Late recurrence of benign multicystic peritoneal mesothelioma complicated with an incisional hernia

Our plain-English summary of Late recurrence of benign multicystic peritoneal mesothelioma complicated with an incisional hernia, by E. Canbay, H. Ishibashi, S. Sako, et al (Case Reports in Surgery, 2013).

The study

• Authors: E. Canbay, H. Ishibashi, S. Sako, T. Kitai, E. Nishino, Y. Yonemura
• Journal: Case Reports in Surgery
• Published: 2013;2013:903795
• Cited by: 7 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Benign multicystic peritoneal mesothelioma (BMPM) is a rare disease arising from the peritoneal mesothelium. Here, we report a 57-year-old woman admitted to our unit with an incisional hernia fifteen years later following her first operation due to BMPM. Computerized tomography demonstrated a cystic appearing mass with intraabdominal extension in hernia sac. The patient underwent en bloc resection of the mass and hernia repair. An immunohistochemical analysis of the mass confirmed the recurrence of BMPM. Our case supports that BMPM has slowly progressive nature and can recur with complicated incisional hernia long time after primary resection. Diagnosis and long-term followup are crucial for clarifying the characteristics of this disease.

In plain English

This is a case report of one patient with benign multicystic peritoneal mesothelioma (BMPM). The authors describe BMPM as a very rare tumor made of many cysts, arising from the peritoneal mesothelium (the lining of the abdomen). The patient was a 57-year-old woman. Fifteen years earlier she had BMPM arising from the mesentery of the appendix and extending to the ascending colon, which was treated by right hemicolectomy. She stopped attending yearly check-ups after 10 years. She came back with abdominal discomfort and swelling, an incisional hernia at her old midline scar, and a painful mass about 4 cm in size around the navel. A CT scan showed a cystic mass extending widely inside the abdomen. Surgeons removed the mass and the navel and repaired the hernia. She recovered without complications. Tissue staining for cytokeratin 5/6 and calretinin confirmed that BMPM had come back. The authors concluded that BMPM can recur as an incisional hernia long after surgery and that patients need proper long-term follow-up. The article does not mention asbestos or any exposure history.

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
• Who was studied: One 57-year-old woman treated at the authors' unit (author affiliations are in Kishiwada City, Osaka, Japan). She had been operated on for BMPM fifteen years earlier.
• Exposure: The article does not mention asbestos or any other exposure.
• Main results:
  • Her earlier BMPM arose from the mesentery of the appendix, extended to the ascending colon, and was treated with right hemicolectomy.
  • She was followed up four times a year for two years, then yearly, but did not attend annual follow-up after 10 years.
  • At presentation she had a painful palpable abdominal mass about 4 cm in size around the umbilicus and an incisional hernia 30 mm in diameter.
  • CT showed an intraperitoneal hypodense cystic mass around the umbilicus. It extended between the greater curvature of the stomach, the spleen and the tail of the pancreas, and down to the upper margin of the pelvis.
  • The mass and umbilicus were completely resected and the hernia repaired. Her recovery was uneventful.
  • Under the microscope the cysts were lined by flat and cuboidal cells. Staining for cytokeratin 5/6 and calretinin confirmed recurrent BMPM.
• The authors' conclusion: The authors concluded that BMPM is difficult to recognize and can recur as an incisional hernia. They wrote that recurrence and uncertain biological behavior indicate the need for proper long-term follow-up, and that complete cytoreductive surgery seems to be the proper management.

Topics

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Mesothelium.

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