We report on a 31-year-old man with a 29 x 15 x 15 cm large abdominal tumor who came to surgery under suspicion of echinococcus cyst of the liver. Histologically, the neoplasm could identified as multicystic peritoneal mesothelioma (synonyma: benign cystic mesothelioma). Additionally some cysts were located in the greater omentum and mesocolon. In contrast to our case the benign cystic mesotheliomas most commonly occur in young women, localized in the pelvis and abdomen and often complicated by postoperative local recurrence. We performed a resection of the right hemicolon and the omentum. Postoperatively no further therapy was necessary because of the benign appearance of the lesion. Close follow-up is required in these patients due to the disposition for recurrences.

Multicystic peritoneal mesothelioma

Multicystic peritoneal mesothelioma (MPM) is an uncommon cystic mesothelial proliferative lesion. It occurs predominantly in women of reproductive age and most commonly arises in the pelvis. The preoperative diagnosis of MPM is difficult to establish based on clinical and radiographic findings, and has therefore traditionally been diagnosed following surgical resection. Due to differing management of MPM and its differential diagnoses including both benign and malignant lesions, it would be beneficial to diagnose MPM preoperatively. We report a case of MPM in a middle aged female that was diagnosed by fine needle core biopsy and touch preparations, allowing for appropriate clinical management. The cytomorphologic features of needle core biopsy, immunocytochemical studies and differential diagnosis are discussed. Furthermore, despite its infrequency, the current case emphasizes the importance of the inclusion of this entity in the differential diagnosis of cystic lesions of the abdomen and pelvis at the time of on-site evaluation and final diagnosis, in order to avoid misinterpretation of strips of benign mesothelial cells as inadequate for diagnosis.

Cytomorphologic characteristics of fine needle core biopsy of multicystic peritoneal mesothelioma: a case report and review of the literature.

Im vorliegenden Fallbericht wird eine 10-jahrige hochtrachtige Braunviehkuh mit dem auffalligsten ausseren Befund eines stark dilatierten Abdomens mit konturlosem Ubergang vom Euter zur ventralen Bauchwand vorgestellt. Die sonographische Untersuchung ergab einen hochgradigen Aszites und mehrere echogene knotige Verdickungen im grossen Netz. Aufgrund samtlicher Befunde wurde die Diagnose nichtentzundlicher Aszites, vermutlich aufgrund des Tumors gestellt. Die Kuh wurde infolge infauster Prognose nach erfolgreich eingeleiteter Geburt euthanasiert und seziert. Bei der Eroffnung der Bauchhohle flossen 248.5 Liter klare Aszitesflussigkeit ab. Das grosse Netz war sulzig verdickt und teilweise mit unterschiedlich grossen, zystischen und flussigkeitsgefullten Hohlraumen durchsetzt. Aufgrund der histologischen, immunhistochemischen und elektronenmikroskopischen Befunde wurde die Diagnose biphasisches Mesotheliom mit Zystenbildung im gesamten Bauchraum gestellt.
Abstract:A 10-year-old Swiss Braunvieh cow near term was referred to our clinic because of severe abdominal distension, which caused loss of demarcation between the udder and ventral abdominal wall. Ultrasonographic examination revealed marked ascites and multiple echogenic nodules in the greater omentum. Based on the findings, non-inflammatory ascites attributable to neoplasia was diagnosed. Rupture of the prepubic tendon from the pubic symphysis was also suspected. Because of a grave prognosis, parturition was induced and a live calf was delivered. The cow was euthanized and a postmortem examination was carried out. The abdominal cavity contained 248.5 litres of clear fluid. The greater omentum was thickened and oedematous and regionally contained fluid-filled cystic structures, which varied in size with a maximum diameter of 10 centimetres. Based on the histological, immunohistochemical and electron microscopical findings, biphasic mesothelioma with cyst formation affecting the entire abdominal cavity was diagnosed.

/pdf/biphasic-mesothelioma-in-a-swiss-braunvieh-cow-clinical-50igbx7fj2.pdf

[Biphasic mesothelioma in a Swiss Braunvieh cow: clinical, histological, immunohistochemical and electron microscopical findings].

Multicystic peritoneal mesothelioma (MCPM) is a rare cystic proliferation most often seen in women of reproductive age with a history of prior abdominal surgery. This is a case report of an 83-year-old woman diagnosed with MCPM during an exploratory laparotomy for presumed peritoneal carcinomatosis from colon cancer. After complete removal of all visible MCPM, the patient remains free of both colon cancer and MCPM. This article reviews the literature with regards to the pathology, natural history, risk of malignant transformation, and current options for management of MCPM, including cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.

Multicystic peritoneal mesothelioma in an octogenarian: diagnosis, natural history, and treatment.

A Case of Benign Multicystic Peritoneal Mesothelioma Combined with Adenomatoid Tumor of the Omentum

Multicystic peritoneal mesothelioma is a rare lesion occurring mainly in women in a reproductive age. Its pathogenesis is unclear. We report three cases of multicystic peritoneal mesothelioma in patients that were 28, 38 and 47 years of age (one male, two females). A history of abdominal surgery was reported in two cases. Explorative laparotomy was presumptive of a pseudomyxoma peritoni in two cases, and hyperthermic intraperitoneal chemotherapy was performed. Histological examination demonstrated multicystic lesions with mesothelial cells lining confirmed by immunohistochemical analysis. Unusual findings such as hyperplasia, hobnail features, cytoplasmic vacuolisation and papillary pattern were occasionally noted. The clinical presentation, pathogenesis and pathologic features including differential diagnosis of multicystic peritoneal mesothelioma are discussed.

Multicystic peritoneal mesothelioma: report of three cases.

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Multicystic peritoneal mesothelioma: report of three cases.