Cystic Mesothelioma Research Articles

Benign Cystic Mesothelioma of the Uterus: Myth or Reality?

Mesothelioma is a very rare tumor of mesodermal origin that covers the surface of body organs such as the peritoneum, pleura and pericardium. This tumour in the majority of cases presents in its malignant form where it represents some characteristics: increased cellularity, cytological atypia, papillary formations, even invasion. We report the case of Mrs AB, 37 years old, blood group A positive with no particular pathological history, nulli gesture nulli pare, consulted for pelvic pain and abdominal bloating. The clinical examination showed a distended bloated abdomen with a 20 centimetre pelvic mass with regular contours and painlessness. Abdominal and pelvic ultrasound showed a globular uterus increased in size by 200 millimetres with a multilocular cystic image intra myometrial (corporal anterior and fundial) of 188*79 millimetres. Intraoperatively, a globular uterus was found to be enlarged with a 15 centimetre parovascular cystic mass, dependent on the anterior aspect of the uterus, with a rock water fluid content, without any other associated abnormalities The postoperative course was simple. To conclude, Benign cystic mesothelioma of the uterus is a tumour of diagnostic value. This tumour is spleen. The preoperative evaluation allows the diagnosis to be suspected, especially by pelvic magnetic resonance imaging.

870 Benign Cystic Mesothelioma- a Rare Intra-Abdominal Tumour

Abstract Introduction Benign cystic mesothelioma is a rare intra-abdominal tumour affects primarily women who are in reproductive. Since this pathology has a rare occurrence, a similar presentation, and similar imaging features, the diagnosis is based on histologic findings and there is no current standard treatment for this condition. Presentation of case In this case report, a 40-year-old female patient presented in the Emergency Department with a five-day history of right-sided, migratory, abdominal pain. She was systemically well, and her inflammatory markers were unremarkable. The patient was investigated for appendicitis, with a CT scan showing a multi-loculated cystic structure below the liver. Her case was discussed with the Basingstoke Peritoneal Malignancy Institute who felt this may demonstrate benign cystic peritoneal mesothelioma. As per their advice, and the thoughts of the local MDT team, the patient underwent a diagnostic laparoscopy, and the cystic mass was removed. The diagnosis of benign cystic peritoneal mesothelioma was then confirmed by histology. Discussion Based on literature, this is a rare and asymptomatic form of mesothelioma.Imaging is able to provide suspicion of this type of benign mesothelium, but only histological examination can provide a definitive diagnosis. Additionally, on review there are no guidelines regarding management and no standard treatment for this condition. The only effective treatment for a benign cystic mesothelioma is surgery, but no evidence-based strategies exist. Conclusions It is critical to publish more case reports on this condition once it is diagnosed in order to formulate guidelines and to advance towards a possible effective treatment solution.

A colic mesothelial cyst, mimicking an appendicular mucocoele in an elderly patient: A case report and a literature review.

Benign cystic mesothelioma is a very rare and uncommon lesion, first reported by Plaut in 1928. It affects young women of reproductive age. It is usually asymptomatic or has non-specific symptoms. Diagnosis remains difficult despite the evolution of imaging, and the histopathological study is the key examination to make the diagnosis. Surgery remains the only curative treatment, regardless of significant rate of recurrence, and until today, no consensus on the therapeutic strategy is established.

Peritoneal Tumors of Mullerian Origin: A Case Report and Review of the Literature

Primary peritoneal tumors share a common anatomical site and therefore their clinical manifestations are very similar. When peritoneal masses are detected, the tentative initial diagnosis is secondary to metastatic disease, which has been determined most frequently in the peritoneal cavity. However, primary peritoneal tumors should always be included in the differential diagnosis. Among the primary malignant peritoneal neoplasms, mesothelial tumors have been identified (malignant mesothelioma, well-differentiated papillary mesothelioma, benign cystic mesothelioma, adenomatoid tumor of the peritoneum), epithelial-type tumors (primary peritoneal serous carcinoma, primary peritoneal serous borderline tumor), tumors of the smooth muscle (disseminated peritoneal leiomyomatosis) and tumors of uncertain or undetermined origin (desmoplastic small round cell tumor, peritoneal solitary fibrous tumor).

