Benign multicystic peritoneal mesothelioma (BMPM) presenting with ambiguous symptoms: A rare case report

Our plain-English summary of Benign multicystic peritoneal mesothelioma (BMPM) presenting with ambiguous symptoms: A rare case report, by A. Hamza, A. Zazo, M.K. Alrifai, et al (Annals of Medicine and Surgery, 2021).

The study

• Authors: A. Hamza, A. Zazo, M.K. Alrifai, S. Khoja, B. Shebli, F. Fattal, R. Alyousfi, M. Trissi
• Journal: Annals of Medicine and Surgery
• Published: 2021;61:85-87
• Type of article: Case report
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Introduction: Benign multicystic peritoneal mesothelioma (BMPM) represents a very rare clinical entity, with only 130 registered cases in the medical literature, therefore it is usually overlooked from the list of differential diagnoses. The treatment consists of surgery and other authors suggest complementing it with hyperthermic intraperitoneal chemotherapy.

Presentation Of Case: A 25-year-old multiparous female experienced periodic abdominal discomfort for two weeks. She developed constipation, urinary urgency, and irregular menstruation. Family history was remarkable for endometrial and breast cancer. Abdominal examination revealed a palpable mass. Abdominal ultrasound and computed tomography scan identified the multicystic appearance of the mass. The diagnosis was unclear, therefore exploratory laparotomy was performed, which revealed multiple grape-like clusters of cysts that were excised immediately. BMPM was diagnosed based on the pathology report. Eventually, the follow-up did not reveal any recurrence.

Discussion: Mesothelial tumors include three pathological entities, including Benign multicystic peritoneal mesothelioma (BMPM). BMPM is an uncommon neoplasm and has a high recurrence rate after surgery. BMPM consists of clear cysts that take the shape of a grape-like cluster. Clinically, BMPM resembles a tangible abdominal mass and it is challenging to be diagnosed, due to its numerous differential diagnoses.

Conclusion: The definitive diagnosis of intraperitoneal cystic masses is usually challenging. Therefore, BMPM -although very rare- should always be thought of when dealing with an intraperitoneal cystic mass, especially in women in the reproductive years. In our case cytoreductive surgery solely was sufficient to achieve a disease free follow up, however, further studies regarding treatment and follow-up are required.

© 2020 The Authors.

In plain English

This article is a case report of one patient: a 25-year-old woman with benign multicystic peritoneal mesothelioma (BMPM), a rare benign cystic tumor of the abdominal lining. She had two weeks of abdominal swelling and discomfort, with irregular periods, constipation and urinary urgency. Her CA 19.9 and CA 125 tumor markers were raised (69.59 and 64.08 U/ml). Ultrasound and CT showed a large multicystic mass (25 by 15 cm on ultrasound, 25 by 10 cm on CT). The diagnosis stayed unclear, so surgeons opened the abdomen and removed grape-like clusters of cysts. Microscopy showed cysts lined by a single layer of mesothelial cells, and the pathology report confirmed the diagnosis. At five months, examination and ultrasound showed no recurrence. The article does not say whether this patient had any asbestos exposure. Its discussion, citing earlier work, states that BMPM has no connection with asbestos exposure, unlike malignant mesothelioma. The authors concluded that BMPM should be considered when a multicystic peritoneal mass is found, especially in women of reproductive age, and recommended further studies on treatment and follow-up.

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 25-year-old woman who had been pregnant twice and given birth twice, reported by authors at hospitals in Aleppo, Syria; dates not given
• Exposure: The article does not say whether this patient had asbestos or other occupational exposure. The discussion, citing earlier literature, states that BMPM in general has no connection with asbestos exposure, unlike malignant mesothelioma.
• Main results:
  • The patient had uneven abdominal swelling and occasional abdominal discomfort for two weeks.
  • The patient's CA 19.9 and CA 125 tumor marker levels were raised, at 69.59 and 64.08 U/ml respectively.
  • Ultrasound showed a multicystic mass with thick septations measuring 25 × 15 cm.
  • CT showed a multi-loculated cystic-appearing mass in the abdomen and pelvis measuring 25 × 10 cm.
  • At surgery, multiple grape-like clusters of cysts were found and removed.
  • Under the microscope, the cysts were lined by a single layer of mesothelial cells.
  • The pathology report confirmed multicystic benign mesothelioma.
  • At five months of follow-up, physical examination and ultrasound showed no clinical evidence of recurrence in this patient.
• The authors' conclusion: The authors concluded that physicians should include BMPM among possible diagnoses for a multicystic peritoneal mass, especially in women of reproductive age.
• Limitations the authors state:
  • Because diagnostic materials were lacking, the diagnosis relied on hematoxylin and eosin staining.
  • Because BMPM is very rare, evidence on its treatment follow-up is lacking.
  • The authors recommended further studies in this area.

Topics

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, HIPEC, Ultrasound, Laparotomy, Pathology Report, Neoplasm, Cytoreductive Surgery.

Related studies

• Benign Multicystic Peritoneal Mesothelioma (BMPM) as a rare cause of abdominal pain in a young male: case report and review of the literature — S. Gussago, P. Spina, et al. (2019)
• Benign Multicystic Peritoneal Mesothelioma (BMPM) as a rare cause of abdominal pain: a case report and review of the literature — H.B. Hassine, M. Touati, et al. (2025)
• Benign Multicystic Peritoneal Mesothelioma: A Rare Condition in an Uncommon Gender — M.S. Khurram, H. Shaikh, et al. (2017)
• Benign multicystic peritoneal mesothelioma presenting as a ghost abdominal mass — H. Jerraya, W. Ghariani, et al. (2016)
• Benign Multicystic Peritoneal Mesothelioma Presenting as a Colonic Mass — K. Pierre, N.F. Gomez, et al. (2021)
• Benign Multicystic Peritoneal Mesothelioma Presenting as Appendiceal Abscess: A Diagnostic and Therapeutic Challenge — C. Seretis, A.M. Elhassan, et al. (2020)

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