Multicystic Peritoneal Mesothelioma Research Articles

Diagnosis and treatment of benign multicystic peritoneal mesothelioma

Benign multicystic peritoneal mesothelioma (BMPM) is a rare cystic mesothelial lesion that occurs predominantly in reproductive aged women. A 56-year-old Caucasian male was admitted to our surgical department with a chief complaint of a painful mass in his right lower abdomen for almost 2 years. The physical examination revealed a palpable painful mass. Computed tomography demonstrated an irregular, cystic tumor in his right lower abdomen. There was no obvious capsule or internal septations. No enhancement after intravenous administration of contrast was noted. An exploratory laparotomy was performed, and a multicystic tumor and adherent to the caecum was noted. The walls of the cysts were thin and smooth, filled with clear fluid, and very friable. An en bloc resection of the tumor, including appendix and caecum, was performed. Histological examination revealed multiple cysts lined with flattened simple epithelial cells, and the capsule walls of the cysts were composed of fibrous tissue. Immunohistochemical analysis documented positive expression of mesothelial cells and calretinin. The final diagnosis was BMPM. The patient was well at 6-mo follow-up. BMPM is exceedingly rare lesion. A complete resection of the tumor is required. The diagnosis of BMPM is based on pathological analysis.

Case Report Benign Multicystic Peritoneal Mesothelioma

Patient aged 45 yrs P2L2 sterilized,presented with mass per abdomen.She had undergone five surgeries prior to admission. Surgery was done for right ovarian cyst. Histopathology confirmed Benign multicystic peritoneal mesothelioma

大網原発adenomatoid tumor合併良性多囊胞性腹膜中皮腫の1例

大網原発adenomatoid tumor合併良性多囊胞性腹膜中皮腫の1例

Late Recurrence of Benign Multicystic Peritoneal Mesothelioma Complicated with an Incisional Hernia

Benign multicystic peritoneal mesothelioma (BMPM) is a rare disease arising from the peritoneal mesothelium. Here, we report a 57-year-old woman admitted to our unit with an incisional hernia fifteen years later following her first operation due to BMPM. Computerized tomography demonstrated a cystic appearing mass with intraabdominal extension in hernia sac. The patient underwent en bloc resection of the mass and hernia repair. An immunohistochemical analysis of the mass confirmed the recurrence of BMPM. Our case supports that BMPM has slowly progressive nature and can recur with complicated incisional hernia long time after primary resection. Diagnosis and long-term followup are crucial for clarifying the characteristics of this disease.

Benign multicystic peritoneal mesothelioma mimicking recurrence of an ovarian borderline tumor: a case report

IntroductionBenign multicystic peritoneal mesothelioma is an extremely rare tumor that occurs mainly in women in their reproductive age. Its preoperative diagnosis and adequate treatment are quite difficult to attain.Case presentationOur patient was a 23-year-old Japanese woman who had a history of right oophorectomy and left ovarian cystectomy for an ovarian tumor at 20 years of age. The left ovarian tumor had been diagnosed on histology as a mucinous borderline tumor. Two years and nine months after the initial operation, multiple cysts were found in our patient. A laparotomy was performed and her uterus, left ovary, omentum and pelvic lymph nodes were removed due to suspicion of recurrence of the borderline tumor. A histological examination, however, revealed that the cysts were not a recurrence of the borderline tumor but rather benign multicystic peritoneal mesothelioma. There were no residual lesions and our patient was followed up with ultrasonography. She remains free from recurrence nine months after treatment.ConclusionWe report a case of benign multicystic peritoneal mesothelioma mimicking recurrence of an ovarian borderline tumor. Benign multicystic peritoneal mesothelioma should be suspected when a multicystic lesion is present in the pelvis as in the case presented here, especially in patients with previous abdominal surgery.