Management of an Uncommun Giant Ovarian Hydatid Cyst

We report the case of a 52-year-old patient. She was overweight and thought at first she was gaining weight. She presented to our department with a gradually increasing huge abdomen after 11 months of clinical evolution. She was not febrile and had normal vital signs on general assessment. No icterus or edema was present. On examination of the abdomen, there was widespread distension and a dull tone on percussion. The liver and spleen could not be felt. A large abdominal echogenic tumor filled the whole abdomen and pelvic cavity, according to the CT scan (Figure 1). Despite their rarity, peritoneal cystic mesothelioma and abdominal cystic lymphangioma should be suspected in the presence of such a pelvic mass. The huge cyst was confirmed on an abdomino-pelvic Magnetic Resonance Imaging (MRI) and measured 65 x 52 cm, supero-laterally displacing the liver and spleen. The kidneys were located in the back, and the bowel loops were located in the front. The ovaries were not visible. There was fluid in the peritoneal cavity (Figures 2 and 3). Tumor markers (CEA, a-fetoprotein and CA-125) were within normal limits. The hydatid cyst serology was positive.

Un kyste müllérien de découverte fortuite dans une localisation rétropéritonéale exceptionnelle

Mullerian cysts are mostly described in women, near the genitourinary organs. Exceptional cases of retroperitoneal and posterior mediastinal located Mullerian cysts have been reported. When located in the retroperitoneum, those cysts are often confused with other retroperitoneal cysts such as cystic lymphangioma and cystic mesothelioma of peritoneum because of the poor clinical picture and a nonspecific radiologic presentation. The histopathological analysis is essential to make the diagnosis, and the positive staining of a Müllerian marker is a decisive argument in favor of a Müllerian cyst. Here, we report a case of an incidental finding of a retroperitoneal Müllerian cyst in a 68-years-old woman.

Benign cystic mesothelioma of the liver: A rare hepatic cyst

A 66-year-old woman presented to our hospital with upper abdominal pain and right chest tightness for 2 weeks. She had past history of hypertension under medical control for decades. Surgical history included laparoscopic cholecystectomy for cholelithiasis, as well as subtotal hysterectomy for leiomyoma and adenomyosis more than 10 years ago. In the clinic, one soft and mobile mass at left upper quadrant was palpated. Intravenous contrast-enhanced coronal computed tomography image of abdomen showed a 15 cm low-attenuation, nonenhancing cystic mass at left upper quadrant of the abdomen, and a small septum with some calcifications (arrow) was also noted.

Benign cystic mesothelioma: A case report on the presentation of an unusual tumor.

IntroductionBenign cystic mesothelioma of the peritoneum is a rare, benign abdominal tumor. It can present with vague signs and symptoms and is often found on imaging or incidentally during surgery.Presentation of caseWe report the case of a 30-year-old man presenting with acute abdominal pain that radiated to the right iliac fossa. No masses were found on superficial or deep palpation or on conducting a sonography. The patient underwent a diagnostic laparoscopy with an appendectomy, which revealed a perforated appendix and two cysts in the pelvis and iliac fossa.DiscussionA benign cystic mesothelioma is an inclusion cyst found in the peritoneal cavity and has no specific clinical presentation. It can be symptomatic or found incidentally during surgery. Benign cystic mesotheliomas have a high recurrence rate and may undergo malignant transformation.ConclusionComplete surgical excision of benign cystic mesothelioma must always be the first step of the treatment plan for this condition. It is difficult to treat with no evidence-based treatment modality available; thus, treatment should only be undertaken in a specialized center.

Mesothelial Cysts.

Peritoneal mesothelial cysts have been reported under various terms, including benign cystic mesothelioma, usually in the form of case reports/series, whereas extraperitoneal cases are rarely reported. Our objective was to report the detailed characteristics of cystic lesions of the serosal cavities. We retrospectively examined the clinicopathologic findings of a series of mesothelial cystic lesions (n = 79). Most cases (n = 68, 86%) concerned the peritoneum, whereas 11 (14%) concerned the pericardium. No pleural cases were found. A total of 51 (64.5%) lesions were solitary, whereas 28 (35.5%) were multiple. Peritoneal lesions harbored a plump eosinophilic mesothelium and a loose connective stroma, whereas pericardial lesions showed a cuboidal/flattened mesothelium, collagenous stroma, intense inflammation, and other tissue types, like adipose and muscle tissue. Solitary peritoneal lesions are usually extrapelvic and found in older patients incidentally during other surgeries, whereas multiple lesions are found in younger patients and usually in the pelvis. The lesions show a benign clinical course with rare recurrences but no malignant transformation. Most mesothelial cysts are peritoneal and rarely pericardial. Peritoneal cysts differ from pericardial cysts. Peritoneal solitary lesions differ from multiple lesions, also suggesting their pathogenetic differences.

Mesenteric Paraganglioma-A Cyst in The Mist

Extraadrenal paraganglioma is rarely found in the mesentery. It accounts only for 5-10% of cases and may present incidentally as abdominal mass. We report a case of 30 year old male presented as mass per abdomen. A differential diagnosis of neurogenic tumor or cystic mesothelioma was considered based on CT-abdomen. Histopathological examination showed features of mesenteric paraganglioma and confirmed on immunohistochemistry. This case report highlighted several important key issues regarding diagnosis of paraganglioma, including malignant or metastatic potential, recurrence rate, pre and postoperative imaging study and lifelong follow-up of the patient.

