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Extensive myxoid change in well-differentiated papillary mesothelioma of the pelvic peritoneum
Leslie K Diaz1, Adaora Okonkwo, Enric P Solans
1Department of Pathology, Northwestern Memorial Hospital and Northwestern University Medical School, Chicago, IL, USA.
Abstract:
We present a unique case of papillary mesothelioma of the pelvic peritoneum with extensive myxoid change in a 44-year-old woman. The patient presented with lower abdominal pain; imaging studies revealed a pelvic mass. Microscopic examination of the surgically resected specimen showed extensive areas of myxoid stroma and only focal areas of classical papillary mesothelioma. A small biopsy of this lesion might have been misinterpreted as a soft tissue neoplasm with myxoid stroma or pseudomyxoma peritonei. It is suggested that mesothelioma with myxoid change should be included with differential diagnoses of myxoid lesions of the peritoneum.
Insights
This case study highlights papillary mesothelioma of the pelvic peritoneum with significant myxoid change. It emphasizes including this rare condition in the differential diagnosis for peritoneal myxoid lesions.
Area of Science:
- Oncology
- Pathology
- Gastroenterology
Background:
- Papillary mesothelioma is a rare tumor arising from the serous membranes.
- Myxoid change in peritoneal lesions can complicate diagnosis.
- Differential diagnosis of peritoneal masses is crucial for appropriate treatment.
Observation:
- A 44-year-old woman presented with lower abdominal pain and a pelvic mass.
- Imaging revealed a significant pelvic mass requiring surgical resection.
- Microscopic examination showed extensive myxoid stroma with focal papillary mesothelioma.
Findings:
- The resected specimen demonstrated extensive myxoid degeneration within the papillary mesothelioma.
- Focal areas of classical papillary mesothelioma were present amidst the myxoid stroma.
- Small biopsies could potentially be misdiagnosed as other myxoid neoplasms or pseudomyxoma peritonei.
Implications:
- Papillary mesothelioma with myxoid change should be considered in the differential diagnosis of peritoneal myxoid lesions.
- Accurate diagnosis is essential to differentiate from other soft tissue neoplasms and pseudomyxoma peritonei.
- This case expands the understanding of mesothelioma's varied histological presentations.