ABSTRACT
BACKGROUND: Multicystic mesothelial cyst is a rare, and usually benign, tumor which is rarely diagnosed preoperatively due to the poor specificity of its symptomatology. METHODS: We report the case of a 63-year-old man with multiple comorbidities (e.g. cryptogenic cirrhosis, chronic heart failure) and a history of surgical resection of a giant abdominal cyst, who complained of recurrent intermittent abdominal pain and vomiting that appeared several weeks before. Abdominal computed tomodensitometry (CT) revealed multiple diffusely localized cysts in the abdominal cavity, ranging from 30 mm to 210 mm. RESULTS: The patient underwent surgical resection of twelve intra-abdominal cysts, identified at final pathology as benign mesothelial cysts, which were probably a recurrence following the previous surgery for a single intra-abdominal cyst. Three months later, the patient recurred with development of two new intraperitoneal cysts, with an increasing volume on CT at last follow-up (18 months). Surveillance was recommended given the patient's comorbidities and the absence of symptoms. CONCLUSIONS: Surgical resection is the treatment of choice for multicystic peritoneal mesothelioma, a rare disease that should be considered more as a borderline tumor than a benign tumor, given the high risk of recurrence and possible malignant transformation.
Subject(s)
Mesothelioma, Cystic , Peritoneal Neoplasms , Tomography, X-Ray Computed , Humans , Male , Middle Aged , Peritoneal Neoplasms/diagnosis , Peritoneal Neoplasms/surgery , Mesothelioma, Cystic/diagnosis , Mesothelioma, Cystic/surgeryABSTRACT
BACKGROUND: Benign cystic mesotheliomas (BCMs), also known as multilocular mesothelial inclusion cysts, inflammatory inclusion cysts or multicystic mesothelial proliferation, are frequently observed in females and are localised localised in the pelvic peritoneum. They are rarely present in the thoracic and mediastinal areas; however, these locations have been reported in a few cases in the literature. CASE PRESENTATION: We present the case of a woman with an intrathoracic BCM. A 28-year-old female patient presented with a cystic mass of 8 × 6 × 6 cm in the left hemithorax shown by computed tomography of the thorax. The patient underwent cystic mass excision with video-assisted thoracoscopic surgery (VATS), which was completed without complications. The diagnosis was confirmed histopathologically after the surgical resection. CONCLUSIONS: Due to BCMs' non-specific clinical symptoms and radiological imaging, preoperative diagnosis is difficult, and they are often confused with pericardial cysts. There is no standard treatment protocol; however, VATS and en bloc resection are the most frequently used treatment options for mediastinal localization. Since these lesions slow proliferation rates have the potential for local recurrence and low malignant transformation, close follow-up is recommended. In this case report, we aimed to present a rare BCM case with intrathoracic paracardiac localization was completely excised through VATS. No recurrence has been detected in three years of follow-up.
Subject(s)
Mediastinal Cyst , Mesothelioma, Cystic , Peritoneal Neoplasms , Female , Humans , Adult , Mesothelioma, Cystic/diagnosis , Mesothelioma, Cystic/surgery , Mesothelioma, Cystic/pathology , Mediastinal Cyst/diagnostic imaging , Mediastinal Cyst/surgery , Peritoneum/pathology , Thoracic Surgery, Video-Assisted/methods , Peritoneal Neoplasms/surgeryABSTRACT
BACKGROUND: Benign Multicystic Peritoneal Mesothelioma (BMPM) is one of the rarest diseases in medicine with only more than 200 cases worldwide. This paper aims to report a case of Benign Multicystic Peritoneal Mesothelioma that strangely arose from the liver and was long treated as Hydatid cyst. The case also had many risk factors including asbestos exposure that had not yet been linked with Benign Multicystic Peritoneal Mesothelioma. CASE PRESENTATION: We report a case of a 62 years old male with a history of a perforated peptic ulcer and a cystic mass in the liver that was misdiagnosed as hydatid cyst 7 years ago. He presented with generalized abdominal pain and bloating. Image studies showed many cystic formations filled with clear fluid. An en bloc surgery was performed and a pathologic study showed a multiloculated mass lined by flat or cuboidal epithelium leading to the diagnosis of BMPM. A follow up was scheduled after 3 months revealed total recurrence. CONCLUSION: BMPM resembles many other cystic lesions in the abdomen and should be taken into consideration when dealing with nontypical cystic formations. Its diagnostic and treatment methods are still hazy making this disease difficult to approach.