Imaging features, complications and differential diagnoses of abdominal cystic lymphangiomas.

The aim of the study is to describe the imaging features, complications and differential diagnoses of abdominal cystic lymphangiomas (ACLs). ACLs are benign lymphatic malformations that mainly arise in the subperitoneal space and the retroperitoneum. The typical presentation of an ACL is a multilocular lesion with homogenous serous content, presenting a thin wall and septa, usually free from adjacent organ compression. Atypical findings, including fat or hemorrhagic content, septal calcifications and unilocular presentation, are not uncommon. Rarely, ACLs can be revealed by acute complications, such as infection, hemorrhage, intussusception, complications with a twisting mechanism (including torsion around its own pedicle) or spontaneous rupture, which can be diagnosed by imaging. Ultrasonography and CT are the most useful modalities in emergency situations. MRI performs best in the noninvasive characterization of cystic lesions. ACLs should be differentiated from normal anatomic structures (e.g., cisterna chyli) or pitfalls (e.g., ascites, extrapancreatic necrosis, lymphocele) that can simulate ACLs. Among other primary peritoneal cystic lesions, benign cystic mesothelioma can be difficult to differentiate from ACL. Some neoplastic peritoneal lesions may have cystic components or content that looks like fluid on imaging (such as mucinous or myxoid content) and be misdiagnosed as ACL. Nodular or thick enhancement of the wall or septa should then be considered worrisome features and should not suggest ACL. ACLs mostly require a simple follow-up. If treatment is necessary, percutaneous sclerotherapy is a safe and effective alternative to surgery. Imaging, especially MRI, allows the noninvasive diagnosis of ACL and helps to exclude potential malignant differential diagnoses.

BENIGN CYSTIC MESOTHELIOMA OF OMENTUM: MIMICKING ABDOMINAL LYMPHANGIOMA

Benign multicystic peritoneal mesothelioma (BMPM) or benign cystic mesothelioma is a very rare disease characterized by proliferative lesions of the peritoneal mesothelial cells mainly in the pelvic or abdominal cavity. It occurs predominantly in young to middle-aged women and the majority of cases were associated with a history of abdominal or pelvic operation, a history of endometriosis, and pelvic inflammatory disease. BMPM involving only the omentum is not mentioned in the literature; here, we present a unique case of BMPM which was diagnosed as cystic lymphangioma with differential diagnosis of pseudomyxoma peritonei in a 40-year-old patient presenting as recurrent abdominal pain.

A Mesothelial Inclusion Cyst Presenting in a 40-Year-Old Woman as Abdominal Pain and Bloating – A Rare Diagnosis

Cystic mesotheliomas (also called mesothelial inclusion cysts) are rare benign neoplasms that occur more often in young women. Symptoms are usually non-specific, demanding a thorough work-up. We report a case of a 40-year-old female patient with 2 prior caesarean sections presenting with a 3-month history of abdominal pain. Laboratory tests revealed microcytic hypochromic anaemia and an elevated tumour marker CA-125. An investigation identified a large cystic abdominal mass, mostly in the left side of the abdomen. A laparotomy was performed with total resection of the lesion. Histological assessment resulted in a diagnosis of a mesothelial inclusion cyst. The patient had no recurrence after 3 years.LEARNING POINTSPeritoneal mesotheliomas are rare conditions, and with benign features are even rarer.Mesothelial inclusion cysts, also known as benign cystic mesothelioma, occur more often in young to middle-aged women with excellent prognosis, although there are high rates of local recurrence.Investigation unmasks large abdominal lesions. A timely diagnosis is of the utmost importance, to prevent a dramatic change in outcome if severe complications develop.

Bubbles in the belly - Cystic mesothelioma.

Bubbles in the belly - Cystic mesothelioma.

