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Malignant peritoneal mesothelioma presenting as a mass in a Spigelian hernia. Report of a case

Paul H Sugarbaker1

  • 1Program in Peritoneal Surface Malignancies, MedStar Washington Hospital Center, 106 Irving St., NW, Suite 3900, Washington, DC, USA.

International Journal of Surgery Case Reports
|March 21, 2020
PubMed
Abstract

Insights

Malignant peritoneal mesothelioma, a rare cancer spread, was found within a Spigelian hernia. This unusual presentation within the abdominal wall defect has not been previously documented in medical literature.

Area of Science:

  • Oncology
  • Surgical Pathology
  • Abdominal Wall Anatomy

Background:

  • Malignant peritoneal mesothelioma can spread widely within the abdomen and pelvis.
  • Cancerous dissemination may involve hernia sacs, particularly in gastrointestinal and gynecologic cancers.
  • Spigelian hernias involve peritoneal protrusion through the anterior abdominal wall's semilunar line.

Observation:

  • A patient presented with an 11 cm left lower quadrant mass.
  • The mass was identified as malignant peritoneal mesothelioma.
  • The tumor was anatomically located within the Spigelian hernia defect.

Findings:

  • The Spigelian hernia contained malignant peritoneal mesothelioma.
  • Multiple abdominal and pelvic sites of mesothelioma were observed during surgery.
  • This represents a previously unreported instance of mesothelioma within a Spigelian hernia.

Implications:

  • Highlights the potential for rare cancer presentations within abdominal wall defects.
  • Suggests Spigelian hernias as a possible, though infrequent, site for malignant peritoneal mesothelioma metastasis.
  • Underscores the importance of thorough examination of abdominal masses, including hernia sacs, in cancer patients.
Keywords:
Cytoreductive surgeryHIPECIntraperitoneal chemotherapyPeritoneal metastasesPeritonectomyTumor cell entrapment

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