| A 19-year-old male with a history of chronic bronchitis who came to the hospital emergency department because of abdominal pain, nausea, dysuria and fever for 8 hours. | |
| Examination revealed a distended abdomen, hard to tapered with voluntary defense, painful diffusely, predominantly in the right f, diffuse iliac peritonitis and cutaneous warmth. | |
| Laboratory tests showed anemia, leukocytosis with severe left shift and hypoproteinemia. | |
| With the diagnosis of peritonitis, an imaging study (ultrasound, MRI, CT) was performed in which a large space-occupying lesion was described, multiseptate and extended into the cystic cavity of the small pelvis. | |
| suspected malignancy, exploratory laparotomy was performed in which a multicystic tumor was found affecting the entire mesentery, from ileum to duodenojejunal angle, with involvement of the mesentery. | |
| Biopsy of the lesion was taken and peritoneal lavage and drainage was performed. | |
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| Macroscopically, the piece is a cystic formation that occurs 8x5 cm in size. The cut corresponds to a multi-eptated formation of purulent walls, some of them due to fluid appearance, which occupies a large proportion of them | |
| In the microscopic study, abundant vascular structures of diverse size and shape are observed, covered by flat endothelium, without atypia, with the presence of incomplete bundles of smooth muscle in the walls. | |
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| The immunohistochemical study shows the expression of CD31 (DAKO Cytomation, Carpin, California) by endothelial cells that cover these spaces. | |
| The patient develops after laparotomy with chylous fistula, digestive rest and total parenteral nutrition, asymptomatic at six months. | |