Multicystic peritoneal mesothelioma: a systematic review of the literature

Our plain-English summary of Multicystic peritoneal mesothelioma: a systematic review of the literature, by B. Noiret, F. Renaud, G. Piessen, et al (Pleura and Peritoneum, 2019).

The study

• Authors: B. Noiret, F. Renaud, G. Piessen, C. Eveno
• Journal: Pleura and Peritoneum
• Published: 2019;4(3):20190024
• Type of article: Review
• Cited by: 47 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Multicystic peritoneal mesothelioma (MCPM) is a particularly rare and benign neoplasm that arises from the peritoneum in reproductive aged females. Its etiopathogenesis is still unclear. The current prevailing theory supports the idea that the tumor is the result of an excessive inflammatory process. Because of a lack of clinical and imaging presentation, the diagnosis is intricate, and heavily relies on case reports and short studies. A histological analysis with immunohistochemistry is required for a definitive diagnosis. To date, there is no standard treatment recommended for MCPM. However, some studies suggest proceeding with a cytoreductive surgery and a hyperthermic intraperitoneal chemotherapy combining CISPLATIN and DOXORUBICIN, due to a high incidence of recurrence rate after medical treatment or surgery alone and potential malignant transformation.

© 2019 Noiret et al., published by De Gruyter.

In plain English

This article is a review of published reports on multicystic peritoneal mesothelioma (MCPM), a rare tumor of the abdominal lining that the authors described as benign and occurring mainly in women of reproductive age. Although titled a systematic review, the text did not describe how studies were searched for or selected. The authors stated that, unlike malignant peritoneal mesothelioma, MCPM has no association with asbestos exposure. They described the leading theory that it results from chronic irritation or inflammation. Citing earlier work, the review reported that MCPM makes up 3 to 5% of peritoneal mesotheliomas, with an estimated incidence of 2 per 1,000,000 per year, and that recurrence after surgical removal is approximately 50%. Other studies it summarized reported no recurrence in 12 patients treated with cytoreductive surgery plus heated chemotherapy inside the abdomen (HIPEC), and recurrence in 4 of 19 patients in another series. The authors concluded that definitive diagnosis requires both histology and immunohistochemistry (microscopic study of tissue, including staining for specific proteins), and that combined surgery and HIPEC in a specialized center is the recommended strategy.

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: Literature review, titled a systematic review. The text gives no search strategy or selection criteria.
• Who was studied: Published case reports and case series on multicystic peritoneal mesothelioma worldwide. The authors note that over 200 cases had been reported by 2017.
• Exposure: No asbestos exposure was studied. The authors state that MCPM, unlike malignant peritoneal mesothelioma, has no association with asbestos exposure. Predisposing factors described in the literature include chronic inflammation, previous surgery, endometriosis, and recurrent peritonitis during peritoneal dialysis.
• Main results:
  • Citing an earlier report, MCPM accounts for 3 to 5% of peritoneal mesotheliomas, with an estimated incidence of 2 per 1,000,000 per year.
  • Citing earlier reports, MCPM occurs mainly in young to middle-aged women, at an average age of 37 years.
  • Citing an earlier report, the recurrence rate after complete resection is approximately 50%, after a period of 3 to 27 months (mean 32 months, as printed).
  • In a multi-institutional study by Baratti et al., 12 MCPM patients treated by cytoreductive surgery and HIPEC had no recurrence over a follow-up period of 64 months.
  • In a study by Nizri et al., 19 MCPM patients underwent 20 cytoreductive surgery and HIPEC procedures. Over a median follow-up of 69 months, all were alive and 4 had recurrence (21%).
  • Definitive diagnosis of MCPM requires histology and immunohistochemistry, because clinical and imaging findings are not specific.
• The authors' conclusion: The authors concluded that definitive diagnosis requires histology and immunohistochemistry, that MCPM has a high risk of recurrence and a significant potential for malignant transformation, and that combined cytoreductive surgery and HIPEC in a specialized center is the recommended strategy.
• Limitations the authors state:
  • The authors note that understanding of the disease relies heavily on case reports and short series.

Topics

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Systematic Review, Neoplasm, Peritoneum, Immunohistochemistry, Cytoreductive Surgery, HIPEC, Cisplatin.

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