Abstract
Malignant peritoneal mesothelioma with invasion of the liver is an invariably fatal disease. We aimed to clarify the characteristics of malignant peritoneal mesothelioma cases with liver involvement. The clinical presentation, computed tomography images, and immunohistochemical and histopathological features of 5 patients with malignant peritoneal mesothelioma and liver involvement were evaluated. The diagnosis was established by imaging and immune profiles of the tumours. A review of 8 cases with primary or invading malignant mesothelioma in liver is presented. All 5 mesothelioma cases were asbestos-related. CT images of malignant peritoneal mesothelioma with the liver involvement typically showed that the lesion grew inside the liver along the capsule and was possibly accompanied by capsule breakthrough and extrahepatic infiltration. The tumours exhibited a common epithelioid appearance in all 5 patients and most cases revealed positive Cal, CK, and MC with negative CEA and HeP. Different from our findings, the review of literature revealed that most malignant mesothelioma of liver was due to primary intrahepatic malignant mesothelioma. Finally, we concluded that the diagnosis of malignant peritoneal mesothelioma cases with liver invasion is reliably achieved by the history of asbestos exposure, the characteristic CT imaging, and immune profiles of the tumours.
Highlights
Malignant mesothelioma is a tumour of the lining of the lung and chest cavity or the lining of the abdomen and is typically related to asbestos exposure [1,2,3,4]
All 5 cases were positive for asbestos exposure and not comorbidity which included malignant pleural mesothelioma
In the absence of heavy exposure, asbestos fibers mostly accumulate in the lungs where some of them may induce the occurrence of lung cancer while others may migrate to the lymph nodes/lymphatics as well as to the pleura and eventually to the peritoneum, which promote malignant mesothelioma development [17]
Summary
Malignant mesothelioma is a tumour of the lining of the lung and chest cavity or the lining of the abdomen and is typically related to asbestos exposure [1,2,3,4]. 35% of all mesotheliomas arise solely from the peritoneum [5]. There are few reports of primary or secondary MPM in the liver, and each such report presents a single case [7,8,9,10,11,12,13,14]. Our report identifies 5 patients with MPM invading the liver to clarify the characteristics of MPM invading the liver and to review cases with primary or invading MPM in liver
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