A Case of Malignant Peritoneal Mesothelioma with an Atypical Clinic Profile (original) (raw)
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Malignant peritoneal mesothelioma: clinicopathological characteristics of two cases
Case reports in surgery, 2014
Introduction. Peritoneal mesothelioma is a rare tumor, presenting difficulties in diagnosis and treatment. Peritoneum is the second most common area of the mesothelioma after pleura, and even synchronous pleural and peritoneal mesotheliomas are observed in 30-45% of all cases. The diagnosis may be difficult due to lack of specific symptoms and clinical findings. In addition, a delay in the diagnosis is not rare especially in the absence of previous asbestos exposure. Here we report two cases of malignant peritoneal mesotheliomas. The diagnostic and therapeutic approaches for these rare neoplasms are discussed. Case Presentation. The cases were two men (one aged 54 years old and the other 40 years old). Prolonged abdominal pain and swelling were the primary presentation symptoms and findings. The mesotheliomas were developed in the right upper quadrant of abdomen in both of the cases. Both cases were treated with surgical resection. Final diagnosis were possible with histological and immunohistochemical documentation of tumor characteristics, which were consistent with dictating a mesothelial origin. No history of asbestos exposure was reported. Conclusion. Peritoneal mesotheliomas are rare clinical entities. However, patients with prolonged abdominal pain and abdominal masses should be considered to have atypical pathologies such as peritoneal mesotheliomas.
An Unusual Case of Primary Peritoneal Mesothelioma
The Internet Journal of Surgery, 2009
Peritoneal mesothelioma is a rare disease, but it is increasing in frequency. Because of its unusual nature, the disease has not been clearly defined either in terms of its natural history, diagnosis, or management. Peritoneal mesothelioma patients generally present with two types of symptoms and signs; those with abdominal pain, usually localized and related to a dominant tumor mass with little or no ascites and those without abdominal pain, but with ascites and abdominal distention. Prognosis as determined by clinical presentation, the completeness of cytoreduction, and gender (females survive longer than males) appears to be improved by the use of intraperitoneal chemotherapy. We would like to report a case where our patient primarily presented with peritoneal mesothelioma without pleural involvement that responded well to standard wide surgical excision and postoperative chemotherapy.
Multidisciplinary Approach to Diagnosing and Managing a Case of Peritoneal Mesothelioma
2020
Peritoneal mesothelioma is a rare cause of a peritoneal mass in adults and can occur in malignant or benign forms. Compared to the pleural variant of mesothelioma, the peritoneal form is understudied due to the small number of reported cases. We present a case of an 84-year-old male with a history of asbestos exposure who initially presented for an aggravated hernia, was found to have an incidental mass on imaging, and ultimately was diagnosed with malignant peritoneal mesothelioma (MPM) 1 likely related to prior asbestos exposure. This case study will provide a review of literature and discuss the role of imaging for MPM.
Rare localization of malignant peritoneal mesothelioma
Archive of Clinical Cases, 2015
Peritoneal mesothelioma represents a rare disease, among its manifestations it can be encountered ascites and tumoral abdominal masses and this condition, untreated can lead to death by bowel obstruction, perforation and cachexia. Due to the rarity of the disease, some patients are misdiagnosed and thus they cannot benefit from a radical form of treatment which leads to an increased survival. We hereby present the case of a 62 year-old male with previous surgery for a retroperitoneal tumor with relapse of the disease. The pathological examination and immunochemistry showed a diffuse peritoneal mesothelioma with poor differentiation. The patient was submitted to chemotherapy and 16 months after surgery on regular control imaging he presented a retroperitoneal recurrence. Unfortunately the patient refused the treatment; we believe that he could benefit from radical surgery associated with hyperthermic intraperitoneal chemotherapy. Preoperative diagnosis of diffuse peritoneal mesothelioma can be difficult due to the lowest predictability of the clinical and imaging studies.
Advances in malignant peritoneal mesothelioma
International journal of colorectal disease, 2015
Malignant mesothelioma is a rare, insidious, and aggressive tumor arising from the mesothelial surface of pleural and peritoneal cavities, the pericardium, or the tunica vaginalis, with an increasing incidence worldwide, high misdiagnosis rate, and overall negative prognosis. A total of 20% of all cases is peritoneum in origin. The present study is a review of literatures focusing on the advances in epidemiology, clinical presentations, radiological features, diagnosis, misdiagnosis, management, and prognostic factors of malignant peritoneal mesothelioma (MPM) occurred in the past decades. Asbestos, SV40, and radiation exposures have been demonstrated to be correlated with the pathogenesis of MPM. The main presentations are abdominal distension and pain. Computed tomography (CT), magnetic resonance imaging (MRI), and positron-emission tomography (PET) play an important role in the preoperative imaging and staging. Definitive diagnosis is made on the basis of immunohistochemistry. Pr...
Oncology in Clinical Practice
Peritoneal mesothelioma is a rare neoplasm that is associated with multiple diagnostic and therapeutic challenges. Therapeutic guidelines are scarce and based on extrapolative data. Histopathological diagnosis is difficult as neither the morphological finding nor the immunohistochemical stains are specific. The mainstay treatment for resectable disease is cytoreductive surgery with intraperitoneal chemotherapy being a valuable addition. Treatment of non-resectable cases includes platinum-based chemotherapy, immune checkpoint inhibitors, and bevacizumab. We present a case of a 49-year-old woman suffering from inoperable peritoneal mesothelioma, which was initially diagnosed as ovarian cancer and treated accordingly.
Malignant peritoneal mesothelioma: a multicenter study on 81 cases
Annals of Oncology, 2010
Background: Malignant peritoneal mesothelioma (MPM) is a rare disease characterized by a difficult diagnosis, different types of presentation, variable course and poor prognosis. Materials and methods: Eighty-one patients with MPM observed in 14 Italian oncology institutions from 1982 to 2007 have been examined with the aim of delineating the history of MPM. Results: Presentation symptoms were ascites, abdominal pain, asthenia, weight loss, anorexia, abdominal mass, fever, diarrhea and vomiting in various associations. Computed tomography scan and echotomography signs were ascites, abdominal mass and peritoneal thickening. Peritoneal fluid cytology (61 cases) was positive for mesothelioma in 31 and for malignancy, not mesothelioma, in 13. Laparoscopy was carried out in 40 cases and laparotomy in 36. Thrombocytosis was present in 59 cases. Associated tumors diagnosed during the lifetime were colorectal cancer in two cases and cheek carcinoma, thyroid carcinoma, tongue carcinoma, bladder carcinoma and testicular seminoma. Thirty patients were treated with surgery and 45 with chemotherapy. The median survival time from diagnosis is 13 months. Ascites, fever and vomiting were significative variables at presentation; only vomiting holds significance in a multivariate analysis. Conclusions: MPM is a disease with various types of presentation, frequently associated with thrombocytosis, sometimes with other tumors. Survival and diagnosis time can differ in various types of MPM. Prognosis is poor.