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#156 Primary peritoneal mesothelioma; two case report and review of the literature
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  1. Pelin Höbek,
  2. Esra Isci Bostanci and
  3. Mehmet Anil Onan
  1. Gazi University Medical School, Ankara, Turkey

Abstract

Introduction/Background Primary peritoneal mesothelioma is a rare and aggressive neoplastic disease with a poor prognosis. The rarity of this entity and the challenging differential diagnosis with other ovarian and peritoneal neoplasms may lead to frequent misdiagnosis and some concerns about its histogenesis.

However, only 8% of patients with malignant peritoneal mesothelioma had a history of asbestos exposure, suggesting that other factors such as chronic inflammatory peritonitis, carcinogenic viruses, may cause the occurrence of malign primary mesothelioma.

We report two cases of malign peritoneal mesothelioma and a literature review.

Methodology A 76 year old patient was admitted as her symptoms of abdominal pain and abdominal distension. An abdominal ultrasound revealed high volume anechoic peritoneal effusion. Further investigation with abdominopelvic computed tomography showed extensive peritoneal disease with large volume ascites, peritoneal nodularity, irregular omental thickening. Ca125 value was 42 U/ml.

A 74 year old patient was admitted as her symptoms of abdominal distension. Diffuse ascites were observed on abdominal ultrasound. Ca125 value was 67 U/ml.

Both of patients were operated with the diagnosis of peritonitis carcinomatosa. After staging surgery, pathology revealed malignant mesothelioma infiltration in the ovaries, uterus, peritoneal surfaces and omentum. Carboplatin-paclitaxel chemotherapy regimen was started in both patients.

Results From 2000 to 2022, 140 cases of peritoneal mesothelioma cases were reached in the literature review. The mean age of the patients was 54,1 and the mean survival was 52 months. This age was quite young compared to the average age of our 2 patients. The first patient is healthy and at the 30th month postoperatively, the second patient has passed the 35th month postoperatively and no recurrence has occurred.

Conclusion Peritoneal mesothelioma and peritoneal carcinomatosis are very similar on clinically and imaging. The clinical presentation is non-specific as in malignant ovarian tumors, symptoms may include abdominal pain and weight loss.

Disclosures Case series and literature review of two similar patients about peritoneal mesothelioma, which is a rare tumor, are presented in this presentation.

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