The difficult diagnostic approach of the intraperitoneal mesothelioma

Our plain-English summary of The difficult diagnostic approach of the intraperitoneal mesothelioma, by S.M. Yoo, A.J. ten Tije, E. van der Harst, et al (The Netherlands Journal of Medicine, 2000).

The study

• Authors: S.M. Yoo, A.J. ten Tije, E. van der Harst, T. van Gelder
• Journal: The Netherlands Journal of Medicine
• Published: 2000;57(6):224-8
• Type of article: Case report
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

The malignant mesothelioma is a rare tumour with a rising incidence during the past decades [Lancet 1 (1986) 1275; Br J Int Med 28 (1971) 59; Am J Int Med 9 (1986) 397]. The tumour is derived from the mesothelial lining of the pleural cavity, the pericardium or the peritoneum. Mesotheliomas solely involving the peritoneum are particularly rare. Two cases of malignant peritoneal mesotheliomas are described to demonstrate the difficulties in diagnosing this disease. Surgical exploration, either by laparotomy, or preferably by laparoscopy, has been proven valuable as a diagnostic method.

In plain English

This brief report described two patients with malignant peritoneal mesothelioma, a cancer of the lining of the abdomen, to show how hard the disease is to diagnose. Patient A, a 61-year-old sailor from the Cape Verde Islands, was diagnosed with obstructive ileus, a blockage of the bowel. An exploratory abdominal operation found a completely fibroid peritoneum. Tissue samples showed malignant mesothelioma of the diffuse fibrous (mesenchymal) type, and the patient died of sepsis a few weeks later. The case description does not mention asbestos exposure for this patient. Patient B, a 59-year-old carpenter, went through about six months of investigations for abdominal pain and weight loss before scans showed thickening of the bowel walls, the mesentery and the peritoneum. A more detailed history revealed 15 years of occupational asbestos exposure. A fine needle aspiration found no abnormality. The patient was too ill for surgery and died. Autopsy showed diffuse malignant mesothelioma of the epithelial type, and the pleural linings were not affected. The authors concluded that surgical exploration, by laparotomy or preferably laparoscopy, is valuable for diagnosis.

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: Brief report of two case reports, followed by a discussion of the literature
• Who was studied: Two men with malignant peritoneal mesothelioma: Patient A, a 61-year-old sailor from the Cape Verde Islands, and Patient B, a 59-year-old carpenter. No dates or setting are given for the cases.
• Exposure: Patient B had 15 years of occupational asbestos exposure, which came to light only on more detailed history taking. No fiber type is reported. No asbestos exposure is described for Patient A in the case description.
• Main results:
  • Patient A was diagnosed with obstructive ileus (bowel obstruction).
  • Patient A: exploratory laparotomy found a completely fibroid peritoneum.
  • Patient A: pathology of the peritoneum showed malignant mesothelioma of the diffuse fibrous (mesenchymal) type, and the patient died of sepsis a few weeks later.
  • Patient B underwent 6 months of investigations at the outpatient department to find the cause of weight loss and abdominal pain.
  • Patient B: ultrasound and computed tomography eventually showed thickening of the bowel walls, the mesentery and the peritoneum.
  • Patient B: an ultrasound-guided fine needle aspiration found no abnormality.
  • Patient B: laparotomy could not be performed because of the patient's poor condition, and the patient died shortly afterwards.
  • Patient B: autopsy found the abdominal cavity filled with a thick white mass enclosing the intestines.
  • Patient B: at autopsy the pleural linings were not affected.
  • Patient B: histology showed a diffuse malignant mesothelioma of the epithelial type.
• The authors' conclusion: The authors concluded that surgical exploration, by laparotomy or preferably by laparoscopy, is valuable as a diagnostic method for peritoneal mesothelioma.

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: Mesothelioma, Malignant Mesothelioma, Pleural Cavity, Pericardium, Peritoneum, Peritoneal Mesothelioma, Laparotomy.

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