Benign Multicystic Peritoneal Mesothelioma (BMPM) as a rare cause of abdominal pain in a young male: case report and review of the literature

Benign multicystic mesothelioma of appendiceal origin treated by hyperthermic intraperitoneal chemotherapy: A case report

Introduction and importance

Peritoneal benign cystic mesothelioma is a rare benign tumor that originates from a mesothelial proliferative lesion of the peritoneum. However, proper surgical management remains unclear due to its low incidence. We report a clinical case of peritoneal benign cystic mesothelioma treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC).

Case presentation

A 60-year-old female who underwent laparoscopic appendectomy in 2015 presented with abdominal pain in right lower quadrant area. Computed tomography of the abdomen and pelvis revealed a ruptured appendiceal mucocele or mucinous neoplasm, and several seeding-like small nodules in the greater omentum and right peritoneum. Cytoreductive surgery followed by HIPEC was performed; right hemicolectomy and lymph node dissection, omentectomy, and right abdominal partial peritonectomy. HIPEC with mitomycin was conducted for 90 min and an anastomosis between the ileum and colon was made after HIPEC. The pathologic results revealed the colonic mass was a multi-loculated cyst lined by mesothelial cells containing amorphous eosinophilic fibrinoid material, which are common features of benign cystic mesothelioma.

Clinical discussion

Peritoneal benign cystic mesothelioma is known as a borderline disease of mesothelial tumors. Because its etiology is unknown, treatment strategies are not determined.

Conclusion

Cytoreductive surgery followed by HIPEC can be considered to treat peritoneal benign cystic mesothelioma and prevent its malignant transformation.

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Cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy can be considered to treat patients with peritoneal benign cystic mesothelioma.

Quistes mesoteliales benignos con posible origen en las trompas de Falopio resecados por laparotomía

Introducción. Los quistes mesoteliales benignos son una entidad poco frecuente, que ocurren especialmente en mujeres en edad reproductiva. Se deben a una proliferación anómala del mesotelio que puede ser originada en varias estructuras intraabdominales e inicialmente es asintomática. Caso clínico. Se presenta el caso de una mujer de 20 años con un cuadro sugestivo de neoplasia maligna, en quien se confirmó el diagnóstico de quiste mesotelial originado en la trompa de Falopio derecha. Se realizó tratamiento quirúrgico exitoso. Discusión. A pesar de la estrecha relación de esta entidad con el útero y los ovarios, no se encuentran reportes de quistes mesoteliales originados a partir de las trompas de Falopio. El tratamiento de los quistes mesoteliales es quirúrgico y en el caso de esta paciente se hizo con la finalidad de mejorar los síntomas y erradicar la enfermedad. Las decisiones fueron tomadas basadas en la opinión de expertos en oncología en una junta de tumores gastrointestinales. Conclusiones. Los quistes mesoteliales son neoplasias de baja incidencia, pero se deben tener en cuenta como diagnóstico diferencial de los tumores abdominales. Se presenta el caso de una paciente tratada de forma quirúrgica con resultados exitosos y seguimiento a un año sin recurrencias

Benign Multicystic Peritoneal Mesothelioma Presenting as a Colonic Mass

Benign multicystic peritoneal mesothelioma (BMPM) is a rare neoplasm of the abdominal mesothelium (i.e., peritoneum, mesentery, and omentum). We present the case of a 74-year-old male who presented with a right paracolic gutter fluid collection and cystic mass. The patient underwent diagnostic laparoscopy with resection of the mass. The final pathology revealed BMPM. The pathogenesis may have been related to longstanding diverticular disease, which could prove to be an underrecognized risk factor for the development of BMPM. Therefore, this case suggests a broadened differential diagnosis to include BMPM in specific cases of pre-operatively diagnosed colonic masses. The patient is disease-free 11 months post-operatively.

Multicystic peritoneal tumor in two layer hens

In chicken, peritoneal cystic lesions have not been clearly categorized. In this study, diffuse peritoneal multiple cysts were observed in two layer hens. The cysts in the serosa were lined with single layers of squamous or cuboidal cells. The papillary proliferations of columnar cells were also observed in one case. The smooth muscle layer or mass were observed around the cysts in both cases. The cystic lining cells were positive for pan-cytokeratin, vimentin, S100 and Wilms tumor 1. Ultrastructurally, they had sparsely microvilli on the luminal surface. The histological results indicated the present cases were multicystic mesothelioma, but also had characteristics of Mullerian epithelium. This is the first report describing the detailed pathological feature of unique multicystic tumor in chicken.