Peritoneal mesothelioma presenting as an adnexal mass

Our plain-English summary of Peritoneal mesothelioma presenting as an adnexal mass, by R.A. Komorowski, D.H. Bobert (Southern Medical Journal, 1975).

The study

• Authors: R.A. Komorowski, D.H. Bobert
• Journal: Southern Medical Journal
• Published: 1975;68(1):83-5
• Type of article: Case report
• Cited by: 15 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

A case of primary peritoneal mesothelioma which presented clinically as an adnexal mass is reviewed. Difficulties in diagnosis and factors affecting prognosis are discussed. Operation to remove as much of the tumor as possible, followed by irradiation therapy, is suggested as a worthwhile approach to improving chances for cure or palliation.

In plain English

This was a case report of one patient with primary peritoneal mesothelioma, a tumor of the abdominal lining. The article did not mention asbestos or any other exposure. A 31-year-old black woman was hospitalized in February 1968 with a clinical diagnosis of pelvic peritonitis secondary to pelvic inflammatory disease, with masses of the tubes and ovaries on both sides. After penicillin, the left mass resolved but the right one persisted. At surgery on October 1, 1968, her uterus, tubes and ovaries looked normal. Surgeons found a 5 cm cystic mass, six 5-mm nodules on the pelvic lining and three small nodules in the omentum (fatty abdominal tissue). These were diagnosed as peritoneal mesothelioma. The nodules, uterus, tubes, ovaries and omentum were removed, followed by 3,800 rads of radiation. No tumor was found at repeat surgery one year after radiation. Five years after the operation she showed no evidence of recurrence. The authors found no other report of this tumor presenting as an adnexal mass. They suggested that surgery with omentectomy followed by radiation appeared a worthwhile approach, while stressing that there were no significant data on combining the two.

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 31-year-old black woman, first hospitalized in February 1968. The authors were from the Pathology Department, Milwaukee County Hospital, Milwaukee, Wisconsin.
• Main results:
  • The initial clinical diagnosis was pelvic peritonitis secondary to pelvic inflammatory disease with bilateral tubal ovarian masses. After penicillin treatment, the right adnexal mass persisted. It was firm, slightly tender and measured 4 x 6 cm.
  • At exploratory laparotomy on Oct 1, 1968, the uterus, fallopian tubes and ovaries appeared normal. There was a largely cystic 5 cm mass, six 5-mm masses on the pelvic peritoneum, and three small omental nodules. Frozen section diagnosis was peritoneal mesothelioma.
  • The omental nodules lay within the folds of the omentum rather than on its surface.
  • Under the microscope, the tumor cells had vacuoles that were sudanophilic but not carminophilic. There was no evidence of invasion into the underlying stroma. Serial sections of both ovaries were normal.
  • Treatment was total hysterectomy, bilateral salpingo-oophorectomy, omentectomy and removal of all visible peritoneal nodules. This was followed by pelvic and abdominal irradiation to 3,800 rads.
  • No tumor was found at reexploration laparotomy one year after radiation therapy ended. The patient was clinically well with no evidence of recurrence five years after operation.
  • The authors found no other report in the literature of this tumor presenting clinically as an adnexal mass.
• The authors' conclusion: The authors suggested that removing the main tumor mass with omentectomy at laparotomy could theoretically improve chances for cure or palliation by radiotherapy. They said this would appear a worthwhile approach.
• Limitations the authors state:
  • The authors emphasized that there are no significant data on combined surgical and radiation therapy.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma, Peritoneal mesothelioma.

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

Related studies

• Benign multicystic peritoneal mesothelioma presenting as a ghost abdominal mass — H. Jerraya, W. Ghariani, et al. (2016)
• Malignant peritoneal mesothelioma presenting as a splenic mass — M. Podberezin, M.J. Fitzpatrick, et al. (2020)
• Malignant peritoneal mesothelioma presenting with respiratory symptoms — M. Daskalogiannaki, P. Prassopoulos, et al. (2000)
• A case of peritoneal mesothelioma masquerading as a urachal mass — K. Huynh, J. Krantz, et al. (2014)
• Cytoreductive surgery with selective versus complete parietal peritonectomy followed by hyperthermic intraperitoneal chemotherapy in patients with diffuse malignant peritoneal mesothelioma: a controlled study — D. Baratti, S. Kusamura, et al. (2012)
• "Signet-ring" cells--a caveat in the diagnosis of a diffuse peritoneal mesothelioma occurring in a lady presenting with recurrent ascites: an unusual case report — B. Rekhi, S. Pathuthara, et al. (2010)

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