Malignant peritoneal mesothelioma with mimicry of pseudomyxoma peritonei in a patient with a history of perforated sigmadiverticulitis.
We describe a 57-year-old man who presented with diffuse abdominal pain, abdominal enlargement, vomitus, dyspnea and a weight loss of 30 kg within 6 months. These acute symptoms were preceded by an episode of ascites and an acute sigmadiverticulitis 7 months ago. Ultrasonography and computed tomography were suggestive of pseudomyxoma peritonei. However, malignant mesothelioma peritonei was diagnosed by open surgery with biopsy for histological examination. Despite R-2-resection of the tumor and following open hyperthermic intraperitoneal chemotherapy with initial remarkable recovery the patient died 5 months after therapeutical intervention. Malignant peritoneal mesothelioma is an extremely rare tumor with great diagnostic and therapeutic difficulties. We report a case including diagnostical work up and the medical surgical therapy of this disease.
Gölkel
C
C
Department of Gastroenterology and Hepatology, Hannover Medical School, Germany.
Widjaja
A
A
Hiller
W
W
Flemming
P
P
Wagner
S
S
Manns
M P
MP
D001706:Biopsy; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D004239:Diverticulitis, Colonic / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D006801:Humans; D006979:Hyperthermia, Induced; D007416:Intestinal Perforation / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008297:Male; D008654:Mesothelioma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D011553:Pseudomyxoma Peritonei / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D012810:Sigmoid Diseases / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed