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Multicystic peritoneal mesothelioma: a systematic review of the literature
Barbara Noiret1, Florence Renaud2,3,4, Guillaume Piessen1,2,3
1Claude Huriez University Hospital, Lille, France.
Abstract:
Multicystic peritoneal mesothelioma (MCPM) is a particularly rare and benign neoplasm that arises from the peritoneum in reproductive aged females. Its etiopathogenesis is still unclear. The current prevailing theory supports the idea that the tumor is the result of an excessive inflammatory process. Because of a lack of clinical and imaging presentation, the diagnosis is intricate, and heavily relies on case reports and short studies. A histological analysis with immunohistochemistry is required for a definitive diagnosis. To date, there is no standard treatment recommended for MCPM. However, some studies suggest proceeding with a cytoreductive surgery and a hyperthermic intraperitoneal chemotherapy combining CISPLATIN and DOXORUBICIN, due to a high incidence of recurrence rate after medical treatment or surgery alone and potential malignant transformation.
Insights
Multicystic peritoneal mesothelioma (MCPM) is a rare benign neoplasm in women. Diagnosis is challenging, and while no standard treatment exists, surgery with chemotherapy is suggested due to recurrence risks.
Area of Science:
- Gynecologic Oncology
- Pathology
- Surgical Oncology
Background:
- Multicystic peritoneal mesothelioma (MCPM) is an exceptionally rare benign neoplasm originating in the peritoneum of women of reproductive age.
- The exact etiopathogenesis of MCPM remains elusive, with current theories suggesting an excessive inflammatory process as a potential cause.
Purpose of the Study:
- To summarize the current understanding of multicystic peritoneal mesothelioma (MCPM), focusing on its rare nature, diagnostic challenges, and therapeutic considerations.
- To highlight the need for definitive diagnostic methods and explore potential treatment strategies for MCPM.
Main Methods:
- Review of existing literature, including case reports and short studies, to consolidate information on MCPM.
- Analysis of diagnostic criteria, emphasizing the necessity of histological examination with immunohistochemistry.
- Exploration of proposed treatment modalities, including cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.
Main Results:
- MCPM presents with non-specific clinical and imaging findings, making diagnosis intricate and reliant on histopathology.
- Histological analysis combined with immunohistochemistry is essential for definitive MCPM diagnosis.
- No standardized treatment protocol exists for MCPM, but recurrence and malignant transformation are noted concerns.
Conclusions:
- Definitive diagnosis of MCPM requires histological confirmation with immunohistochemistry due to non-specific presentations.
- Given the high recurrence rates and potential for malignant transformation, a multimodal approach involving cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) with agents like CISPLATIN and DOXORUBICIN is suggested.
