Benign cystic peritoneal mesothelioma incorrectly diagnosed as an ovarian borderline mucinous tumor of intestinal type at transvaginal preoperative ultrasound evaluation

Our plain-English summary of Benign cystic peritoneal mesothelioma incorrectly diagnosed as an ovarian borderline mucinous tumor of intestinal type at transvaginal preoperative ultrasound evaluation, by A.C. Testa, G.F. Zannoni, S. Ferrari, et al (Ultrasound in Obstetrics & Gynecology, 2011).

The study

• Authors: A.C. Testa, G.F. Zannoni, S. Ferrari, A. Lecca, E. Marana, R. Marana
• Journal: Ultrasound in Obstetrics & Gynecology
• Published: 2011;37(2):248-50
• Type of article: Case report, Letter
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This letter to the editor was a case report about one patient treated by authors at the Catholic University of the Sacred Heart in Rome, Italy. An asymptomatic 70-year-old woman was referred after a left ovarian mass was found by chance. Transvaginal ultrasound showed a multilocular cyst of 56 × 31 × 40 mm with many small locules and no solid component. The examiner suggested a mucinous borderline ovarian tumor of intestinal type. Tumor markers were negative. At laparoscopy, innumerable small translucent vesicles covered the left ovary, and similar cysts covered 80% of the right ovary. Both adnexa and about 90% of the vesicles were removed. Final pathology confirmed a benign mesothelioma, supported by immunohistochemical staining. The authors wrote that benign cystic mesothelioma, unlike malignant mesothelioma, is not associated with prior asbestos exposure. The letter did not report whether this patient had any asbestos exposure. The authors concluded that, for multilocular pelvic tissue, the absence of a regular capsule and of an ovoid overall shape should raise suspicion of mesothelioma.

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 (letter to the editor)
• Who was studied: one asymptomatic 70-year-old woman (gravida 3 para 3) referred after an incidental finding of a left ovarian mass; authors at the Catholic University of the Sacred Heart, Rome, Italy
• Exposure: No asbestos or other exposure was reported for this patient. In their discussion, the authors state that benign cystic mesothelioma, unlike malignant mesothelioma, is not associated with prior asbestos exposure.
• Main results:
  • Transvaginal ultrasound showed a multilocular left ovarian cyst measuring 56 × 31 × 40 mm, with a very high number of locules and no solid component.
  • The ultrasound examiner considered a diagnosis of mucinous borderline ovarian tumor of intestinal type, which proved incorrect.
  • The tumor markers CA125 and CA19-9 were negative.
  • At laparoscopy, innumerable small translucent vesicles completely covered the left ovary. The right ovary had 80% of its surface covered by the same cysts.
  • A bilateral adnexectomy was performed and about 90% of the vesicles were removed. Because frozen section showed benign mesothelial cysts, radical surgery was not done, and fewer than 10% of the vesicles were left in place.
  • Final pathology confirmed a benign mesothelioma, with no pathology of the adnexa.
  • Immunohistochemical staining was positive for calretinin, podoplanin and cytokeratin 5/6, and negative for carcinoembryonic antigen and BerEP4.
• The authors' conclusion: The authors concluded that, when multilocular tissue is found in the pelvis, the absence of a regular capsule and the absence of an ovoid shape of the whole lesion should raise suspicion of mesothelioma.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Ovarian cancer.

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Ultrasound.

Related studies

• Giant benign cystic peritoneal mesothelioma: US, CT, and MRI findings — A. Ozgen, D. Akata, et al. (1998)
• Evaluation of MTAP immunohistochemistry loss of expression in ovarian serous borderline tumors as a potential marker for prognosis and progression — N. Nilforoushan, N.A. Moatamed (2020)
• Rectus abdominis muscle resection for abdominal wall recurrence of mucinous adenocarcinoma or peritoneal mesothelioma — T. Yan, P. Sugarbaker (2008)
• Peritoneal benign cystic mesothelioma: a case report and review of the literature — S. van Ruth, M.W. Bronkhorst, et al. (2002)
• van Ruth S, Bronkhorst MWGA, van Coeverden F, Zoetmulder FAN. Peritoneal benign cystic mesothelioma: a case report and review of literature. Eur J Surg Oncol 2002; 28(2): 192-5 — K. Sethna, F. Mohamed, et al. (2002)
• Pediatric Benign Cystic Peritoneal Mesothelioma — J. Durell, H. Dagash, et al. (2016)

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