Mesenteric Mass Misnomer: Unraveling the Differential

Abstract

Introduction: Intra-abdominal cystic collections often masquerade as neoplastic or mesenteric masses in patients. Their infected variants are rare and may closely mimic GIST[ gastrointestinal stromal tumor], mesenteric cysts, or lymphoma on imaging. This highlights such a diagnostic dilemma resolved through laparoscopic excision and histopathological confirmation. Case presentation: A 33-year-old male presented with vague abdominal pain for a month which was insidious, progressive in nature and dyspepsia with no history of pancreatitis or alcohol use. CT imaging showed a 5.3 × 3.1 × 8 cm lobulated infracolic mass adherent to the mesocolon and pancreatic tail. The patient underwent diagnostic laparoscopy, which revealed an infected pancreatic pseudocyst which was excised with complete recover. Conclusion: This case underscores the importance of including pseudocysts in the differential for cystic abdominal masses without classic risk factors and highlights the diagnostic and therapeutic value of minimally invasive exploration. Surgical excision remains the gold standard in infected or symptomatic pseudocysts, especially when malignancy cannot be excluded.