Abstract
Benign multicystic peritoneal mesothelioma (BMPM) is a rare condition, more common in females of reproductive age, which arises from the peritoneal mesothelium. A 33-year-old male presented to our unit with abdominal pain and constipation. His past medical history included a previous unilateral nephrectomy for Wilms' tumor and the previous incidental finding of some intra-abdominal cystic formations at the level of the mesentery. After performing a CT scan, an exploratory laparotomy was done and a voluminous cystic mesenteric mass, composed of 3 confluent formations, was observed. Some other similar but significantly smaller lesions were found. An en bloc resection of the mesenteric mass together with the corresponding intestinal loops, an appendicectomy, and some peritoneal biopsies were performed. The postoperative period was complicated by a peritonitis due to dehiscence of the intestinal anastomosis, which required another operation, and a delayed return of normal bowel function, which was resolved through prokinetic therapy. Through histological examination, a BMPM was diagnosed. At 8 months of follow-up, the patient is free of symptoms. BMPM exact etiopathogenesis still remains uncertain. Given his high recurrence rate, a long-term follow-up is recommended.
Highlights
Benign multicystic peritoneal mesothelioma (BMPM) is an uncommon benign tumor that arises from the peritoneal mesothelial cells
Less than 200 cases have been reported in literature [1, 2]. This tumor usually affects females of reproductive age, and it is very rare in males [1, 2, 13, 15]
The prevailing theory considers BMPM as the result of a persistent inflammatory status involving the peritoneum because of its association with endometriosis, pelvic inflammatory disease, previous abdominal surgery, and recurrent peritonitis episodes associated with peritoneal dialysis and familial Mediterranean fever [3, 18, 19]
Summary
Benign multicystic peritoneal mesothelioma (BMPM) is an uncommon benign tumor that arises from the peritoneal mesothelial cells. It usually affects females of reproductive age. Its etiopathogenesis is still controversial [1, 2]. The prevailing theory considers this tumor as the result of a persistent inflammatory process involving the peritoneum [3]. Other possible etiopathogenetic mechanisms have been suggested [4,5,6,7,8,9,10,11]. Surgery is considered the mainstay of treatment [1, 4, 12, 13, 15]. We report a case of BMPM in a male patient submitted to unilateral nephrectomy for a right-sided Wilms’ tumor when he was a child
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