Abstract
A 70-year-old man, with a history of occupational asbestos exposure for more than 50 years, complained of abdominal distension and came to our hospital in May 2008. No original malignancy which could have caused the massive ascites was detected, so we performed diagnostic laparoscopy after the paracentesis to evacuate ascites. All around the peritoneum we found numerous white nodules, specimens of which were diagnosed as malignant mesothelioma pathologically. We chose a combination of chemotherapy with CDDP and Pemetrexed as the first line of treatment. He showed temporary improvement initially, but after the 5th cycle he became worse and ascites increased again. Although we tried some other chemotherapy, his condition deteriorated and he died about 15 months after the diagnosis. Peritoneal mesothelioma is such a rare entity that there is no standard management. But the disease is expected to increase in number in the near future, so management techniques need to be investigated further.
