Diffuse malignant peritoneal mesothelioma

Abstract

Mesothelioma often originates in the pleura and less frequently in the peritoneum. This article describes a rare case of diffuse malignant peritoneal mesothelioma in a 54-year-old male construction worker who was admitted to our hospital with a 2-month history of progressive abdominal distention. Abdominal computed tomography revealed extensive peritoneal nodularity and omental cake along with massive ascites. Imaging findings initially suggested peritoneal carcinomatosis, primary peritoneal carcinoma, and tuberculous peritonitis. Laparoscopic biopsy of the omentum and peritoneum confirmed the diagnosis of malignant peritoneal mesothelioma of epitheloid type. Although systemic chemotherapy was administered, no tumor regression was found. The patient finally died of nosocomial infection.

Malignant Peritoneal Mesothelioma Presenting with Polymyalgia Rheumatica-like Syndrome

“…This patient was a bus driver and had no history of asbestos exposure, which is the most common cause of malignant mesothelioma, particularly in men, possibly because of occupational risks (3,18,19). Asbestos exposure is evident in 80% of malignant pleural mesothelioma cases but in only 33% to 50% of MPM cases.…”

Primary Peritoneal Mesothelioma Resulting in Small Bowel Obstruction: A Case Report and Review of Literature

“…There are several different histological types of malignant peritoneal mesothelioma: epithelioid, sarcomatous/fibrous, and biphasic [ 6 ]. Epithelioid type is the most common presentation, followed by biphasic and sarcomatoid types.…”

“…Cytokeratin staining is used to confirm invasion and to distinguish malignant mesothelioma from sarcoma or melanoma [ 10 ]. Malignant mesothelioma is further differentiated from adenocarcinoma by the use of specific markers: calretinin, WT1, cytokeratin 5/6, epithelial membrane antigen (EMA), mesothelin, and anti-mesothelial cell antibody [ 6 , 10 ]. In addition to the positive staining for the aforementioned markers, the absence of staining for antigens such as carcinoembryonic antigen (CEA), thyroid transcription factor-1, tumor glycoproteins MOC-31, B72.3 and Ber-EP4, and epithelial glycoprotein BG8 is necessary for definitive diagnosis [ 10 ].…”

“…New therapeutic treatments aim to prolong survival. These strategies consist of a combined approach with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy [ 6 , 8 ]. The cytoreductive surgery aims to separate adhesions and to remove bulky tumor masses.…”

Peritoneal Mesothelioma and Asbestos: Clarifying the Relationship by Epidemiology

“…Most peritoneal mesotheliomas are epithelial and are histologically similar to pleural mesothelioma; peritoneal mesotheliomas have a tubulopapillary pattern and are stromal malignant [27]. As characterized by Shih CA et al [31] in describing a case in a 54 old male construction worker "…diffuse malignant peritoneal mesothelioma is a rare disease characterized by a difficult diagnosis, different presentations, variable course, and poor prognosis. " In a study of 25 female patients [32], survival prognosis was found to be from 1 month to 15 years, often less than one year.…”