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Updated: Apr 25, 2026
Laparoscopic S7 Hepatectomy with Positive Fluorescence Staining
Published on: May 9, 2025
[A case of malignant peritoneal mesothelioma diagnosed with laparoscopic biopsy]
Yasumichi Yagi1, Tsutomu Maeda, Yutaka Yoshimitsu
1Dept. of Surgery, Houju Memorial Hospital.
Abstract:
A 66-year-old woman was admitted to our hospital for massive ascites of unknown origin. Peritoneal mesothelioma was suspected because of her history of asbestos exposure. Diagnostic laparoscopy with biopsy of the peritoneum and greater omentum was performed. Pathological examination with immunostaining provided a definite diagnosis of malignant peritoneal mesothelioma. The patient underwent early postoperative induction therapy with pemetrexed and carboplatin, which resulted in a reduction in ascites. Laparoscopic biopsy contributed to the definite diagnosis of malignant peritoneal mesothelioma, and thereby, early induction of chemotherapy.
Insights
A laparoscopic biopsy confirmed malignant peritoneal mesothelioma in a patient with ascites and asbestos exposure. This diagnosis enabled early chemotherapy, leading to reduced ascites.
Area of Science:
- Oncology
- Gastroenterology
- Pathology
Background:
- Massive ascites of unknown origin can present diagnostic challenges.
- Asbestos exposure is a known risk factor for mesothelioma.
Observation:
- A 66-year-old woman presented with massive ascites.
- Diagnostic laparoscopy with peritoneal and omental biopsy was performed.
- Pathological examination with immunostaining was crucial for diagnosis.
Findings:
- The patient was diagnosed with malignant peritoneal mesothelioma.
- Early postoperative induction therapy with pemetrexed and carboplatin was initiated.
- The chemotherapy resulted in a significant reduction in ascites.
Implications:
- Laparoscopic biopsy is a valuable tool for diagnosing malignant peritoneal mesothelioma.
- Early diagnosis and chemotherapy can effectively manage ascites in these patients.
- This case highlights the importance of considering asbestos exposure in patients with unexplained ascites.