Subject(s)
Asbestos , Echinococcosis , Mesothelioma, Cystic , Abdomen , Diagnostic Errors , Humans , Liver , Male , Mesothelioma, Cystic/diagnosis , Mesothelioma, Cystic/surgery , Middle Aged , Neoplasm Recurrence, LocalABSTRACT
Benign multicystic peritoneal mesothelioma is a rare pathology that arises from the abdominal peritoneum. It has an affinity to develop on the surfaces of pelvic viscera. It predominantly occurs in women of reproductive age. The most used form of treatment is complete surgical removal. We report a case of a a 21-year-old female patient who presented with unclear diffuse abdominal pain. Transvaginal ultrasound and magnetic resonance imaging of the abdomen and pelvis revealed multiple functional cysts in the projection of the right and left ovary and free fluid in the pouch of Douglas. Laparoscopy was performed and multicystic tumor with thin, smooth walls, filled with clear serous content was found in lesser pelvis spreading to the left paracolic region and under the spleen. The multicystic mass was removed. Histologic examination revealed cystic formations filled with mucous content and formed from connective tissue outside and single row epithelium-mesothelium inside. Definitive diagnosis was benign multicystic mesothelioma of the abdominal peritoneum. The patient was well at one year follow-up.
Subject(s)
Laparoscopy , Mesothelioma, Cystic , Peritoneal Neoplasms , Abdomen , Abdominal Pain , Adult , Female , Humans , Mesothelioma, Cystic/diagnostic imaging , Mesothelioma, Cystic/surgery , Peritoneal Neoplasms/diagnostic imaging , Peritoneal Neoplasms/surgery , Young AdultABSTRACT
BACKGROUND: Benign peritoneal cystic mesothelioma (BPCM) is a rare disease entity that arises from mesothelioma cells. We describe a rare case of BPCM recurrence 36 years after its initial presentation. CASE: A 62-year-old woman was referred to an outpatient gynaecologic oncology clinic with an incidental finding of multiple pelvic cysts. She had a preceding history of known BPCM treated with extensive debulking surgery. She presented after 36 years of clinical remission. A repeat laparotomy for a debulking surgical procedure confirmed a recurrence of BPCM. CONCLUSION: Our current case represents a woman with a remote recurrence of BPCM after initial optimal debulking surgery. Her clinical presentation of recurrence after 36 years illustrates the need for long-term follow-up and clinical suspicion in symptomatic patients with previously diagnosed BPCM.
Subject(s)
Mesothelioma, Cystic/diagnosis , Neoplasm Recurrence, Local/diagnosis , Peritoneal Neoplasms/diagnosis , Diagnosis, Differential , Female , Humans , Hysterectomy , Laparoscopy , Mesothelioma, Cystic/pathology , Mesothelioma, Cystic/surgery , Middle Aged , Neoplasm Recurrence, Local/pathology , Neoplasm Recurrence, Local/surgery , Peritoneal Neoplasms/pathology , Peritoneal Neoplasms/surgeryABSTRACT
Benign multicystic peritoneal mesothelioma is an uncommon lesion arising from the peritoneal mesothelium. It is asymptomatic or presents with unspecific symptoms. Imaging techniques may reveal it, however the final diagnosis can only be made by histopathology. Surgery is the only effective treatment considering its high recurrence rate. We report a 19 years old male with Crohns disease. Due to persistent abdominal pain, an abdominal magnetic resonance imaging was performed, showing a complex cystic mass in the lower abdomen. The patient underwent surgery and the lesion was completely resected. The pathological study reported a benign multicystic peritoneal mesothelioma.
