Multicystic Peritoneal Mesothelioma Research Articles

Benign Multicystic Peritoneal Mesothelioma: A Case Report

Benign multicystic peritoneal mesothelioma (BMPM) is a rare tumor originating from peritoneal mesothelial cells. Here, we present a case of an 18-year-old male with right lower abdominal pain. Physical examination revealed a palpable mass with unclear boundaries. Laboratory tests showed elevated levels of monocytes and high-sensitivity C-reactive protein. CT scan revealed a cystic mass in the ileocecal region with multiple septations. Laparoscopic surgery confirmed a cystic solid mass resembling beads on the colon’s right side. Immunohistochemistry confirmed BMPM diagnosis. BMPM, especially in the ileocecal region, is uncommon and presents diagnostic challenges. Differential diagnosis includes lymphangioma, peritoneal metastasis, and malignant mesothelioma. CT findings, such as thin cyst walls and septations, aid in diagnosis. Recognition of BMPM’s imaging features improves diagnostic accuracy. Surgical resection remains the primary treatment. This case underscores the importance of considering BMPM in young male patients with abdominal pain and emphasizes the value of imaging modalities in accurate diagnosis and management.

Benign Multicystic Peritoneal Mesothelioma: Two Rare Cases and Review of the Literature

Background:: Benign multicystic peritoneal mesothelioma is a multiloculated cystic mass which originates from the peritoneum. This rare tumor is usually seen in women of childbearing age and has a high recurrence rate after surgery. Case Presentation:: We present two benign multicystic peritoneal mesothelioma cases with different imaging modalities, which were also pathologically proven. Conclusion:: The imaging features which may be diagnostic should be well known as there are very few reports regarding this entity

Pelvic cyst that turned out to be a rare benign multicystic peritoneal mesothelioma

Pelvic cyst that turned out to be a rare benign multicystic peritoneal mesothelioma

Rare Variants of Malignant Peritoneal Mesothelioma: a Literature Review.

Primary peritoneal mesothelioma (PM) is a rare and aggressive malignancy that arises from the peritoneum and classified into diffuse malignant peritoneum mesothelioma (DMPM) and borderline variants, viz. multicystic peritoneal mesothelioma (MCPM) and well-differentiated papillary peritoneal mesothelioma (WDPPM). The borderline variants are rarer than conventional DMPM, are less aggressive form accounting for 3-5% of all cases of peritoneal mesothelioma. In this narrative review article, we have discussed the pathogenesis, clinical presentation, natural history, and management of these rarer variants of PM, viz. MCPM and WDPPM. Histologically, MCPM typically consists of small cysts composed of mesothelial epithelium with benign bland cuboidal cells with clear fluids; cells lack cellular atypia and have increased number of mitoses. WDPPM has specific papillary component with myxoid plump cores and single layer of bland mesothelial cells. Both the variants commonly present as incidental finding or symptoms of chronic abdominal pain, chronic pelvic inflammatory disease, pelvic mass, and infertility. In the absence of treatment, these diseases are slow growing with major concerns being that both the variants have malignant transformation capabilities and a high rate of recurrence. In the light of current evidences, it is recommended that MCPM and WDPPM patients should be offered a complete cytoreductive surgery and hyperthermic intraperitoneal chemotherapy consisting of cisplatin and doxorubicin. Collaborative multi-institutional studies are needed to generate more data and formulate robust guidelines.

Peritoneal Mesothelioma in a High Volume Peritoneal Surface Malignancies Unit.

Diffuse malignant peritoneal mesothelioma (PM) is a rare neoplasm, traditionally associated with a poor prognosis. There are other varieties of PM that are even less frequent and of uncertain malignancy. Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) has achieved prolonged survival in selected patients. The aim of this study is to analyze the patients with PM assessed in our center. Clinicopathological characteristics, diagnostic procedures and survival results from patients with PM appraised at our unit, according to the applied treatment, were analyzed. Seventeen patients were assessed between 2007 and 2019. Three cases had multicystic PM that were treated with complete CRS + HIPEC; all patients are alive and free of disease after a long follow-up. Three other cases had biphasic PM; a curative treatment could be performed in none of them, and their survival was minimal (<6 moths). Lastly, 11 cases with epithelioid PM were treated. Two cases were considered unresectable at laparoscopy (PCI 39); one of them had a long survival (67 months) with three iterative laparoscopic palliatives HIPECs for refractory ascites. The other nine cases were treated with curative CRS + HIPEC, with a median PCI of 14 (range 4-25), and a median overall survival (OS) of 58 months, with a 5-year OS of 47.4%. In conclusion, CRS + HIPEC, when possible, appears to be the optimal treatment for patients with PM. Knowledge of this therapeutic option is crucial, both to offer it to patients and to avoid delays in their referral to appropriate centers for treatment.

