Benign Multicystic Peritoneal Mesothelioma (BMPM) as a rare cause of abdominal pain: a case report and review of the literature

Our plain-English summary of Benign Multicystic Peritoneal Mesothelioma (BMPM) as a rare cause of abdominal pain: a case report and review of the literature, by H.B. Hassine, M. Touati, A. Bouchrika, et al (International Journal of Surgery Case Reports, 2025).

The study

• Authors: H.B. Hassine, M. Touati, A. Bouchrika, F. Boughanmi, I. Korbi, F. Noomen
• Journal: International Journal of Surgery Case Reports
• Published: 2025;131:111448
• Type of article: Case report
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Introduction: Benign Multicystic Peritoneal Mesothelioma (BMPM) is a rare, benign cystic neoplasm arising from the peritoneum, predominantly affecting women of reproductive age. It is characterized by a slow progression and a high recurrence rate post-surgical resection. Due to its non-specific clinical presentation, BMPM remains a diagnostic challenge.

Case Presentation: We report a case of a 38-year-old female with a history of left ovarian cystectomy who presented with acute, stinging abdominal pain. Imaging studies, including ultrasound, contrast-enhanced computed tomography, and magnetic resonance imaging, revealed a large multicystic lesion in the left flank. Complete surgical excision was performed. Histopathology confirmed the diagnosis of BMPM.

Discussion: Benign multicystic peritoneal mesothelioma (BMPM) is a rare, often asymptomatic cystic lesion predominantly affecting women of reproductive age, with unclear etiology possibly linked to hormones or prior inflammation. Imaging shows multiloculated cystic masses, and diagnosis is confirmed histologically and immunohistochemically. Surgical resection is the main treatment due to high recurrence, with close follow-up recommended.

Conclusion: BMPM is a rare peritoneal neoplasm with a challenging diagnosis due to its non-specific symptoms and imaging characteristics. Complete surgical resection remains the mainstay of treatment, although close follow-up is necessary due to its high recurrence potential.

Copyright © 2025 The Authors. Published by Elsevier Ltd.. All rights reserved.

In plain English

This article was a case report, with a discussion of published literature, from a surgery department in Monastir, Tunisia. It described a 38-year-old woman who had had a left ovarian cystectomy five years earlier, had intermittent abdominal discomfort for three years, and then developed sudden, sharp left-sided abdominal pain. Her examination, blood tests and tumor markers were normal. Ultrasound, CT and MRI showed a multicystic mass about 15 cm across in the left flank. Surgeons operated through an open abdominal incision and removed the cystic lesions completely. She went home on the fourth day without complications. Laboratory examination of the tissue confirmed benign multicystic peritoneal mesothelioma (BMPM). She remained recurrence-free ten months after surgery. The article did not report on any asbestos exposure for her. Its discussion, citing other work, stated that BMPM, unlike pleural mesothelioma, has not been linked to asbestos exposure. The authors concluded that once BMPM is diagnosed, surgery should aim to remove both visible and microscopic disease.

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) followed by a narrative discussion of published literature
• Who was studied: One 38-year-old woman treated at the Department of Visceral Surgery, Fattouma Bourguiba Hospital, Monastir, Tunisia. She had had a left ovarian cystectomy five years earlier and had intermittent abdominal discomfort for three years, followed by sudden sharp left-sided pain.
• Exposure: No asbestos exposure history was reported for the patient. The discussion, citing another publication (reference 12), stated that BMPM, unlike pleural mesothelioma, has not been linked to asbestos exposure.
• Main results:
  • The patient's laboratory blood tests and tumor markers were normal.
  • Abdominal ultrasound showed a multicystic mass about 15 cm in diameter on the left flank.
  • Contrast-enhanced CT showed a hypodense, multilobulated lesion with multiple thin internal septations that enhanced with contrast, measuring 150 × 95 mm. MRI supported these findings.
  • At exploratory laparotomy, the cystic lesions arose from the peritoneum, with some involving the omentum and minimal adhesions to the descending colon and rectum. They were completely excised.
  • The patient was discharged on the fourth postoperative day without complications.
  • Histopathology showed multiple cysts lined by a single layer of mesothelial cells, with fibrous walls containing adipose tissue. The final diagnosis was benign multicystic peritoneal mesothelioma.
  • The patient was recurrence-free ten months after surgery.
• The authors' conclusion: The authors concluded that BMPM is an uncommon benign tumor whose diagnosis often remains uncertain until histopathological confirmation. Once it is definitively diagnosed, surgery should aim to remove both visible and microscopic disease.

Topics

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Neoplasm, Peritoneum, Surgical Resection, Ultrasound, Histopathology, Etiology, Inflammation.

Related studies

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• Multicystic benign mesothelioma of the pelvic peritoneum presenting as acute abdominal pain in a young woman — J.H. Hong, S. Jeon, et al. (2013)
• Intra-abdominal benign multicystic peritoneal mesothelioma — I. Jouvin, A. Dohan, et al. (2014)
• Benign multicystic peritoneal mesothelioma presenting as a ghost abdominal mass — H. Jerraya, W. Ghariani, et al. (2016)

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