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Published on: October 2, 2015
Pediatric Malignant Peritoneal Mesothelioma With Meningeal Metastasis
Denise Aldrian1, Nikolaus Neu1, Georg Oberhuber2
1Department of Paediatrics I.
Abstract:
Malignant peritoneal mesothelioma (MPM) is an extremely rare entity with a poor prognosis. We report on a 16-year-old boy with ascites and abdominal distension. A computed tomography scan showed peritoneal thickening and a mass adjacent to the transverse colon. Neither repeated cytologic testing of ascitic fluid, nor peritoneal tissue biopsy detected malignant cells. After the patient became progressively comatose, a magnetic resonance imaging scan of the brain showed leptomeningeal enhancement. An autopsy showed MPM infiltrating the pleura and the meninges. This is the first report on meningeal metastasis of MPM in a pediatric patient illustrating the enigmatic behavior of the tumor and highlighting the diagnostic pitfalls.
Insights
Malignant peritoneal mesothelioma (MPM) is rare and aggressive. This case highlights diagnostic challenges and the first reported pediatric meningeal metastasis of MPM.
Area of Science:
- Oncology
- Pathology
- Pediatric Medicine
Background:
- Malignant peritoneal mesothelioma (MPM) is an exceptionally rare cancer with a poor prognosis.
- Diagnosis can be challenging due to its rarity and non-specific symptoms.
Purpose of the Study:
- To report a unique case of malignant peritoneal mesothelioma in a pediatric patient.
- To illustrate the diagnostic difficulties and unusual metastatic pattern of MPM.
Main Methods:
- Case report of a 16-year-old male with ascites and abdominal distension.
- Utilized computed tomography (CT) and magnetic resonance imaging (MRI) for diagnosis.
- Autopsy confirmed the diagnosis and extent of disease.
Main Results:
- Initial cytologic and biopsy results were negative for malignancy.
- Patient developed neurological symptoms, with MRI revealing leptomeningeal enhancement.
- Autopsy demonstrated MPM infiltration of the pleura and meninges.
Conclusions:
- This case represents the first reported instance of meningeal metastasis from MPM in a pediatric patient.
- Highlights the enigmatic behavior of MPM and potential diagnostic pitfalls, especially in younger individuals.
- Emphasizes the importance of considering rare diagnoses and advanced imaging in unexplained neurological deterioration.