Intermediate malignant peritoneal mesothelioma: a rare clinical case report

Background: Multicystic peritoneal mesothelioma (MCPM) is an uncommon mesothelium-related neoplasm, representing 3%-5% of peritoneal mesotheliomas. The annual incidence rate is 2 per 1,000,000. Typically, it is discovered unintentionally and accompanied by subacute abdominal pain. Surgery is the initial treatment option and involves the removal of cysts entirely from the body. In our case we describe an uncommon clinical and radiological presentation of this rare clinical entity. Case Presentation: We present the case of a 48-year-old male who presented with severe abdominal pain. The computed tomography scan of the abdomen revealed a septate pluriconcameral oval formation, hyperdense, suprahydric density content. The patient underwent exploratory laparoscopy. Numerous cystic structures were discovered. A histopathological examination revealed the MCPM. The patient was discharged and pursued follow-up at a specialized center. Conclusion: MPCM is a neoplasm whose pathophysiology is yet unknown, due to the lack of longitudinal studies and its rarity. Further studies are necessary to improve the treatment and management of the patients.

Benign Multicystic Peritoneal Mesothelioma as a Rare Cause of Death

Abstract Introduction/Objective Benign multicystic peritoneal mesothelioma (BMPM) is a tumor arising from the serosa of the peritoneal cavity, often in the pelvis, and is comprised of multiple cysts lined by bland mesothelial cells. It is a rare entity with less than 200 cases reported. The clinical course is often indolent with nonspecific symptoms. It has a strong predilection for females (90%) and is commonly associated with endometriosis or prior surgeries. A high local recurrence rate (50%) following excision has been reported, but malignant transformation is rare. Methods/Case Report The decedent was a 53-year-old male with a history of multiple hernia repairs who presented following three days of diffuse abdominal pain and obstipation. Imaging showed large volume, complex ascites with multiple rim-enhancing fluid collections, diffuse peritoneal thickening, and a soft tissue density in the lower abdomen/pelvis. Exploratory laparotomy was congruent and revealed 2L of purulent ascites, numerous peritoneal cystic lesions, and a bulky tumor in the pelvis. Blood and ascites cultures later grew Bacteroides species, and Escerichia coli was also isolated from the blood. Postoperatively, the decedent continued to decline, and death occurred the following day. Autopsy demonstrated that the firm pelvic mass entrapped the bladder, rectum, and segments of the small intestine. Sectioning revealed numerous cystic spaces of varying size. Microscopically, they were lined by a single layer of benign cells with mild to focally moderate atypia. These cells stained positive for Calretinin, Pan-cytokeratin, and D2-40 and negative for CD31, which is characteristic of mesothelial cells. These findings are consistent with BMPM. Results (if a Case Study enter NA) NA. Conclusion The decedent’s death is the result of sepsis following acute peritonitis due to BMPM. Death resulting from this entity is exceedingly rare, and to our knowledge this case is only the second reported death due to BMPM.

Multiloculated peritoneal inclusion cyst in male patient: a case report

Multilocular peritoneal inclusion cyst (MPIC), also known as benign multicystic peritoneal mesothelioma, is a rare mesothelial lesion arising from the peritoneal mesothelium. This condition most commonly occurs in females of reproductive age group and are very rare in males. We report a case of young male patient, presented with the chief complaint of lower abdominal pain, without any previous history of surgery. After radiological investigations which were suggestive of pelvic inclusion cysts, pt. was planned for diagnostic laparoscopy (D/L). On D/L, multiple free-floating cysts were found in pelvis between rectum and bladder which were successfully extracted and sent for histopathological examination (HPE). HPE confirmed it to be MPIC.

Benign multicystic peritoneal mesothelioma occurring in bilateral inguinal canals metachronously: a case report

