Benign multicystic peritoneal mesothelioma treated with laparoendoscopic single site surgery: a case report and review of the literature

Our plain-English summary of Benign multicystic peritoneal mesothelioma treated with laparoendoscopic single site surgery: a case report and review of the literature, by K.S. Cha, Y.H. Choi, Y.S. Lee, et al (Obstetrics & Gynecology Science, 2018).

The study

• Authors: K.S. Cha, Y.H. Choi, Y.S. Lee, E.K. Park
• Journal: Obstetrics & Gynecology Science
• Published: 2018;61(1):170-174
• Type of article: Case report
• Cited by: 8 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Benign multicystic peritoneal mesothelioma (BMPM) is rare and difficult to diagnose before surgery. We report a case of BMPM incidentally discovered during laparoendoscopic single site surgery (LESS) for treatment of a pelvic mass. A 47-year-old Korean menopaused woman presented to our outpatient clinic with a pelvic mass. She had a history of right ovary cystectomy with adhesiolysis at a local hospital in 2010. Imaging study of the pelvis revealed a multilocular cystic mass. LESS was performed and multiple grapelike clusters of cysts were seen in the uterus, cul-de-sac, both adnexa, pelvic wall, and omentum. The appendix was grossly free. Frozen biopsy confirmed BMPM. Excision of multiple cyst clusters of cysts, resection of the uterus with both adnexa, appendectomy, omentectomy, and adhesiolysis were performed with LESS. She is well for 2 years with no recurrence. BMPM should be included in the differential diagnosis when small multichamber cystic mass is found on ultrasonography.

In plain English

This article was a case report about one woman with benign multicystic peritoneal mesothelioma (BMPM), a rare tumor of the lining of the abdomen. It also briefly discussed earlier published reports. The patient was a 47-year-old Korean woman who had gone through menopause 5 months earlier. She came in with 2 days of low abdominal pain. In 2010 she had surgery to remove a cyst from her right ovary. Imaging showed a multilocular cystic mass in the pelvis. During single-incision laparoscopic surgery, the surgeons found grapelike clusters of cysts. The cysts appeared to arise from the peritoneum and were attached to the uterus and both adnexa, with smaller cysts on the omentum, small bowel mesentery and appendix. All visible cysts, the uterus with both adnexa, the appendix and the omentum were removed. Examination of the tissue was consistent with benign multicystic mesothelioma of the pelvic peritoneum. She remained well for 2 years with no sign of recurrence. The case description did not describe any asbestos exposure. The authors wrote that, unlike pleural mesothelioma, BMPM is not associated with prior asbestos exposure. The authors concluded that BMPM is difficult to diagnose before surgery and should be considered when grapelike multicystic structures are seen on ultrasonography.

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), with a brief discussion of previously published reports
• Who was studied: One 47-year-old woman (gravida 3, para 1), postmenopausal for 5 months, treated at Daejeon St. Mary's Hospital, Korea; previous right ovary cystectomy with adhesiolysis by laparotomy in 2010 (pathology: right ovarian mucinous cystadenoma)
• Exposure: No asbestos exposure is described in the case history. In the discussion the authors state that, unlike pleural mesothelioma, BMPM is not associated with prior asbestos exposure; the sentence is worded ambiguously regarding the patient.
• Main results:
  • The patient's CA-125 level was slightly elevated at 60.55 (reference range 0 to 39 U/mL).
  • Ultrasonography and CT of the patient's pelvis showed a multilocular cystic mass in the pelvic cavity.
  • At laparoscopy, clusters of cysts appeared to originate from the peritoneum and were attached to the uterus and both adnexa.
  • Additional small cysts were found on the omentum, small bowel mesentery and appendix.
  • Frozen section during surgery suggested possible mucinous-type benign cysts.
  • The surgeons excised the cyst clusters and removed the uterus with both adnexa, the appendix and the omentum, and also performed adhesiolysis.
  • The lining cells stained positive for pan-cytokeratin and calretinin, and the findings were consistent with benign multicystic mesothelioma of the pelvic peritoneum.
  • The patient was well for 2 years with no clinical evidence of recurrence.
• The authors' conclusion: The authors concluded that BMPM is difficult to diagnose before surgery and should be considered when grapelike multicystic structures are seen on ultrasonography. They recommended careful follow-up because recurrence can be as high as 50%.

Topics

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Omentum, Biopsy, Differential Diagnosis.

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• Multicystic peritoneal mesothelioma treated with complete cytoreductive surgery, peritonectomy and hyperthermic intra-peritoneal chemotherapy-A case report — N. Padmanabhan, H. Ishibashi, et al. (2020)
• Imaging appearance of benign multicystic peritoneal mesothelioma: a case report and review of the literature — V. Mehta, V. Chowdhary, et al. (2017)
• Benign multicystic peritoneal mesothelioma: literature review and update — M.T. Chand, J. Edens, et al. (2020)
• Benign Multicystic Peritoneal Mesothelioma (BMPM) as a rare cause of abdominal pain in a young male: case report and review of the literature — S. Gussago, P. Spina, et al. (2019)

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