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Updated: Jul 5, 2026
Generation and Expansion of Primary, Malignant Pleural Mesothelioma Tumor Lines
Published on: April 21, 2022
Primary peritoneal mesotheliomas in children: a clinicopathological and immunohistochemical study of eight cases
C A Moran1, J Albores-Saavedra, S Suster
1Department of Pathology, M D Anderson Cancer Center, Houston, TX 77030, USA. cesarmoran@mdanderson.org
Insights
Pediatric malignant mesothelioma of the peritoneum is rare and challenging to diagnose. This study reviewed eight cases, highlighting diagnostic difficulties in children.
Area of Science:
- Pediatric Oncology
- Surgical Pathology
- Abdominal Imaging
Background:
- Primary diffuse peritoneal malignant mesothelioma is an exceptionally rare neoplasm in children.
- Diagnosis can be challenging due to its rarity and potential mimicry of other intra-abdominal pathologies in the pediatric age group.
Observation:
- Eight pediatric cases (<15 years) of primary diffuse peritoneal malignant mesothelioma were analyzed.
- Patients presented with abdominal pain, distention, and ascites, with diffuse peritoneal nodules observed grossly.
- Histopathology revealed epithelioid mesothelioma in seven cases and biphasic mesothelioma in one, confirmed by immunohistochemistry (CK 5/6, calretinin).
Findings:
- Seven of eight cases were epithelioid mesothelioma, and one was biphasic.
- Four patients with epithelioid mesothelioma showed good outcomes (12-18 months survival).
- One patient with biphasic mesothelioma died 24 months post-diagnosis.
Implications:
- This rare pediatric malignancy presents diagnostic challenges requiring careful histopathological evaluation.
- Early diagnosis and appropriate management are crucial for improving outcomes in pediatric peritoneal mesothelioma.
- Further research into the specific characteristics and treatment strategies for pediatric peritoneal mesothelioma is warranted.
Aims:
To present eight cases of primary diffuse peritoneal malignant mesothelioma in children <15 years old, with a discussion of the pitfalls of this diagnosis in the paediatric age group.
Methods And Results:
The cases were selected based on the following criteria: (i) primary peritoneal neoplasms confined grossly or radiographically to the abdominal cavity; (ii) negative history of previous or another associated malignancy; (iii) histopathological confirmation. All patients (five female, three male) presented clinically with symptoms of abdominal pain, distention and ascites. Grossly, the tumours showed multiple, diffuse peritoneal nodules. Histologically, seven cases corresponded to epithelioid mesotheliomas and one case displayed biphasic (epithelioid and spindle) cellular proliferation. Immunohistochemical studies for cytokeratin (CK) 5/6, calretinin and low-molecular-weight CK (CAM5.2) showed strong cytoplasmic positivity in the neoplastic cells. Three patients were treated by chemotherapy. On clinical follow-up, four patients with epithelioid mesotheliomas were alive and well from 12 to 18 months after initial diagnosis; one patient with a mixed (biphasic epithelioid/sarcomatoid) mesothelioma died of tumour 24 months after diagnosis.
Conclusions:
Peritoneal malignant mesothelioma in children is a rare condition that can introduce difficulties in histopathological diagnosis.
