Cystic mesothelioma of the peritoneum. A report of three cases

Our plain-English summary of Cystic mesothelioma of the peritoneum. A report of three cases, by S. Villaschi, F. Autelitano, G. Santeusanio, et al (American Journal of Clinical Pathology, 1990).

The study

• Authors: S. Villaschi, F. Autelitano, G. Santeusanio, P. Balistreri
• Journal: American Journal of Clinical Pathology
• Published: 1990;94(6):758-61
• Type of article: Case report
• Cited by: 22 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Three cases of peritoneal cystic mesothelioma are reported. All patients were women who had undergone previous abdominal surgery for unrelated conditions. Tumors consisted of solitary and multiple cystic masses involving the abdominal and pelvic peritoneum. The cysts focally infiltrated the muscularis externa of the small intestine in case 1, the outer muscular layer of the uterus in case 2, and the omental tissue in case 3. These findings give morphologic support to the borderline clinical behavior of this tumor that often recurs and support the hypothesis that previous surgery may play a role in its pathogenesis.

In plain English

This article reported three cases of cystic mesothelioma of the peritoneum, a rare tumor of the abdominal lining, from Rome, Italy. All three patients were white women who had earlier had abdominal surgery for unrelated conditions. The second and third women were 58 and 42. The first had been 49 at a hysterectomy in 1977, and her cysts were operated on in 1987. The article did not discuss asbestos. The first and third women had surgery for the cysts and were reported alive and well three and two years later. In the second woman, cysts were found at autopsy after she died of other causes. Under the microscope no atypical cells or cell divisions were seen. In each case, however, cysts focally grew into nearby tissue: the small intestine wall, the outer uterine muscle, or the omentum. Other organs were free of metastases. The authors wrote that staining confirmed the tumor's mesothelial origin. They concluded that the tumor can infiltrate locally, giving a basis for its tendency to recur. They also concluded that their findings support the hypothesis that previous abdominal surgery may play a role in its development.

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 series (report of three cases), with microscopic, electron microscopic and immunohistochemical examination of tumor tissue
• Who was studied: Three white women with cystic mesothelioma of the peritoneum, seen at the Universita di Roma "Tor Vergata" and Ospedale S. Eugenio, Rome, Italy. The tumors were found between 1987 and 1988. Ages given: 49 for case 1 (at a hysterectomy in 1977, before the cystic disease), 58 for case 2 (died 1988), and 42 for case 3 (in 1988). All had had previous abdominal surgery for unrelated conditions.
• Exposure: The article does not mention asbestos. The factor the authors considered was previous abdominal surgery for unrelated conditions: hysterectomy and later removal of both tubes and ovaries in case 1, cholecystectomy and appendectomy in case 2, and two cesarean deliveries in case 3.
• Main results:
  • Case 1 (woman aged 49 at her hysterectomy in 1977): in December 1987 large numbers of cysts were found throughout her peritoneal cavity. Lysis of adhesions and resection of a 60-cm small intestinal loop were performed. She was alive and well three years after the last operation.
  • Case 2 (woman aged 58): she died in 1988 of respiratory complications after surgery for subarachnoid hemorrhage. Cysts were found at autopsy on the posterior wall of the uterus and the left adnexa.
  • Case 3 (woman aged 42, in 1988): a multiloculated cystic tumor involving the pelvic cavity, left ovary and omentum was removed. She was alive and well two years after the operation.
  • In all cases, microscopy showed cysts lined by flattened and cuboidal cells, with neither atypical cells nor mitoses.
  • Cysts focally infiltrated the muscularis externa of the small intestine in case 1, the outer smooth muscle layers of the uterus in case 2, and the omentum in case 3. Other organs were free of metastases.
  • In all tumors, cells lining the cysts stained for all antikeratin and antivimentin antibodies, and not for FVIII-RA, CA 19.9, CA 125 or CEA. The authors stated this confirmed the mesothelial origin of the tumor.
  • Electron microscopy was done on case 1 only. It showed lining cells with the features of mesothelial cells. Smooth muscle cells, myofibroblasts and fibroblasts were present in the stroma between the cysts, at least in cases 1 and 2.
• The authors' conclusion: The authors concluded that cystic mesothelioma of the peritoneum is capable of local infiltration, giving a morphologic basis to its clinical recurrence and the difficulty of complete surgical removal. They also concluded that their findings support the hypothesis that previous abdominal surgery may play a role in its pathogenesis.

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: Mesothelioma, Peritoneum.

Related studies

• Peritoneal cystic mesothelioma: an electron microscopic and immunohistochemical study of two male patients — I.K. Sienkowski, A.J. Russell, et al. (1986)
• Value of mesothelial and epithelial antibodies in distinguishing diffuse peritoneal mesothelioma in females from serous papillary carcinoma of the ovary and peritoneum — R.L. Attanoos, R. Webb, et al. (2002)
• Pseudomesotheliomatous carcinoma involving pleura and peritoneum: A clinicopathologic and immunohistochemical study of three cases — I.A. Shah, J.R. Salvatore, et al. (1999)
• Cystic mesothelioma of the peritoneum — J.D. O'Neil, P.R. Ros, et al. (1989)
• Benign cystic mesothelioma of the peritoneum in a male child — Z. Stojsic, R. Jankovic, et al. (2012)
• Benign cystic mesothelioma of the peritoneum--a case report — Y.L. Suh, W.J. Choi (1989)

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