Benign multicystic peritoneal mesothelioma. A case report

Benign multicystic peritoneal mesothelioma is a rare malignancy with unknown etiology, first described in 1980, which have been reported to date about 150 cases in the literature. Although the term "benign", used mainly to distinguish it from the classic malignant mesothelioma, a more aggressive cancer, is considered "borderline" in terms of aggression: it tends to local recurrence but cases of lymph node metastases or in other locations at a distance are not described. The symptoms are often vague and nonspecific (abdominal pain, enlarged abdomen and ascites). The common diagnostic imaging techniques (CT, MRI) may appear similar to ovarian or peritoneal cancer by more aggressive mesenchymal neoplasms. Histological examination, accurately with the aid of immunohistochemical techniques, is therefore essential for diagnosis. Treatment is surgical and consists of peritonectomy. After surgery, the prognosis is generally good. In 50% of cases may have local recurrences; so rigorous follow-up is indicated.

MULTICYSTIC PERITONEAL MESOTHELIOMA: report of a case

SummaryBackground:Multicystic peritoneal mesothelioma is a rare disease. It is not certain if it is a benign or a borderline tumor. Although many therapeutic approaches have been used, complete cytoreductive surgery in combination with hyperthermic intraoperative intraperitoneal chemotherapy has gained acceptance.Case Report:A case of multicystic peritoneal mesothelioma in a 16-year old patient is reported. The patient underwent complete cytoreduction and received intraoperative hyperthermic intraperitoneal chemotherapy. The patient is disease-free one year after surgery.Conclusions:Complete cytoreductive surgery in combination with hyperthermic intraoperative intraperitoneal chemotherapy appears to be a rational therapeutic approach in multicystic peritoneal mesothelioma.

A case of multicystic peritoneal mesothelioma

Multicystic peritoneal mesothelioma is an unusual mesothelial lesion that deserves separate consideration because of its characteristic histologic picture and its benign behavior. In the past, this lesion was often confused with cystic lymphangioma, mesenteric lymphatic cyst, diffuse mesothelioma, and disseminated form of mucin-producing adenocarcinoma. Diagnostic accuracy and long-term follow-up are needed due to high incidence of recurrence. We report a rare case of huge multicystic peritoneal mesothelioma in a 36-year-old woman. At follow-up 18 months after surgery, the patient remained asymptomatic with no further growth.

A Rare Case of Benign Multicystic Peritoneal Mesothelioma: A Clinical Dilemma

A middle aged housewife presented with an anterior abdominal wall mass which was slowly growing over a period of 1years over the midline scar of previous caesarean section with cystic degeneration in a part of the tumor. Fine needle aspiration cytology revealed a papillary serous cystadenoma. At exploratory laparotomy tumor was seen arising from the ventral surface of the parietal peritoneum with normal viscera, omentum and ovaries. The pathologist reported the tumor as Benign Multicystic Peritoneal Mesothelioma. It is a rare but clinically favourable neoplasm with wide excision as the definitive treatment. Of the 130 cases reported in the literature, it has the least incidence in the Indian Subcontinent.

Multicystic Peritoneal Mesothelioma in an Octogenarian

Multicystic peritoneal mesothelioma (MCPM) is a rare cystic proliferation most often seen in women of reproductive age with a history of prior abdominal surgery. This is a case report of an 83-year-old woman diagnosed with MCPM during an exploratory laparotomy for presumed peritoneal carcinomatosis from colon cancer. After complete removal of all visible MCPM, the patient remains free of both colon cancer and MCPM. This article reviews the literature with regards to the pathology, natural history, risk of malignant transformation, and current options for management of MCPM, including cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.

Benign multicystic peritoneal mesothelioma: A rare case presenting as pneumoperitoneum and pneumotosis intestinalis.

Benign multicystic peritoneal mesothelioma (BMPM) is a rare peritoneal lesion that commonly presents as lower abdominal pain, palpable mass, or both. A case of BMPM presenting as pneumoperitoneum and pneumotosis intestinalis is described. Utilizing PubMed, a review of the literature was performed using the search words “benign multicystic peritoneal mesothelioma,” “multilocular peritoneal inclusion cysts,” “pneumoperitoneum,” and “pneumotosis intestinalis.” Although this lesion is typically benign, it has a high recurrence rate as well as the potential for malignant transformation; it is important to confirm the diagnosis in a minimally invasive manner, and to formulate a surgical treatment strategy to avoid unnecessary re-operations.

