A Rare Case Of Peritoneal Mesothelioma

Abstract

Background: Malignant peritoneal mesothelioma is an uncommon primary tumor of the
peritoneal lining and is the second most common type of mesothelioma; it accounts for about 30% of all
malignant mesotheliomas, with an overall incidence of 2 to 2.6 cases per million. Aims and objectives: To
establish the role of radiological findings in a case of peritoneal malignancy. Result: A 47 years old female
patient came to surgery OPD in our hospital with complain of abdominal pain associated with abdominal
distension, nausea, significant weight loss, constipation on/off since last two months. Routine blood
investigations and Xray abdomen, USG abdomen and contrast CT abdomen were done. Patient was
planned for surgery and Exploratory laparotomy + Resection of cysts + ileoileal anastomosis + Paul mikulicz
ileostomy was done. A huge cyst was resected and sent for histopathological examination. On
histopathological examination, it shows neoplastic acini and micropapillae in serosa and muscularis propria.
Lymphovascular invasion is also seen. Sections from the nodule show cyst lined by neoplastic cells forming
micropapillae with presence of necrosis in the center, malignant peritoneal mesothelioma was diagnosed.
Conclusion: Malignant peritoneal mesothelioma is very rare tumour of peritoneum diagnosed less
frequently than the pleural variant. Radiological findings are of paramount importance in cases of
peritoneal malignancy – mesothelioma, which enables accurate diagnosis in appropriate settings. Early
diagnosis and timely operative interventions must occur in order to provide best outcome for patient. With
advances in treatment, the primary treatment includes excision of the tumour followed by intraperitoneal
chemotherapy. [Gulabkhan M Natl J Integr Res Med, 2023; 14(4): 32-36 , Published on Dated: 15/03/2023]