[Benign multicystic peritoneal mesothelioma (BMPM) - a surprising differential diagnosis in case of an expected intraabdominal abscess formation]. / Das benigne multizystische peritoneale Mesotheliom (BMPM) ­ Eine überraschende Differenzialdiagnose bei Verdacht auf einen intraabdominellen Abszess.

The benign multicystic peritoneal mesothelioma is a rare disease. Most frequently, young women in reproductive age are affected by this disease. Nevertheless, there are known cases of multicystic peritoneal mesothelioma in male patients. The pathogenesis remains uncertain. Whereas asbestos fibers can cause the development of malignant mesothelioma, the exposure to asbestos particles cannot induce this type of mesothelioma. An inflammatory genesis is discussed as well as the idea of a neoplastic development. Since a high rate of recurrence after surgery is observed, an aggressive surgical treatment is recommended. The complete resection of affected tissue is recently considered to be the therapy of choice. The combination of complete surgical tumor reduction with an intraperitoneal hyperthermic chemotherapy (HIPEC) seems to be promising. Although malignant transformation is detected very rarely a close follow up in centers with high surgical and oncological expertise is recommended.

[Benign multicystic peritoneal mesothelioma in a patient with Crohn disease]. / Mesotelioma benigno como causa de dolor abdominal inespecífico en un paciente con Enfermedad de Crohn.

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 Crohn’s 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.

Cystic peritoneal mesothelioma: report of a case.

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.

I-131 accumulation in a benign cystic mesothelioma in a patient with follicular thyroid cancer.

Focal I-131 accumulation is generally a reliable indicator of functioning normal thyroid tissue or a differentiated thyroid cancer metastasis. However, physiologic accumulation of activity may also be observed in organs such as the intestinal tract, liver, and salivary glands. Extrathyroidal I-131 accumulation has been reported in various sites, such as ectopic gastric mucosa, gastrointestinal and urinary tract abnormalities, cysts (mammary, liver, kidney, and ovaries), and inflammation and infection foci. We report a case of focal I-131 accumulation in a benign cystic mesothelioma in a patient with follicular thyroid cancer.

[Benign peritoneal cystic mesothelioma as differential diagnose of an ovarian dependant tumor. Case report and review of the literature]. / Mesotelioma quistico peritoneal benigno como diagnóstico diferencial de tumor dependiente del ovario. Comunicación de un caso y revisión bibliográfica.

Benign cystic mesothelioma is an uncommon lesion of the peritoneum, occurring predominantly in women of reproductive age. The present case is a multitreated perimenopausal woman with lower urinary tract symptoms without clinical improvement despite the treatment, and pelvic pain with physical findings and radiology studies of a probable ovarian mass dependant tumoration, requiring protocolized exploratory laparotomy, finding a benign cystic mesothelioma. Despite the low incidence of this tumoration the gynecologist must be familiar with this disease, because of the high recurrence. Nowadays, steroid hormone receptors typification seems to play an important role to control the recurrence of this tumoration.

Multiple pelvic cysts in a patient with familial Mediterranean fever: Benign cystic mesothelioma.

Benign cystic mesothelioma (BCM) is a rare tumor arising from endothelial cells of the pelvic visceral or parietal peritoneum. It is a clinically and histopathologically benign disease. Etiology and pathogenesis of BCM remain unclear. Familial Mediterranean fever (FMF) is an inherited disorder characterized by episodes of fever, and abdominal, chest and/or joint inflammation. Association between malignant mesothelioma and FMF has been reported previously; however, co-existence of FMF and BCM is rare. Here, we report a case of BCM in a 43-year-old male patient with FMF.

Acute urinary retention caused by a large peritoneal inclusion cyst: a case report.

