Thinking outside the pelvis: benign peritoneal multicystic mesothelioma of the ascending colon

Our plain-English summary of Thinking outside the pelvis: benign peritoneal multicystic mesothelioma of the ascending colon, by B. Murphy, M. Ismaeil, D.C. Winter (Journal of Surgical Case Reports, 2023).

The study

• Authors: B. Murphy, M. Ismaeil, D.C. Winter
• Journal: Journal of Surgical Case Reports
• Published: 2023;2023(9):rjz328
• Type of article: Case report
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Benign peritoneal multicystic mesothelioma is a rare tumor of the visceral peritoneum. The authors present an atypical case of a 74-year-old man who presented with a multicystic mesothelioma of the ascending colon.

Published by Oxford University Press and JSCR Publishing Ltd. © The Author(s) 2019.

In plain English

This case report, from St. Vincent's University Hospital in Dublin, Ireland, described one 74-year-old male construction worker and ex-smoker who had six months of pain in the lower right abdomen. A CT scan showed a 6.6-cm cystic mass between the sigmoid colon and caecum. A repeat scan four months later showed no change in size. The patient chose surgery and had an uncomplicated laparoscopic right hemicolectomy, going home 5 days later. The removed tumor measured 6 × 6 × 4.5 cm and contained cysts from under 1 mm to 2 cm across. Staining was positive for the mesothelial markers cytokeratin and calretinin, which gave a diagnosis of benign multicystic mesothelioma. The article did not mention asbestos or any other fiber exposure, and it did not report how the patient did after discharge. The authors stated that, to their knowledge, this was the second reported case presenting in the right colon and the first in an elderly man. They described en bloc surgical removal as the treatment for this tumor and wrote that patients should receive long-term follow-up, tailored to the individual.

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 74-year-old man, a construction worker, treated at the Centre for Colorectal Disease, St. Vincent's University Hospital, Dublin, Ireland. The article does not give the dates of treatment.
• Exposure: The article does not mention asbestos or any fiber exposure. It records only the patient's job (construction worker) and a past heavy smoking history.
• Main results:
  • In this patient, a CT scan showed a 6.6-cm cystic mass between the sigmoid colon and caecum.
  • A repeat CT scan four months after first presentation showed no change in the size of the mass.
  • After laparoscopic right hemicolectomy, the patient was discharged home 5 days after surgery.
  • Histology showed a 6 × 6 × 4.5 cm polycystic tumor with cysts from less than 1 mm to 2 cm. About 21 lymph nodes were removed with the specimen.
  • Immunohistochemistry was positive for cytokeratin and calretinin, and the diagnosis was benign multicystic mesothelioma.
• The authors' conclusion: The authors stated that, to their knowledge, this is the second reported case of a right colonic presentation of benign peritoneal multicystic mesothelioma and the first in an elderly man. They described en bloc surgical excision as the treatment. They wrote that patients should receive long-term follow-up, and that because there are no unifying treatment and surveillance guidelines, this should be tailored to the individual.

Topics

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

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• Benign multicystic mesothelioma and peritoneal inclusion cysts: are they the same clinical and histopathological entities? A systematic review to find an evidence-based management — A.M.C. Rapisarda, A. Cianci, et al. (2018)
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• Benign multicystic peritoneal mesothelioma: literature review and update — M.T. Chand, J. Edens, et al. (2020)
• Imaging appearance of benign multicystic peritoneal mesothelioma: a case report and review of the literature — V. Mehta, V. Chowdhary, et al. (2017)

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