Rare localization of malignant peritoneal mesothelioma

Ionuț Huțanu, Bogdan Filip, Mihaela Buna, Dragoș Viorel Scripcariu, Dan Ferariu, Viorel Scripcariu


Peritoneal mesothelioma represents a rare disease, among its manifestations it can be encountered ascites and tumoral abdominal masses and this condition, untreated can lead to death by bowel obstruction, perforation and cachexia. Due to the rarity of the disease, some patients are misdiagnosed and thus they cannot benefit from a radical form of treatment which leads to an increased survival. We hereby present the case of a 62 year-old male with previous surgery for a retroperitoneal tumor with relapse of the disease. The pathological examination and immunochemistry showed a diffuse peritoneal mesothelioma with poor differentiation. The patient was submitted to chemotherapy and 16 months after surgery on regular control imaging he presented a retroperitoneal recurrence. Unfortunately the patient refused the treatment; we believe that he could benefit from radical surgery associated with hyperthermic intraperitoneal chemotherapy. Preoperative diagnosis of diffuse peritoneal mesothelioma can be difficult due to the lowest predictability of the clinical and imaging studies.


diffuse malignant peritoneal mesothelioma, immunohistochemistry, survival, intraperitoneal chemotherapy

Full Text:



Peto J, Decarli A, La Vecchia C, Levi F, Negri E. The European mesothelioma epidemic. Br J cancer 1999; 79(3-4):666-672.

Boffetta P. Epidemiology of peritoneal mesothelioma: a review. Ann oncol 2007; 18(6):985-990.

Fasola G, Puglisi F, Follador A, Aita M, Di Terlizzi S, Belvedere O. Dramatic tumour response to pemetrexed single-agent in an elderly patient with malignant peritoneal mesothelioma: a case report. BMC Cancer 2006; 6:289.

Testa JR, Cheung M, Pei J, et al. Germline BAP1 mutations predispose to malignant mesothelioma. Nat Genet 2011; 43(10):1022-1025.

Brigand C, Monneuse O, Mohamed F, et al. Peritoneal mesothelioma treated by cytoreductive surgery and intraperitoneal hyperthermic chemotherapy: results of a prospective study. Ann surg oncol 2006; 13(3):405-412.

Diop AD, Fontarensky M, Montoriol PF, Da Ines D. CT imaging of peritoneal carcinomatosis and its mimics. Diagn Interv Imaging 2014; 95(9):861-872.

Ordonez NG. Role of immunohistochemistry in distinguishing epithelial peritoneal mesotheliomas from peritoneal and ovarian serous carcinomas. Am J Surg Pathol 1998; 22(10):1203-1214.

Chirieac LR, Pinkus GS, Pinkus JL, Godleski J, Sugarbaker DJ, Corson JM. The immunohistochemical characterization of sarcomatoid malignant mesothelioma of the pleura. Am J Cancer Res 2011; 1(1):14-24.

Turner K, Varghese S, Alexander HR Jr. Current concepts in the evaluation and treatment of patients with diffuse malignant peritoneal mesothelioma. J Natl Compr Canc Netw 2012; 10(1):49-57.

Baker PM, Clement PB, Young RH. Malignant peritoneal mesothelioma in women: a study of 75 cases with emphasis on their morphologic spectrum and differential diagnosis. Am J Clin Pathol 2005; 123(5):724-737.

Grzankowski KS, Brightwell RM, Kasznica JM, Odusi KO. Malignant peritoneal mesothelioma without asbestos exposure: An ovarian cancer imitator. Gynecol Oncol Rep 2015; 11:10-12.

Ross MJ, Welch WR, Scully RE. Multilocular peritoneal inclusion cysts (so-called cystic mesotheliomas). Cancer 1989; 64(6):1336-1346.

Yan TD, Deraco M, Elias D, et al. A novel tumor-node-metastasis (TNM) staging system of diffuse malignant peritoneal mesothelioma using outcome analysis of a multi-institutional database. Cancer 2011; 117(9):1855-1863.

Zannella S, Testi MA, Cattoretti G, Pelosi G, Zucchini N. Peritoneal malignant mesothelioma metastatic to supraclavicular lymph nodes. Int J Surg Pathol 2014; 22(6):552-554.

Haberman A. Unusual appearance of malignant peritoneal mesothelioma. J Comput Assist Tomogr 2015; 39(3):419-421.

Garcia-Carbonero R, Paz-Ares L. Systemic chemotherapy in the management of malignant peritoneal mesothelioma. Eur J Surg Oncol 2006; 32(6):676-681.

Yan TD, Deraco M, Baratti D, et al. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for malignant peritoneal mesothelioma: multi-institutional experience. J Clin Oncol 2009; 27(36):6237-6242.

Baratti D, Kusamura S, Cabras AD, Bertulli R, Hutanu I, Deraco M. Diffuse malignant peritoneal mesothelioma: long-term survival with complete cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy (HIPEC). Eur J Cancer 2013; 49(15):3140-3148.

Kusamura S, Baratti D, Hutanu I, Rossi P, Deraco M. The importance of the learning curve and surveillance of surgical performance in peritoneal surface malignancy programs. Surg Oncol Clin N Am 2012; 21(4):559-576.

Squires MH, 3rd, Staley CA, Knechtle W, et al. Association between hospital finances, payer mix, and complications after hyperthermic intraperitoneal chemotherapy: deficiencies in the current healthcare reimbursement system and future implications. Ann Surg Oncol 2015; 22(5):1739-1745.

DOI: http://dx.doi.org/10.22551/2015.07.0203.10048

Copyright (c) 2015 Archive of Clinical Cases

Creative Commons License
Archive of Clinical Cases is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.


ISSN: 2360-6975