BACKGROUND: Pelvic masses have been known to cause bladder symptoms and compression. This is the first documented case of a large peritoneal inclusion cyst causing acute urinary retention from bladder outlet obstruction. CASE: A 36-year-old woman, gravida 2, para 2, presented to the gynecology clinic with an indwelling Foley catheter that was placed at an outside hospital secondary to acute urinary retention. Computed tomography, performed several days earlier for complaints of progressively worsening lower abdominal and pelvic pain, revealed a 10-cm, complex, cystic mass within the pelvis between the rectum and sigmoid colon, with anterior displacement of the bladder. The patient's past surgical history included a total abdominal hysterectomy as well as separate exploratory laparotomy for resection of a 20-cm peritoneal inclusion cyst and a prophylactic bilateral salpingo-oophorectomy. Due to the acute urinary retention and worsening pain, the decision was made to proceed with laparoscopic removal and drainage of the mass, which turned out to be consistent with a recurrent peritoneal inclusion cyst. Symptom relief was immediate. CONCLUSION: A large, recurrent, peritoneal inclusion cyst obstructed the bladder neck and presented as acute urinary retention. Laparoscopy relieved the symptoms.

Benign cystic mesothelioma presenting as a huge pelvic mass--a case report.

Benign cystic mesothelioma is an extremely rare peritoneal tumor. It is reported in women of childbearing [corrected] age but also in males and needs a careful [corrected] differential diagnosis between benign and malign neoplasia to choose the most [corrected] adeguate therapy. A 25-year-old female [corrected] was treated in our clinic for a gigantic cystic mass (25 x 22 x 3 cm in diameter) containing [corrected] many to [corrected] cysts of different sizes. All tumoral markers were within normal range. Surgical [corrected] treatment consisted of radical excision of the mass and the prognosis was good [corrected].

Benign multicystic mesothelioma of peritoneum complicating acute appendicitis in a man: a case report.

BACKGROUND: Benign multicystic mesothelioma is a rare pathology. Few cases are reported in the medical literature and acute presentation is extremely uncommon. CASE PRESENTATION: We describe an acute clinical presentation of the neoplasm that revealed itself with signs and symptoms attributable to acute appendicitis in a 41-year-old white man. Abdominal echography and computed tomography scans demonstrated the presence of a mass in direct contiguity with cecal fundus, but diagnosis remained unclear. Our patient underwent surgery and complete removal of the neoplasm. Only a definitive histological examination defined the nature of the lesion. No signs of relapse were demonstrated 1 year after the operation. CONCLUSIONS: We showed that an acute presentation of a benign neoplasm represents a diagnostic and therapeutic challenge for the surgeon, because of the difficult differential diagnosis that acute presentation can sometimes pose and the trouble that an emergence treatment can imply.

Mesothelial inclusion cysts (so-called benign cystic mesothelioma)--a clinicopathological analysis of six cases.

The report presents six cases of mesothelial inclusion cysts (MIC), detected in five females (22-53 years of age) and one male (47 years old). The lesions were unifocal (four cases) and multifocal (two cases), and were located on the surface of the peritoneum in the cul de sac, on the intestines, urinary bladder, uterine adnexa, also involved round ligament within the pelvis and in the inguinal canal (one patient). Additionally, in one female, small cysts, free-floating in the peritoneal cavity were present. In three patients, clinical signs resulted directly from the presence of MIC. One female had been 7 years previously operated on due to endometrioid ovarian cysts. Apart from MIC, three patients presented with concomitant diseases: appendicitis (two cases), peritoneal pseudomyxoma or primary ovarian carcinoma. Gross appearance: the lesions were polycystic, the surgical materials ranging from three fragments measuring 0.5 cm each to seven fragments, with the maximum size of 14x6 cm. The cysts were from microscopic size to 2 cm in diameter, the majority were thin-walled, semitranslucent, filled with clear or yellowish fluid or gelatinous contents. In one case, the cyst walls were thicker and showed intense inflammatory lesions and fibrinous exudate. Microscopically, the majority of cysts were lined with a single layer of flattened or cuboid mesothelial cells (CK+, calretinin+). In two patients, the mesothelium demonstrated diffuse squamous cell metaplasia; in one individual, the cells focally formed small papillae and were vacuolated. No mucus was observed either in the cytoplasm or outside the cells. Immunohistochemical reactions to CEA, ER, PR and MIB-1 were negative. Intramural proliferations and intracystic detached clumps of cells showed both mesothelial cells (without any mitotic activity and signs of atypia) and macrophages (CD68+). To date, the follow-up has been 7 years and 3 years in two individuals, and from 1 to 7 months in the remaining three patients--all of them are free from recurrent disease. One female failed to report for follow-up examinations. The report also presents the review of literature.

