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

Pediatric Benign Cystic Peritoneal Mesothelioma

BACKGROUND

Benign cystic peritoneal mesothelioma is a rare tumor comprising multiple cysts typically found within the abdominal cavity. Although the literature has numerous accounts of this entity in adults, only a handful of cases have been published regarding its presence in the pediatric population.

CASE

We present the case of a prepubertal 10-year-old girl with the finding of benign cystic peritoneal mesothelioma at laparoscopy for suspected appendicitis, the management, and outcome.

SUMMARY AND CONCLUSION

Although benign cystic peritoneal mesothelioma can be treated with primary excision, the high recurrence rate in adult cases of this disease necessitates the need for long-term follow-up of these patients and provides a challenge to surgeons in providing continuing care.

Benign Cystic Mesothelioma in a Child: Case Report and Review of the Literature

BACKGROUND

Benign cystic mesothelioma (BCM) is a rare tumor with benign characteristic. There are only 8 child cases reported in the English literature. In this report, we present this rare entity a brief review of the literature.

CASE REPORT

A two year-old boy presenting with abdominal swelling was hospitalized. Physical examination revealed a mass filling the abdomen. Laboratory findings were not specific. Abdominal computerized tomography showed a 15×13×11 cm cystic mass extending from the bladder to the liver with no solid components and no infiltration to adjacent organs. Operation revealed a cystic mass filled with yellow-green serous fluid which was attached to the right lobe of the liver with a 1 cm thick peduncle. Total excision of the mass was performed by clamping and cutting the narrow attachment. Recovery was uneventful. Pathology revealed multiple cysts lined with mesothelial cells. No recurrence was seen after 5 years of follow-up.

CONCLUSION

BCM should be kept in mind as a rare cause of the abdominal mass in children, as it may lead to confusion in preoperative diagnosis. Although rare, patients should be followed throughout life because of the risk of recurrence and malignant degeneration.

Benign cystic mesothelioma of the peritoneum in a 12-year-old boy, diagnosed via telepathology

Low resource countries often have inadequate healthcare systems that, among other problems, suffer from a severe shortage of local expertise. In fields such as pathology, however, where diagnoses are mainly based on macroscopic and histological images, telemedicine can provide an opportunity to supplement the local capabilities by involving a world-wide network of experts. For this, the local pathologist can upload images to an online platform and then consult with international colleagues via teleconferencing, which can be particularly useful in rare or difficult cases. We present the case of a 12-year-old Afghan boy with benign cystic mesothelioma, an extremely rare benign tumour. Using the online platform IPath, we were able to diagnose the eighth reported case of this rare condition in a child, in collaboration with our colleagues in Afghanistan.

Novel TNS3-MAP3K3 and ZFPM2-ELF5 fusion genes identified by RNA sequencing in multicystic mesothelioma with t(7;17)(p12;q23) and t(8;11)(q23;p13)

Multicystic mesothelioma is a rare disease of unknown etiology and pathogenesis. Nothing has been known about the cytogenetic and molecular genetic features of these tumors. Here we present the first cytogenetically analyzed multicystic mesothelioma with the karyotype 46,XX,t(7;17)(p13;q23),t(8;11)(q23;p13). RNA-sequencing showed that the t(7;17)(p13;q23) generated a chimeric TNS3-MAP3K3 gene, which codes for a chimeric protein kinase, as well as the reciprocal MAP3K3-TNS3 in which the region of TNS3 coding for the SH2_Tensin_like region and the tensin phosphotyrosine-binding domain is under the control of the MAP3K3 promoter. The other translocation, t(8;11)(q23;p13), generated a chimeric ZFPM2-ELF5 gene which codes for a chimeric transcription factor in which the first 40 amino acids of ELF5 are replaced by the first 100 amino acids of ZFPM2. RT-PCR together with Sanger sequencing verified the presence of the above-mentioned fusion transcripts. The finding of acquired clonal chromosome abnormalities in cells cultured from the lesion and the presence of the TNS3-MAP3K3 chimeric protein kinase and the ZFPM2-ELF5 chimeric transcription factor confirm the neoplastic nature of multicystic mesothelioma.

Benign cystic mesothelioma associated with ipsilateral renal agenesis: a case report and review of literature

Benign Cystic Mesothelioma (BCM) is an uncommon peritoneal lesion that usually occurs in reproductive age females with a history of abdominal surgery. Occasional expression of estrogen and progesterone receptor in these cells may explain female predilection. Reports of BCM in males are rare. We describe a case of BCM associated with ipsilateral renal agenesis in a young male without any surgical history. The cyst lining stained positive for cytokeratin, Wilms Tumor-1, epithelial membrane antigen, CD10, estrogen receptor, and progesterone receptor, and negative for PAX-8. Only three cases of BCM associated with congenital renal anomalies have been reported. To the best of our knowledge, this is the first case of BCM associated with ipsilateral renal agenesis in an adult male and the first male case of BCM displaying estrogen and progesterone receptor positivity. Such a case reveals the presence of congenital anomalies should be considered in patients with BCM.

Benign cystic mesothelioma of the peritoneum in a male child

The benign cystic mesothelioma of the peritoneum is a rare lesion that occurs predominatly in women of reproductive age and has a high propensity for local recurrence. It is very rare in childhood, especially in boys, being reported in only 4 cases. A new case of benign cystic mesothelioma of the peritoneum in an 11-year-old boy is reported. The lesion occupied the entire left abdomen, arising from the transverse mesocolon, and it was accompanied by 4 small cysts. The patient had a coexistent right-sided renal agenesis. The mesothelial nature of the cysts epithelial lining cells was confirmed by immunopositivity for calretinin, cytokeratin 5/6, HBME1, and epithelial membrane antigen (EMA). No recurrence of the lesion was noted in the 7-month follow-up. Pathologists and clinicians should be aware of the existence of this rare entity in childhood to establish an accurate diagnosis and provide close follow-up after the surgery.

Benign cystic mesothelioma of the peritoneum: a rare case and review of the literature

A 19-year-old male presented with right lower quadrant pain. Imaging studies revealed a cystic peritoneal mass. At surgery, a large peritoneal mass was excised. The pathology report revealed a benign cystic mesothelioma, and a right hemicolectomy with cytoreductive surgery was completed.