Localized intrapancreatic malignant mesothelioma: a rare entity that may be confused with other pancreatic neoplasms

Abstract

Malignant mesothelioma usually presents with diffuse involvement of the pleura or peritoneum. Circumscribed or localized malignant mesothelioma has been described in these locations, as well as the viscera, in which case it may cause diagnostic confusion with other, more common entities. Herein, we describe the first well-documented case of primary intrapancreatic malignant mesothelioma in the English literature. The patient was an otherwise healthy 39-year-old woman who presented with a symptomatic mass in the head of the pancreas that was completely resected via pancreaticoduodenectomy. The tumor was composed of cysts, papillae, and tubules lined by cells with abundant eosinophilic cytoplasm and immunohistochemically expressed CA-125, calretinin, and D2-40. Follow-up revealed no evidence of residual or recurrent disease 32 months after surgery. This report also describes the clinical and pathologic characteristics of an intrapancreatic mesothelioma and provides a review of the literature regarding entities that may be considered in the differential diagnosis of this tumor.

Localized Intrasplenic Mesothelioma

“…In the English literature only very few cases have been reported that occurred in lung, 5 testis, 6 ovary, 6 liver, 3 and pancreas. 4 In the present report, we describe an epithelioid malignant mesothelioma arising inside the splenic parenchyma of a 48-year-old man without a history of asbestos exposure. The tumor was incidentally detected as an intrasplenic nodule without any other lesions in the pleura and peritoneum.…”

“…In the English literature only very few cases have been reported that occurred in lung, 5 testis, 6 ovary, 6 liver, 3 and pancreas. 4…”

“…To the best of our knowledge, only few cases of primary visceral mesothelioma have been reported in the pertinent literature, arising in liver, 3 pancreas, 4 lung, 5 testis, and ovary. 6 Here, we report the first case of primary intrasplenic malignant mesothelioma.…”

Case report: Rare intrapulmonary malignant mesothelioma complicated with myositis

“…Malignant mesothelioma often presents with diffuse involvement of the serous membranes, localized malignant mesotheliomas are extremely rare solitary circumscribed nodular tumors ( 4 ). Only very few cases have been reported that presented in ovary ( 5 ), liver ( 6 ), pancreatic ( 7 ) and lung ( 8 ). Diagnosing intrapulmonary malignant mesothelioma on the basis of clinical findings alone is difficult.…”

Primary Sarcomatoid Malignant Mesothelioma of the Pancreas

“…The prognosis of pancreatic mesothelioma is different depending on the pathological type and stage. Rosanny et al 3 reported a case of intra-pancreatic epithelioid malignant mesothelioma. Follow-up revealed no evidence of residual or recurrent disease 32 months after pancreatoduodenectomy without adjuvant radiotherapy and chemotherapy.…”