Laparoscopic management of peritoneal mesothelioma associated with pelvic endometriosis

Our plain-English summary of Laparoscopic management of peritoneal mesothelioma associated with pelvic endometriosis, by F.R. Nezhat, S.M. DeNoble, D.N. Brown, et al (Journal of Minimally Invasive Gynecology, 2010).

The study

• Authors: F.R. Nezhat, S.M. DeNoble, D.N. Brown, A. Shamshirsaz, D. Hoehn
• Journal: Journal of Minimally Invasive Gynecology
• Published: 2010;17(5):646-50
• Type of article: Case report
• Cited by: 7 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Objective: To describe 3 cases of peritoneal mesothelioma associated with endometriosis that were managed laparoscopically.

Design: Case series.

Setting: University and community hospitals.

Patients: Three women with well-differentiated papillary mesothelioma of the peritoneum associated with endometriosis.

Interventions: Laparoscopic excision and treatment of mesothelioma and endometriosis.

Results: Three patients underwent laparoscopy for treatment of endometriosis and were found to have peritoneal mesothelioma. All 3 patients underwent total laparoscopic excision of the lesions and were followed up regularly for surveillance of possible recurrence.

Conclusions: In selected cases of well-differentiated papillary mesothelioma associated with pelvic endometriosis, operative laparoscopy can be used effectively to diagnose and treat this condition.

Copyright © 2010 AAGL. Published by Elsevier Inc. All rights reserved.

In plain English

This case report described three women, aged 32, 35 and 47, who were referred to a New York center with peritoneal mesothelioma found alongside pelvic endometriosis. All three had first had diagnostic laparoscopy (keyhole surgery) elsewhere for chronic pelvic pain. Each denied any history of exposure to asbestos or other known toxins. All three were treated by laparoscopy, with CO2 laser removal of the visible lesions and treatment of the endometriosis. One woman, who wanted future pregnancy, kept her uterus; the other two had hysterectomies. Final pathology showed well-differentiated papillary mesothelioma in the first woman, well-differentiated malignant papillary mesothelioma in the second, and benign cystic mesothelioma in the third. The second woman had a recurrence, reported as malignant mesothelioma, which was removed laparoscopically in June 2009. At the last report, all three were without evidence of disease. The authors concluded that in selected cases of well-differentiated papillary mesothelioma with pelvic endometriosis, operative laparoscopy can be used effectively to diagnose and treat the condition. They proposed surveillance every 4 to 6 months.

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 (case report of 3 patients)
• Who was studied: Three women aged 32, 35 and 47 with peritoneal mesothelioma and endometriosis. All had first had diagnostic laparoscopy for chronic pelvic pain at other institutions and were referred to the authors' center in New York (St. Luke's-Roosevelt Medical Center). They were treated between 2000 and 2009.
• Exposure: No asbestos exposure was reported. Each of the three patients denied any history of exposure to asbestos or other toxins.
• Main results:
  • Case 1 (32-year-old with stage IV endometriosis): She had CO2 laser resection and debulking of the visible mesothelioma, with conservative treatment of the endometriosis. Final pathology showed well-differentiated papillary mesothelioma and endometriosis. She was without evidence of disease at follow-up in November 2009.
  • Case 2 (35-year-old): She had a laparoscopic hysterectomy and CO2 laser resection in January 2002, with final pathology of well-differentiated malignant papillary mesothelioma and endometriosis. Second-look laparoscopy at 6 months showed mesothelial hyperplasia with a focus of endometriosis.
  • Case 2 recurrence: In June 2009 lesions were found on the abdominal wall, rectosigmoid mesentery and omentum. They were removed laparoscopically, and pathology showed malignant mesothelioma consistent with recurrent disease. She was without evidence of disease as of March 2010.
  • Case 3 (47-year-old): She had a laparoscopic-assisted vaginal hysterectomy with removal of both tubes and ovaries. Pathology showed endometriosis in both adnexa, mesothelial hyperplasia in the sigmoid lesion, and benign cystic mesothelioma on the uterine surface. She was currently without evidence of disease.
• The authors' conclusion: The authors concluded that in selected cases of well-differentiated papillary mesothelioma associated with pelvic endometriosis, operative laparoscopy can be used effectively to diagnose and treat the condition. They proposed complete laparoscopic treatment followed by close surveillance every 4 to 6 months.

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: Peritoneal Mesothelioma, Well-Differentiated Papillary Mesothelioma, Peritoneum, Mesothelioma.

Related studies

• Surgical treatment of endometriosis — F.M. Howard (2011)
• Laparoscopic diagnosis and treatment of pelvic benign multicystic mesothelioma associated with high CA19.9 serum concentration — V. Pinto, A.C. Rossi, et al. (2010)
• Malignant peritoneal mesothelioma in patients with endometriosis — K.J. Butnor, J. Rueckert, et al. (2018)
• Postoperative outcomes of laparoscopic vs open cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy for treatment of peritoneal surface malignancies — G. Passot, N. Bakrin, et al. (2014)
• A recurrence of benign multicystic peritoneal mesothelioma treated through laparoscopic excision: a case report and review of the literature — T.D. Witek, J.W. Marchese, et al. (2014)
• Laparoscopic excision of a benign peritoneal cystic mesothelioma — A. Limone, J. Maier, et al. (2010)

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