A CASE OF MALIGNANT OMENTAL MESOTHELIOM WITH PULMONARY ASBESTOSIS

Abstract

Malignant peritoneal mesotheliomas lack in clinical manifestations, are difficult to be diagnosed preoperatively, and have no effective treatments with poor prognosis. Etiologically malignant mesotheliomas are often associated with asbestos exposure, however, peritoneal ones are rarely caused by as bestos exposure and only 18 cases have been reported in Japan.The case is a 45-year-old male carpenter who had the past history of exposure to asbestos from 1961 to 1965. The patient had been in good health until 1988, when he first noticed abdominal distention. On admission, abdominal CT scan revealed ascites and a soft tissue density mass just beneath the abdominal wall. The diagnosis of malignant mesothelioma was made as a result of cytological examination of ascites. When laparotomy was performed, a malignant mesothelioma araising in the omentum with multiple intraperitoneal dissemination was found. Though chemotherapy, irradiation, and steroid the rapy were given, he died 4 months after his admission. At autopsy, numerous asbestos bodies were found in the alveolar spaces, and also interstitial fibrosis and pleural thicknings were found, which led to a diagnosis of pulmonary asbestosis. From around 1960 a use of a large quantity of asbestos was started, and in a relation to fact a possible increase in the occurrence of malignant tumors due to asbestos exposure can be inferred. Health care including the abdomen as well as chest is necessary for those experienced asbestos exposure throughout all their lives.