Single-incision laparoscopic surgery for benign multicystic mesothelioma of the peritoneum in a young man: A case report.

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.

Benign multicystic peritoneal mesothelioma in a sexagenerian man: an uncommon case presentation.

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.

Benign multicystic peritoneal mesothelioma mimicking mucinous ovarian neoplasm with pseudomyxoma peritonei.

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.

Thoracic benign cystic mesothelioma.

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.

A rare case of benign multicystic peritoneal mesothelioma misdiagnosed as hydatid cyst found in the liver parenchyma and abdomen cavity of a male with asbestos exposure.

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.

Benign multicystic peritoneal mesothelioma in a postmenopausal woman complicated with an ovarian cyst: a case report.

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.

Mesotelioma peritoneal multiquístico benigno: reporte de un caso y revisión de la literatura / Benign multicystic peritoneal mesothelioma: case report and literature review

INTRODUCCIÓN: El mesotelioma peritoneal multiquístico benigno (MPMB) es una entidad con muy baja incidencia que se presentan con mayor frecuencia en mujeres jóvenes. CASO CLÍNICO: Paciente de 17 años que consulta por amenorrea secundaria. Además, refería pérdida de peso, estreñimiento y molestias abdominales. La exploración fue normal y en las pruebas de imagen se objetivó una pelvis ocupada por una masa multiquística, de unos 20 cm de diámetro máximo, de paredes finas y contenido anecoico. Se solicitaron marcadores tumorales de los cuales sólo se encontró elevado el CA 19.9 (35,2 U/mL). Se decidió realizar una laparoscopia exploradora para establecer un diagnóstico y ante los hallazgos y al considerarse la masa fácilmente resecable, en el mismo acto quirúrgico se extirpó por completo para su estudio anatomopatológico, que confirmó un MPMB. Se desestimaron tratamientos adicionales y actualmente se encuentra en seguimiento y asintomática. CONCLUSIÓN: La patogénesis del MPMB no está clara. Algunos autores defienden que se trata de una reacción peritoneal a un daño inflamatorio, otros apoyan que se trata de una neoplasia benigna. Esta naturaleza incierta, junto con la escasa experiencia, hacen que el manejo resulte complejo. Es necesario individualizar cada caso e intentar ser conservadores especialmente en pacientes jóvenes. Si se opta por un manejo activo, lo más acertado es la citorreducción completa seguida de quimioterapia hipertérmica peritoneal. El seguimiento, en cualquier caso, debe ser exhaustivo y multidisciplinar principalmente con pruebas de imagen.

BACKGROUND: Benign Multicystic Peritoneal Mesothelioma (BMPM) is an entity with a very low incidence that occurs more frequently in young women. CASE REPORT: A 17-year-old woman attended for secondary amenorrhea. She also referred to weight loss, constipation and abdominal discomfort. The examination was normal and echography revealed a pelvis occupied by a 20 centimeters multicystic mass, with thin walls and anechoic content. A preoperative study with tumor markers was requested in which only a CA 19.9 elevation was observed (35.2 U/ml 0-27). It was decided to perform an exploratory laparoscopy to establish a diagnosis. Due to the findings and because of the fact that the mass was considered easy to remove, it was completely removed in the same surgical act. The pathological result confirmed a BMPM. Additional treatments have been dismissed and are the patient is currently being followed up without symptoms. CONCLUSION: The pathogenesis of BMPM is unclear. Some authors argue that it is a peritoneal reaction to inflammatory damage, others support that it is a benign neoplasm. This uncertain nature coupled with limited experience make management complex. It is necessary to evaluate each case and try to be conservative especially in young patients. If surgery management is chosen, complete cytoreduction followed by hyperthermic peritoneal chemotherapy is the most successful option. The follow-up in any case must be exhaustive and multidisciplinary, mainly with imaging tests.

Benign Multicystic Peritoneal Mesothelioma in a Male Teen: Case Report and Review of the Literature.

