Benign cystic mesothelioma: A case report on the presentation of an unusual tumor

Our plain-English summary of Benign cystic mesothelioma: A case report on the presentation of an unusual tumor, by Y. Salem, A. Farhan, H.S. Aljawder, et al (International Journal of Surgery Case Reports, 2021).

The study

• Authors: Y. Salem, A. Farhan, H.S. Aljawder, A. Abualsel
• Journal: International Journal of Surgery Case Reports
• Published: 2021;82:105918
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Introduction: Benign cystic mesothelioma of the peritoneum is a rare, benign abdominal tumor. It can present with vague signs and symptoms and is often found on imaging or incidentally during surgery.

Presentation Of Case: We report the case of a 30-year-old man presenting with acute abdominal pain that radiated to the right iliac fossa. No masses were found on superficial or deep palpation or on conducting a sonography. The patient underwent a diagnostic laparoscopy with an appendectomy, which revealed a perforated appendix and two cysts in the pelvis and iliac fossa.

Discussion: A benign cystic mesothelioma is an inclusion cyst found in the peritoneal cavity and has no specific clinical presentation. It can be symptomatic or found incidentally during surgery. Benign cystic mesotheliomas have a high recurrence rate and may undergo malignant transformation.

Conclusion: Complete surgical excision of benign cystic mesothelioma must always be the first step of the treatment plan for this condition. It is difficult to treat with no evidence-based treatment modality available; thus, treatment should only be undertaken in a specialized center.

Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.

In plain English

This case report, from King Hamad University Hospital in Bahrain, described a benign cystic mesothelioma of the peritoneum (the abdominal lining). A 30-year-old man with no significant medical or surgical history had one day of severe upper abdominal pain spreading to the lower right abdomen, with nausea and vomiting. Blood tests and the examination pointed to acute appendicitis, and an ultrasound showed no masses in the abdomen. During laparoscopic (keyhole) surgery, an inflamed appendix was removed. Two cysts containing gelatinous material were found by chance in the pelvis and lower left abdomen and were also removed. Tissue examination showed an inflamed, non-perforated appendix and a multicystic benign mesothelioma that stained positive for calretinin. The man recovered without complications, returned to work one week after surgery, and had follow-up visits up to one year. The article does not mention asbestos or any exposure history. Citing earlier reports, the authors concluded that this rare benign tumor has a high recurrence rate and can potentially become malignant. They recommended close follow-up and described complete surgical removal as the mainstay of treatment.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient)
• Who was studied: One 30-year-old man with no significant medical or surgical history, treated at King Hamad University Hospital, Bahrain
• Exposure: The article reports no asbestos or other exposure history for the patient
• Main results:
  • Before surgery, ultrasound detected no masses inside the abdomen
  • At surgery, two cysts containing gelatinous material were found by chance in the pelvis and left iliac fossa (lower left abdomen)
  • Neither cyst was attached to the abdominal organs or the abdominal wall
  • Tissue examination confirmed an inflamed, non-perforated appendix and a multicystic benign mesothelioma, which stained positive for calretinin
  • The patient had follow-up visits at 2 weeks, 3 months and 1 year, and returned to work 1 week after surgery
• The authors' conclusion: The authors concluded that benign cystic mesothelioma is a rare benign tumor with a high recurrence rate and potential malignant transformation, and they recommended close and regular follow-up. They also stated that complete surgical excision is the mainstay of treatment and that care should be given in a specialized center. The statements on recurrence and malignant change draw on previously reported cases, not on this patient.

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Peritoneum, Diagnostic Laparoscopy, Peritoneal Cavity, Malignant Transformation.

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• Acute presentation of multi-cystic peritoneal mesothelioma — M. Redden, A. Riddell (2022)

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