Benign multicystic peritoneal mesothelioma: literature review and update

ABSTRACTBenign multicystic peritoneal mesothelioma (BMPM) is a rare peritoneal tumor diagnosed predominantly in pre-menopausal women. Associated risk factors include endometriosis and pelvic inflammatory disease in women, and prior abdominal surgery in both genders. To date, the pathogenesis of this disease remains controversial with possible etiologies, including a neoplastic versus a reactive process. Given the risk factors, some authors believe that this disease is secondary to a reactive process. However, because some studies describe cases where there is no prior surgical history or inflammatory milieu present, and because of this entity’s predilection for recurrence, some authors believe the origin to be neoplastic. Some genetic and familial associations have also been reported. Malignant transformation is extremely rare, with only two cases reported in the literature, despite the recurrence potential. Like the etiology, the name of this entity is also controversial. Some authors prefer the term “peritoneal inclusion cyst (PCM)” instead of “benign cystic mesothelioma” and argue that the term mesothelioma should only be used when there is evidence of atypia. Most cases of BMPM are discovered incidentally. Others reflect sequela of tumor mass effect. It appears intra-operatively as large, multi-focal, cystic lesions in the peritoneal and pelvic cavity. Diagnosis is achieved through surgical sampling with histopathological examination. Immunobiologically, BMPM exhibits multiple small cystic spaces with flattened lining containing calretinin positive cells without atypical features, mitotic figures, or tissue invasion. Treatment includes cytoreductive surgery. Here we present a case of BMPM in a 60-year-old male – a rare disease in an uncommon patient population.

An Interesting Case of a Large Cystic Mesothelioma of the Omentum in a Pediatric Patient

AbstractWe present an interesting case of a large intra-abdominal cystic lesion in a 14-year-old girl who presented with abdominal discomfort and pain. The patient was evaluated with magnetic resonance imaging (MRI) and found to have a large septated cystic lesion arising from the gastrohepatic omentum. She underwent surgery, and the diagnosis of cystic mesothelioma was confirmed in the histopathology. To the best of our knowledge, only a few cases of benign omental mesothelial cysts have been reported.

Rare case of retroperitoneal cystic lymphangioma in an adult

Cystic lymphangioma is benign tumor originating from the lymphatic vessels. Most commonly occurs in childhood and in the head or neck regions, retroperitoneal localization and presentations in adulthood are rare. Making a pre-operative diagnosis is challenging, and only possible subsequent to the histological examination. En bloc resection is the recommended treatment for cystic lymphangioma, and recurrence occurs due to an incomplete excision. We here present a case of 40 year female presenting with progressive palpable lump associated with pain in right quadrant of abdomen, which on computed tomography revealed a large retroperitoneal cystic lesion probably lymphanigoma or cystic mesothelioma.

Mesenteric Hydatid Cyst

The aim of this article is to make radiologists and clinicians familial with the spectrum of cystic lesions in the abdomen. Mesenteric and omental cystic lesions are uncommon. One should be familiar with them as well as with other conditions that manifest as cysts. Initial step in diagnosing a cystic abdominal mass is to localize the organ of origin. Differential diagnosis includes enteric duplication cyst, enteric cyst, mesothelial cyst, non pancreatic pseudocyst, cystic mesothelioma, cystic teratoma, and urachal cyst. There is significant overlap in imaging features of abdominal cysts, which often require histological correlation to establish a final diagnosis. The main role of imaging is to document the nature of the abdominal mass and its origin.

Benign multicystic mesothelioma and peritoneal inclusion cysts: are they the same clinical and histopathological entities? A systematic review to find an evidence-based management.

Peritoneal mesothelial cysts (PMC) are a clinical dilemma because of their true pathogenic nature. Many definitions have been associated with PMC, including "benign multicystic mesothelioma", "cystic mesothelioma", "multilocular peritoneal inclusion cysts", ''inflammatory cysts of the peritoneum" or "postoperative peritoneal cyst". We herein performed a systematic review of the literature focusing on clinical and histopathological aspects of PMC, diagnosis, and therapies. Moreover, we described our experience with a case of PMC in a young female. Since there is often a history of prior surgery or inflammatory disease, most authors consider PMC of reactive origin. However, in some cases they occur without any documentable signs of disease or injury. A variety of clinical findings can complicate the preoperative assessment and a multitude of histological pictures may potentially lead to a misdiagnosis. The absence of a uniform treatment strategy and lack of long-term follow-up often hinder the accurate definition leading to unnecessary or unnecessarily aggressive therapy. PMC are more common than had previously been thought. Most authors consider them non-neoplastic; thus the designation of "peritoneal inclusion cyst" is preferable. The term "mesothelioma" should be used only in cases of histological evidences of atypia. The high rates of recurrence suggest that the goal of treatment should not be necessarily complete eradication, but symptomatic relief through individualized treatment. This is a topic of particular importance, especially in young female where recurrence rates could be lower than those reported in adults and where an improperly aggressive treatment could have repercussions on fertility.

Benign Cystic Mesothelioma in a Girl

Benign cystic mesothelioma (BCM) is an uncommon tumor. A 9-year-old girl presented with acute abdominal pain and vomiting for the last 24 hours. Ultrasound abdomen and contrast enhanced CT scan were suggestive of cystic lesion. At laparotomy, a cystic mass arising from the peritoneum was found, which was excised completely. On histopathological examination it was diagnosed as benign mesothelioma.