A Case of Multiple Small Nodular Peritoneal Mesothelioma / 대한소화기내시경학회지

ABSTRACT

Peritoneal mesothelioma is a rare disease which arises from the mesothelial lining cells in the peritoneum and spreads to the peritoneal wall, omentum and other abdomina1 organs. Aabestos is one etiologic factor and the other factors are genetic cause, radiation, exposure to toxic materials and recurrent yeritonitis. We experienced a case of multiple small nodular peritoneal mesothelioma after exposure to asbestos for over 20 years. He was a sailor and had worked in the engine department of the ship, in which he wrapped up the pipe of engine in asbestos. This person came to our hospital because of inconvenience due to a distended abdomen. Tumor markers were all within normal limits and there was no evidence of tuberculosis in the abdomen and chest. The CT findings of the abdomen were as follows There was abundant ascites in the abdominal cavity and multiple small nodules on the parietal peritoneum and especially on the lower abdomen. The omentum thickened diffusely. It was difficult to distinguish from peritoneal mesothelioma and peritoneal carcinomatosis or intestinal tuberculosis. The laparoscopic findings were as follows There were multiple small nodules on the parietal peritoneum and omentum. The small nodules were a gray white color and uneven compared to tuberculous peritonitis. Therefore, we observed the malignant mesothelial cells by means of the light microscope and electron microscope and concluded that this case was peritoneal mesothelioma.