Subject(s)
Crohn Disease/complications , Mesothelioma, Cystic/complications , Peritoneal Neoplasms/complications , Humans , Male , Mesothelioma, Cystic/pathology , Mesothelioma, Cystic/surgery , Peritoneal Neoplasms/pathology , Peritoneal Neoplasms/surgery , Young AdultABSTRACT
An epicardial mesothelial cyst, which can be defined as a mesothelial cyst attached to the epicardium surrounding the heart and the great vessels inside the pericardial sac, is a rare condition. We herein report a case of epicardial cyst, which was attached to the ascending aorta. The patient was a 76-year-old male who underwent coronary artery bypass surgery, and the cyst was found incidentally. It was approximately 5 cm in diameter, and histological examination confirmed mesothelial cell origin. The ascending aorta has not previously been reported as the origin of an epicardial mesothelial cyst. This case gives new insight into the embryology of these cysts.
Subject(s)
Aorta/pathology , Heart Neoplasms/pathology , Heart Neoplasms/surgery , Mesothelioma, Cystic/pathology , Mesothelioma, Cystic/surgery , Pericardium/pathology , Aged , Aorta/surgery , Humans , Incidental Findings , Male , Pericardium/surgery , Treatment OutcomeABSTRACT
Benign multicystic peritoneal mesothelioma (BMPM) is a rare peritoneal tumor. Surgery is the only effective treatment for BMPM, and affected tissues occasionally must be sacrificed to achieve adequate debulking. A 25-year-old female was diagnosed with BMPM. She was counseled on fertility preservation and had oocyte cryopreservation prior to her debulking. Fertility preservation through embryo or oocyte cryopreservation is a valuable option for patients at risk of losing reproductive tissues during extensive surgery and chemotherapy.
Subject(s)
Fertility Preservation , Mesothelioma, Cystic/surgery , Peritoneal Neoplasms/surgery , Adult , Cryopreservation , Female , Humans , Mesothelioma, Cystic/pathology , Oocytes/physiology , Peritoneal Neoplasms/pathologyABSTRACT
Benign multicystic mesothelioma (BMM) is a benign intra-abdominal lesion that generally occurs in women in their reproductive years. A urachal cyst occurs when the epithelial-lined urachal canal fails to completely obliterate. We report a case of a 38-year-old female presenting with abdominal pain found to have a lesion highly suspicious for a urachal cyst. On pathologic evaluation the lesion was identified as a BMM. This is the first report of BMM presenting as a lesion suspected to be a urachal cyst.
Subject(s)
Mesothelioma, Cystic/diagnosis , Neoplasms/diagnosis , Peritoneal Neoplasms/diagnosis , Urachal Cyst/diagnosis , Adult , Diagnosis, Differential , Female , Humans , Laparoscopy , Mesothelioma, Cystic/surgery , Neoplasms/surgery , Peritoneal Neoplasms/surgery , Robotic Surgical Procedures , Tomography, X-Ray Computed , Treatment Outcome , Urachal Cyst/surgeryABSTRACT
Benign multicystic peritoneal mesothelioma (BMPM) is a rare condition, particularly in men, and the preoperative diagnosis poses a challenge. Here, we present a case involving single-incision laparoscopic surgery (SILS) for BMPM in a 24-year-old man with a pelvic mass and a history of ulcerative colitis. Pelvic imaging revealed multifocal cysts, prompting the performance of SILS. The tumor was successfully resected with no residual lesions, and pathology confirmed the diagnosis of BMPM. This case represents the first documented instance of SILS being employed for BMPM in a man. BMPM, characterized by pelvic multifocal cysts, is a differential diagnosis, and SILS emerges as a viable option for both diagnosis and treatment.
