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Case Reports
. 2017 Mar 19;9(3):e1104.
doi: 10.7759/cureus.1104.

A Case of Well-Differentiated Papillary Mesothelioma of the Male Peritoneum: Successful Treatment by Systemic Chemotherapy

Aziz Bazine  1 , Mohamed Fetohi  1 , Tariq Namad  1 , Asmae Benzekri  2 , Brahim Zainoun  3 , Rachid Tanz  4 , Mohamed Ichou  4
Affiliations
Case Reports

A Case of Well-Differentiated Papillary Mesothelioma of the Male Peritoneum: Successful Treatment by Systemic Chemotherapy

Aziz Bazine et al. Cureus. .

Abstract

Well-differentiated papillary mesothelioma of the peritoneum (WDPMP) is a rare subtype of epithelioid mesothelioma, which is usually seen in young women without a history of asbestos exposure, and generally, has an indolent course. The relative rarity of this neoplasm in males prompted us to report this case of a well-differentiated papillary mesothelioma of the peritoneum in a 36-year-old man. The patient, who had no history of asbestos exposure, presented with abdominal pain and ascites of unknown etiology. Computed tomography showed abundant ascites with nodules of the peritoneal cavity. Laparoscopic examination revealed a large number of white miliary nodules diffusely covering the peritoneum. Pathology revealed a diagnosis of well-differentiated papillary mesothelioma of the peritoneum, based on histomorphology and immunohistochemistry. The patient started chemotherapy with cisplatin and pemetrexed. After six cycles of chemotherapy, the effectiveness of this chemotherapy was checked by only the computed tomography. PET scan was not used because it is not routinely recommended in WDPMP. Few data are currently available in the literature regarding the performance of the PET scan in WDPMP. Nine months later, the patient was free of symptoms. Based on reviewing the literature and our observations in this case, consultation of other pathologists is highly recommended to discern WDPMP from other disseminated peritoneal diseases, in order to offer the most effective and safe therapeutic strategy. Chemotherapy should be strongly considered if the tumor is unresectable and accompanied by symptoms. Cisplatin and pemetrexed chemotherapy could be a promising therapeutic choice.

Keywords: chemotherapy; mesothelioma; peritoneal effusion; peritoneal neoplasms; well-differentiated papillary mesothelioma.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Peritoneal effusion with micronodular peritoneal implants in abdominal computed tomography.
Figure 2
Figure 2. Histologic appearance (A, B) and immunocytochemical analyses of well-differentiated papillary mesothelioma of the peritoneum.
Figure 3
Figure 3. Complete regression of both the ascites and the peritoneal micronodules in computed tomography of the abdomen.
See this image and copyright information in PMC

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