Peritoneal Mesothelioma in Women: Diagnosis, Talc Exposure, and Legal Options

Peritoneal mesothelioma affects women differently than it affects men, and differently than pleural mesothelioma affects anyone. Women make up a much larger share of peritoneal cases than of pleural cases, they're often diagnosed younger, they're exposed through routes that aren't always obvious, some related lesions are found more often in women, and they face a particular kind of diagnostic confusion, because the disease so closely resembles ovarian cancer.^2,3

This page is for women who've been diagnosed with peritoneal mesothelioma, women who are still in the diagnostic process and suspect something's been missed, and the families trying to understand what happened. It covers how the disease presents differently in women, how women are exposed (including through a talc pathway most people don't connect to asbestos), the variants and look-alike lesions that are more common in women and what they mean for treatment, and the legal options, including claims against cosmetic-product makers that many people don't know exist.

It builds on our main peritoneal mesothelioma page, which covers the disease, its diagnosis, staging, and treatment in general. If you haven't read that yet, it's a useful foundation.

The misdiagnosis problem: when peritoneal mesothelioma is mistaken for ovarian cancer

For many women, the path to a peritoneal mesothelioma diagnosis doesn't start with mesothelioma at all. It starts with ovarian cancer.

The symptoms are nearly identical: abdominal swelling, pelvic or abdominal pain, fluid buildup (ascites), unexplained weight loss, feeling full quickly, and diffuse disease across the peritoneum on imaging. Advanced ovarian cancer produces all of these, and it's far more common than peritoneal mesothelioma, so a woman in her fifties or sixties with these symptoms is statistically much more likely to have ovarian or primary peritoneal cancer. Clinicians working from those odds reasonably pursue the more common diagnosis first.

The consequence, for the women who actually have mesothelioma, is that the right diagnosis often arrives weeks, months, or sometimes more than a year after symptoms began, after a gynecologic workup, nonspecific CA-125 results, and imaging that showed peritoneal disease without pinning down its cause. In one large series of 164 women with peritoneal mesothelioma, 15 percent were diagnosed incidentally, during surgery or imaging for something else, such as another cancer, a hernia repair, or an infertility evaluation. Among the cases sent to that center for a second opinion, the final diagnosis differed from the initial one in about half (73 of 147), most often because the tumor had first been called a carcinoma.¹ A national review of 155 patients in the UK and Ireland, about half of them women, likewise notes that diagnosis is often delayed because the symptoms are nonspecific and many patients present with advanced disease.²

Why the delay matters

The delay isn't only frustrating; it can change what treatment is possible. Peritoneal mesothelioma is staged by how widely it has spread across the abdomen, and that spread is the main thing determining whether a woman is a candidate for CRS-HIPEC, the surgery that drives the best outcomes (the staging system is explained on the main peritoneal mesothelioma page). Tumor burden can rise over time, so months spent treating the wrong cancer may make complete surgery harder, though how much any delay matters depends on the individual tumor, and some patients receive drug treatment before surgery by design. In a disease where being a surgical candidate matters this much, time lost to misdiagnosis can have real consequences.

Telling mesothelioma from ovarian cancer

The two diseases can look alike on imaging and even on fluid cytology. What usually separates them is immunohistochemistry (IHC), a panel of antibody stains applied to tumor tissue. Each marker tends to point in a different direction for the two diseases, but none is perfectly specific, so the pathologist reads the whole panel together with the tumor's appearance:⁴

The full diagnostic panel, including the markers that separate mesothelioma from gastrointestinal cancers, is on the main peritoneal mesothelioma page. The point specific to women is this distinction from ovarian and primary peritoneal carcinoma, and the requirement that the panel be read by a pathologist experienced in peritoneal disease. General pathologists see this cancer rarely, and misreading it as ovarian or primary peritoneal carcinoma is a documented error with real consequences: it produces a treatment plan built for a different cancer, delays evaluation for CRS-HIPEC, and can mean chemotherapy chosen for ovarian cancer rather than mesothelioma.

