Primary Peritoneal Desmoplastic Mesothelioma

Our plain-English summary of Primary Peritoneal Desmoplastic Mesothelioma, by S. Malla, P. Kumar, P. Das, et al (ACG Case Reports Journal, 2020).

The study

• Authors: S. Malla, P. Kumar, P. Das, D. Kandasamy
• Journal: ACG Case Reports Journal
• Published: 2020;7(6):e00404
• Read it: PubMed · Publisher · Free full text

In plain English

This article was a case report about one patient, written by doctors at the All India Institute of Medical Sciences in New Delhi, India. A 40-year-old man had had abdominal pain, swelling of the abdomen and loss of appetite for 9 months. A CT scan showed loops of his small intestine bunched together in the middle of the abdomen and wrapped in a thick membrane, without blockage of the bowel. This pattern suggested a condition called encapsulating peritoneal sclerosis, or "abdominal cocoon." Tissue samples taken during a small abdominal operation showed tumor cells within dense fibrous tissue. Laboratory staining of the cells pointed to desmoplastic mesothelioma of the peritoneum, the lining of the abdomen. He received two cycles of pemetrexed and cisplatin chemotherapy and died of multiorgan failure about 4 months after he first came for care. The article did not mention asbestos or any other exposure. The authors wrote that, to their knowledge, this tumor had not been described before as appearing like encapsulating peritoneal sclerosis. They concluded that doctors should include this rare tumor among the conditions they consider when findings suggest encapsulating peritoneal sclerosis.

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 40-year-old man with 9 months of abdominal pain, abdominal distension and loss of appetite; the authors were from the All India Institute of Medical Sciences, New Delhi, India
• Exposure: Not reported. The article does not mention asbestos or any other exposure, occupation or cause.
• Main results:
  • In this patient, contrast-enhanced CT of the abdomen showed clumping of the jejunal and ileal loops of the small intestine in the central abdomen, enclosed by a thick enhancing membrane
  • The imaging findings in this patient suggested abdominal cocoon (encapsulating peritoneal sclerosis)
  • In this patient, peritoneal biopsies showed staining positive for WT1 and calretinin and negative for desmin, suggestive of peritoneal desmoplastic mesothelioma
  • This patient was given pemetrexed and cisplatin-based chemotherapy and died of multiorgan failure after 2 cycles, approximately 4 months after he first presented
• The authors' conclusion: The authors stated that, to their knowledge, primary peritoneal desmoplastic mesothelioma presenting as encapsulating peritoneal sclerosis had not been described before. They concluded that the desmoplastic variety of primary peritoneal mesothelioma should be included in the differential diagnosis of encapsulating peritoneal sclerosis, that is, among the conditions considered when findings suggest it, albeit as a rare one.

Topics

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

Related studies

• From the archives of the AFIP: primary peritoneal tumors: imaging features with pathologic correlation — A.D. Levy, J. Arnáiz, et al. (2008)
• Treatment of primary peritoneal mesothelioma by continuous hyperthermic peritoneal perfusion (CHPP) — B.J. Park, H.R. Alexander, et al. (1999)
• Primary malignant peritoneal mesothelioma. A report of seven cases and a review of the literature — J.A. Asensio, P. Goldblatt, et al. (1990)
• The Pathologic Peritoneal Cancer Index (PCI) Strongly Differs From the Surgical PCI in Peritoneal Metastases Arising From Various Primary Tumors — A. Bhatt, Y. Yonemura, et al. (2020)
• Peritoneal malignant mesothelioma (PMM), and primary peritoneal serous carcinoma (PPSC) and reactive mesothelial hyperplasia (RMH) of the peritoneum. Immunohistochemical and fluorescence in situ hybridisation (FISH) analyses — T. Kawai, S. Tominaga, et al. (2016)
• Incidence, Survival Analysis and Future Perspective of Primary Peritoneal Mesothelioma (PPM): A Population-Based Study from SEER Database — A. Ullah, A. Waheed, et al. (2022)

Browse return to medical research.