Malignant peritoneal mesothelioma presenting as a complex omental lesion

Our plain-English summary of Malignant peritoneal mesothelioma presenting as a complex omental lesion, by R. Sudanthiram, C. Vemulapalli, A. Raja, et al (Radiology Case Reports, 2012).

The study

• Authors: R. Sudanthiram, C. Vemulapalli, A. Raja, R. Santhosam, S. Joseph
• Journal: Radiology Case Reports
• Published: 2012;7(2):539
• Type of article: Case report
• Cited by: 8 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Malignant peritoneal mesothelioma is a rare, aggressive neoplasm with a poor prognosis. It simulates a spectrum of conditions and thus poses great difficulty in diagnosis and management. We report a case of malignant peritoneal mesotheolima in a young female whose abdominal CT showed a complex lesion occupying the entire abdominal cavity. This lesion mimicked an ovarian malignancy with peritoneal carcinomatosis.

In plain English

This was a case report by radiologists in Chennai, India, describing one patient with malignant peritoneal mesothelioma. A 28-year-old woman had one month of abdominal pain, abdominal swelling and loss of appetite. She was pale with a large abdominopelvic mass, and her hemoglobin was printed as 7.3 gm/ml. CT showed large multinodular lesions around the edges of the abdominal cavity pushing the small bowel to the center, a cystic lesion near the left ovary, and fluid around the liver, left lung and heart. Blood tumor markers were normal. At surgery, the abdomen was covered with nodular masses that seemed to arise from the omentum and weighed about 2 kg. Her uterus, tubes and ovaries were also removed because ovarian cancer was suspected; histology showed a hyperplastic uterine lining and a benign physiological left ovarian cyst. Tissue staining confirmed malignant peritoneal mesothelioma. She received chemotherapy and had no symptoms two months after surgery. The authors reported that the lesion mimicked ovarian cancer spread through the peritoneum. The report did not say whether the patient had any asbestos 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 (single patient)
• Who was studied: One 28-year-old woman. The authors are in the Department of Radiology, Sri Ramachandra University, Chennai, India. The date of the case is not stated.
• Exposure: Not reported for this patient. Asbestos and other risk factors are mentioned only in the general background discussion, not as part of this patient's history.
• Main results:
  • The patient had abdominal pain, abdominal distension and loss of appetite for one month. Baseline tests were normal except hemoglobin, printed as 7.3 gm/ml.
  • CT of the abdomen showed large, nonenhancing, multinodular lesions (attenuation 27-35 HU) around the periphery of the abdominal cavity, with the small bowel and mesentery displaced to the center. It also showed a cystic lesion in the left adnexa and ascites around the liver. CT of the thorax showed moderate left pleural and pericardial effusion.
  • Serum alpha-fetoprotein, CA-125 and CA-19.9 were within normal limits.
  • At surgery, the whole abdomen was covered with massive nodular masses that seemed to arise from the omentum. The main text describes them as infiltrating the omentum. The whole mass weighed approximately 2 kg. The patient underwent complete omentectomy with cytoreductive surgery.
  • Histology showed a highly cellular spindle-cell tumor. Immunohistochemistry was positive for CD 10, WT1 and C-Kit and negative for ER and PR, confirming malignant peritoneal mesothelioma.
  • Total abdominal hysterectomy with bilateral salpingo-oophorectomy was done because ovarian malignancy was suspected. Histology showed a hyperplastic endometrium and a benign physiological left ovarian cyst.
  • The patient was followed up with chemotherapy and was asymptomatic two months after surgery.
• The authors' conclusion: The authors reported that the lesion mimicked an ovarian malignancy with peritoneal carcinomatosis. They described malignant peritoneal mesothelioma as simulating a spectrum of conditions and therefore difficult to diagnose and manage.

Topics

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

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