Benign papillary mesothelioma of the peritoneum: a consideration in the differential diagnosis of peritoneal implants

Our plain-English summary of Benign papillary mesothelioma of the peritoneum: a consideration in the differential diagnosis of peritoneal implants, by G. Tzanakakis, K.S. McCully, M.P. Vezeridis (Southern Medical Journal, 1989).

The study

• Authors: G. Tzanakakis, K.S. McCully, M.P. Vezeridis
• Journal: Southern Medical Journal
• Published: 1989;82(12):1579-80
• Type of article: Case report
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

We have reported a case of benign papillary mesothelioma of the peritoneum found incidentally during surgical exploration in a patient with rectal carcinoma. Clinicians and pathologists alike may find it difficult to differentiate this uncommon lesion from metastatic tumors.

In plain English

This article was a case report about one patient. A 58-year-old man at the Providence VA Medical Center had rectal adenocarcinoma. In January 1985, during surgery to remove the rectal cancer, surgeons found multiple flat nodules 1 to 4 mm across on the peritoneum, the lining of the abdomen. Because they strongly resembled spread cancer, a sample was examined during the operation, and it was negative for metastatic adenocarcinoma. Under the microscope the nodules were made of mesothelial cells forming papillary structures, with no dysplasia or mitotic figures. They were diagnosed as benign papillary mesothelioma of the peritoneum. The patient was free of disease three years after the operation. The report does not say whether he had been exposed to asbestos. Citing earlier reports, the authors wrote that there appears to be no association between asbestos exposure and benign mesothelioma, though an occasional exposed patient has been reported. The authors concluded that this uncommon lesion should be considered when peritoneal implants are found in patients with intra-abdominal and pelvic cancers.

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 (one patient)
• Who was studied: One 58-year-old man with rectal adenocarcinoma, treated at the Providence VA Medical Center, Providence, RI. He had a colostomy on Nov 27, 1984 and an abdominoperineal resection on Jan 2, 1985.
• Exposure: No asbestos or other fiber exposure is reported for this patient. Asbestos appears only in the authors' discussion of other reports.
• Main results:
  • During surgery for the rectal cancer, multiple gray-tan flat nodules 1 to 4 mm in diameter were found in the peritoneum overlying the root of the mesentery.
  • A frozen section biopsy of the nodules, taken because they resembled metastatic implants, was negative for metastatic adenocarcinoma.
  • Under the microscope the peritoneal lesion consisted of mesothelial cells covering connective tissue in papillary structures. There was no dysplasia or mitotic figures, and alcian blue stain was weakly positive.
  • The diagnosis of benign papillary mesothelioma was based on lack of invasion, cytologic uniformity, morphologic differentiation, and lack of mitotic figures.
  • The rectal adenocarcinoma invaded the full thickness of the bowel wall. Both specimen margins were free of tumor, and seven pericolic lymph nodes showed no metastasis.
  • The patient was free of disease three years after the operation.
• The authors' conclusion: The authors concluded that benign papillary mesothelioma, although uncommon, should be considered in the differential diagnosis when peritoneal implants are found in patients with intra-abdominal and pelvic malignancies. They also concluded that lesions found incidentally during cancer surgery should be confirmed by histopathology.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma, Peritoneal mesothelioma.

Medical terms in this study, explained in our Lexicon: Well-Differentiated Papillary Mesothelioma, Peritoneum, Differential Diagnosis, Carcinoma.

Related studies

• Papillary tumors of the peritoneum in women: mesothelioma or papillary carcinoma — M. Kannerstein, J. Churg, et al. (1977)
• Primary papillary serous neoplasia of the peritoneum: a clinicopathologic and ultrastructural study of eight cases — U. Raju, G. Fine, et al. (1989)
• Well-differentiated papillary mesothelioma of the peritoneum: a pathological analysis and review of the literature — A.V. Hoekstra, M.W. Riben, et al. (2005)
• Well-differentiated papillary mesothelioma: peritoneal implants are not always metastases in the presence of cancer — G.W. Irwin, A. Ervine, et al. (2014)
• Peritoneal papillary carcinoma — S.B. Lele, M.S. Piver, et al. (1988)
• PAX8 Expression in a Subset of Malignant Peritoneal Mesotheliomas and Benign Mesothelium has Diagnostic Implications in the Differential Diagnosis of Ovarian Serous Carcinoma — D.B. Chapel, A.N. Husain, et al. (2017)

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