Multi-institutional experience of diffuse intra-abdominal multicystic peritoneal mesothelioma

This study was undertaken to measure survival of patients with multicystic peritoneal mesothelioma treated by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy through a multi-institutional collaboration. A multi-institutional data registry, established by the Peritoneal Surface Oncology Group, was used to identify patients with peritoneal mesothelioma and the subgroup with multicystic tumours, treated by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Outcomes for this subgroup are reported. The primary endpoint was overall survival. A secondary endpoint was the incidence of treatment-related complications. Of 405 patients with peritoneal mesothelioma, 26 (6·4 per cent) had multicystic tumours. There were 20 women and six men with a mean(s.d.) age of 42(12) years. The median peritoneal carcinomatosis index (PCI) was 14 (range 6-39). There was no perioperative mortality. Six patients developed grade III or IV complications. After a median follow-up of 54 (range 5-129) months, all 26 patients were still alive. Multicystic peritoneal mesothelioma appears to be a distinct subtype of peritoneal mesothelioma, where long-term survival may be achieved through cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.

Cystic peritoneal mesothelioma: Report of a case

Benign multicystic peritoneal mesothelioma (BMPM) is a rare disease with good short-term prognosis and rare malignant transformation. However, its biological significance remains unexplained. A neoplastic origin is considered by many authors to require a surgical excision, based on the high recurrence and progressive growth rate of the tumors. However, alternative or integrative treatment options have also been proposed. A 45-year-old woman presented to our unit with a history of occasional discomfort and pain in the left hip. On physical examination, we noticed a tough-elastic, fixed mass located in the iliac fossa. Computed tomography scan detected a mass with multiseptated cystic-like areas. Due to the similarity of these findings to a primitive sarcomatous tumor of the retroperitoneum, an arteriographic study was also performed. The patient underwent en bloc resection of the mass, including a segment of the sigmoid colon. The final pathologic diagnosis was cystic mesothelioma. Further studies are needed to better understand the etiology and pathogenesis of this rare disease, and to define a more tailored treatment plan.

Benign multicystic peritoneal mesothelioma: a case report

IntroductionWe report the case of a patient with a benign multicystic peritoneal mesothelioma and describe its appearance on computed tomography scans and ultrasonography, in correlation with gross clinical and pathological findings.Case presentationA 72-year-old Caucasian woman presented to our emergency department with acute abdomen signs and symptoms. A clinical examination revealed a painful palpable mass in her left abdomen. Abdominal ultrasonography and computed tomography demonstrated the presence of a large cystic mass in her left upper abdomen, adjacent to her left hemidiaphragm. The lower border of the mass extended to the upper margin of her pelvis. A complete resection of the lesion was performed. Pathological analysis showed a benign multicystic peritoneal mesothelioma.ConclusionsBenign multicystic peritoneal mesothelioma is a rare lesion with a non-specific appearance on imaging. Its diagnosis always requires pathological analysis.

Multicystic peritoneal mesothelioma: outcomes and patho-biological features in a multi-institutional series treated by cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

Aim This retrospective multi-institutional study addresses the role of surgical cytoreduction and hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of multicystic peritoneal mesothelioma (MCPM). MCPM is an uncommon tumour with uncertain malignant potential and no current standard therapy. Additionally, poorly defined pathological and biological features of this disease were investigated. Methods Twelve patients with MCPM underwent 14 procedures of cytoreduction and HIPEC in two Italian referral centres. Nine patients had recurrent disease after previous debulking (one operation in six patients, two in two, four in one). Biological markers related to mesothelioma origin and clinical features were assessed by immunohistochemical studies. Results Median follow-up was 64 months (range 5–148). Optimal cytoreduction (residual tumour nodules ≤2.5 mm) was performed in all the procedures. One grade IV postoperative complication (NCI/CTCAE v.3.0) and no operative death occurred. All the patients are presently alive with no evidence of disease, including two patients who underwent the procedure twice, due to locoregional disease recurrence. Five- and ten-year progression-free survival was 90% and 72%, accounting for a. statistically significant difference ( P = 0.0001) with progression-free survival following previous debulking surgery (median 11 months; range 2–31). All cases showed low proliferative activity assessed by mitotic rate and Ki-67 expression. Conclusions MCPM is a borderline tumour with a high propensity to local–regional recurrence. Definitive tumour eradication by means of cytoreduction and HIPEC seems more effective than debulking surgery in preventing disease relapse. Low mitotic rate and poor Ki-67 expression might be related to the peculiar behaviour of MCMP.

