Surgical management of a benign multicystic peritoneal mesothelioma: A case report

Our plain-English summary of Surgical management of a benign multicystic peritoneal mesothelioma: A case report, by S. Amine, O. Yacine, A. Souhaib, et al (International Journal of Surgery Case Reports, 2023).

The study

• Authors: S. Amine, O. Yacine, A. Souhaib, J. Yasmine, M. Amine, M. Kacem
• Journal: International Journal of Surgery Case Reports
• Published: 2023;107:108308
• Type of article: Case report
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Introduction And Importance: Benign multicystic peritoneal mesothelioma is rare, with around 200 cases reported in the literature. We report the case of a patient operated on for the diagnosis of cystic lymphangioma but the pathology examination retained the diagnosis of benign cystic peritoneal mesothelioma.

Case Presentation: A 47-year-old patient, who consulted for abdominal distension evolving for a year. Examination revealed a 30-centimeter abdominal mass. The CT scan showed an intraperitoneal cystic mass measuring 24 × 13 × 32 cm. The diagnosis of cystic lymphangioma was suspected and we decided to surgically remove the mass. We performed a laparotomy. There was a large multi-cystic formation that seemed to develop at the expense of the parietal peritoneum and the greater omentum. A monobloc resection was performed. The postoperative was eventless. Pathology concluded to a benign cystic peritoneal mesothelioma.

Discussion: The BMPM is a rare peritoneal neoplasm that develops mainly in women, during sexual activity. Its etiopathogenesis is unknown. It is often mesenteric or omental. Generally, resection is considered the sole treatment for benign mesotheliomas. However, this surgery needs to be R0 or it will expose to a certain recurrence. Some authors recommend a more aggressive approach associating cytoreductive surgery with heated intraperitoneal chemotherapy.

Conclusion: Benign multicystic peritoneal mesothelioma is a rare pathology of the peritoneum which develops mainly in women during periods of reproductive activity. Despite its benignity, it presents a high risk of recurrence, up to 50 % of cases.

Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.

In plain English

This case report from La Rabta Hospital in Tunis, Tunisia, described a 47-year-old woman with no past medical history and one year of abdominal swelling. Examination found a 30-centimetre mass, and a CT scan showed a cystic mass inside the abdomen measuring 24 by 13 by 32 cm. Before surgery, the doctors suspected a cystic lymphangioma, a different cystic growth. During open surgery, they found a large mass of many cysts filled with clear fluid. It seemed to arise from the lining of the abdominal wall and the omentum and did not invade any abdominal structure. They removed the tumor and omentum in one piece. Recovery was uneventful. Examination of the removed tissue confirmed benign cystic peritoneal mesothelioma. Over two years of check-ups, with CT scans every six months, there were no signs of recurrence. The article did not mention asbestos; the authors wrote that the disease's cause remains unclear. The authors concluded that, despite being benign, it carries a high risk of recurrence, up to 50 % of cases. That figure comes from other published reports, not from this patient.

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 47-year-old woman with no past medical history and one year of abdominal distension, treated at the Department of Surgery A, La Rabta Hospital, Tunis, Tunisia. Dates of treatment are not given.
• Exposure: Not reported. The article does not mention asbestos or any occupational or environmental exposure. The authors state that the cause (pathogenesis) of this disease is unclear.
• Main results:
  • In this patient, CT showed a large intraperitoneal cystic mass of 24 by 13 by 32 cm. Cystic lymphangioma was the suspected diagnosis before surgery.
  • At surgery, the multi-cystic mass seemed to develop from the parietal peritoneum and the great omentum and did not invade any abdominal structure.
  • In this patient, the tumor and the great omentum were removed in one piece (en-bloc resection), and the postoperative course was uneventful.
  • In this patient, pathological examination of the surgical specimen confirmed benign cystic peritoneal mesothelioma.
  • This patient had no signs of recurrence over two years of follow-up, with clinical examinations and CT scans every 6 months.
• The authors' conclusion: The authors concluded that benign multicystic peritoneal mesothelioma is rare, has no specific radiologic signs, is often confused with cystic lymphangioma, and is treated surgically. They concluded that, despite being benign, it carries a high risk of recurrence, up to 50 % of cases. This figure comes from the literature, not from this patient.

Topics

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Pathology, CT Scan, Laparotomy, Peritoneum, Omentum, Neoplasm, Mesothelioma.

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