Diffuse malignant peritoneal mesothelioma

Our plain-English summary of Diffuse malignant peritoneal mesothelioma, by C.A. Shih, S.P. Ho, F.W. Tsay, et al (The Kaohsiung Journal of Medical Sciences, 2013).

The study

• Authors: C.A. Shih, S.P. Ho, F.W. Tsay, K.H. Lai, P.I. Hsu
• Journal: The Kaohsiung Journal of Medical Sciences
• Published: 2013;29(11):642-5
• Type of article: Case report
• Cited by: 9 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Mesothelioma often originates in the pleura and less frequently in the peritoneum. This article describes a rare case of diffuse malignant peritoneal mesothelioma in a 54-year-old male construction worker who was admitted to our hospital with a 2-month history of progressive abdominal distention. Abdominal computed tomography revealed extensive peritoneal nodularity and omental cake along with massive ascites. Imaging findings initially suggested peritoneal carcinomatosis, primary peritoneal carcinoma, and tuberculous peritonitis. Laparoscopic biopsy of the omentum and peritoneum confirmed the diagnosis of malignant peritoneal mesothelioma of epitheloid type. Although systemic chemotherapy was administered, no tumor regression was found. The patient finally died of nosocomial infection.

Copyright © 2013. Published by Elsevier B.V.

In plain English

This case report from Kaohsiung Veterans General Hospital, Taiwan, described one patient with diffuse malignant peritoneal mesothelioma, a cancer of the abdominal lining. The patient was a 54-year-old male construction worker admitted with two months of worsening abdominal swelling. A CT scan showed widespread nodules on the abdominal lining, an 'omental cake' and a large amount of abdominal fluid (ascites). Imaging at first suggested other conditions, including spread of another cancer and tuberculous peritonitis. No cancer cells were found in the fluid, and a chest X-ray showed no pleural thickening or effusion. A laparoscopic biopsy with special staining confirmed malignant peritoneal mesothelioma of the epitheloid type. Chemotherapy did not shrink the tumor, and the patient died of a hospital-acquired infection. The authors stated the patient had no definite history of asbestos exposure, but noted that a construction worker is more likely than the general population to contact materials such as fire-retardant coatings and cement. The authors concluded that this disease, though a rare cause of ascites in Taiwan, should be considered in patients with ascites, particularly those without cirrhosis, pulmonary tuberculosis or a nonperitoneal cancer.

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 discussion drawing on earlier literature
• Who was studied: one 54-year-old male construction worker admitted to Kaohsiung Veterans General Hospital, Taiwan, with a 2-month history of progressive abdominal distention
• Exposure: no definite history of asbestos exposure; the authors noted that his work in construction made contact with fire-retardant coatings, cement, bricks, pipes, flooring and roofing more likely than in the general population (no fiber type or dose given)
• Main results:
  • Abdominal CT showed extensive peritoneal nodularity and omental cake with massive ascites
  • Imaging findings initially suggested peritoneal carcinomatosis, primary peritoneal carcinoma and tuberculous peritonitis
  • No malignant cells were found in the patient's ascitic fluid
  • The patient's chest X-ray showed no active lung lesions such as pleural thickening or pleural effusion
  • Laparoscopic biopsy showed epitheloid mesothelioma; immunohistochemistry was positive for WT1, D2-40, calretinin and other markers, confirming malignant peritoneal mesothelioma, epitheloid type
  • Systemic chemotherapy produced no tumor regression in this patient, who died of nosocomial (hospital-acquired) infection
• The authors' conclusion: The authors concluded that diffuse malignant peritoneal mesothelioma is a rare cause of ascites in Taiwan, but that it should be considered in patients with ascites, particularly those without cirrhosis, pulmonary tuberculosis or nonperitoneal malignancy

Topics

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

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Mesothelioma, Pleura, Peritoneum, Ascites, Primary Peritoneal Carcinoma, Biopsy, Omentum.

Related studies

• Diffuse Malignant Peritoneal Mesothelioma Presenting with Psammomatous Calcification on a Cervical Smear — A. Tan, P. Cohen, et al. (2015)
• CT differentiation of diffuse malignant peritoneal mesothelioma and peritoneal carcinomatosis — Y.F. Liang, G.Q. Zheng, et al. (2016)
• 18F-FDG PET/CT in a recurrent diffuse malignant peritoneal mesothelioma — Q. Cao, M. Lu, et al. (2012)
• Mesothelin and osteopontin as circulating markers of diffuse malignant peritoneal mesothelioma: A preliminary study — F. Bruno, D. Baratti, et al. (2018)
• Clinical picture, response to therapy, and survival of women with diffuse malignant peritoneal mesothelioma — G.H. Eltabbakh, M.S. Piver, et al. (1999)
• 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)

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