BackgroundBenign multicystic peritoneal mesothelioma (BMPM) is a benign tumor that usually occurs in middle-aged females. Although several published studies have reported the occurrence of this tumor in the abdominal cavity, few have documented its development in the inguinal region.Case presentationWe present a case of a 48-year-old female presenting with a bulge in her left inguinal region. Physical examination revealed a golf ball-sized nodule in the left inguinal region that could not be pushed back into the abdominal cavity. Contrast-enhanced computed tomography showed a multicystic tumor; therefore, the patient was diagnosed with inguinal hernia or hydrocele of the Nuck’s canal. We performed surgical resection and hernia repair using the mesh plug method. The resected specimen was 80 mm in length and contained a multicystic tumor. Pathological examination showed that the cyst wall was lined by a single layer of cuboidal to single layer squamous epithelium. Immunohistochemistry revealed positivity for calretinin in the epithelial cells, for which a diagnosis of BMPM was established. The patient returned to our hospital after 5 years with symptoms similar to the previous episode, but this time in the right inguinal region. Imaging studies showed a tumor in the right inguinal region with the same characteristics as the previous one. The patient underwent tumor resection and hernia repair using the same technique. The resected tumor was 45 mm in length and had characteristics similar to the previously resected tumor. The presence of calretinin and D2-40 on immunohistochemistry led to the diagnosis of BMPM. There was no recurrence of BMPM for 33 months after the secondary surgery.ConclusionsHere we present the first report of metachronous BMPM occurring in bilateral inguinal canals. Although the pathogenesis of BMPM remains unclear, reactive changes have been suggested to cause tumors originating from the groin. The treatment of choice for BMPM is surgical resection. For diagnosis, pathological examination with immunostaining can be useful. The most appropriate postoperative follow-up for inguinal BMPM is controversial, and the accumulation of more inguinal BMPM cases is needed.

Benign multi-cystic peritoneal mesothelioma discovered at the time of acute appendicitis: a rare pathology in association with a common disease.

Benign multi-cystic peritoneal mesothelioma discovered at the time of acute appendicitis: a rare pathology in association with a common disease.

Multicystic Peritoneal Mesothelioma with Long-term, Recurrence-free Survival—A Series of Three Cases—

Multicystic Peritoneal Mesothelioma with Long-term, Recurrence-free Survival—A Series of Three Cases—

A rare case of benign multicystic peritoneal mesothelioma misdiagnosed as hydatid cyst found in the liver parenchyma and abdomen cavity of a male with asbestos exposure

BackgroundBenign Multicystic Peritoneal Mesothelioma (BMPM) is one of the rarest diseases in medicine with only more than 200 cases worldwide. This paper aims to report a case of Benign Multicystic Peritoneal Mesothelioma that strangely arose from the liver and was long treated as Hydatid cyst. The case also had many risk factors including asbestos exposure that had not yet been linked with Benign Multicystic Peritoneal Mesothelioma.Case presentationWe report a case of a 62 years old male with a history of a perforated peptic ulcer and a cystic mass in the liver that was misdiagnosed as hydatid cyst 7 years ago. He presented with generalized abdominal pain and bloating. Image studies showed many cystic formations filled with clear fluid. An en bloc surgery was performed and a pathologic study showed a multiloculated mass lined by flat or cuboidal epithelium leading to the diagnosis of BMPM. A follow up was scheduled after 3 months revealed total recurrence.ConclusionBMPM resembles many other cystic lesions in the abdomen and should be taken into consideration when dealing with nontypical cystic formations. Its diagnostic and treatment methods are still hazy making this disease difficult to approach.

Benign multicystic peritoneal mesothelioma: a case report

Free-floating peritoneal masses found during laparotomy should arouse a suspicion of benign multicystic peritoneal mesothelioma and they must be removed and subjected to histopathological examination and immunochemical staining to ascertain their benign nature. The objective of the study was to report a rare case of benign multicystic peritoneal mesotheliomas. We report an incidental finding of multiple free-floating peritoneal masses in a pregnant primigravida woman with a normal antenatal course who underwent a cesarean section in a rural hospital setting in India for fetal distress. The masses were removed from the peritoneal cavity during the surgery and subjected to histopathological examination and found to be benign multicystic peritoneal mesotheliomas. Immunohistochemistry of the cysts revealed that the mesothelial cells lining the cysts were positive for calretinin and WT1 and negative for CD31.

Multicystic peritoneal mesothelioma treated with cytoreductive surgery followed or not by hyperthermic intraperitoneal chemotherapy: results from a large multicentric cohort

Background Multicystic peritoneal mesothelioma (MCPM) is a rare, slowly growing, condition prone to recur after surgery. The role of hyperthermic intraperitoneal chemotherapy (HIPEC) added to complete cytoreductive surgery (CRS) remains controversial and difficult to assess. As patients are mostly reproductive age women, surgical approach, and fertility considerations are important aspects of the management. This observational retrospective review aimed to accurate treatment strategy reflections. Methods The RENAPE database (French expert centers network) was analyzed over a 1999–2019 period. MCPM patients treated with CRS were included. A special focus on HIPEC, mini-invasive approach, and fertility considerations was performed. Results Overall 60 patients (50 women) were included with a median PCI of 10 (4–14) allowing 97% of complete surgery, followed by HIPEC in 82% of patients. A quarter of patients had a laparoscopic approach. Twelve patients (20%) recurred with a 3-year recurrence free survival of 84.2% (95% confidence interval 74.7–95.0). The hazard of recurrence was numerically reduced among patients receiving HIPEC, however, not statistically significant (hazard ratio 0.41, 0.12–1.42, p = 0.200). A severe post-operative adverse event occurred in 22% of patients with five patients submitted to a subsequent reoperation. Among four patients with a childbearing desire, three were successful (two had a laparoscopic-CRS-HIPEC and one a conventional CRS without HIPEC). Conclusion MCPM patients treatment should aim at a complete CRS. The intraoperative treatment options as laparoscopic approach, fertility function sparing and HIPEC should be discussed in expert centers to propose the most appropriate strategy.

