Malignant peritoneal mesothelioma in patients with endometriosis

Abstract

To our knowledge, this is the first report of MM in women with endometriosis. Interestingly, MM in the setting of endometriosis has only been observed in the peritoneum and not in other serosal cavities. The findings in the present study suggest that chronic serosal inflammation secondary to endometriosis may be an inducing factor in rare cases of MM of the peritoneum.

Malignant Peritoneal Mesothelioma Associated With Endometriosis: A Clinicopathologic Study of 15 Cases

“…Six (40%) of our 15 patients had biphasic MPeM; this contrasts with a single patient (14%) out of 7 patients in the literature (1,2). A concurrent, rather than metachronous, diagnosis of endometriosis was made in 73.3% of our patients, a higher incidence than the 57% obtained from previous reports (1,2). With the exception of a higher expression of PAX-8 and ER in our study, all our immunohistochemistry results are in concordance with previous reports (26)(27)(28)(29)(30).…”

“…The association of endometriosis and MPeM has seldom been reported (1,2); however, it can occur in up to 23% of WDPM cases (6) and in 7% of cases of multilocular peritoneal inclusion cysts (7). The 15 cases with this association presented herein accounted for 10.8% of MPeM in female patients seen in our hospital over a period of 42 yr (4); which is higher than the 5.8% published previously (1). In concordance with the latter report, patients with endometriosis and MPeM tend to be younger than patients with MPeM and no associated endometriosis.…”

“…Racial distribution of the patients was as follows: Caucasians (11), Native American (1), and unknown (3). Patients presented with abdominal/pelvic pain (10), abdominal/pelvic mass and ascites (1), abdominal distention due to ascites (1), gastrointestinal symptoms such as diarrhea and vomiting (1). In one patient, mesothelioma was an incidental finding in a total hysterectomy with bilateral salpingooophorectomy and staging obtained for endometrial cancer.…”

“…The occurrence of malignant peritoneal mesothelioma (MPeM) in association with endometriosis has seldom been reported with only 1 small series with 6 cases, and 1 case report published thus far in the English literature (1,2). Some investigators have suggested that chronic inflammation of the peritoneum secondary to endometriosis may play a role in the pathogenesis of MPeM; however, this association may only be coincidental considering the prevalence of endometriosis (3).…”

Inflammation of the Pleural Cavity: A Review on Pathogenesis, Diagnosis and Implications in Tumor Pathophysiology

“…Other causes, such as different than asbestos mineral fibers, radiation exposure or a genetic predisposition can be involved; regarding chronic inflammation, only rare reports exist in cases of recurrent peritonitis or long-standing empyema associated with mesothelioma [99]. Peritoneal mesotheliomas have been reported in the context of endometriosis, and the chronic inflammation [100] seen in these cases has been elicited as a possible etiopathogenetic factor, however, other factors, such as personal/familial history of malignancies could also predispose these patients in developing mesothelial malignancy [101]. Similarly, in a database of 3800 mesothelioma patients, three (0.08%) had Crohn disease, while no ulcerative colitis cases were found, also suggesting a role for the transmural inflammation in this context [102].…”