What to do if you suspect a misdiagnosis

If you've been diagnosed with ovarian or primary peritoneal carcinoma and any of the following is true, it's reasonable to ask your team whether peritoneal mesothelioma has been specifically ruled out:

• Your cancer isn't responding to treatment the way ovarian cancer usually does. Ovarian carcinoma is usually treated first with carboplatin and paclitaxel, while mesothelioma is usually treated with pemetrexed combined with a platinum drug. An unexpected response is not a diagnostic test, but it is a reason to revisit the diagnosis.
• You have any history of asbestos exposure, occupational or secondhand, or years of talcum powder use. These raise the likelihood of mesothelioma more than of ovarian cancer, and they should shift the thinking toward mesothelioma in any woman with peritoneal findings.
• Your CA-125 is elevated but the overall picture doesn't quite fit. CA-125 rises in both diseases, so it doesn't settle the question on its own; an atypical picture alongside it is worth a closer look.
• Your pathology was done somewhere without specific peritoneal expertise. Many hospitals do solid general pathology but see this cancer too rarely to recognize it confidently.

In any of these situations, a second pathology opinion at a major mesothelioma center is reasonable, and it doesn't mean starting over. It means sending your existing biopsy slides to a pathologist who specializes in this disease, which we can help arrange.

If you think your diagnosis might be wrong, or your peritoneal cancer isn't responding the way your doctors expected, call us at 833-4-ASBESTOS. A member of our litigation team, not a screener, will talk it through with you, and we can help arrange for your slides to be reviewed by a pathologist at a major mesothelioma center.

How women are exposed to asbestos

Women are diagnosed with peritoneal mesothelioma through the same occupational and secondhand routes that affect men, and those routes are well documented and legally recognized. But women also have a distinctive exposure source: long-term use of asbestos-contaminated talcum powder, including perineal use, which raises a proposed route through the reproductive tract that has no male equivalent. For women with no obvious workplace asbestos history, it is a potential source that deserves product- and period-specific investigation.

Occupational and secondhand exposure

Women's occupational asbestos exposure tended to happen in particular settings: textile mills that used asbestos in heat-resistant fabrics (concentrated in the South), wartime shipyard work during the labor shortages of the 1940s and 1950s, custodial and maintenance roles in older schools and hospitals full of asbestos materials, and the cosmetics and talc plants that processed contaminated raw talc. Any of these can support a claim the same way a man's occupational exposure does.

Secondhand exposure, sometimes called take-home exposure, is an important documented route for women. A wife or daughter who laundered a worker's dust-covered clothes, or who simply lived in a home where fibers were carried in day after day, could inhale enough asbestos to cause disease without ever setting foot in the workplace. Many women diagnosed today never worked around asbestos themselves; their only contact came through a husband's or father's job, and that history is a recognized and sufficient basis for a legal claim. Reconstructing a family member's work history from decades ago is part of what we do, and it's covered more fully in our related resources.

Asbestos-contaminated talc: the pathway specific to women

The exposure route most distinctly tied to peritoneal mesothelioma in women is one most people don't recognize as asbestos exposure at all: years of using talcum powder that was contaminated with asbestos.

Why talc carries asbestos. Talc and asbestos are minerals that form together in the ground, often in the same or adjacent rock. When talc is mined from those deposits without rigorous testing and separation, asbestos fibers can end up in the finished powder. This isn't a rare manufacturing fluke; internal documents produced in litigation indicate that some talc suppliers and product makers knew their raw talc and products could contain asbestos, and that testing and disclosure were inconsistent. (The science and the corporate record here are contested by manufacturers and are the subject of ongoing litigation; the legal section below covers that.)

How fibers may reach the peritoneum. One proposed route is that particles in powder applied to the genital area travel up through the reproductive tract, through the cervix, uterus, and fallopian tubes, into the peritoneal cavity. How often particles actually travel this way is debated, but the World Health Organization's cancer agency treats perineal use as a route of talc exposure; inhaled fibers can also reach the abdomen through lymphatic and other routes. Once asbestos fibers lodge on the peritoneal surfaces, they can set off the slow process of inflammation, cellular damage, and mutation that asbestos causes wherever it settles.⁵ The genital-tract passage exists in women and not in men, which is why the talc pathway is discussed specifically for women. The interval between exposure and diagnosis is usually measured in decades, so a woman diagnosed now who used powder regularly decades ago fits the expected pattern.

Which products. Testing over several decades has found asbestos in talcum powder products from a number of major and store-brand manufacturers, but the brand name isn't the determining factor. What matters is whether the talc in a particular product, during the specific years a woman used it, came from contaminated sources, because products changed suppliers and formulations over time. A powder contaminated in the 1970s might have been reformulated later, or the reverse. So a woman who used a product not widely known from the lawsuits shouldn't assume her exposure doesn't count; the specific product, the years of use, and that product's talc sourcing are what the analysis turns on. The named defendants and how those cases work are in the legal section below.

