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Benign Multicystic Peritoneal Mesothelioma Presents as a Tumor in an Elderly Man: An Uncommon Diagnosis
Ahmet Askar1, Ergin Erginoz1, Ayse Hanım Yavuz2
1Department of General Surgery, Istanbul University Cerrahpasa-Cerrahpasa School of Medicine, Istanbul, Turkey
Background:
Mesotheliomas are benign masses that can arise from any body parts that contain mesothelium, such as the abdominal, pelvic, pleural, and pericardial cavities. Benign multicystic peritoneal mesothelioma is a cystic tumor that arises from peritoneal mesothelial cells. It is a rare pathological entity, as only fewer than 200 cases have been reported. Benign multicystic peritoneal mesothelioma mainly occurs in women, and it is extremely rare in men. Its diagnosis and management are often challenging.
Case Presentation:
This report demonstrates a case of a 61-year-old man who presented to the outpatient clinic with persistent abdominal discomfort that progressed over the years. He had visited different clinics and was referred to a gastroenterologist because of a misdiagnosis. After an extensive clinical evaluation, we failed to provide a definitive diagnosis; thus, diagnostic laparotomy for possible intra-abdominal malignancy was performed. After successful surgical resection of the lesions, the pathology was found compatible with benign multicystic peritoneal mesothelioma.
Conclusion:
Given its high recurrence rates and potential malignant transformation, meticulous and detailed surgical excision of the cystic lesions is of utmost importance to avoid repeated surgeries. Long-term follow-up is recommended.
Insights
Benign multicystic peritoneal mesothelioma is a rare tumor, particularly in men. Surgical excision is crucial for this challenging diagnosis to prevent recurrence and potential malignancy.
Area of Science:
- Oncology
- Pathology
Background:
- Mesotheliomas are neoplasms arising from mesothelial cells in body cavities.
- Benign multicystic peritoneal mesothelioma (BCPM) is a rare cystic tumor of peritoneal mesothelial cells, with fewer than 200 reported cases.
- BCPM predominantly affects women, making it exceptionally rare in men.
Observation:
- A 61-year-old man presented with chronic, progressive abdominal discomfort.
- Initial misdiagnosis led to multiple clinic visits and referral to a gastroenterologist.
- Diagnostic laparotomy was performed due to persistent diagnostic uncertainty and suspicion of intra-abdominal malignancy.
Findings:
- Surgical resection of abdominal lesions was successfully performed.
- Pathological examination confirmed the diagnosis of benign multicystic peritoneal mesothelioma.
- This case highlights the diagnostic challenges and rarity of BCPM in males.
Implications:
- Meticulous surgical excision of cystic lesions is vital due to high recurrence rates.
- Complete resection is essential to avoid repeat surgeries and manage potential malignant transformation.
- Long-term patient follow-up is recommended for monitoring and management.