Subject(s)
Laparoscopy , Mesothelioma, Cystic , Peritoneal Neoplasms , Humans , Male , Laparoscopy/methods , Peritoneal Neoplasms/surgery , Peritoneal Neoplasms/diagnosis , Peritoneal Neoplasms/pathology , Peritoneal Neoplasms/diagnostic imaging , Mesothelioma, Cystic/surgery , Mesothelioma, Cystic/pathology , Mesothelioma, Cystic/diagnosis , Mesothelioma, Cystic/diagnostic imaging , Young AdultABSTRACT
Cystic mesothelioma, also known as benign multicystic peritoneal mesothelioma (BMPM), is a rare neoplasm and one of the five main histological types of peritoneal mesothelioma. Although it is usually considered benign histologically, it is increasingly accepted as a 'borderline malignancy' because the local recurrence rate is high. It is more common in middle-aged women and is generally asymptomatic. Considering that BMPM is often found in the pelvis, it is difficult to differentiate from other pelvic and abdominal lesions, such as cystic ovarian masses, especially mucinous cystadenoma-adenocarcinoma, pseudomyxoma peritonei, etc. Preoperative diagnosis is very difficult due to its rarity and lack of specific diagnostic imaging and clinical findings. Definitive diagnosis is made only by pathological evaluation. In this article, we aimed to present the imaging findings of a BMPM case in a woman who was diagnosed with mucinous ovarian neoplasm with pseudomyxoma peritonei preoperatively and underwent cytoreductive surgery with hyperthermic intraperitoneal chemotherapy.
Subject(s)
Gastrointestinal Neoplasms , Mesothelioma, Cystic , Mesothelioma , Ovarian Neoplasms , Peritoneal Neoplasms , Pseudomyxoma Peritonei , Middle Aged , Female , Humans , Pseudomyxoma Peritonei/diagnosis , Mesothelioma, Cystic/diagnosis , Mesothelioma, Cystic/surgery , Ovarian Neoplasms/diagnosis , Peritoneal Neoplasms/diagnostic imaging , Mesothelioma/diagnosisABSTRACT
The benign cystic mesothelioma of the peritoneum is a rare lesion and is known for local recurrence. This is first case report of a rapidly developing massive abdominal tumor with histological finding of benign cystic mesothelioma (BCM). We describe a BCM arising in the retroperitoneal tis[sue on the right side, lifting ascending colon and cecum to the left side of abdomen. Patient was an active 58-year-old man who noticed a rapid abdominal swelling within a two month time period with a weight gain of 40 pounds. Patient had no risk factors including occupational (asbestos, cadmium), family history, social (alcohol, smoking) or history of trauma. We will discuss the clinical, radiologic, intra-operative, immunohistochemical, pathologic findings, and imaging six months after surgery. Patient has no recurrence and no weight gain on follow up visits and imaging.
Subject(s)
Abdominal Neoplasms/diagnosis , Mesothelioma, Cystic/diagnosis , Peritoneal Neoplasms/diagnosis , Abdominal Neoplasms/surgery , Humans , Male , Mesothelioma, Cystic/surgery , Middle Aged , Peritoneal Neoplasms/surgery , PrognosisABSTRACT
Benign multicystic peritoneal mesothelioma is a rare malignancy with unknown etiology, first described in 1980, which have been reported to date about 150 cases in the literature. Although the term "benign", used mainly to distinguish it from the classic malignant mesothelioma, a more aggressive cancer, is considered "borderline" in terms of aggression: it tends to local recurrence but cases of lymph node metastases or in other locations at a distance are not described. The symptoms are often vague and nonspecific (abdominal pain, enlarged abdomen and ascites). The common diagnostic imaging techniques (CT, MRI) may appear similar to ovarian or peritoneal cancer by more aggressive mesenchymal neoplasms. Histological examination, accurately with the aid of immunohistochemical techniques, is therefore essential for diagnosis. Treatment is surgical and consists of peritonectomy. After surgery, the prognosis is generally good. In 50% of cases may have local recurrences; so rigorous follow-up is indicated.
