Multicystic peritoneal mesothelioma treated with complete cytoreductive surgery, peritonectomy and hyperthermic intra-peritoneal chemotherapy—A case report

Abstract

Highlights Multicystic Peritoneal mesothelioma is a distinct type of peritoneal mesothelioma with borderline malignant potential and tendency to recur after tumor debulking. Morphologically MCPM has grapelike cysts filled with clear fluid and microscopically it has cystic spaces lined by cuboidal epithelium. There are areas of increased proliferative activity in the background of benign cyst representing potential for aggressiveness. Peritoneal free floating cysts can be formed from disintegration of main mass and deposit in other areas to form metastatic deposits. Comprehensive treatment – Complete cytoreduction, involved peritonectomy and HIPEC is required for treatment of macroscopic tumor and microscopic residue.

Peritoneal inclusion cysts in a young male: A case report

“…Peritoneal inclusion cyst, otherwise known as multicystic peritoneal mesothelioma (MCPM), is a rare variant of peritoneal mesothelioma [1] . It is a benign condition of uncertain pathogenesis, where multiloculated cysts are formed from reactive mesothelial proliferation [2] , [3] .…”

“…It is a benign condition of uncertain pathogenesis, where multiloculated cysts are formed from reactive mesothelial proliferation [2] , [3] . It is most common in women of reproductive age and thought to be due to chronic peritoneal inflammation secondary to endometriosis, pelvic inflammatory disease or previous surgery [1] , [2] , [4] . Less than 200 cases are reported in the literature with an incidence of 0.15/100,000 annually, thus making the pathology difficult to treat [1] , [2] , [4] , [5] .…”

“…It is most common in women of reproductive age and thought to be due to chronic peritoneal inflammation secondary to endometriosis, pelvic inflammatory disease or previous surgery [1] , [2] , [4] . Less than 200 cases are reported in the literature with an incidence of 0.15/100,000 annually, thus making the pathology difficult to treat [1] , [2] , [4] , [5] . Peritoneal inclusion cyst has a good prognosis and low malignant potential, but has a recurrence rate up to 50 % [1] , [2] .…”

“…Less than 200 cases are reported in the literature with an incidence of 0.15/100,000 annually, thus making the pathology difficult to treat [1] , [2] , [4] , [5] . Peritoneal inclusion cyst has a good prognosis and low malignant potential, but has a recurrence rate up to 50 % [1] , [2] . Current first line treatment is debulking surgery, however, given the potential for transformation to invasive mesothelioma and the high recurrence rate, some institutions are treating with more aggressive approaches such as complete cytoreductive (CRS) surgery, peritonectomy and hyperthermic intra-peritoneal chemotherapy (HIPEC) to aim for complete disease resolution [1] , [4] .…”

“…Peritoneal inclusion cyst has a good prognosis and low malignant potential, but has a recurrence rate up to 50 % [1] , [2] . Current first line treatment is debulking surgery, however, given the potential for transformation to invasive mesothelioma and the high recurrence rate, some institutions are treating with more aggressive approaches such as complete cytoreductive (CRS) surgery, peritonectomy and hyperthermic intra-peritoneal chemotherapy (HIPEC) to aim for complete disease resolution [1] , [4] . At this stage, there is insufficient data for aggressive treatment to be considered first-line [4] .…”