Laparoscopic excision of a retroperitoneal mucinous cystic neoplasm: A case report

•Primary retroperitoneal mucinous cystic neoplasms are rare.•Due to potential seeding intra-operatively, laparoscopic removal was avoided.•Our case showed efficient and safe use of a laparoscopic approach.•Surgeons must plan for every cyst to be malignant when planning for removal.•With a laparoscopic approach, care is required when aspirating the cyst in vivo. A 22-year-old female presented with a large abdominal mass that was revealed to be a primary retroperitoneal mucinous cystadenoma. A 22-year-old female presented with a two day history of bloating, mid-epigastric pain, and nausea without vomiting. A CT scan of her abdomen/pelvis showed a large left retroperitoneal mass, possibly a mesenteric cyst. The patient underwent laparoscopic surgery for mass excision. Once the cystic mass was completely dissected laparoscopically, it was placed in a large endobag. The fluid was then aspirated while in the bag to decompress and then completely taken out through a port site. She was discharged the following day. Final pathology revealed a benign mucinous cystadenoma/cystadenofibroma of mesenteric origin. Primary retroperitoneal mucinous cysts are rare occurrences and benign mucinous cystadenomas are the rarest subtype. We use an innovative laparoscopic technique with complete excision of the cyst without spillage of content, thus preventing possible seeding in case of malignancy. There is some previous caution in using a laparoscopic approach for cystic masses due to potential seeding intra-operatively, in case of fluid spillage of a possible malignant neoplasm. We show through our case that it is possible to efficiently and safely use such an approach.