Benign Cystic Mesothelioma of the Peritoneum Arising at the Greater Omentum in a 14-Year-Old Boy

Our plain-English summary of Benign Cystic Mesothelioma of the Peritoneum Arising at the Greater Omentum in a 14-Year-Old Boy, by Y. Hirayama, N. Higashidate, K. Nakaya, et al (Surgical Case Reports, 2025).

The study

• Authors: Y. Hirayama, N. Higashidate, K. Nakaya, Y. Iinuma
• Journal: Surgical Case Reports
• Published: 2025;11(1)
• Type of article: Case report
• Read it: PubMed · Publisher · Free full text

Abstract

Introduction: Mesothelioma arises from mesothelial cells. This tumor is very rare among pediatric abdominal neoplasms. We herein report an extremely rare case of acute abdomen with cystic mesothelioma of the peritoneum in a child.

Case Presentation: A 14-year-old boy was referred to our hospital for emergency surgery. Surgery revealed a primary tumor arising from the greater omentum. The tumor was macroscopically diagnosed as a benign omental lymphangioma and was resected en bloc with the greater omentum. A histopathological examination of the tumor revealed a simple columnar epithelium-like mesothelioma with poor cell-atypia. Immunohistochemical examination showed antibody reactivity in the cyst epithelium, including an anti-calretinin antibody. The final pathological diagnosis was a mesothelioma originating from the peritoneum.

Conclusions: In pediatric cases diagnosed with cystic lymphatic malformation, the possibility of peritoneal mesothelioma needs to be considered and carefully confirmed or ruled out.

© 2025 The Author(s). Published by Japan Surgical Society.

In plain English

This article is a case report from the Department of Pediatric Surgery at Niigata City General Hospital in Japan. It describes a 14-year-old boy who came to the hospital with fever and right-sided abdominal pain. The article states he had no history of drug treatment or exposure to asbestos. Blood tests showed marked inflammation: white blood cell count 20900/μL, neutrophils 88.3%, and C-reactive protein 5.82 mg/dL. A CT scan showed a multicystic lesion in the right lower abdomen. During emergency surgery, the tumor was found to arise from the greater omentum, and it was removed together with the omentum. It weighed 555 g and measured 150 mm by 100 mm. Microscope and staining tests were positive for calretinin, CK 5/6, WT-1 and D2-40. These led to a final diagnosis of mesothelioma originating in the peritoneum, which the title calls benign cystic mesothelioma. Ten years after surgery, no signs of recurrence were found. The authors concluded that in children diagnosed with cystic lymphatic malformation, peritoneal mesothelioma should be considered and carefully confirmed or ruled out.

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 14-year-old boy with fever and right-sided abdominal pain, treated at Niigata City General Hospital, Niigata, Japan
• Exposure: No asbestos exposure reported; the article states the patient had no history of drug treatment or exposure to asbestos
• Main results:
  • Blood tests in the patient showed marked inflammation: white blood cell count 20900/μL, neutrophil proportion 88.3%, C-reactive protein 5.82 mg/dL
  • CT scan of the patient showed a multicystic lesion in the right ileocecal region (right lower abdomen)
  • At emergency surgery, the tumor was found to arise from the greater omentum
  • The tumor was removed in one piece together with the greater omentum
  • The removed tumor weighed 555 g and measured 150 mm by 100 mm
  • Staining of the cyst lining was positive for calretinin, CK 5/6, WT-1 and D2-40
  • The final pathological diagnosis was a mesothelioma originating in the peritoneum
  • Ten years after surgery, no findings suggesting recurrence or complications were seen in the patient
• The authors' conclusion: The authors concluded that in children diagnosed with cystic lymphatic malformation, the possibility of peritoneal mesothelioma needs to be considered and carefully confirmed or ruled out
• Limitations the authors state:
  • The authors state that many mechanisms of the natural history of cystic mesothelioma of the peritoneum in children remain unexplained, and that the patient needs continued follow-up

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Peritoneum, Omentum, Mesothelial Cells, Neoplasm, Epithelium, Calretinin, Peritoneal Mesothelioma.

Related studies

• Benign cystic mesothelioma of the peritoneum: a case report and literature review — H. Elbouhaddouti, A. Bouassria, et al. (2013)
• Benign cystic mesothelioma of the peritoneum: a rare case and review of the literature — S. Khuri, H. Gilshtein, et al. (2012)
• Benign cystic mesothelioma of the peritoneum in a male child — Z. Stojsic, R. Jankovic, et al. (2012)
• Benign cystic mesothelioma of the peritoneum in a child-case report and review of the literature — V.C. Shakya, C.S. Agrawal, et al. (2011)
• Benign cystic mesothelioma of the peritoneum--a case report — Y.L. Suh, W.J. Choi (1989)
• Incidental benign cystic mesothelioma of the peritoneum: A case report — M.M. Ianieri, D.I. Buca, et al. (2016)

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