history of abdominal surgery. Twelve peritoneal inclusion cysts were identified, ranging from 1 cm to 7 cm in greatest diameter. Most were uninvolved in coexisting adhesions and non-adherent to pelvic or abdominal structures. Each had a well-defined pedicle connection to the peritoneum. No associated complications were identified. Their appearance conformed to established morphologic and immunohistochemical criteria, although accompanying mesothelial-associated changes occasionally reported in other populations were not detected. No recurrences were recorded.
  
  
  CONCLUSIONS
  Young female adolescents with peritoneal inclusion cysts share presenting symptoms and histories of previous abdominal surgery similar to those reported in older female adolescents and adults. A palpable mass may not be detected on examination, but can often be identified using radiographic studies. Our cases differ from previous reports by smaller cyst size, presence of a pedicle, and uncomplicated gross and microscopic appearances. Additionally, local recurrences and associated complications occurred less than reported in adults.
authors.affiliation: Section of Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology, Wright State University Boonshoft School of Medicine, Dayton, Ohio 45409-2793, USA. lsamesse@mvh.org
authors.forename: Lawrence S
authors.initials: LS
authors.lastname: Amesse
authors.forename: Paul
authors.initials: P
authors.lastname: Gibbs
authors.forename: John
authors.initials: J
authors.lastname: Hardy
authors.forename: Kimberly R
authors.initials: KR
authors.lastname: Jones
authors.forename: Teresa
authors.initials: T
authors.lastname: Pfaff-Amesse
mesh_terms: D000293:Adolescent; D002648:Child; D003560:Cysts / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D004312:Douglas' Pouch / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D018301:Neoplasms, Mesothelial / Q000000981:diagnostic imaging / Q000473:pathology*; D010048:Ovarian Cysts / Q000150:complications / Q000473:pathology; D010532:Peritoneal Diseases / Q000000981:diagnostic imaging / Q000473:pathology; D000267:Tissue Adhesions / Q000150:complications*; D014463:Ultrasonography