[Benign cystic mesothelioma, a rare tumor of the peritoneum]. / Benignus cisztikus mesothelioma, a peritoneum ritka daganata.

We report the case of a 28-year-old woman, who presented with acute abdominal and pelvic pain, the appearance of appendicitis. Because of her symptoms urgent operation was performed. Appendicetomy was performed, during the operation multiple cystic lesions were discovered on the right ovary and the peritoneal surface of the mesentery. Laparatomy was performed with removal of the visible cystic lesions, which contained mucous fluid. Final histology revealed benign cystic mesothelioma, which is a rare lesion of the peritoneum, occurring mainly in women in reproductive age. The etiology of cystic mesothelioma is still unclear. The short-term prognosis is favourable, but high recurrence rate. Some authors reported effective intraperitoneal chemotherapy, but no clinical study is available about long term outcome. We hope that surgical eradication was effective to prevent recurrence. One year after the operation the patient is complaint and symptom free.

Benign cystic mesothelioma: a rare cause of ascites in a case with familial Mediterranean fever.

Benign cystic mesothelioma (BCM) is a rare neoplasm of the peritoneum, consisting of solitary or multiple cysts arising from mesothelial cells. Here we report a patient with a previous diagnosis of familial Mediterranean fever (FMF) presenting with abdominal distension and ascites which were found to be due to BCM. The co-existence of these two entities has not been reported previously. Ascites as the presenting feature of BMC is also a rare observation.

Benign multicystic mesothelioma: a case report.

Benign multicystic mesothelioma (also known as multilocular peritoneal inclusion cyst) is a rare lesion found on any abdominal peritoneal surface that occurs most frequently in premenopausal women. We report the case of a 36-year- old woman, who presented with a history of generalized abdominal pain, intermittent abdominal bloating, and episodes of loose stools. A pelvic ultrasound revealed a complex cystic mass with fine internal septations. The patient was managed by laparotomy with removal of mass, total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and multiple peritoneal biopsies. Final pathology revealed benign multicystic mesothelioma. Although mesothelioma is a rare tumour, it is important for all gynaecologists to recognize its existence, the appearance of this lesion, and its generally benign course. This is especially important as it occurs in young women where fertility considerations must be part of the discussion of any pelvic surgery.

Diagnosis and treatment of benign multicystic peritoneal mesothelioma.

Benign multicystic peritoneal mesothelioma (BMPM) is a rare cystic mesothelial lesion that occurs predominantly in reproductive aged women. A 56-year-old Caucasian male was admitted to our surgical department with a chief complaint of a painful mass in his right lower abdomen for almost 2 years. The physical examination revealed a palpable painful mass. Computed tomography demonstrated an irregular, cystic tumor in his right lower abdomen. There was no obvious capsule or internal septations. No enhancement after intravenous administration of contrast was noted. An exploratory laparotomy was performed, and a multicystic tumor and adherent to the caecum was noted. The walls of the cysts were thin and smooth, filled with clear fluid, and very friable. An en bloc resection of the tumor, including appendix and caecum, was performed. Histological examination revealed multiple cysts lined with flattened simple epithelial cells, and the capsule walls of the cysts were composed of fibrous tissue. Immunohistochemical analysis documented positive expression of mesothelial cells and calretinin. The final diagnosis was BMPM. The patient was well at 6-mo follow-up. BMPM is exceedingly rare lesion. A complete resection of the tumor is required. The diagnosis of BMPM is based on pathological analysis.

Mesotelioma benigno como causa de dolor abdominal inespecífico en un paciente con Enfermedad de Crohn / Benign multicystic peritoneal mesothelioma in a patient with Crohn disease

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 Crohn’s 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.

Benign cystic mesothelioma of the peritoneum in a child-case report and review of the literature.

A 4-year old female child presented with clinical features of ascites that, on computed tomography, showed a huge thin-walled cystic lesion in the peritoneum. Laparotomy confirmed a unilocular cyst in the peritoneum adhered to the parietal wall and bowel but not originating from any internal organs. Histopathologic examination of the cyst wall was consistent with the diagnosis of benign mesothelioma. Benign cystic mesothelioma of the peritoneum has rarely been reported in children.