A challenging diagnosis of malignant peritoneal mesothelioma

Malignant Peritoneal Mesothelioma (MPM) is a rare and aggressive cancer originating in the mesothelial serosal membranes, often associated with pleural mesothelioma. Its diagnosis is challenging due to its nonspecific symptoms, such as abdominal distension, pain, weight loss, and ascites, which overlap with other abdominal conditions. This case study details a 64-year-old male patient with a complex clinical presentation, initially misdiagnosed with seronegative celiac disease, before ultimately being diagnosed with MPM through video-laparoscopy. Despite extensive workup-including CT, PET scans, and colonoscopy-the diagnosis was delayed until peritoneal nodules were identified. MPM remains difficult to detect, often identified at advanced stages, with a poor prognosis and a median survival of less than 1 year post-diagnosis. This case underscores the importance of a comprehensive diagnostic approach, particularly in patients with nonspecific abdominal symptoms, to improve early detection and treatment outcomes for MPM.