Multicystic benign cystic mesothelioma presenting as a pelvic mass

Our plain-English summary of Multicystic benign cystic mesothelioma presenting as a pelvic mass, by M. Momeni, E. Pereira, G. Grigoryan, et al (Case Reports in Obstetrics and Gynecology, 2014).

The study

• Authors: M. Momeni, E. Pereira, G. Grigoryan, K. Zakashansky
• Journal: Case Reports in Obstetrics and Gynecology
• Published: 2014;2014:852583
• Cited by: 24 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background. Benign cystic mesothelioma (BCM) is a rare tumor that arises from the abdominal peritoneum with a predilection to the pelvic peritoneum. For this reason, it can often mimic gynecologic malignancies. Case. A 47-year-old perimenopausal female presented reporting several weeks of abdominal distention associated with abdominal tenderness and constipation. Computed tomography revealed a 24 cm multiloculated pelvic mass, and tumor markers were notable for an elevated CA-125. The patient was taken to the operating room for an exploratory laparotomy, total abdominal hysterectomy, bilateral salpingoophorectomy, and removal of pelvic mass. Final pathologic evaluation revealed a benign cystic mesothelioma. Conclusion. Classically these tumors present as large multicystic masses with thin-walled septations and on preoperative evaluation BCM can mimic many different disease entities including ovarian malignancies and cystic lymphangioma. Often diagnosis can only be made at time of surgery.

In plain English

This case report described one patient, a 47-year-old perimenopausal woman. She saw her gynecologist after more than three weeks of worsening abdominal swelling, tenderness and constipation. Ultrasound showed a large multiloculated pelvic mass measuring 24 × 18 cm, thought likely to arise from the left ovary. A CT scan measured a predominantly cystic mass of 28.3 × 24.4 × 16.3 cm. Her CA125 tumor marker was elevated, at a value of 95. Because cancer was strongly suspected, she had open abdominal surgery that removed the mass, her uterus, both fallopian tubes and ovaries, and part of the omentum. Her uterus, tubes and ovaries were normal. The cyst arose from the uterus on a wide stalk, and three liters of fluid were drained. Cytology showed reactive benign mesothelial cells, and the diagnosis was multilocular peritoneal inclusion cyst (benign cystic mesothelioma). One year after surgery she had no evidence of recurrence. The article does not mention asbestos. The authors concluded that before surgery this tumor can mimic ovarian cancers and cystic lymphangioma, and that diagnosis often can only be made at surgery.

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 47-year-old perimenopausal woman seen at a gynecology practice. The authors are from the Icahn School of Medicine at Mount Sinai, New York. No dates of care are given.
• Exposure: The article does not mention asbestos or any other environmental or occupational exposure for this patient.
• Main results:
  • On ultrasound, the patient had a multiloculated pelvic mass with thick septations measuring 24 × 18 cm.
  • On CT, the patient had a predominantly cystic mass measuring 28.3 × 24.4 × 16.3 cm.
  • The patient's CA125 was elevated, at a value of 95 (units not stated).
  • At surgery, the patient's uterus, fallopian tubes and ovaries were normal.
  • Three liters of cyst fluid were drained and sent for cytology, which showed reactive benign mesothelial cells.
  • The final diagnosis was multilocular peritoneal inclusion cyst (benign cystic mesothelioma).
  • At 1 year after surgery the patient had no new complaints and no evidence of recurrence.
• The authors' conclusion: The authors concluded that before surgery benign cystic mesothelioma can mimic other conditions, including ovarian malignancies and cystic lymphangioma, and that diagnosis often can only be made at surgery.

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Peritoneum, Tumor Marker, CA-125, Laparotomy, Bilateral.

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