Mesothelioma as a rapidly developing Giant Abdominal Cyst

Our plain-English summary of Mesothelioma as a rapidly developing Giant Abdominal Cyst, by D. Vyas, K. Pihl, S. Kavuturu, et al (World Journal of Surgical Oncology, 2012).

The study

• Authors: D. Vyas, K. Pihl, S. Kavuturu, A. Vyas
• Journal: World Journal of Surgical Oncology
• Published: 2012;10:277
• Type of article: Case report
• Cited by: 10 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

The benign cystic mesothelioma of the peritoneum is a rare lesion and is known for local recurrence. This is first case report of a rapidly developing massive abdominal tumor with histological finding of benign cystic mesothelioma (BCM). We describe a BCM arising in the retroperitoneal tis[sue on the right side, lifting ascending colon and cecum to the left side of abdomen. Patient was an active 58-year-old man who noticed a rapid abdominal swelling within a two month time period with a weight gain of 40 pounds. Patient had no risk factors including occupational (asbestos, cadmium), family history, social (alcohol, smoking) or history of trauma. We will discuss the clinical, radiologic, intra-operative, immunohistochemical, pathologic findings, and imaging six months after surgery. Patient has no recurrence and no weight gain on follow up visits and imaging.

In plain English

This case report described one patient, a healthy and active 58-year-old man, with a benign cystic mesothelioma, a rare non-cancerous growth, that developed quickly in the tissue at the back of the abdomen (the retroperitoneum). Over the months before diagnosis he gained weight and his abdomen swelled. The authors stated he had no known risk factors, including occupational exposure to asbestos or cadmium, alcohol, smoking, family history or trauma. A CT scan showed a cystic mass measuring 32 cm by 25 cm that filled nearly the whole abdomen and pushed his bowel to the left. During surgery the thin cyst wall ruptured and 15 liters of serous fluid were aspirated. Under the microscope it was a benign multicystic lesion lined by cuboidal cells that stained positive for pancytokeratin, calretinin and D2-40 and negative for CD34. The authors reported no recurrence at follow-up. They recommended CT follow-up at least yearly for 5 years. Because this report describes one person, his outcome cannot show how often such tumors recur.

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 healthy, active 58-year-old man with a benign cystic mesothelioma arising in the retroperitoneum. The article does not state where or when he was treated; the authors are at Michigan State University.
• Exposure: None identified. The authors reported no occupational risk factors (asbestos, cadmium, and in the case text also silica), and no family history, alcohol use, smoking or history of trauma.
• Main results:
  • The patient's CT scan showed a large spherical cystic mass in the abdomen measuring 32 cm by 25 cm, occupying nearly the entire abdomen and displacing the bowel to the left.
  • At surgery, an attempt to remove the cyst intact failed when its thin wall ruptured, and 15 liters of serous fluid were aspirated.
  • Microscopy showed a benign multicystic lesion lined by cuboidal cells that stained positive for pancytokeratin, calretinin and D2-40 and negative for CD34.
  • The patient had no recurrence on post-operative visits, and CT at the second clinical visit showed no recurrence.
• The authors' conclusion: The authors recommended CT follow-up at least yearly for 5 years. For this patient they were scanning every 3 months for the first year and then yearly, because of fluid spillage during the operation.

Topics

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

Related studies

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• Resection of mesothelial cyst of uterine round ligament by laparoscopic transabdominal preperitoneal procedure alone or combined with open surgery — D. Chen, P. Zhang, et al. (2019)
• Peritoneal, benign, cystic mesothelioma with free-floating cysts, re-examined by new methods. A case report — O.H. Iversen, T. Hovig, et al. (1988)
• Benign multicystic mesothelioma and peritoneal inclusion cysts: are they the same clinical and histopathological entities? A systematic review to find an evidence-based management — A.M.C. Rapisarda, A. Cianci, et al. (2018)
• Multilocular peritoneal inclusion cyst (multicystic mesothelioma) with hyaline globules — J. Lamovec, J. Sinkovec (1996)
• Loose mesothelial cysts in the peritoneal cavity — Y. Ramirez, J. Rosai, et al. (2010)

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