The first case of benign multicystic mesothelioma presenting as a splenic mass

Our plain-English summary of The first case of benign multicystic mesothelioma presenting as a splenic mass, by A. D'Antonio, C. Baldi, M. Addesso, et al (Ecancermedicalscience, 2016).

The study

• Authors: A. D'Antonio, C. Baldi, M. Addesso, C. Napolitano
• Journal: Ecancermedicalscience
• Published: 2016;10:678
• Type of article: Case report
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Multicystic mesothelioma (MM) is a relatively rare tumour arising in the pelvic peritoneum of the tuboovarian region of young woman. Exceptionally, MM occurs on the serosal surfaces of various organs including kidney, bladder, lymph nodes, and liver. We report here the first case of MM wherein a 58-year-old woman with a previous history of endometriosis of the right ovary presented with a large multicystic mass of the spleen. The diagnosis of MM was made on a surgical specimen after splenectomy. A histopathologic examination is always necessary for the diagnosis of MM which should be differentiated from other lesions particularly from cystic lymphangioma. At one year follow-up, the patient had no evidence of recurrence. Despite the high frequency of local recurrences, MM is a benign lesion and 'en bloc' surgical excision with prolonged follow-ups is the treatment of choice.

In plain English

This article is a case report about one patient. The authors described a 58-year-old woman who had earlier had her right ovary removed because of endometriosis. She came to medical attention with weakness, pain in the left flank and a bulging left side of the abdomen. A CT scan showed a large mass of many cysts in the spleen. A blood-vessel growth was suspected, and the spleen was removed. It measured 20 x 10 cm. Under the microscope, the cysts were lined by bland cells, with no abnormal cell features (atypia) and no dividing cells (mitoses). The lining cells stained positive for calretinin, the mesothelial marker HMBE-1, other markers and the oestrogen receptor. They stained negative for the endothelial markers CD34, CD31 and FVIII. The diagnosis was multicystic mesothelioma, which the authors called the first such case in the spleen. One year after surgery, a CT scan showed no recurrence. The authors concluded that this is a benign, reactive lesion that needs tissue examination for diagnosis, complete surgical removal and prolonged follow-up. The article does not mention asbestos.

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 58-year-old woman with a history of right oophorectomy (removal of the right ovary) for ovarian endometriosis, who presented with weakness, left flank pain and bulging of the left side of the abdomen
• Exposure: No asbestos or other environmental or occupational exposure is reported. The relevant history given is a previous right oophorectomy for ovarian endometriosis.
• Main results:
  • CT of the abdomen and pelvis showed a large multicystic mass of the spleen. A vascular proliferation was suspected and splenectomy was carried out.
  • Tumour markers were normal (alpha-fetoprotein 0,9 ng/mL, carcinoembryonic antigen 2,1 ng/mL) except for an elevated serum carbohydrate antigen 125 (more than 625 U/mL)
  • The spleen measured 20 x 10 cm and contained a large mass with many large and small cysts filled with gelatinous or haemorrhagic fluid
  • Under the microscope, atypia and mitoses were absent
  • The lining cells were positive for CKPan, calretinin, HMBE-1, CK5/6 and oestrogen receptor (ER), and negative for CD34, CD31 and FVIII
  • The patient had no complaints and normal abdominal ultrasound at about three and six months, and a CT scan at one year showed no disease recurrence
• The authors' conclusion: The authors concluded that multicystic mesothelioma is a benign and reactive lesion that can mimic other diseases on imaging, so tissue (histopathologic) examination is always necessary for diagnosis. They also concluded that surgery is reported to be the only effective treatment, that there is a high risk of local recurrence if the lesion is not completely removed, and that prolonged follow-up is necessary.

Topics

Medical terms in this study, explained in our Lexicon: Multicystic Mesothelioma (MCM), Peritoneum, Serosal Surface.

Related studies

• Multicystic benign cystic mesothelioma presenting as a pelvic mass — M. Momeni, E. Pereira, et al. (2014)
• Benign multicystic peritoneal mesothelioma presenting as a ghost abdominal mass — H. Jerraya, W. Ghariani, et al. (2016)
• Benign Multicystic Peritoneal Mesothelioma Presenting as a Colonic Mass — K. Pierre, N.F. Gomez, et al. (2021)
• 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)
• Malignant peritoneal mesothelioma presenting as a splenic mass — M. Podberezin, M.J. Fitzpatrick, et al. (2020)
• Primary Malignant Mesothelioma of the Tunica Vaginalis Presenting as a Benign Scrotal Mass: A Case Report — Z.C. Dagdeviren, O. Amac, et al. (2025)

Browse more research in Ecancermedicalscience, or return to medical research.