Well-differentiated Mesothelioma Research Articles

Multimodality imaging of common and uncommon peritoneal diseases: a review for radiologists.

Peritoneal disease can be caused by a wide spectrum of pathologies. While peritoneal disease is usually caused by primary or secondary malignancies, benign diseases can occur and mimic malignancies. This article begins with an overview of peritoneal embryology and anatomy followed by a detailed description of the multimodality imaging appearance of peritoneal diseases. Common diseases include peritoneal carcinomatosis, pseudomyxoma peritonei, lymphomatosis, sarcomatosis, and tuberculous peritonitis. The uncommon diseases which cause peritoneal disease include desmoid fibromatosis, desmoplastic small round cell tumor, malignant mesothelioma, well-differentiated mesothelioma, multicystic mesothelioma, papillary serous carcinoma, leiomyomatosis, extramedullary hematopoiesis, inflammatory pseudotumor and amyloidosis. This manuscript will help the radiologist become familiar with the different peritoneal spaces, pathways of spread, multimodality imaging appearance and differential diagnoses of peritoneal diseases in order to report the essential information for surgeons and oncologists to plan treatment.

Metastatic Appendiceal Mucinous Adenocarcinoma to Well-Differentiated Diffuse Mesothelioma of the Peritoneal Cavity: A Mimicker of Florid Mesothelial Hyperplasia in Association With Neoplasms

Atypical/florid mesothelial hyperplasia associated with another neoplastic process is not an infrequent phenomenon and has been reported in a variety of tumors. In those instances, the mesothelial proliferation might create a misdiagnosis of metastatic carcinoma but seldom raises the possibility of a well-differentiated mesothelioma seeded by metastatic neoplastic cells. Herein, we report the case of a 40-year-old woman originally diagnosed with exuberant atypical mesothelial hyperplasia after an diagnostic laparoscopy. The subsequent operation, however, demonstrated a mucinous neoplasm of the appendix with involvement of the peritoneal cavity in the form of peritoneal mucinous carcinomatosis as well as metastases to the uterine serosa and adnexal surfaces. Microscopic analysis revealed an appendiceal adenocarcinoma with signet-ring-cell features that has metastasized to a diffuse well-differentiated mesothelioma of the peritoneal cavity. In many areas, the atypical mesothelial proliferation is indistinguishable from florid mesothelial hyperplasia. The true nature of the mesothelial proliferation was only confirmed after extensive additional sampling, which showed unequivocal stromal invasion. To the best of our knowledge, this is the first report of a metastatic appendiceal mucinous adenocarcinoma to a well-differentiated diffuse mesothelioma of the peritoneal cavity. Although commonly associated with atypical/ florid mesothelial hyperplasia, a carcinoma can rarely metastasize to a well-differentiated mesothelioma, which can pose significant diagnostic difficulties because it can mimic a reactive process. This unusual case report expands the spectrum of mesothelial proliferation in conjunction with a malignant neoplasm and serves to remind pathologists that such a concomitant occurrence exists.

An incidental diagnosis of well-differentiated papillary mesothelioma in a woman operated on for recurrent endometriosis

The case presented involves a report of severe endometriosis with recurrent disabling dysmenorrhea associated with well-differentiated mesothelioma. Although the course of mesotheliomas is predominantly benign, the diversity of lesions, variable behavior, and resemblance, and association with endometriosis warrant thorough diagnostic investigation. Multiple biopsies and differential diagnoses are recommended in cases of peritoneal endometriosis.

Papillary peritoneal tumors in women.

Twenty-five peritoneal tumors in women are described. All were partly or entirely of papillary or tubulopapillary structure and multifocal. Eight were unusually well-differentiated mesotheliomas. This appearance was associated with indolent behavior. In 10 cases the growth closely resembled serous papillary carcinoma, including the frequent presence of psammoma bodies, but the ovaries were free of primary tumor. The latter group of tumors progress rapidly and are thought to be derived from extraovarian mesothelium with müllerian potential. Four further cases showed some resemblance to ovarian papillary carcinoma. Only three tumors in the entire series (12%) closely resembled papillary or tubulopapillary diffuse malignant mesothelioma of the type that occurs in the pleural cavities in both sexes. The histopathologic spectrum of papillary tumors of peritoneum in women is extensive, and mesothelial tumors of the type known to be associated with asbestos are rare.