How much use matters. Reported cases have often involved daily or regular use as part of a hygiene routine over many years, the kind of regular perineal use manufacturers marketed. More frequent and longer use generally means more exposure. But because no safe threshold of asbestos exposure has been established, even moderate use over a long period can be medically and legally relevant, which is worth raising rather than dismissing.

If you used talcum powder regularly for years and have been diagnosed with peritoneal mesothelioma, especially if you have no clear workplace or household asbestos exposure, call us at 833-4-ASBESTOS. The talc history is the most important thing to discuss, and we can investigate whether your specific product and years of use point to a claim, at no cost.

Variants and look-alike lesions more common in women

Several lesions are found more often in women than in men, or were first described in women, and they behave differently enough from standard disease that knowing which one you have changes the whole treatment conversation. The pathology and survival figures for each are covered in the histology section of the main peritoneal mesothelioma page; what follows is what they mean specifically for a woman's care and decisions.

Well-differentiated papillary mesothelial tumor (WDPMT)

This lesion was long called well-differentiated papillary mesothelioma (WDPM). Current pathology guidance renames it well-differentiated papillary mesothelial tumor (WDPMT) to avoid confusion with malignant mesothelioma: it is a noninvasive papillary growth of bland mesothelial cells and is genetically distinct from mesothelioma. It is usually found by accident during surgery for something else. Older series described it mainly in women; in a 54-patient cancer-center series, half the patients were women and the median age was 55. In that series, there were no deaths from WDPMT and no transformation to mesothelioma.^4,6 For a woman's care, that favorable biology changes several things:

• The urgency is different. Diffuse malignant mesothelioma calls for prompt multidisciplinary planning, often including evaluation for CRS-HIPEC. WDPMT usually doesn't carry that urgency, and for limited or asymptomatic disease, careful monitoring (watchful waiting with regular imaging) may be appropriate, an approach that would be entirely wrong for high-grade disease. The right path depends on the extent of disease and the judgment of a specialist who has actually managed WDPMT.
• Focal removal may be enough. When WDPMT is confined to a small area, removing just the visible disease, without full CRS-HIPEC and heated chemotherapy, has produced long disease-free intervals. A less aggressive operation may be the right operation.
• Diagnosis and follow-up still matter. The main risk is a lesion that has been misclassified: true invasive mesothelioma or mesothelioma in situ must be excluded by a specialist pathologist, often with BAP1 testing. Follow-up is reasonable, and its intensity depends on the findings.
• The fertility window is often wider. Because WDPMT is frequently managed less aggressively and over a longer timeline, younger women with it often have more room for fertility planning than women facing urgent high-grade treatment. The fertility section below applies here especially.

The biggest risk with WDPMT is the opposite of the usual one: not under-treatment but over-treatment. A pathologist without peritoneal experience can misread WDPMT as malignant mesothelioma, which can send a woman into major surgery and chemotherapy she didn't need and saddle her with a grim prognosis that doesn't match her actual disease. If a high-grade diagnosis was made somewhere without specific peritoneal pathology expertise and your slides haven't been reviewed by a specialist, that review is worth getting before treatment starts.

Peritoneal inclusion cysts (formerly multicystic mesothelioma)

These lesions show up as clusters of thin-walled, fluid-filled cysts on the peritoneal surfaces, usually in the pelvis, and they are found mostly in women of reproductive age, often incidentally. They were long called multicystic mesothelioma, but current pathology guidance discourages that name in favor of (multiloculated) peritoneal inclusion cyst, to avoid confusion with malignant mesothelioma. They are not classified as cancer, and whether they are reactive or a true growth is still debated. They can recur after removal, sometimes more than once, and rare malignant transformation has been reported.⁴ The practical implication is that they are managed by surgical removal when needed, followed by surveillance, not by chemotherapy, and recurrences are best handled by a physician experienced with these lesions rather than treated as a fresh emergency each time.

Deciduoid features

Deciduoid mesothelioma is malignant epithelioid mesothelioma whose cells resemble the lining of the uterus in pregnancy. It was first described in young women with peritoneal disease, but it also occurs in men and in the pleura. Current pathology guidance does not treat deciduoid features as prognostically significant on their own, although a large series of peritoneal mesothelioma in women found worse survival when deciduoid cells predominated.^1,4 If your pathology report mentions deciduoid features, it's worth asking your oncologist what the overall grade and pattern mean for your prognosis and treatment plan.

