Malignant Peritoneal Mesothelioma: A Rare Cause of Ascites

Abstract

Malignant peritoneal mesothelioma (MPM) is a rare diagnosis that presents with difficulties in diagnosis and management. This article reports a case of an 88-year-old male who presented with a 2-week history of abdominal distention and bloating. He worked at an insulation production factory between the ages of 23 and 25 years with presumed asbestos exposure. On the computed tomography scan of the abdomen/pelvis, the patient was found to have diffuse omental, peritoneal, and mesenteric nodularity with moderate to large ascites. Omental biopsy revealed MPM. The overall prognosis of MPM remains poor, with a median survival time of 12 months at the time of diagnosis. Treatment modalities offered in the United States include chemotherapy alone, cytoreductive surgery alone, or cytoreductive surgery/chemotherapy combination.

Mesothelioma in two sheep with pericardial effusion and ascites

“…In case 2, the cause of the ascites was less clear; however, these tumours can metastasise and may block lymphatic drainage. In addition, peritoneal mesotheliomas produce excess peritoneal fluid and have been described as a cause of ascites in humans 8…”

Ascites with infrequent origin: peritoneal mesothelioma

“…El mesotelioma peritoneal es un tumor infrecuente y agresivo [1][2][3] . En Europa se estima una incidencia de 1,2-1,3 casos/ millón personas/año 3 .…”

“…En Europa se estima una incidencia de 1,2-1,3 casos/ millón personas/año 3 . En un 50% hay antecedente de exposición a asbesto y es más frecuente en pleura que en peritoneo 2,3 . El mesotelioma peritoneal papilar bien diferenciado es un subtipo aun más raro de mesotelioma.…”

“…Produce síntomas inespecíficos, lo que retrasa el diagnóstico 2,3 . Habitualmente se manifiesta como dolor y distensión abdominal y ascitis [1][2][3] . En ocasiones incluso se requiere una laparoscopia diagnóstica para toma de muestras 1 .…”

Acute popliteal thrombus workup leads to discovery of primary peritoneal mesothelioma in the absence of any known asbestos exposure

“…The diagnosis becomes even more difficut when there is no clear known exposure to asbestos. As a result, the estimated average duration from presentation to diagnosis in a patient of peritoneal mesothelioma without any known exposure to asbestos is 122 days 6. We report a case of primary peritoneal mesothelioma in a 75-year-old man without any known asbestos exposure.…”