Malignant mesothelioma of the greater omentum mimicking omental infarction: a case report.
Mesothelioma develops most commonly in the pleura, and less frequently in the peritoneum. Usually, it manifests as diffuse peritoneal thickening and multiple nodules, and rarely as a solitary mass. We report a rare case of primary malignant mesothelioma of the greater omentum, which mimicked omental infarct. A 54-year-old Korean man was admitted because of severe abdominal pain of sudden onset. A tender mass with indistinct margins was palpated in the upper abdomen. Abdominal ultrasound and computed tomography showed an ill-defined mass in the greater omentum and little ascites in the peri-hepatic space, and neutrophil-dominant exudates were documented on paracentesis. Intravenous antibiotics and analgesics were given for omental infarction with superimposed infection, which resulted in symptomatic improvement. The imaging studies after a week revealed a growing mass and ascites. Laparoscopic surgery was performed and an 8 cm x 3.3 cm greater omental mass was found, with multiple small nodules on the peritoneum, diaphragm, and pelvic cavity wall. Histological examination showed proliferating malignant epithelioid cells that stained strongly for calretinin, which was compatible with malignant mesothelioma. We recommend that primary omental mesothelioma should be included in the differential diagnosis of patients with omental infarction, despite its rarity.
Shin
Min-Kee
MK
Department of Internal Medicine & Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Gyeongnam, South Korea.
Lee
Ok-Jae
OJ
Ha
Chang-Yoon
CY
Min
Hyun-Joo
HJ
Kim
Tae-Hyo
TH
D015746:Abdominal Pain; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005762:Gastroenterology / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008654:Mesothelioma / Q000175:diagnosis* / Q000601:surgery; D008875:Middle Aged; D009852:Omentum / Q000473:pathology* / Q000601:surgery; D010532:Peritoneal Diseases / Q000175:diagnosis / Q000601:surgery; D010534:Peritoneal Neoplasms / Q000175:diagnosis* / Q000601:surgery; D010537:Peritoneum / Q000473:pathology; D011379:Prognosis
D000900:Anti-Bacterial Agents