Lymph Node Involvement in Multicystic Peritoneal Mesothelioma

Multicystic peritoneal mesothelioma is an uncommon lesion most frequently encountered in women of reproductive age. Although the pathologic characteristics have been documented, the lymph node status associated with this pathology, the etiopathogenesis and prognosis of which remain unclear, is unknown. We report here the case of a 35-year-old woman with a 5.5 cm multicystic mesothelioma affecting the pelvic peritoneum of the rectum. Involvement by multicystic mesothelioma was observed within two lymph nodes simultaneously resected with the tumor. To the best of our knowledge, lymph node involvement has not been described in previous studies.

Benign Multicystic Peritoneal Mesothelioma Associated with Hydronephrosis and Colovesical Fistula Formation: Report of a Case

Mesotheliomas usually arise from the pleura and are malignant. We report an unusual case of benign peritoneal mesothelioma presenting in a 59-year-old woman. The disease resulted in bilateral hydronephrosis, colovesical fistula formation, recurrent small bowel obstruction and chronic abdominal pain. To date only a handful of cases have been reported and to the best of our knowledge, none has been so aggressive.

Cytomorphologic characteristics of fine needle core biopsy of multicystic peritoneal mesothelioma: A case report and review of the literature

Multicystic peritoneal mesothelioma (MPM) is an uncommon cystic mesothelial proliferative lesion. It occurs predominantly in women of reproductive age and most commonly arises in the pelvis. The preoperative diagnosis of MPM is difficult to establish based on clinical and radiographic findings, and has therefore traditionally been diagnosed following surgical resection. Due to differing management of MPM and its differential diagnoses including both benign and malignant lesions, it would be beneficial to diagnose MPM preoperatively. We report a case of MPM in a middle aged female that was diagnosed by fine needle core biopsy and touch preparations, allowing for appropriate clinical management. The cytomorphologic features of needle core biopsy, immunocytochemical studies and differential diagnosis are discussed. Furthermore, despite its infrequency, the current case emphasizes the importance of the inclusion of this entity in the differential diagnosis of cystic lesions of the abdomen and pelvis at the time of on-site evaluation and final diagnosis, in order to avoid misinterpretation of strips of benign mesothelial cells as inadequate for diagnosis.

Cytology of benign multicystic peritoneal mesothelioma in peritoneal washings

To describe the cytological aspect of peritoneal washings in benign multicystic peritoneal mesothelioma (BMPM). Three peritoneal washing specimens stained by standard cytological and histological procedures and analysed by light microscopy. The specimens showed an abundance of monomorphous mesothelial cells devoid of atypia or mitoses. The mesothelial cells were calretinin positive. They also showed numerous squamous metaplastic cells arranged in flat sheets or isolated cells. The background contained some inflammatory cells. The combination of cytology of the peritoneal washing, histology (cell block and surgical specimen) and clinical history allow differentiation of BMPM from other cystic lesions (cystic lymphangioma and malignant mesothelioma).

Benign multicystic peritoneal mesothelioma in a cesarean-section scar presenting as a fungating mass

We report a case of a benign multicystic mesothelioma, which presented as a fungating mass through the anterior abdominal wall and arose in a cesarean-section scar without direct peritoneal involvement. A wide local excision was done and the diagnosis was confirmed by histopathology and immunohistochemistry. The postoperative course was uneventful and the patient is asymptomatic at 3 years' follow-up. Although a history of previous abdominal surgery has been reported in a patient with benign multicystic mesothelioma, to the best of our knowledge, there is no report of a benign multicystic mesothelioma arising in a cesarean-section scar or presentation as a fungating skin mass. This unusual presentation may point to a traumatic or inflammatory etiology, although seeding of the wound during the previous surgeries is a more likely postulate. A pertinent review of the literature on benign multicystic mesothelioma is also presented.