Cystic peritoneal mesothelioma: Report of a case

Abstract

Benign multicystic peritoneal mesothelioma (BMPM) is a rare disease with good short-term prognosis and rare malignant transformation. However, its biological significance remains unexplained. A neoplastic origin is considered by many authors to require a surgical excision, based on the high recurrence and progressive growth rate of the tumors. However, alternative or integrative treatment options have also been proposed. A 45-year-old woman presented to our unit with a history of occasional discomfort and pain in the left hip. On physical examination, we noticed a tough-elastic, fixed mass located in the iliac fossa. Computed tomography scan detected a mass with multiseptated cystic-like areas. Due to the similarity of these findings to a primitive sarcomatous tumor of the retroperitoneum, an arteriographic study was also performed. The patient underwent en bloc resection of the mass, including a segment of the sigmoid colon. The final pathologic diagnosis was cystic mesothelioma. Further studies are needed to better understand the etiology and pathogenesis of this rare disease, and to define a more tailored treatment plan.

Benign Multicystic Peritoneal Mesothelioma: Case Report

“…CT scan typically shows a multicystic lesion with density similar to blood. Magnetic resonance, however, shows a multilocular cystic lesion with low intensity in T1 and mean intensity in T2 [5].…”

“…The inflammatory hypothesis postulates that tumors arise from a peritoneal inflammation caused by chronic peritoneal irritation, proliferation, and cystic formation of mesothelial cells. Corroborate to this hypothesis association with previous abdominal surgery, endometriose [5,14,19] and mediterranean fever familiar [20,10]. Neoplastic origin was proposed before the slow growth characteristics, but progressive untreated injuries and also a marked tendency to recur after resection [21].…”

“…Some cases have also been described in vaginal tunic [5]. Most papers about the disease are case reports [1,5,8] and clinical series, the largest with 17 patients [8].…”

“…The definitive diagnosis is made by histopathologic study [5]. The electron microscopy or immunohistochemically can assist diagnosis.…”

“…Treatment includes surgical approach with extensive lesions resection [4]. However other less aggressive therapies have been advocated for younger women [5]. It is important to follow-up these patients after surgical treatment because of the possibility of recurrences and tendency to transform into malignancy [5] We will report a case of BMPM followed in our service, then we will have a discussion and review of the literature about this rare disease.…”