What the low-grade variants mean for a claim

One nuance matters legally. The link between asbestos and high-grade mesothelioma is firmly established; the link between asbestos and the low-grade lesions (WDPMT and peritoneal inclusion cysts) is less settled, and many women with these variants have no identifiable asbestos exposure. That doesn't make a claim impossible where there is an exposure history, but the analysis is more involved than for high-grade disease and should be evaluated by an attorney familiar with these specific variants before any conclusion is reached. If you have one of these low-grade lesions and any history of asbestos or talc exposure, it's still worth raising.

Treatment considerations specific to women

The treatment of peritoneal mesothelioma in women follows the same framework as in men: CRS-HIPEC for those who qualify, systemic chemotherapy and, in some cases, immunotherapy for those who don't. The full detail of those treatments, including what CRS-HIPEC involves, the chemotherapy and immunotherapy regimens, and what each costs, is on the peritoneal mesothelioma treatment page. A few considerations, though, are specific to women and worth raising with your team directly rather than waiting for them to come up.

Pelvic and reproductive-organ surgery

Peritoneal mesothelioma often involves the pelvic peritoneum, the lining over the pelvis and the reproductive organs. When the disease has spread onto the uterus, ovaries, or fallopian tubes, achieving a complete cytoreduction (removing all visible tumor, the goal that drives the best outcomes) can mean removing those organs, including a hysterectomy and removal of both ovaries and tubes. These are permanent decisions. For a woman who has completed childbearing, the conversation may be straightforward; for a younger woman, the implications deserve explicit discussion before surgery, not after.

A few things are worth asking the surgical team directly:

• Is organ-sparing surgery feasible given my specific disease? The answer depends on exactly where the tumor sits and how much of the reproductive structures are involved. It deserves a specific answer, not a general statement about doing whatever complete cytoreduction requires.
• How much experience does this surgeon have with pelvic cytoreduction specifically? Thorough pelvic dissection is its own skill, and the completeness of the cytoreduction (one of the strongest predictors of outcome) depends partly on how well the pelvic portion is done. Experience varies between surgeons even at good centers.
• If my ovaries have to be removed, what does that mean for me? In a premenopausal woman, removing both ovaries causes immediate surgical menopause, with effects on bone, heart, and quality of life that reach beyond the cancer itself. These are usually manageable, often with hormone therapy, but managing them starts with naming them before surgery rather than discovering them after.

Fertility considerations for younger women

Peritoneal mesothelioma does occur at reproductive age, and so do the low-grade lesions described above. For any woman of reproductive age, whatever the variant, fertility should be part of the conversation before treatment begins, because both surgery and chemotherapy can affect it permanently.

• Egg or embryo freezing before surgery or chemotherapy preserves future options. Major cancer centers have fertility-preservation programs set up for oncology patients, and a focused consultation can often be arranged within days of diagnosis. The treatment timeline isn't always flexible enough for extensive fertility treatment, but that determination should be made after a fertility consult, not instead of one.
• Chemotherapy and ovarian function. The platinum drugs used in this disease carry a recognized risk of ovarian damage that varies with age and dose; the effect of pemetrexed on ovarian reserve is not well characterized. For younger women, that uncertainty is worth discussing with both the oncology team and a reproductive endocrinologist before systemic treatment starts.
• A wider window with WDPMT. Women with WDPMT managed by monitoring or focal surgery rather than urgent CRS-HIPEC and chemotherapy often have more time for fertility planning, because the treatment timeline is less compressed. The slower pace is one of the few advantages of that diagnosis.

These conversations move quickly once treatment is planned, so raising fertility early, even in the first days after diagnosis, is the way to keep the options open.

Prognosis for women

On average, women with peritoneal mesothelioma do somewhat better than men, and it's worth understanding both why and what that average does and doesn't mean for any one person.

In a large multi-institutional peritoneal series, among 168 patients with epithelioid disease diagnosed after 2000, women had a median overall survival of 44 months, compared with 34 months for men. The difference was statistically significant on its own, but sex was not an independent predictor once surgery, nuclear grade, and tumor architecture were accounted for. That survival analysis excluded WDPMT and inclusion cysts, so the difference is within malignant disease.³ The reasons aren't fully understood, but they likely include favorable epithelioid patterns and the younger age at which women tend to be diagnosed.

