Abstract
Background: Malignant peritoneal mesothelioma (PeM) is a rare form of malignant mesothelioma that accounts for 10-15% of all cases of mesothelioma. Of these rare tumors, the rhabdoid subtype is exceptionally infrequent with only three cases reported in the current literature. PeM most commonly presents with non-specific symptoms such as abdominal distention, anorexia and weight loss that are difficult to diagnose until the disease is advanced. In this case report, we present a case of malignant peritoneal rhabdoid mesothelioma and review the literature. Case presentation: The patient is a 76-year-old woman who originally presented with necrotizing pancreatitis one year prior to diagnosis. The patient continued to complain of abdominal pain, nausea, vomiting, and weight loss. She experienced recurrent deep vein thrombosis (DVT), recurrent chylous, and mucinous ascites. Diagnostic work-up including MRI, repeat CT, EUS, and MRCP were inconclusive. Additionally, cytology from multiple paracenteses were negative for malignancy. Diagnostic laparoscopy revealed diffuse carcinomatosis, abdominal wall and peritoneal implants and a large epigastric mass. Biopsies of lesions taken during the procedure were identified as peritoneal mesothelioma. Conclusions: To our knowledge, we have presented the first case of PeM with rhabdoid features present in the peritoneum and in gastric polyps. The large amount of histopathogical variation of these tumors requires surgical biopsy, as cytology alone is non-diagnostic.
Highlights
Malignant Mesothelioma (MM) is a great masquerader, presenting as an infection, metastasis, another type of cancer or as a paraneoplastic syndrome [1,2,3,4,5]
We have presented a case of peritoneal mesothelioma (PeM) with rhabdoid features present in the peritoneum and in gastric polyps
We presented the clinicopathological features of a patient with PeM with rhabdoid features present in the peritoneum and in gastric polyps
Summary
Malignant Mesothelioma (MM) is a great masquerader, presenting as an infection, metastasis, another type of cancer or as a paraneoplastic syndrome [1,2,3,4,5]. Malignant peritoneal mesothelioma (PeM) accounts for about 10-15% of all cases of mesothelioma, presenting at a slightly younger age, with a median age of 51-59 years [6, 7] Unlike pleural mesothelioma, it has an even distribution in men and women [8,9,10]. We present the clinicopathologic findings of a case of a malignant peritoneal rhabdoid mesothelioma presenting as a necrotizing pancreatic mass, recurrent deep vein thrombosis (DVT), chylous, mucinous ascites, and late onset weight loss. An endoscopic retrograde cholangiopancreatography was performed with pancreatic and biliary stents placed By this time, the patient was requiring monthly paracentesis for management of symptoms. She subsequently developed recurrent DVTs while on anticoagulation and an inferior vena cava (IVC) filter was placed
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