Complicated benign cystic mesothelioma of mesoappendix misdiagnosed as an appendiceal abscess in a postpartum period woman

Our plain-English summary of Complicated benign cystic mesothelioma of mesoappendix misdiagnosed as an appendiceal abscess in a postpartum period woman, by S. Yeom, T. Son, Y.O. Hong (Annals of Surgical Treatment and Research, 2015).

The study

• Authors: S. Yeom, T. Son, Y.O. Hong
• Journal: Annals of Surgical Treatment and Research
• Published: 2015;88(3):170-3
• Type of article: Case report
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Benign cystic mesothelioma is an uncommon tumor arising from the peritoneal mesothelium. It is characterized by multilocular grapelike, thin-, and translucent-walled cysts, or a unilocular cyst lined by benign mesothelial cells. It occurs predominantly in women of reproductive age, and shows a predilection for the surface of the pelvic peritoneum or visceral peritoneum. Patients usually present abdominal pain and palpable mass, but many cases have been found incidentally during laparotomy. Definite preoperative diagnosis is known to be difficult. Benign cystic mesothelioma has a tendency towards local recurrence, although the gross microscopic features are benign. Moreover, there is controversy over whether this disease is neoplastic or reactive. Initial complete surgical resection and cytoreductive surgery for recurred cases are standard treatments. In the following report, we describe a case of complicated benign cystic mesothelioma in a postpartum woman, involving the pelvic peritoneum and mesoappendix, which was initially misdiagnosed as a periappendiceal abscess.

In plain English

This article was a case report from a hospital in Seoul, Korea. It described one patient, a 27-year-old woman who had delivered a baby two weeks earlier and came to the hospital with right lower abdominal pain, tenderness and fever lasting two days. She had been referred with a suspected abscess near the appendix or a ruptured mucocele of the appendix. During emergency laparoscopy, surgeons found a multiloculated, translucent cystic mass around the base of the cecum involving the parietal peritoneum and the mesoappendix (the fold of tissue attaching the appendix). The lesion and appendix were removed together. Complete excision was not possible because the edge of the lesion was not distinct from normal tissue. Laboratory staining of the tissue led to a diagnosis of benign cystic mesothelioma. The woman was discharged five days after surgery and refused further surgery. She had no recurrence during 18 months of follow-up. The authors concluded that because this tumor tends to recur and has malignant potential, repeated complete removal and careful long-term follow-up are required. The article did not mention asbestos or any other exposure.

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 27-year-old woman, two weeks after giving birth, referred to Eulji General Hospital, Seoul, Korea
• Exposure: None described; the article does not mention asbestos or any other exposure
• Main results:
  • The patient presented with right lower quadrant abdominal pain, tenderness and fever for two days. She was referred with a possible diagnosis of a periappendiceal abscess or a ruptured mucocele of the appendix.
  • At laparoscopy a multiloculated, translucent, cystic mass was found around the cecal base. It involved the parietal peritoneum and mesoappendix.
  • The lesion was resected en bloc with the appendix, but complete excision was not possible. The cysts ruptured during dissection.
  • Immunohistochemistry was positive for calretinin and D2-40 and negative for CD10 and estrogen receptor. On that basis the lesion was diagnosed as benign cystic mesothelioma.
  • The patient was discharged five days after surgery, refused further surgical treatment, and remained free of recurrence during 18 months of follow-up.
• The authors' conclusion: The authors concluded that, because benign cystic mesothelioma tends to recur and has malignant potential, repeated and complete surgical removal with careful long-term follow-up are required.

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Mesothelium, Mesothelial Cells, Peritoneum, Laparotomy, Surgical Resection, Cytoreductive Surgery.

Related studies

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• Benign cystic mesothelioma: a case series with one case complicated by pregnancy — O. Akbayir, A. Gedikbasi, et al. (2011)
• Benign cystic mesothelioma of the appendix presenting in a woman: a case report — D.B. O'Connor, D. Beddy, et al. (2010)
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