Abstract
Benign multicystic peritoneal mesothelioma (BMPM) is a rare neoplasm of the abdominal mesothelium (i.e., peritoneum, mesentery, and omentum). We present the case of a 74-year-old male who presented with a right paracolic gutter fluid collection and cystic mass. The patient underwent diagnostic laparoscopy with resection of the mass. The final pathology revealed BMPM. The pathogenesis may have been related to longstanding diverticular disease, which could prove to be an underrecognized risk factor for the development of BMPM. Therefore, this case suggests a broadened differential diagnosis to include BMPM in specific cases of pre-operatively diagnosed colonic masses. The patient is disease-free 11 months post-operatively.
Highlights
Benign multicystic peritoneal mesothelioma (BMPM) is a loculated neoplasm arising from the mesothelial lining of the abdominal cavity [1]
The patient was first diagnosed with an intraabdominal fluid collection in 2017, status post CT-guided interventional radiology (IR) drainage, and positron emission tomography CT scan, which were negative for malignancy
Photomicrographs of benign multicystic peritoneal mesothelioma (BMPM) showing multiple cysts lined by a single layer of bland, flat to the cuboidal epithelium (H&E stain; 20X (A), 200X (B)) and cysts lined with calretinin-positive cells (200X (C))
Summary
Benign multicystic peritoneal mesothelioma (BMPM) is a loculated neoplasm arising from the mesothelial lining of the abdominal cavity [1]. A 74-year-old male with a past medical history of diverticulitis presented to the clinic in November 2018 for evaluation of a recurrent 13.5 cm right lower quadrant (RLQ) paracolic gutter fluid collection (Figure 1). CT of the abdomen showing a 13.5 cm right lower quadrant (RLQ) paracolic gutter fluid collection. Follow-up CT in August 2019 was significant for severe colonic diverticulosis and a right paracolic gutter lobular fluid-attenuated structure with features of a cystic lymphangioma that measured 11.7 cm (Figure 2). CT of the abdomen showing a right paracolic gutter lobular fluid-attenuated structure with features of a cystic lymphangioma measuring 11.7 cm. Photomicrographs of benign multicystic peritoneal mesothelioma (BMPM) showing multiple cysts lined by a single layer of bland, flat to the cuboidal epithelium (H&E stain; 20X (A), 200X (B)) and cysts lined with calretinin-positive cells (200X (C))
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