That advantage operates within the usual prognostic categories rather than overriding them. For high-grade disease, the variables that matter most are the same for women as for men: the treatment received and where it's delivered, how far the disease has spread, the nuclear grade and architectural pattern within epithelioid disease, and overall fitness. Female sex shifts the averages a little; it doesn't change which factors drive the outcome.

And that's the important caveat. The women's epithelioid median sits only modestly above the overall epithelioid figure, so the advantage is real but small, and it isn't a reason to ease off. It's not a reason to defer evaluation at a high-volume center, to accept a community oncologist's plan without a specialist's input, or to skip a clinical-trial conversation. Getting to experienced specialists matters for women just as it does for men.

How a case unfolds

The following is a composite example, not a real client.

Diane was 63 when months of bloating, abdominal pain, and feeling full after a few bites finally sent her in for imaging. The scan showed fluid in her abdomen and disease across the peritoneum, and the picture pointed, as it usually does, toward ovarian cancer. She was referred to a gynecologic oncologist, started on a carboplatin-based regimen, and told she had primary peritoneal carcinoma. When the tumor didn't respond the way her doctors expected after several rounds, her daughter started asking questions and reading, and pushed for a second look at the original biopsy.

That second pathology review, at a major center, changed the diagnosis. The immunohistochemistry pointed not to ovarian or primary peritoneal cancer but to peritoneal mesothelioma, epithelioid type. It also changed the plan: instead of continuing a regimen built for the wrong cancer, Diane was evaluated for CRS-HIPEC, the combined surgery and heated chemotherapy that offers the best outcomes in this disease, and the center's team judged her a candidate.

When Diane and her daughter pieced together where the asbestos could have come from, two sources stood out. Her father had been an auto mechanic who did brake work for years and came home in dusty coveralls she remembered hugging him in as a child. And she had used talcum powder daily, for decades, the way she'd been taught was just part of staying clean. Neither had ever seemed like a danger.

For Diane's family, the legal side ran alongside the medical one, and what it really bought was access. The history pulled together more than one possible channel: the secondhand asbestos exposure from her father's trade, and a separate claim tied to the contaminated talc, neither of which required Diane to produce old brand names or employment records herself; the product history and her father's work history were reconstructed from other sources. The recovery covered the travel and lodging for the trips to the distant center, paid for the parts of her care that insurance resisted, and replaced the income she lost during treatment, and it meant her husband and daughter could be with her for the surgery and the recovery without the household finances unraveling at the same time. A year and a half on, Diane was in surveillance at the center that treated her, back to gardening, and planning to be there for her granddaughter's graduation.

This example is general. Every case depends on the diagnosis, the exposure history, the dates, the family situation, the available evidence, and the applicable law.

Legal options for women with peritoneal mesothelioma

A woman with peritoneal mesothelioma may have legal claims from more than one exposure pathway at once, and coordinating them takes experience across both traditional asbestos litigation and talc product-liability cases, which involve different defendants, different legal theories, and different evidence. The general compensation channels are covered on the main peritoneal mesothelioma page; this section focuses on what's specific to women, and on the talc pathway in particular.

The asbestos channels, in brief

For exposure that traces to a workplace or to a family member's job, the standard asbestos channels apply to women exactly as they do to men, and they're explained in full on the main page:

• Bankruptcy trust claims against the companies that made the asbestos products and later went bankrupt. These are paper claims, with no lawsuit or courtroom. Each trust requires a qualifying diagnosis under its own medical criteria and evidence of exposure to that company's products; mesothelioma qualifies whether it formed in the chest or the abdomen. Secondhand exposure to a husband's or father's work can qualify, though some trusts route those claims to individual rather than expedited review. Mesothelioma sits at the highest disease level, but most trusts pay only a published percentage of the scheduled value, and timing varies.
• Lawsuits against asbestos manufacturers still in business and the premises owners responsible for an exposure, which can recover more than a trust claim but take longer.
• VA benefits for women exposed during military service, and Social Security disability, which can speed medical review of peritoneal mesothelioma through its Compassionate Allowances program. These are separate systems from trust, lawsuit, and talc claims, though offset, reimbursement, and disclosure rules may apply.

