Benign Multicystic Peritoneal Mesothelioma Presenting as a Colonic Mass

Our plain-English summary of Benign Multicystic Peritoneal Mesothelioma Presenting as a Colonic Mass, by K. Pierre, N.F. Gomez, S. Bing, et al (Curēus, 2021).

The study

• Authors: K. Pierre, N.F. Gomez, S. Bing, C.E. Garcia, B.G. Dalton
• Journal: Curēus
• Published: 2021;13(6):e15540
• Type of article: Case report
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Benign multicystic peritoneal mesothelioma (BMPM) is a rare neoplasm of the abdominal mesothelium (i.e., peritoneum, mesentery, and omentum). We present the case of a 74-year-old male who presented with a right paracolic gutter fluid collection and cystic mass. The patient underwent diagnostic laparoscopy with resection of the mass. The final pathology revealed BMPM. The pathogenesis may have been related to longstanding diverticular disease, which could prove to be an underrecognized risk factor for the development of BMPM. Therefore, this case suggests a broadened differential diagnosis to include BMPM in specific cases of pre-operatively diagnosed colonic masses. The patient is disease-free 11 months post-operatively.

Copyright © 2021, Pierre et al.

In plain English

This case report described a 74-year-old man with a history of diverticulitis who had benign multicystic peritoneal mesothelioma (BMPM). The authors described BMPM as a rare tumor arising from the lining of the abdominal cavity. The article does not mention asbestos. The man had a recurring right lower abdominal fluid collection, first diagnosed in 2017 and measuring 13.5 cm in November 2018. Drainage procedures showed no evidence of malignancy. An August 2019 CT showed severe colonic diverticulosis and an 11.7 cm structure resembling a cystic lymphangioma. A January 2020 scan also showed scattered nodules in the abdomen and pelvis. In February 2020, surgeons removed a 13 cm cystic mass that appeared to arise from the omentum and found a second, 5 cm cystic mass in the upper left abdomen. Pathology showed benign multicystic mesothelioma. Eleven months after surgery there was no evidence of recurrence. The authors suggested that inflammation from diverticulitis may have played a role. They concluded that BMPM should be considered for a colonic mass with diverticular disease, a benign recurring fluid collection and a normal colonoscopy, once colon cancer is ruled out.

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 (one patient)
• Who was studied: One 74-year-old man with a past history of diverticulitis. He was first diagnosed with an abdominal fluid collection in 2017, evaluated in clinic in November 2018, and operated on in February 2020. The authors are from General Surgery, University of Florida College of Medicine – Jacksonville.
• Exposure: No asbestos exposure or other fiber exposure is reported. The article discusses longstanding diverticular disease (diverticulitis) as a possible contributor to the tumor.
• Main results:
  • The patient had a recurrent 13.5 cm fluid collection in the right lower quadrant paracolic gutter. CT-guided drainage showed no evidence of malignancy.
  • August 2019 CT showed severe colonic diverticulosis and an 11.7 cm right paracolic gutter structure with features of a cystic lymphangioma.
  • January 2020 imaging showed a similar mass plus numerous scattered mesenteric and peritoneal nodules in the abdomen and pelvis.
  • At laparoscopy in February 2020, a complex 13 cm cystic mass appeared to arise from the omentum in the right lower quadrant.
  • A similar 5 cm cystic mass was found in the left upper quadrant.
  • Final pathology showed benign multicystic mesothelioma with calretinin-positive staining.
  • The patient was discharged on postoperative day 1. At 11 months after surgery there was no evidence of recurrent disease.
• The authors' conclusion: The authors concluded that BMPM, though rare, especially in males, should be considered in the differential diagnosis of a colonic mass in patients who have a benign recurrent abdominal fluid collection, diverticular disease and a normal colonoscopy. In the discussion they framed this as applying after colon cancer is ruled out. They called for further identification of risk factors, which they suggested may include diverticulitis.

Topics

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Neoplasm, Mesothelium, Peritoneum, Mesentery, Omentum, Diagnostic Laparoscopy, Pathology.

Related studies

• Benign multicystic peritoneal mesothelioma presenting as a ghost abdominal mass — H. Jerraya, W. Ghariani, et al. (2016)
• Benign multicystic peritoneal mesothelioma presenting as a retroperitoneal pelvic mass in a young woman: a case report — E.A. Amaireh, O. Al-Natour, et al. (2026)
• Multicystic benign cystic mesothelioma presenting as a pelvic mass — M. Momeni, E. Pereira, et al. (2014)
• The first case of benign multicystic mesothelioma presenting as a splenic mass — A. D'Antonio, C. Baldi, et al. (2016)
• Benign multicystic peritoneal mesothelioma (BMPM) presenting with ambiguous symptoms: A rare case report — A. Hamza, A. Zazo, 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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