[Primary well-differentiated papillary mesothelioma of the peritoneum--a rare but important differential diagnosis].
The primary well-differentiated papillary mesothelioma of the peritoneum is a rare neoplasm, characterized by an indolent course and good prognosis. We report the case of a 55-year-old male, who presented progressive abdominal swelling due to ascites. On computerized tomography, the peritoneum was diffusely thickened and irregular. Cytologic examination showed a lymphocyte rich ascitic fluid. Malignant cells could not be identified. On laparoscopy, numerous nodular lesions were observed on the peritoneal surface. A biopsy of the latter showed an unusual malignant growth. Using immunohisto-chemistry and electron microscopy, typical features of a well-differentiated papillary mesothelioma were recognized. The patient underwent tumor debulking. Two years later he is symptom free. This case study, much similar to another 38 reported cases in the MEDLINE database, illustrates the characteristic features of this rare malignancy that should be recognized and distinguished from other, common, more aggressive neoplasms involving the peritoneum.
Assaf
Nurit
N
Department of Internal Medicine A, Bnei-Zion Medical Center, Rappaport Medical Center, Technion, Haifa.
Naroditsky
Inna
I
Naschitz
Jochanan E
JE
Lev
Louise M
LM
D003937:Diagnosis, Differential; D006801:Humans; D016239:MEDLINE; D008297:Male; D008654:Mesothelioma / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome