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Gynecology
Diagnosis
Ovary
Nonneoplastic Ovarian Lesions
Peritoneal Inclusion Cysts
Peritoneal Inclusion Cysts
Marc S. Tubay, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        TERMINOLOGY

        • Abbreviations

          • Peritoneal inclusion cyst (PIC)

        • Synonyms

          • Peritoneal pseudocyst
          • Inflammatory cysts of pelvic peritoneum
          • Multilocular inclusion cyst
          • Entrapped ovarian cyst/syndrome
          • Benign (multi) cystic peritoneal mesotheliomas
          • Postoperative peritoneal cysts
          • Benign papillary peritoneal cystosis

        • Definitions

          • Benign cystic pelvic masses secondary to nonneoplastic reactive mesothelial proliferation
          • Occur almost exclusively in premenopausal females who have active ovaries and pelvic adhesions with impaired absorption of peritoneal fluid

        IMAGING

        • General Features

          • Fluoroscopic Findings

            • CT Findings

              • MR Findings

                • Ultrasonographic Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Gross Pathologic & Surgical Features

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Ackerman S et al: Ovarian cystic lesions: a current approach to diagnosis and management. Radiol Clin North Am. 51(6):1067-85, 2013
                                        2. Bharwani N et al: Peritoneal pseudocysts: aetiology, imaging appearances, and natural history. Clin Radiol. 68(8):828-36, 2013
                                        3. Patel MD et al: Managing incidental findings on abdominal and pelvic CT and MRI, part 1: white paper of the ACR Incidental Findings Committee II on adnexal findings. J Am Coll Radiol. 10(9):675-81, 2013
                                        4. Ross EK et al: Incidental ovarian cysts: When to reassure, when to reassess, when to refer. Cleve Clin J Med. 80(8):503-14, 2013
                                        5. Veldhuis WB et al: Peritoneal inclusion cysts: clinical characteristics and imaging features. Eur Radiol. 23(4):1167-74, 2013
                                        6. Ho-Fung V et al: Peritoneal inclusion cyst. Pediatr Emerg Care. 27(5):430-1, 2011
                                        7. Saxena AK et al: Pre-pubertal presentation of peritoneal inclusion cyst associated with congenital lower extremity venous valve agenesis. JSLS. 15(2):264-7, 2011
                                        8. Heilbrun ME et al: Imaging of benign adnexal masses: characteristic presentations on ultrasound, computed tomography, and magnetic resonance imaging. Top Magn Reson Imaging. 21(4):213-23, 2010
                                        9. Lim HK et al: Sclerotherapy of peritoneal inclusion cysts: a long-term evaluation study. Abdom Imaging. 35(4):431-6, 2010
                                        10. Moyle PL et al: Nonovarian cystic lesions of the pelvis. Radiographics. 30(4):921-38, 2010
                                        11. Paspulati RM et al: Imaging of complications following gynecologic surgery. Radiographics. 30(3):625-42, 2010
                                        12. Amesse LS et al: Peritoneal inclusion cysts in adolescent females: a clinicopathological characterization of four cases. J Pediatr Adolesc Gynecol. 22(1):41-8, 2009
                                        13. Heilbrun ME et al: Imaging of benign adnexal masses: characteristic presentations on ultrasound, computed tomography, and magnetic resonance imaging. Clin Obstet Gynecol. 52(1):21-39, 2009
                                        14. Vallerie AM et al: Peritoneal inclusion cysts: a review. Obstet Gynecol Surv. 64(5):321-34, 2009
                                        15. Advincula AP et al: Acute urinary retention caused by a large peritoneal inclusion cyst: a case report. J Reprod Med. 51(3):202-4, 2006
                                        16. Chang WC et al: CT and MRI of adnexal masses in patients with primary nonovarian malignancy. AJR Am J Roentgenol. 186(4):1039-45, 2006
                                        17. Durak E et al: Multilocular peritoneal inclusion cyst. Surgery. 137(5):580, 2005
                                        18. Guerriero S et al: Role of transvaginal sonography in the diagnosis of peritoneal inclusion cysts. J Ultrasound Med. 23(9):1193-200, 2004
                                        19. Savelli L et al: Transvaginal sonographic appearance of peritoneal pseudocysts. Ultrasound Obstet Gynecol. 23(3):284-8, 2004
                                        20. Toprak U et al: Sonographic, CT, and MRI findings of endometrial stromal sarcoma located in the myometrium and associated with peritoneal inclusion cyst. AJR Am J Roentgenol. 182(6):1531-3, 2004
                                        21. Adolph AJ et al: Benign multicystic mesothelioma: a case report. J Obstet Gynaecol Can. 24(3):246-7, 2002
                                        22. Jeong JY et al: Sclerotherapy of peritoneal inclusion cysts: preliminary results in seven patients. Korean J Radiol. 2(3):164-70, 2001
                                        23. Omeroglu A et al: Multilocular peritoneal inclusion cyst (benign cystic mesothelioma). Arch Pathol Lab Med. 125(8):1123-4, 2001
                                        24. Brustmann H: Multilocular peritoneal inclusion cyst with extensive xanthogranulomatous stromal changes: a differential diagnosis of cystic pelvic tumors in women. Ann Diagn Pathol. 4(5):308-10, 2000
                                        25. Jain KA: Imaging of peritoneal inclusion cysts. AJR Am J Roentgenol. 174(6):1559-63, 2000
                                        26. Nozawa S et al: Gonadotropin-releasing hormone analogue therapy for peritoneal inclusion cysts after gynecological surgery. J Obstet Gynaecol Res. 26(6):389-93, 2000
                                        27. Kim JS et al: Peritoneal inclusion cysts and their relationship to the ovaries: evaluation with sonography. Radiology. 204(2):481-4, 1997
                                        28. Sohaey R et al: Sonographic diagnosis of peritoneal inclusion cysts. J Ultrasound Med. 14(12):913-7, 1995
                                        29. Kurachi H et al: Imaging of peritoneal pseudocysts: value of MR imaging compared with sonography and CT. AJR Am J Roentgenol. 161(3):589-91, 1993
                                        30. Hoffer FA et al: Peritoneal inclusion cysts: ovarian fluid in peritoneal adhesions. Radiology. 169(1):189-91, 1988
                                        31. McFadden DE et al: Peritoneal inclusion cysts with mural mesothelial proliferation. A clinicopathological analysis of six cases. Am J Surg Pathol. 10(12):844-54, 1986
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              TERMINOLOGY

                                              • Abbreviations

                                                • Peritoneal inclusion cyst (PIC)

                                              • Synonyms

                                                • Peritoneal pseudocyst
                                                • Inflammatory cysts of pelvic peritoneum
                                                • Multilocular inclusion cyst
                                                • Entrapped ovarian cyst/syndrome
                                                • Benign (multi) cystic peritoneal mesotheliomas
                                                • Postoperative peritoneal cysts
                                                • Benign papillary peritoneal cystosis

                                              • Definitions

                                                • Benign cystic pelvic masses secondary to nonneoplastic reactive mesothelial proliferation
                                                • Occur almost exclusively in premenopausal females who have active ovaries and pelvic adhesions with impaired absorption of peritoneal fluid

                                              IMAGING

                                              • General Features

                                                • Fluoroscopic Findings

                                                  • CT Findings

                                                    • MR Findings

                                                      • Ultrasonographic Findings

                                                        • Imaging Recommendations

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Gross Pathologic & Surgical Features

                                                                • Microscopic Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Ackerman S et al: Ovarian cystic lesions: a current approach to diagnosis and management. Radiol Clin North Am. 51(6):1067-85, 2013
                                                                              2. Bharwani N et al: Peritoneal pseudocysts: aetiology, imaging appearances, and natural history. Clin Radiol. 68(8):828-36, 2013
                                                                              3. Patel MD et al: Managing incidental findings on abdominal and pelvic CT and MRI, part 1: white paper of the ACR Incidental Findings Committee II on adnexal findings. J Am Coll Radiol. 10(9):675-81, 2013
                                                                              4. Ross EK et al: Incidental ovarian cysts: When to reassure, when to reassess, when to refer. Cleve Clin J Med. 80(8):503-14, 2013
                                                                              5. Veldhuis WB et al: Peritoneal inclusion cysts: clinical characteristics and imaging features. Eur Radiol. 23(4):1167-74, 2013
                                                                              6. Ho-Fung V et al: Peritoneal inclusion cyst. Pediatr Emerg Care. 27(5):430-1, 2011
                                                                              7. Saxena AK et al: Pre-pubertal presentation of peritoneal inclusion cyst associated with congenital lower extremity venous valve agenesis. JSLS. 15(2):264-7, 2011
                                                                              8. Heilbrun ME et al: Imaging of benign adnexal masses: characteristic presentations on ultrasound, computed tomography, and magnetic resonance imaging. Top Magn Reson Imaging. 21(4):213-23, 2010
                                                                              9. Lim HK et al: Sclerotherapy of peritoneal inclusion cysts: a long-term evaluation study. Abdom Imaging. 35(4):431-6, 2010
                                                                              10. Moyle PL et al: Nonovarian cystic lesions of the pelvis. Radiographics. 30(4):921-38, 2010
                                                                              11. Paspulati RM et al: Imaging of complications following gynecologic surgery. Radiographics. 30(3):625-42, 2010
                                                                              12. Amesse LS et al: Peritoneal inclusion cysts in adolescent females: a clinicopathological characterization of four cases. J Pediatr Adolesc Gynecol. 22(1):41-8, 2009
