Acute presentation of multi-cystic peritoneal mesothelioma

Our plain-English summary of Acute presentation of multi-cystic peritoneal mesothelioma, by M. Redden, A. Riddell (Journal of Surgical Case Reports, 2022).

The study

• Authors: M. Redden, A. Riddell
• Journal: Journal of Surgical Case Reports
• Published: 2022;2022(1):rjab627
• Type of article: Case report
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Multi-cystic peritoneal mesothelioma (MCPM) is a rare intra-abdominal neoplasm that occurs most commonly in young females. The disease usually presents as an incidental finding or with sub-acute abdominal pain. The mainstay of treatment is complete excision; however, local recurrence frequently occurs and malignant transformation has been reported. We describe a unique case of MCPM that presented with acute abdominal pain. A 32-year-old female presented with a 24-hour history of abdominal pain. Computed tomography abdomen demonstrated a low-density mass with surrounding inflammatory changes anterior to the ascending colon, which was initially thought to represent an abscess. A percutaneous drain was inserted; however, only clear fluid was aspirated and the lesion did not resolve. The patient subsequently underwent laparoscopy which identified a cystic structure overlying the ascending colon. The structure was excised whole with histology demonstrating MCPM. The patient recovered from surgery and will undergo a period of surveillance.

Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author(s) 2022.

In plain English

This article was a case report from colorectal surgeons at Redcliffe Hospital in Australia. It described one 32-year-old woman who came to the emergency department with right lower abdominal pain that had started suddenly the day before. She had previously had a laparoscopy for endometriosis, gallbladder removal and a hysterectomy. Ultrasound found a complex multi-locular cyst. CT showed a low-density mass measuring 43 × 55 × 54 mm in front of the ascending colon, with inflammation around it. Doctors first thought it was an abscess and drained it, but only clear fluid came out, and laboratory culture showed no growth. A CT one month later showed the lesion unchanged. At laparoscopy, a multi-cystic structure over the colon was removed whole, and tissue examination showed multi-cystic peritoneal mesothelioma. She recovered well and was to be monitored. The authors considered the case unique because the pain came on so suddenly. They said her history was consistent with a reported link between this disease and previous surgery and endometriosis. The article did not mention asbestos or any other exposure.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient)
• Who was studied: One 32-year-old woman seen at Redcliffe Hospital, Australia, with a history of laparoscopy for endometriosis, cholecystectomy and hysterectomy
• Main results:
  • Ultrasound showed a 102 × 43 × 52 mm complex multi-locular cyst.
  • CT showed a low-density mass with adjacent inflammatory change in front of the ascending colon, measuring 43 × 55 × 54 mm.
  • The mass was drained as a suspected abscess. Clear fluid was obtained and culture showed no growth.
  • A CT one month later showed the lesion unchanged.
  • Laparoscopy found a multi-cystic structure over the distal ascending colon and hepatic flexure. It was removed whole, and histology showed multi-cystic peritoneal mesothelioma (MCPM).
  • The patient recovered well from surgery and was to undergo surveillance.
• The authors' conclusion: The authors concluded that the case was unique because of how sudden the presenting pain was. They stated that a period of clinical surveillance is necessary after removal of MCPM. They noted the patient's history was consistent with the reported association between MCPM and previous surgery and endometriosis.

Topics

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Neoplasm, Malignant Transformation, Histology.

Related studies

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• A Case Report of Peritoneal Mesothelioma as an Acute Abdomen Mimic: A Rare Presentation and Diagnostic Challenges — L. Fadl, M. Fadl, et al. (2024)
• Benign multi-cystic peritoneal mesothelioma of the porta hepatis — H. Aziz, M. Hao, et al. (2020)
• Benign cystic mesothelioma: A case report on the presentation of an unusual tumor — Y. Salem, A. Farhan, et al. (2021)
• Acute effects of multi-walled carbon nanotubes on primary bronchial epithelial cells from COPD patients — S. Beyeler, S. Chortarea, et al. (2018)
• Peritoneal benign cystic mesothelioma: a case report and review of the literature — S. van Ruth, M.W. Bronkhorst, et al. (2002)

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