Pediatric Benign Cystic Peritoneal Mesothelioma

Our plain-English summary of Pediatric Benign Cystic Peritoneal Mesothelioma, by J. Durell, H. Dagash, B. Eradi, et al (Journal of Pediatric and Adolescent Gynecology, 2016).

The study

• Authors: J. Durell, H. Dagash, B. Eradi, S. Nour
• Journal: Journal of Pediatric and Adolescent Gynecology
• Published: 2016;29(2):e33-4
• Type of article: Case report
• Cited by: 8 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Background: Benign cystic peritoneal mesothelioma is a rare tumor comprising multiple cysts typically found within the abdominal cavity. Although the literature has numerous accounts of this entity in adults, only a handful of cases have been published regarding its presence in the pediatric population.

Case: We present the case of a prepubertal 10-year-old girl with the finding of benign cystic peritoneal mesothelioma at laparoscopy for suspected appendicitis, the management, and outcome.

Summary And Conclusion: Although benign cystic peritoneal mesothelioma can be treated with primary excision, the high recurrence rate in adult cases of this disease necessitates the need for long-term follow-up of these patients and provides a challenge to surgeons in providing continuing care.

Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

In plain English

This case report came from the Department of Paediatric Surgery, Leicester Royal Infirmary, United Kingdom. It describes one 10-year-old prepubertal girl with benign cystic peritoneal mesothelioma, a rare condition in which many cysts form in the lining of the abdomen. She was admitted with five days of worsening pain in the lower right abdomen. Her blood tests for inflammation were normal. No scans were done because doctors strongly suspected appendicitis. During keyhole surgery (laparoscopy), surgeons found many clear, fluid-filled cysts throughout the abdomen and pelvis and removed them. Under the microscope, the cysts were lined by mesothelial cells showing marked reactive changes. Fluid-sample cells looked abnormal; given the tissue findings, the authors said this could be explained by reactive change. She went home on the third day after surgery. Six months later she was well, and ultrasound showed no sign of the cysts returning. The authors concluded that because the condition often comes back in adults, these patients need long-term follow-up. They recommended ultrasound scans every six months for two years. The article does not mention asbestos.

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), with a brief discussion of the published literature
• Who was studied: One 10-year-old prepubertal girl treated at the Department of Paediatric Surgery, Leicester Royal Infirmary, Leicester, United Kingdom; dates of treatment not given
• Main results:
  • The girl had 5 days of worsening right iliac fossa (lower right abdominal) pain. Her inflammatory markers were within normal range, and no imaging was done before surgery because appendicitis was strongly suspected.
  • At diagnostic laparoscopy, numerous transparent, fluid-filled vesicles (cysts) were found throughout the abdomen and pelvis.
  • The cysts were excised laparoscopically, and no other abnormalities or foci of infection were found in the abdominal cavity.
  • Histopathology showed multiple cystic spaces lined by mesothelial cells with florid reactive changes.
  • A peritoneal fluid sample showed cytological atypia of the mesothelial cells. The authors said that, in the context of the histopathology, this could be explained by reactive mesothelial cells.
  • The patient recovered uneventfully and was discharged on the third postoperative day.
  • At 6-month follow-up she remained well, with no evidence of recurrence on ultrasonography, and was clinically asymptomatic.
• The authors' conclusion: The authors concluded that benign multicystic peritoneal mesothelioma is rare in children and can be difficult to diagnose. Because of the high recurrence rate in adults, they said long-term follow-up is needed, and they recommended ultrasound scans every 6 months for 2 years.

Topics

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

Related studies

• Benign multicystic peritoneal mesothelioma: a rare cause of intra-abdominal cystic disease — B. Campbell, D. Mehanna, et al. (2017)
• Laparoscopic excision of a benign peritoneal cystic mesothelioma — A. Limone, J. Maier, et al. (2010)
• Benign cystic mesothelioma: a diagnostic dilemma — T.S. Usha Kiran, A. Agboola, et al. (2002)
• Peritoneal benign cystic mesothelioma: a case report and review of the literature — S. van Ruth, M.W. Bronkhorst, et al. (2002)
• van Ruth S, Bronkhorst MWGA, van Coeverden F, Zoetmulder FAN. Peritoneal benign cystic mesothelioma: a case report and review of literature. Eur J Surg Oncol 2002; 28(2): 192-5 — K. Sethna, F. Mohamed, et al. (2002)
• Giant benign cystic peritoneal mesothelioma: US, CT, and MRI findings — A. Ozgen, D. Akata, et al. (1998)

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