                                                                              13. Heilbrun ME et al: Imaging of benign adnexal masses: characteristic presentations on ultrasound, computed tomography, and magnetic resonance imaging. Clin Obstet Gynecol. 52(1):21-39, 2009
                                                                              14. Vallerie AM et al: Peritoneal inclusion cysts: a review. Obstet Gynecol Surv. 64(5):321-34, 2009
                                                                              15. Advincula AP et al: Acute urinary retention caused by a large peritoneal inclusion cyst: a case report. J Reprod Med. 51(3):202-4, 2006
                                                                              16. Chang WC et al: CT and MRI of adnexal masses in patients with primary nonovarian malignancy. AJR Am J Roentgenol. 186(4):1039-45, 2006
                                                                              17. Durak E et al: Multilocular peritoneal inclusion cyst. Surgery. 137(5):580, 2005
                                                                              18. Guerriero S et al: Role of transvaginal sonography in the diagnosis of peritoneal inclusion cysts. J Ultrasound Med. 23(9):1193-200, 2004
                                                                              19. Savelli L et al: Transvaginal sonographic appearance of peritoneal pseudocysts. Ultrasound Obstet Gynecol. 23(3):284-8, 2004
                                                                              20. Toprak U et al: Sonographic, CT, and MRI findings of endometrial stromal sarcoma located in the myometrium and associated with peritoneal inclusion cyst. AJR Am J Roentgenol. 182(6):1531-3, 2004
                                                                              21. Adolph AJ et al: Benign multicystic mesothelioma: a case report. J Obstet Gynaecol Can. 24(3):246-7, 2002
                                                                              22. Jeong JY et al: Sclerotherapy of peritoneal inclusion cysts: preliminary results in seven patients. Korean J Radiol. 2(3):164-70, 2001
                                                                              23. Omeroglu A et al: Multilocular peritoneal inclusion cyst (benign cystic mesothelioma). Arch Pathol Lab Med. 125(8):1123-4, 2001
                                                                              24. Brustmann H: Multilocular peritoneal inclusion cyst with extensive xanthogranulomatous stromal changes: a differential diagnosis of cystic pelvic tumors in women. Ann Diagn Pathol. 4(5):308-10, 2000
                                                                              25. Jain KA: Imaging of peritoneal inclusion cysts. AJR Am J Roentgenol. 174(6):1559-63, 2000
                                                                              26. Nozawa S et al: Gonadotropin-releasing hormone analogue therapy for peritoneal inclusion cysts after gynecological surgery. J Obstet Gynaecol Res. 26(6):389-93, 2000
                                                                              27. Kim JS et al: Peritoneal inclusion cysts and their relationship to the ovaries: evaluation with sonography. Radiology. 204(2):481-4, 1997
                                                                              28. Sohaey R et al: Sonographic diagnosis of peritoneal inclusion cysts. J Ultrasound Med. 14(12):913-7, 1995
                                                                              29. Kurachi H et al: Imaging of peritoneal pseudocysts: value of MR imaging compared with sonography and CT. AJR Am J Roentgenol. 161(3):589-91, 1993
                                                                              30. Hoffer FA et al: Peritoneal inclusion cysts: ovarian fluid in peritoneal adhesions. Radiology. 169(1):189-91, 1988
                                                                              31. McFadden DE et al: Peritoneal inclusion cysts with mural mesothelial proliferation. A clinicopathological analysis of six cases. Am J Surg Pathol. 10(12):844-54, 1986
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