Laparoscopic treatment of retroperitoneal cystic mesothelioma. Two cases reported

Our plain-English summary of Laparoscopic treatment of retroperitoneal cystic mesothelioma. Two cases reported, by S. Morales Artero, C.J. Castellón Pavón, E. Larraz Mora, et al (International Journal of Surgery Case Reports, 2016).

The study

• Authors: S. Morales Artero, C.J. Castellón Pavón, E. Larraz Mora, J.M. de Jaime Guijarro, C. García Vásquez, M. Calvo Serrano
• Journal: International Journal of Surgery Case Reports
• Published: 2016;29:230-233
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Retroperitoneal cystic mesothelioma is a very rare lesion. The pathogeny is unclear and establishing a preoperative diagnosis versus others retroperitoneal cystic lesions is difficult. Thus, with increasing experience in laparoscopic retroperitoneal surgery, the use of this approach for exploration of a retroperitoneal mass of unknown origin may provide an alternative to classic open surgery and all the benefits of laparoscopy. We present two cases treated laparoscopycally and review the literature.

Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

In plain English

This article reported two patients with cystic mesothelioma in the retroperitoneum (the space behind the abdominal lining), treated near Madrid, Spain, with a literature review. Both had laparoscopic (keyhole) surgery. The first, a 49-year-old man, had a cyst measuring 19 by 13.5 by 30 cm on CT, suspected before surgery to be a simple liver cyst. Surgery took 90 minutes; he went home on day three. Tissue showed mesothelial cells without malignancy; CT showed no recurrence two years later. The second, a 28-year-old woman with night sweats, had an 11 by 9 by 5 cm cyst on MRI. Surgery took 140 minutes; she went home on day four. Tissue showed a benign lining consistent with a mesothelioma; there was no recurrence at twelve months. No asbestos exposure history was given for either patient. Citing earlier publications, the authors wrote that these lesions, unlike malignant mesothelioma, have no relation with asbestos exposure. The authors concluded that laparoscopy is a valid and safe approach for highly suspected benign cystic retroperitoneal mesothelioma.

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 of two patients, with a review of the literature
• Who was studied: Two patients with retroperitoneal cystic mesothelioma treated at hospitals in the Madrid area, Spain: a 49-year-old man admitted after a hip fracture, and a 28-year-old woman seen for profuse night sweating. Dates of treatment are not given.
• Exposure: No asbestos or other exposure is reported for either patient. In the discussion, citing other publications, the authors state that cystic mesotheliomas, unlike malignant mesothelioma, have no relation with asbestos exposure. The treatment studied was laparoscopic surgical removal.
• Main results:
  • Case 1 (man, 49): CT showed a large cystic, lobulated lesion of 19 × 13.5 × 30 cm in the right abdomen
  • Case 1: a simple liver (hepatic) cyst was suspected before surgery
  • Case 1: surgery took 90 minutes and the patient was discharged on the third day
  • Case 1: pathology showed a cystic structure lined with flat mesothelial cells, focally reactive and without malignancy
  • Case 1: two years after surgery the patient had no symptoms and no recurrence on CT scan
  • Case 2 (woman, 28): MRI showed an 11 × 9 × 5 cm septated cystic lesion behind the liver
  • Case 2: operating time was 140 minutes and the patient was discharged on the fourth day
  • Case 2: pathology showed a cystic lesion with a benign cuboidal epithelial lining, consistent with a mesothelioma
  • Case 2: at twelve months of follow-up she had no symptoms and no recurrence on CT scan
• The authors' conclusion: The authors concluded that laparoscopy is a valid and safe approach for highly suspected benign cystic retroperitoneal mesothelioma, because it allows complete excision and a favourable prognosis. Elsewhere in the discussion they wrote that laparotomy should be performed only when malignancy is highly suspected. They also stated that preoperative diagnosis is difficult.

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma.

Related studies

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• Postoperative outcomes of laparoscopic vs open cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy for treatment of peritoneal surface malignancies — G. Passot, N. Bakrin, et al. (2014)
• Long-term results of laparoscopic cytoreductive surgery and HIPEC for the curative treatment of low-grade pseudomyxoma peritonei and multicystic mesothelioma — F. Mercier, G. Jeremie, et al. (2020)
• Treatment of postoperative chylothorax through laparoscopic thoracic duct ligation — B.C. Vassallo, D. Cavadas, et al. (2002)
• Laparoscopic diagnosis and treatment of pelvic benign multicystic mesothelioma associated with high CA19.9 serum concentration — V. Pinto, A.C. Rossi, et al. (2010)
• Diagnosis and treatment of malignant retroperitoneal mesothelioma: A case report — F. Tang, Y. Cui, et al. (2024)

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