Talc litigation: claims against cosmetic-product makers

Talc litigation is a separate legal pathway, and it exists because cosmetic companies sold talcum powder that could contain asbestos to millions of women, for decades, with inconsistent testing and disclosure. It's the pathway most relevant to women who have no workplace or household asbestos exposure, and it can be pursued at the same time as any asbestos claims.

Who the defendants are. Talc defendants are makers and suppliers of cosmetic talc rather than industrial asbestos producers. The principal defendants in this litigation have included Johnson & Johnson (which made Johnson's Baby Powder, discontinuing the talc version in the U.S. and Canada in 2020 and worldwide in 2023, and made Shower to Shower until it sold the brand in 2012), Colgate-Palmolive (Cashmere Bouquet), and the talc supplier Imerys, among others, along with various store-brand manufacturers whose products can be traced to contaminated talc. Which company a given claim runs against depends on the specific products a woman used, the years she used them, and which supplier's talc went into them, and the channel for each depends on that company's current status. Imerys is in bankruptcy, and a talc trust proposed in that case has not yet opened. We work that out case by case.

The legal theories. Talc claims are product-liability claims. They generally rest on failure to warn (the maker knew or should have known the product could contain asbestos and didn't disclose it), failure to test (inadequate testing of talc that was known to risk asbestos contamination), and defective design (formulating the product with talc from sources where contamination was a foreseeable risk). Internal company documents produced in litigation are part of the evidentiary record on what manufacturers knew and when.

The evidence. Talc cases draw on a record that differs from a traditional asbestos case: laboratory testing of archived product samples, the manufacturers' internal documents and testing records, talc supply-chain documentation tracing which mines fed which products in which years, and the scientific literature on the migration pathway and on talc use and peritoneal mesothelioma. Assembling that record is specialized work, which is why coordinating talc and asbestos claims together takes a firm that handles both.

Two systems that don't compete. This is the structural point that matters most: talc claims and asbestos claims don't cancel each other out. They're separate pathways against different companies, and a woman with both a secondhand asbestos history and a talc history may have claims on both tracks at once. They can proceed during the same period, but they don't simply add together without consequence: trust submissions may have to be disclosed in a lawsuit, state law or court orders may allow credits or setoffs, and liens, reimbursement rights, and releases can affect how recoveries interact.

Deadlines

Like asbestos claims, talc claims are subject to filing deadlines that vary by state, and some are short. They often run from the date of diagnosis rather than the date of exposure, and claims brought after a death, such as wrongful-death claims, usually run from the date of death. The specifics depend on your state and the type of claim, so the safe step is to ask promptly. A consultation costs nothing and commits you to nothing, and the information is useful whenever you decide what to do. Find your state's asbestos laws and filing deadlines.

References

1. Malpica A, Euscher ED, Marques-Piubelli ML, et al. Malignant mesothelioma of the peritoneum in women: a clinicopathologic study of 164 cases. Am J Surg Pathol. 2021;45(1):45–58. doi:10.1097/PAS.0000000000001545
2. Brandl A, Westbrook S, Nunn S, et al. Clinical and surgical outcomes of patients with peritoneal mesothelioma discussed at a monthly national multidisciplinary team video-conference meeting. BJS Open. 2020;4(2):260–267. doi:10.1002/bjs5.50256
3. Chapel DB, Schulte JJ, Absenger G, et al. Malignant peritoneal mesothelioma: prognostic significance of clinical and pathologic parameters and validation of a nuclear-grading system in a multi-institutional series of 225 cases. Mod Pathol. 2021;34(2):380–395. doi:10.1038/s41379-020-00688-4
4. Husain AN, Chapel DB, Attanoos R, et al. Guidelines for pathologic diagnosis of mesothelioma: 2023 update of the consensus statement from the International Mesothelioma Interest Group. Arch Pathol Lab Med. 2024;148(11):1251–1271. doi:10.5858/arpa.2023-0304-RA
5. International Agency for Research on Cancer. Talc and Acrylonitrile. IARC Monographs on the Identification of Carcinogenic Hazards to Humans, Volume 136. Lyon: IARC; 2025. https://publications.iarc.who.int/646
6. Offin M, Aguirre N, Yang SR, et al. Clinical characteristics and outcomes of patients with well-differentiated papillary peritoneal mesothelial tumors. Ann Surg Oncol. 2024;31(12):7973–7977. doi:10.1245/s10434-024-16004-2