The case of a Peruvian 15-year-old male with a left-flank abdominal mass suspected to be a peritoneal pseudomyxoma is presented. The patient underwent a R0 surgery, and the pathology review showed a benign multicystic peritoneal mesothelioma. Characterized by recurrent mesothelial peritoneal cysts originating in the epithelial and mesenchymal elements of mesothelial tissue, this benign tumor is unusual among young males.

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.

Remote Recurrence of Benign Multicystic Peritoneal Mesothelioma.

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.

Mesotelioma multiquístico benigno / Benign multicystic mesothelioma

Introducción: el mesotelioma multiquístico es una neoplasia rara que afecta al peritoneo o al espacio extraperitoneal, el epiplón y las vísceras abdominales o pélvicas. Se deriva de las células del revestimiento de la pleura o peritoneo. El origen primario es poco frecuente, al igual que sus manifestaciones. Objetivo: presentar un caso clínico atípico con énfasis en los hallazgos aportados por los estudios imagenológicos en el diagnóstico del mesotelioma multiquístico benigno.Presentación del caso: paciente femenina, de color de piel blanco y 47 años de edad, con antecedentes de diabetes mellitus tipo II de 10 años de evolución. Acude a consulta por presentar cuadro doloroso abdominal difuso, predominantemente en las zonas del epigastrio y mesogastrio. Durante el examen físico se identificó el abdomen ligeramente distendido y doloroso a la palpación en epigastrio y parte del mesogastrio. En los estudios imagenológicos se identificó una masa de aspecto multiquístico en el mesenterio con escasa vascularización, proyectada por delante del estómago.Discusión: la sintomatología es inespecífica con dolor subagudo o crónico, sensación de plenitud, aumento del perímetro abdominal y masa palpable. Muchos casos son hallazgos identificados mediante estudios imagenológicos incidentales o durante intervenciones quirúrgicas al tratar otras enfermedades. Conclusiones: los métodos de imágenes fueron esenciales para el diagnóstico y evaluación de esta afección mesentérica, en especial la ecografía abdominal, la resonancia magnética de alto campo y la tomografía computada. Mediante ellos se pudo valorar la extensión de la lesión y los órganos involucrados en el proceso, así como diferenciar ante otros posibles diagnósticos(AU)

Introduction: multicystic mesothelioma is a rare neoplasm that affects the peritoneum or extraperitoneal space, the omentum and the abdominal or pelvic viscera. It is derived from the cells of the lining of the pleura or peritoneum. The majority of mesenteric masses correspond to intra-abdominal secondary processes. The primary origin is rare, as well as its manifestations.Objective: to present an atypical case of benign multicystic mesothelioma diagnosed through imaging studies.Presentation of the case: female patient, of white skin color and 47 years old, with a history of type II diabetes mellitus of 10 years of evolution. She came to the clinic for presenting diffuse abdominal pain, predominantly in the epigastrium and mesogastrium areas. During the physical examination the abdomen was slightly distended and painful on palpation in the epigastrium and part of the mesogastrium. Complementary examinations were carried out and in the imaging studies, a mass of multicystic aspect was observed in the mesentery, with little vascularization and projected in front of the stomach.Discussion: The symptomatology is nonspecific with subacute or chronic pain, sensation of fullness, increase of the abdominal perimeter and palpable mass. Many cases are findings identified by incidental imaging studies or during surgical procedures when treating other diseases. Conclusions: imaging methods were essential for the diagnosis and evaluation of this mesenteric condition, especially abdominal ultrasound, high field magnetic resonance imaging and computed tomography. Through them it was possible to assess the extent of the lesion and the organs involved in the process, as well as to differentiate it from other possible diagnoses(AU)

Multicystic peritoneal mesothelioma: A short review.