Subject(s)
Mesothelioma, Cystic/diagnosis , Mesothelioma, Cystic/surgery , Peritoneal Neoplasms/diagnosis , Peritoneal Neoplasms/surgery , Aged , Diagnosis, Differential , Female , Humans , Mesothelioma, Cystic/pathology , Peritoneal Neoplasms/pathology , Prognosis , Treatment OutcomeABSTRACT
Benign cystic mesothelioma (BCM) is a rare tumor of unknown origin, most frequently encountered in women of reproductive age and with unknown etiology. Most patients have a history of previous pelvic operation, endometriosis, or pelvic inflammatory disease. Preoperative diagnosis is difficult. We report the cases of three patients, with one case complicated by pregnancy, and discuss the diagnostic evaluation and treatment of this rare disease. Complete surgical resection is recommended if feasible. However, recurrent disease is not uncommon. Clinical positive effects of different adjuvant medical treatments are also discussed.
Subject(s)
Mesothelioma, Cystic/pathology , Peritoneal Neoplasms/pathology , Pregnancy Complications, Neoplastic/pathology , Adult , Cesarean Section , Female , Humans , Incidental Findings , Mesothelioma, Cystic/diagnosis , Mesothelioma, Cystic/surgery , Peritoneal Neoplasms/diagnosis , Peritoneal Neoplasms/surgery , Pregnancy , Pregnancy Complications, Neoplastic/diagnosis , Pregnancy Complications, Neoplastic/surgeryABSTRACT
Benign multicystic peritoneal mesothelioma (BMPM) is a rare disease with good short-term prognosis and rare malignant transformation. However, its biological significance remains unexplained. A neoplastic origin is considered by many authors to require a surgical excision, based on the high recurrence and progressive growth rate of the tumors. However, alternative or integrative treatment options have also been proposed. A 45-year-old woman presented to our unit with a history of occasional discomfort and pain in the left hip. On physical examination, we noticed a tough-elastic, fixed mass located in the iliac fossa. Computed tomography scan detected a mass with multiseptated cystic-like areas. Due to the similarity of these findings to a primitive sarcomatous tumor of the retroperitoneum, an arteriographic study was also performed. The patient underwent en bloc resection of the mass, including a segment of the sigmoid colon. The final pathologic diagnosis was cystic mesothelioma. Further studies are needed to better understand the etiology and pathogenesis of this rare disease, and to define a more tailored treatment plan.
Subject(s)
Mesothelioma, Cystic/diagnosis , Mesothelioma, Cystic/surgery , Peritoneal Neoplasms/diagnosis , Peritoneal Neoplasms/surgery , Female , Humans , Mesothelioma, Cystic/complications , Middle Aged , Peritoneal Neoplasms/complicationsSubject(s)
Mesothelioma, Cystic/diagnosis , Peritoneal Neoplasms/diagnosis , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Child, Preschool , Cisplatin/administration & dosage , Combined Modality Therapy , Diagnosis, Differential , Doxorubicin/administration & dosage , Female , Humans , Lymphangioma, Cystic/diagnosis , Mesothelioma, Cystic/drug therapy , Mesothelioma, Cystic/pathology , Mesothelioma, Cystic/surgery , Neoplasm Recurrence, Local/drug therapy , Neoplasm Recurrence, Local/surgery , Peritoneal Neoplasms/drug therapy , Peritoneal Neoplasms/pathology , Peritoneal Neoplasms/surgery , Remission InductionABSTRACT
Benign multicystic peritoneal mesothelioma is a rare cystic neoplasm, characterized by subtle symptoms, that occurs predominantly in reproductive-aged women. The pathogenesis and etiology of the disease are yet to be determined. We herein present a 71-year-old woman presented to our clinic with persistent low back pain. The clinical examination showed a palpable mass in the abdominal area. The magnetic resonance imaging revealed multiple cystic lesions that occupy the largest part of the pelvis, posterior to the uterus. The patient underwent cyst excision, total hysterectomy with bilateral salpingo-oophorectomy, omentectomy and lymph node dissection. Postoperative course was uneventful and histopathology of the specimen revealed a benign multicystic peritoneal mesothelioma. Complete tumor resection is considered the optimal therapeutic approach of peritoneal mesothelioma. Histopathological analysis is required to confirm the diagnosis of multicystic peritoneal mesothelioma.