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Benign Multicystic Peritoneal Mesothelioma

Laura Toussaint1, Daniel Clerc1,2, Stéphane Yerly3, Nicolas Demartines2, Martin Hübner2* and Olivier Pittet1
1Department of Surgery, Hôpital Riviera-Chablais, Switzerland
2Department of Visceral Surgery, University Hospital of Lausanne, Switzerland
3Department of Histocytopathology, Hôpital du Valais, Switzerland

*Corresponding author: Martin Hübner, Department of Visceral Surgery, University Hospital CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland

Published: 12 Dec, 2016
Cite this article as: Toussaint L, Clerc D, Yerly S, Demartines N, Hübner M, Pittet O. Benign Multicystic Peritoneal Mesothelioma. Clin Surg. 2016; 1: 1246.

Clinical Image

A 16-year-old young man without prior medical history presented to the emergency department complaining of lower abdominal pain and a 20 lbs weight loss since the onset of symptoms 3 months ago. Clinical examination and blood samples were unremarkable. Ultrasonography and computed tomography scan of the abdomen revealed free abdominal fluid. An exploratory laparoscopy showed multiple peritoneal cystic lesions in the pelvis and omentum (Figure 1). Pathology was consistent with benign multicystic peritoneal mesothelioma (BMPM). Patient underwent complete cytoreductive surgery (CC-0) in association with hyperthermic intraperitoneal chemotherapy (HIPEC: cisplatin 50mg/m2 and doxorubicin 15 mg/m2) (Figure 2). Postoperative course was uneventful and patient showed no signs of recurrence after 9 months.
BMPM is a rare primary tumor of the peritoneum. Etiology remains unknown [1]. The disease affects predominantly reproductive females with a mean onset at 40 years [2-3]. Symptoms are mostly unspecific, and exploratory laparoscopy with biopsies are typically required to establish the diagnosis. BMPM is considered a benign disease with very low malignant potential [3-5]. Therefore, treatment aims at symptom control and preventing local recurrence. Recurrence is more frequent in females [1,6] and patients having incomplete surgery and no intraperitoneal chemotherapy [7]. In this context, complete cytoreductive surgery with HIPEC represents the best treatment option for patients being fit for major surgery.

Figure 1

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Figure 1
Laparoscopic view showing multiple cysts on the omentum and peritoneum.

Figure 2

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Figure 2
Intraoperative view of the pelvis.


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