Peritoneal well-differentiated papillary mesothelioma associated with infertility in a 37-year-old woman
Bo Pang1,2, Cong Hu2,3, Qian Liu3
1Department of Cardiology, The First Hospital of Jilin University, Changchun, Jilin, China.
Abstract:
Well-differentiated papillary mesothelioma (WDPM) is an uncommon mesothelial tumor. The lesions may be single or multiple and usually behave in a benign or indolent fashion, sometimes persisting for many years. In the present case, a 37-year-old woman had experienced primary infertility for 12 years, and a diagnostic laparoscopy was performed. Approximately 200 mL of dark red, free fluid in the pelvis and more than 10 yellow-white nodules on the surface of the right round ligament, sacrum ligament, right fallopian tube, and both sides of the uterus were found. A lesionectomy was performed and immunohistochemical markers indicated WDPM with adenomatoid tumor. The patient was monitored by computed tomography and serum CA125 (cancer antigen 125) levels for 49 months with no recurrence. WDPM and adenomatoid tumor are both benign tumors of mesothelial origin. Because of the lack of effective radical treatment, regular follow-up is sufficient. However, the effects of estrogen and progesterone on WDPM and adenomatoid tumors during ovulation or pregnancy remains unclear. Although WDPM is not life threatening, a strategy to fulfill the fertility requirements of women with this condition is a new challenge for infertility doctors.
Insights
Well-differentiated papillary mesothelioma (WDPM) is a rare, benign tumor. This case highlights WDPM
Area of Science:
- Gynecologic Oncology
- Pathology
- Reproductive Medicine
Background:
- Well-differentiated papillary mesothelioma (WDPM) is an uncommon, typically benign mesothelial tumor.
- WDPM can present as single or multiple lesions with an indolent clinical course.
- The management and fertility implications for women with WDPM remain areas of limited understanding.
Observation:
- A 37-year-old woman with a 12-year history of primary infertility underwent diagnostic laparoscopy.
- Pelvic examination revealed significant free fluid and multiple yellow-white nodules on pelvic structures, including the uterus and fallopian tubes.
- Surgical resection of the lesions was performed for diagnosis.
Findings:
- Immunohistochemical analysis confirmed the presence of well-differentiated papillary mesothelioma (WDPM) co-existing with an adenomatoid tumor.
- The patient experienced no recurrence over a 49-month follow-up period, monitored via CT scans and serum cancer antigen 125 (CA125) levels.
- Both WDPM and adenomatoid tumors are benign neoplasms of mesothelial origin.
Implications:
- Regular follow-up is currently the standard of care for WDPM due to the absence of effective radical treatments.
- The influence of hormonal fluctuations, such as during pregnancy or ovulation, on WDPM and adenomatoid tumors requires further investigation.
- Developing strategies to address fertility concerns in women diagnosed with WDPM presents a novel challenge for infertility specialists.
