Abstract
IntroductionMalignant peritoneal mesothelioma is a well-described entity in many reports in the literature in which it has been associated with asbestosis. However, there is no information describing the gross appearance and cardinal features seen during laparotomy, hence it is easy for the unwary surgeon to miss the diagnosis of this rare condition.Case presentationA 49-year-old man of African descent presented to our hospital with a three-month history of weight loss, anorexia, abdominal distension, and general signs of cachexia and ascites on second presentation. At first presentation one year prior to this, he had undergone a laparotomy at our institution by a different team for intestinal obstruction secondary to adhesions with no biopsy taken. The patient's condition subsequently progressively deteriorated, and investigations including upper and lower gastrointestinal endoscopies and computed tomography of the abdomen were inconclusive, except for some free fluid in the peritoneal cavity and diffuse, mild thickening of the gut wall and mesentery. A second-look exploratory laparotomy revealed widespread nodular thickening of the visceral peritoneum with a striking, uniformly diffuse, erythematous, and velvety appearance. The peritoneal biopsy histology showed that the patient had malignant peritoneal mesothelioma. His condition deteriorated rapidly, and he died eight weeks after surgery.ConclusionOur report aims to increase the diagnosing clinician's awareness of the cardinal features of malignant peritoneal mesothelioma and thus reduce diagnostic errors and delays in treatment.
Highlights
Malignant peritoneal mesothelioma is a well-described entity in many reports in the literature in which it has been associated with asbestosis
We present the case of a 49-year-old man with asbestos exposure to illustrate the rarity and difficulty of the diagnosis of malignant peritoneal mesothelioma (MPM)
This case report is important to public health, since it deals with the detection and diagnosis of MMP, which is a very important public health issue
Summary
We present the case of a 49-year-old man with asbestos exposure to illustrate the rarity and difficulty of the diagnosis of malignant peritoneal mesothelioma (MPM). This case report focuses on the clinical appearance of the condition during exploratory laparotomy and demonstrates the striking, uniformly diffuse, erythematous, and velvety aspect of the tumor as it infiltrates the peritoneal surface. A second-look exploratory laparotomy revealed widespread nodular thickening of the visceral peritoneum with a striking diffusely erythematous and velvety look (Figures 2 and 3). His peritoneal biopsy histology showed this to be MPM. Adjuvant systemic chemotherapy was administered; the patient’s condition worsened rapidly, and he died eight weeks after surgery
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