Outcomes of multicystic peritoneal mesothelioma treatment with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

BackgroundMulticystic peritoneal mesothelioma (MCPM) is a rare neoplasm, generally considered a borderline malignancy, best treated by cytoreductive surgery (CRS) to remove macroscopic disease, combined with hyperthermic intraperitoneal chemotherapy (HIPEC). Owing to its rarity, little has been published on clinical presentation, clinical behaviour over time, or an optimal treatment approach.MethodsA prospectively developed peritoneal malignancy database was interrogated for the years 2001–2018. Details on all patients with MCPM as a definitive diagnosis after CRS and HIPEC were analysed, including previous interventions, mode of presentation, surgical treatment, postoperative outcomes, and late follow-up information from abdominal CT and tumour markers.ResultsSome 40 patients with MCPM underwent CRS and HIPEC between 2001 and 2018. Of these, 32 presented with abdominal pain, distension or bloating, six patients presented with recurrence following previous surgery at the referring hospitals, and two had coincidental diagnoses during a surgical procedure. CRS involved peritonectomy in all 40 patients. Bowel resection was required in 18 patients, and seven had a temporary stoma. Thirty-eight patients were considered to have undergone a complete macroscopic tumour removal (completeness of cytoreduction CC0), and two had residual tumour nodules less than 2.5 mm in size, classified as CC1. Median duration of follow-up was 65 (range 48–79) months. There were no deaths during follow-up. The Kaplan–Meier-predicted recurrence-free interval was 115.4 months.ConclusionMCPM is a rare peritoneal neoplasm with a heterogeneous pattern of presentation. CRS and HIPEC is an effective management option for this group of patients, with favourable long-term survival.

A Case of Retroperitoneal Benign Multicystic Peritoneal Mesothelioma with Acute Abdomen

A Case of Retroperitoneal Benign Multicystic Peritoneal Mesothelioma with Acute Abdomen

Multicystic and diffuse malignant peritoneal mesothelioma in children.

Malignant and multicystic peritoneal mesotheliomas are extremely rare tumors in children, developing from mesothelial cells. No specific guidelines are available at this age. We performed a retrospective analysis of all identified children(<18-year-old) treated in France from 1987 to 2017 for a diffuse malignant peritoneal mesothelioma (DMPM) or a multicystic peritoneal mesothelioma (MCPM). Fourteen patients (5 males and nine females), aged 2.2 to 17.5 years, were included. The most frequent presenting symptoms were abdominal pain, ascitis, and alteration in the general condition. Eight patients had epithelioid mesothelioma, three had biphasic mesothelioma, and three had MCPM. Eight patients with DMPM diagnosis received cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC). Among them, six patients had neoadjuvant systemic chemotherapy, one patient, post-operative chemotherapy, and one patient CRS and HIPEC only. Three patients received only systemic chemotherapy. All patients with MCPM had only surgery. After a median follow-up of seven years (2-15), six patients (6/11; one death) with DMPM and two patients (two/three) with MCPM had a local and distant recurrences. Peritoneal mesothelioma in children is a rare condition with difficult diagnosis and high risk of recurrence. Worldwide interdisciplinary collaboration and networking are mandatory to help diagnosis and provide harmonious treatment guidelines.

BENIGN CYSTIC MESOTHELIOMA OF OMENTUM: MIMICKING ABDOMINAL LYMPHANGIOMA

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

Peritoneal mesothelioma: PSOGI/EURACAN clinical practice guidelines for diagnosis, treatment and follow-up

Peritoneal mesothelioma (PM) is a rare and aggressive primary peritoneal malignancy characterized by widespread multiple metastatic tumour nodules originating from the peritoneum. The conventional classification distinguishes diffuse malignant peritoneal mesothelioma (DMPM) and border-line forms: multicystic peritoneal mesothelioma (MCPM) and well-differentiated papillary peritoneal mesothelioma (WDPPM). Despite the novel achievements in the management of PM, there is difficulty in conducting randomized trials due to its rarity and aggressive biology in many cases.

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.