Long-term survival of a woman with well differentiated papillary mesothelioma of the peritoneum: a case report and review of the literature

Abstract

Introduction: Well-differentiated papillary mesothelioma of the peritoneum (WDPMP) is a rare subtype of epitheloid mesothelioma, which is usually seen in young women. WDPMP is generally considered of low malignant potential, however the long-term nature of the tumor remains poorly defined.

Case presentation: We describe the long-term follow-up of a 60-year-old woman of West African descent who has survived 24 years with WDPMP after receiving extensive local and systemic adjuvant chemotherapy. Her clinical course has included three exploratory laparotomies with intraperitoneal and intravenous chemotherapy over two decades. Her course was complicated by anthracycline-induced cardiomyopathy, for which she underwent an orthotopic heart transplant. Our patient is alive with stable radiological evidence of peritoneal disease, and continues to suffer from chronic abdominal pain.

Conclusion: No consensus exists regarding optimal treatment strategies for WDPMP. However, given the low malignant potential of the tumor, careful consideration should be made before proceeding with aggressive interventions. Further, long-term follow-up reports are required to fully characterize this tumor.

Figure 1

Well differentiated papillary mesothelioma of the peritoneum (40× magnification). Multiple coarse papillae are present with varying fibrovascular cores and minimal cellular atypia.

Figure 2

Cross-sectional computed tomography (CT) images displaying a right-sided, perihepatic soft tissue mass containing calcifications and subhepatic loculated fluid collection.