Asymptomatic peritoneal carcinomatosis originating from benign cystic peritoneal mesothelioma

Our plain-English summary of Asymptomatic peritoneal carcinomatosis originating from benign cystic peritoneal mesothelioma, by S. Iacoponi, J. Calleja, G. Hernandez, et al (Ecancermedicalscience, 2015).

The study

• Authors: S. Iacoponi, J. Calleja, G. Hernandez, R.S. de la Cuesta
• Journal: Ecancermedicalscience
• Published: 2015;9:605
• Type of article: Case report
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Benign multicystic mesothelioma is a rare tumour that originates from the abdominal peritoneum with a predisposition to the pelvic peritoneum. It typically affects women of reproductive age. There have been less than 200 cases of this rare neoplasia reported to date. We present the case of a 35-year-old woman who was referred to our centre because of the detection of a peritoneal carcinomatosis during a gynaecological exam. A diagnostic laparoscopy was performed. The findings included multiple cysts appearing as 'a bunch of grapes' occupying the omentum. Biopsies were taken during the surgery and the results showed benign multicystic peritoneal mesothelioma. Benign multicystic mesothelioma can simulate other conditions, such as malignant ovarian tumours or cystic lymphangioma. It is often diagnosed accidentally during surgery performed for another reason. The diagnosis is interoperative, observing multicystic structures grouped as a 'bunch of grapes' containing clear fluid with thin walls made of connective tissue. Immunohistochemistry confirmed mesothelial origin. Surgery is considered the treatment of choice and is based on the removal of the cysts from the abdominal cavity. Hyperthermic intraperitoneal chemotherapy can be considered as a primary treatment in patients with recurrences or even as a part of primary treatment associated with surgery. Survival at 5 years is 100% and invasive or malignant progression is extraordinary. The treatment approach should be multidisciplinary, and the patient should be referred to a referral centre.

In plain English

This article is a case report from a gynaecologic oncology unit in Madrid, Spain. It describes one patient with benign multicystic peritoneal mesothelioma, a rare tumour of the abdominal lining. A 35-year-old woman was referred by her gynaecologist after a routine gynaecological examination found signs suggesting peritoneal carcinomatosis (spread of tumour deposits through the abdomen). She had no symptoms, her gynaecological examination was normal, and peritoneal marker tests were negative. CT and MRI scans showed small lesions on the omentum, a fatty fold of tissue in the abdomen. During keyhole surgery (laparoscopy), surgeons saw many cysts, like 'a bunch of grapes', covering the omentum. Biopsies showed benign multicystic peritoneal mesothelioma. The operation was converted to open surgery: the omentum was removed and all peritoneal implants were ablated (destroyed), leaving no visible tumour. After one year of monitoring, she had no symptoms and no sign of disease. The article does not mention asbestos or any other exposure. The authors wrote that this tumour's cause is not clear. The authors concluded that treatment should be multidisciplinary, in a specialised referral centre.

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 35-year-old woman seen at the Gynecologic Oncology Unit, Quiron University Hospital, Madrid, Spain. She was referred by her gynaecologist. The date of the case is not given; the article was published in 2015.
• Exposure: Not reported. The article does not mention asbestos or any other exposure. The authors state that the cause of this tumour is not clear.
• Main results:
  • The patient had no symptoms, her gynaecological examination was normal, and her peritoneal markers were negative.
  • CT and MRI scans showed small lesions suggesting mucinous implants on the omentum, attached to the liver and lying between loops of intestine.
  • Exploratory laparoscopy showed multiple grape-like cysts occupying the omentum.
  • Pathology of the biopsies showed benign multicystic peritoneal mesothelioma.
  • The surgery was converted to open surgery (laparotomy). The omentum was removed (omentectomy) and all peritoneal implants were ablated, leaving no visible tumour.
  • After 1 year of monitoring, the patient had no symptoms and was free of disease.
• The authors' conclusion: The authors concluded that treatment of this disease should be multidisciplinary and reviewed by a medical committee in a specialised referral centre. They added that there are no validated recommendations for clinical management.

Topics

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Multicystic Mesothelioma (MCM), Peritoneum, Diagnostic Laparoscopy, Omentum, Immunohistochemistry, HIPEC.

Related studies

• Benign Cystic Mesothelioma Misdiagnosed as Peritoneal Carcinomatosis — H.D. Shin, S.B. Kim (2016)
• Peritoneal benign cystic mesothelioma: a case report and review of the literature — S. van Ruth, M.W. Bronkhorst, et al. (2002)
• Giant benign cystic peritoneal mesothelioma: US, CT, and MRI findings — A. Ozgen, D. Akata, et al. (1998)
• Benign cystic peritoneal mesothelioma — J.A. Schneider, E.J. Zelnick (1985)
• Peritoneal, benign, cystic mesothelioma with free-floating cysts, re-examined by new methods. A case report — O.H. Iversen, T. Hovig, et al. (1988)
• Peritoneal benign cystic mesothelioma — J. Hidvégi, F. Schneider, et al. (1991)

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