ABSTRACT
A case of multicystic mesothelioma of the liver with secondary involvement of the pelvic peritoneum and the inguinal region is presented. The case is of interest because of its unusual location and peculiar biological behavior.
Subject(s)
Inguinal Canal/pathology , Liver Neoplasms/pathology , Mesothelioma, Cystic/secondary , Peritoneal Neoplasms/secondary , Diagnosis, Differential , Female , Humans , Immunohistochemistry , Middle AgedSubject(s)
Cell Transformation, Neoplastic , Mesothelioma, Cystic/secondary , Neoplasms, Second Primary/pathology , Peritoneal Neoplasms/pathology , Adult , Calbindin 2 , Fatal Outcome , Female , Humans , Immunohistochemistry , Mesothelioma, Cystic/chemistry , Mesothelioma, Cystic/surgery , Mucin-1/analysis , Neoplasms, Second Primary/chemistry , Neoplasms, Second Primary/surgery , Peritoneal Neoplasms/chemistry , Peritoneal Neoplasms/surgery , S100 Calcium Binding Protein G/analysis , Thrombomodulin/analysisABSTRACT
BACKGROUND AND OBJECTIVES: Peritoneal mesothelioma is being diagnosed with greater accuracy as a result of immunocytochemical analysis. The histological type of peritoneal mesothelioma has a great influence on the natural history of the disease. Benign cystic mesothelioma is a definite clinical entity; however, the absence of a uniform approach to treatment and a lack of long-term follow-up of patients seriously hinders an accurate assessment of the disease process. METHODS: The medical history of a patient with a diagnosis of benign peritoneal cystic mesothelioma followed for 10 years is presented. The medical literature of this disease is reviewed. RESULTS: The patient was a 36-year-old woman initially diagnosed with benign cystic peritoneal mesothelioma; however, after six surgical procedures with the aim of reducing the volume of intraperitoneal fluid and cysts, the disease developed into an aggressive, diffuse malignant mesothelioma. Involvement of abdominal incisions, invasion of lymph nodes, and invasion of the viscera occurred. CONCLUSIONS: Peritoneal cystic mesothelioma is a disease in need of careful longitudinal studies in order to better define the clinical course of these patients. This case report along with a literature review suggests caution in the assessment of cystic mesothelioma as a benign process. This patient had a clear malignant transformation of benign cystic mesothelioma to an invasive and potentially lethal process.
Subject(s)
Mesothelioma, Cystic/pathology , Peritoneal Neoplasms/pathology , Adult , Cell Transformation, Neoplastic/pathology , Female , Humans , Lymphatic Metastasis , Mesothelioma, Cystic/secondary , Mesothelioma, Cystic/surgery , Neoplasm Invasiveness , Peritoneal Neoplasms/surgeryABSTRACT
Peritoneal multicystic mesothelioma is a very rare clinical condition. This neoplastic variant has a high incidence of recurrence after surgical resection. It usually occurs in middle-aged women with a previous history of gynaecological surgery and presents with the symptoms of an abdominal or pelvic mass. The case reported here is that of a 58-year-old woman, characterised first by a left liver-lobe tumour and then by a subsequent episode of emission of cystic matter from an abdominal fistula. The relevant literature is reviewed and the clinical aspects and treatment of this disease are discussed.