Multicystic peritoneal mesothelioma (MCPM) is a rare neoplasm, predominantly affecting female patients during their reproductive years. The lesion is usually distributed diffusely in the abdomen and pelvis, but the peritoneum of the pelvic organs is the most common site. MCPM is composed of fluid-filled translucent cysts, connected by varying amounts of fibrous tissue, and lined by a layer of mesothelial cells. Because of the rarity of this disease, the pathogenesis and natural history of MCPM remain poorly understood and continuously debated. Some authors consider it to be a reactive process for its association with prior surgery or abdominal inflammation. But its high rate of local-regional recurrence, as well as its malignant potential, suggests a neoplastic etiology. Preoperative diagnosis is often very difficult. Imaging methods, such as ultrasound, computed tomography, and magnetic resonance imaging, are of little value for an accurate diagnosis of MCPM. The definitive diagnosis relies on histologic examination of target lesions combined with immunohistochemical stains. There is no consensus on the clinical management of MCPM, although surgical removal remains the first-line treatment of choice. But no standards have been reached concerning which surgical options-traditional debulking surgery or more aggressive one-should be chosen. Alternative therapeutic approaches include hand-off treatment, hormonal supplementation, laser vaporization, and sclerotherapy, and they all come with uncertain results. Moreover, the lesions show no response to adjuvant chemotherapy and radiotherapy. This article aimed to focus on those controversial problems in pathogenesis, natural history, diagnosis, and treatment strategies to help medical workers to better understand this rare disease.

Diffuse malignant biphasic peritoneal mesothelioma with cystic areas.

UNLABELLED: We report a case of peritoneal biphasic mesothelioma with cystic areas in a patient with professional exposure to asbestos. It showed focal epithelial glandular and papillary proliferations, also presenting fluid filled cysts, whose wall consisted of a proliferation of spindle cells. Atypia and mitoses were very scanty. EMA, vimentin, CK5/6, D2-40, calretinin and P53 were positive and desmin was negative in both epithelial and spindle areas, including the ones surrounding the cystic spaces. These findings gave an essential aid in the differential diagnosis with a benign cystic mesothelioma and with a cystic epithelial mesothelioma with secondary pseudosarcomatous myofibroblastic proliferation. The presence of cystic areas in a malignant mesothelioma could make difficult the diagnosis. A large amount of tumour tissue is necessary for confirming the biphasic histotype, an aggressive histotype, even in the presence of mild histological features and of some others favourable clinical prognostic indices as in this case. To our knowledge this is the first case of malignant peritoneal biphasic mesothelioma with cystic features reported in the literature. KEY WORDS: Cystic Mesothelioma, Immunohistochemistry, Malignant Mesothelioma, Peritoneal Diseases, Mesothelial Neoplasms.

Benign Multicystic Peritoneal Mesothelioma: AIRP Best Cases in Radiologic-Pathologic Correlation.

RadioGraphics continues to publish radiologic-pathologic case material selected from the American Institute for Radiologic Pathology (AIRP) "best case" presentations. The AIRP conducts a 4-week Radiologic Pathology Correlation Course, which is offered five times per year. On the penultimate day of the course, the best case presentation is held at the American Film Institute Silver Theater and Cultural Center in Silver Spring, Md. The AIRP faculty identifies the best cases, from each organ system, brought by the resident attendees. One or more of the best cases from each of the five courses are then solicited for publication in RadioGraphics. These cases emphasize the importance of radiologic-pathologic correlation in the imaging evaluation and diagnosis of diseases encountered at the institute and its predecessor, the Armed Forces Institute of Pathology (AFIP).

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.

[Recurrent benign multicystic peritoneal mesothelioma: Approach to this rare condition]. / Mesotelioma multiquístico peritoneal benigno recidivante: abordaje de esta entidad tan poco frecuente.

BACKGROUND: Benign multicystic mesothelioma is a rare benign tumour derived from the peritoneal mesothelium. The aim of this paper is to present a case of this rare tumour and review the clinical features, diagnosis and treatment of this disease. CLINICAL CASE: The case is presented of a 22-year-old female diagnosed with multicystic mesothelioma after an urgent resection of intra-abdominal tumour in the context of acute abdominal pain. In the subsequent follow-up, the patient had a recurrence of the lesion, and at 2 years was treated by further resection. CONCLUSIONS: Benign multicystic mesothelioma is a benign tumour of unknown origin, and with a non-specific clinical manifestation. The most effective treatment is surgical, although there is a high tendency to local recurrence.