Benign Multicystic Peritoneal Mesothelioma in a Male Patient with Previous Wilms' Tumor: A Case Report and Review of the Literature

Our plain-English summary of Benign Multicystic Peritoneal Mesothelioma in a Male Patient with Previous Wilms' Tumor: A Case Report and Review of the Literature, by G.L. Canu, F. Medas, G. Columbano, et al (Case Reports in Surgery, 2018).

The study

• Authors: G.L. Canu, F. Medas, G. Columbano, L. Gordini, L. Saba, E. Erdas, P.G. Calò
• Journal: Case Reports in Surgery
• Published: 2018;2018:4324986
• Type of article: Case report
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Benign multicystic peritoneal mesothelioma (BMPM) is a rare condition, more common in females of reproductive age, which arises from the peritoneal mesothelium. A 33-year-old male presented to our unit with abdominal pain and constipation. His past medical history included a previous unilateral nephrectomy for Wilms' tumor and the previous incidental finding of some intra-abdominal cystic formations at the level of the mesentery. After performing a CT scan, an exploratory laparotomy was done and a voluminous cystic mesenteric mass, composed of 3 confluent formations, was observed. Some other similar but significantly smaller lesions were found. An en bloc resection of the mesenteric mass together with the corresponding intestinal loops, an appendicectomy, and some peritoneal biopsies were performed. The postoperative period was complicated by a peritonitis due to dehiscence of the intestinal anastomosis, which required another operation, and a delayed return of normal bowel function, which was resolved through prokinetic therapy. Through histological examination, a BMPM was diagnosed. At 8 months of follow-up, the patient is free of symptoms. BMPM exact etiopathogenesis still remains uncertain. Given his high recurrence rate, a long-term follow-up is recommended.

In plain English

This article was a case report from a surgical unit at the University of Cagliari, Italy. It described one patient with benign multicystic peritoneal mesothelioma (BMPM), a rare benign tumor of the abdominal lining that the authors noted usually affects women of reproductive age. The patient was a 33-year-old man who came in after 3 days of worsening abdominal pain and who also reported constipation for some days. At age 2 he had a kidney removed for a right-sided Wilms' tumor, a childhood kidney tumor. A CT scan showed three connected cysts in the mesentery, 115 mm across in total. Surgeons removed the main mass, about 10 cm, along with the attached loops of intestine, the appendix, and peritoneal tissue samples. He needed a second operation after the bowel join leaked and was discharged 33 days after the first operation. Examination of the tissue under the microscope confirmed BMPM. At 8 months he had no symptoms. The article did not mention asbestos. The authors concluded that the most probable explanation for BMPM seemed to be persistent inflammation of the peritoneum, as after earlier abdominal operations, and said their case also suggested this. Because of the tumor's high recurrence rate, they recommended long-term 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), with discussion of previously published literature
• Who was studied: One 33-year-old Caucasian man treated at the surgical unit of the University of Cagliari, Italy (article published 2018; the date he presented is not given)
• Exposure: No asbestos or fiber exposure is reported. The relevant history was a right-sided Wilms' tumor treated by removal of one kidney (unilateral nephrectomy) at age 2. The authors linked the BMPM to this earlier abdominal operation.
• Main results:
  • The patient presented after 3 days of progressively worsening abdominal pain and also reported constipation for some days
  • The CT scan showed 3 contiguous, communicating cystic formations in the mesentery with a combined major axis of 115 mm (largest 87 mm), plus smaller similar lesions
  • Surgery found a cystic mass of 3 confluent formations, about 10 cm, in the mesentery of the last ileal loops. It was removed en bloc with those intestinal loops, together with an appendicectomy and peritoneal biopsies.
  • On the 8th postoperative day the patient developed a circumscribed peritonitis because the ileoileal anastomosis (the bowel join) broke down, and he needed a second operation
  • A delayed return of bowel function resolved with prokinetic therapy (levosulpiride and neostigmine methylsulfate). The patient was discharged 33 days after the first operation.
  • Histological examination diagnosed benign multicystic peritoneal mesothelioma
  • The patient was free of symptoms at 8 months of follow-up
• The authors' conclusion: The authors concluded that the exact cause of BMPM remains unclear. They considered the most probable theory, which they said their case also suggested, to be persistent inflammation of the peritoneum, as after previous abdominal operations. They recommended long-term follow-up because local recurrence remains high.

Topics

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Mesothelium, Mesentery, CT Scan, Laparotomy.

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)
• A rare case of benign multicystic peritoneal mesothelioma misdiagnosed as hydatid cyst found in the liver parenchyma and abdomen cavity of a male with asbestos exposure — A.B. Kelarji, M.S. Alshutaihi, et al. (2021)
• Imaging appearance of benign multicystic peritoneal mesothelioma: a case report and review of the literature — V. Mehta, V. Chowdhary, et al. (2017)
• Benign multicystic peritoneal mesothelioma: literature review and update — M.T. Chand, J. Edens, et al. (2020)
• A recurrence of benign multicystic peritoneal mesothelioma treated through laparoscopic excision: a case report and review of the literature — T.D. Witek, J.W. Marchese, et al. (2014)
• Benign multicystic peritoneal mesothelioma treated with laparoendoscopic single site surgery: a case report and review of the literature — K.S. Cha, Y.H. Choi, et al. (2018)

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