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Case Reports
. 2020 Dec 24:61:85-87.
doi: 10.1016/j.amsu.2020.12.022. eCollection 2021 Jan.

Benign multicystic peritoneal mesothelioma (BMPM) presenting with ambiguous symptoms: A rare case report

Amr Hamza  1 , Aya Zazo  1 , M Khalil Alrifai  2 , Shahed Khoja  1 , Baraa Shebli  1 , Farah Fattal  3 , Rama Alyousfi  4 , Mazen Trissi  4
Affiliations
Case Reports

Benign multicystic peritoneal mesothelioma (BMPM) presenting with ambiguous symptoms: A rare case report

Amr Hamza et al. Ann Med Surg (Lond). .

Abstract

Introduction: Benign multicystic peritoneal mesothelioma (BMPM) represents a very rare clinical entity, with only 130 registered cases in the medical literature, therefore it is usually overlooked from the list of differential diagnoses. The treatment consists of surgery and other authors suggest complementing it with hyperthermic intraperitoneal chemotherapy.

Presentation of case: A 25-year-old multiparous female experienced periodic abdominal discomfort for two weeks. She developed constipation, urinary urgency, and irregular menstruation. Family history was remarkable for endometrial and breast cancer. Abdominal examination revealed a palpable mass. Abdominal ultrasound and computed tomography scan identified the multicystic appearance of the mass. The diagnosis was unclear, therefore exploratory laparotomy was performed, which revealed multiple grape-like clusters of cysts that were excised immediately. BMPM was diagnosed based on the pathology report. Eventually, the follow-up did not reveal any recurrence.

Discussion: Mesothelial tumors include three pathological entities, including Benign multicystic peritoneal mesothelioma (BMPM). BMPM is an uncommon neoplasm and has a high recurrence rate after surgery. BMPM consists of clear cysts that take the shape of a grape-like cluster. Clinically, BMPM resembles a tangible abdominal mass and it is challenging to be diagnosed, due to its numerous differential diagnoses.

Conclusion: The definitive diagnosis of intraperitoneal cystic masses is usually challenging. Therefore, BMPM -although very rare- should always be thought of when dealing with an intraperitoneal cystic mass, especially in women in the reproductive years. In our case cytoreductive surgery solely was sufficient to achieve a disease free follow up, however, further studies regarding treatment and follow-up are required.

Keywords: BMPM; Benign tumor; Case report; Cytoreductive surgery; Peritoneum.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
(A) Axial and (B) sagittal computed tomography (CT) images show an irregular cystic-appearing mass, measuring 25 × 10 cm.
Fig. 2
Fig. 2
The gross appearance of the tumor shows multiple grape-like clusters of cysts.
Fig. 3
Fig. 3
Microscopic examination, using Hematoxylin and Eosin (H&E) Staining, demonstrated a single layer of mesothelial cells lining the cysts and varying from flattened to cuboidal.
See this image and copyright information in PMC

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