Multicystic Peritoneal Mesothelioma with Long-term, Recurrence-free Survival—A Series of Three Cases—

Abstract

Multicystic peritoneal mesothelioma is a rare subtype of peritoneal mesothelioma with a high recurrence rate after surgical resection and low to intermediate malignant potential. Three cases of multicystic peritoneal mesothelioma were managed in our institution between 2010 and 2016. All patients were diagnosed with pseudomyxoma peritonei and were referred to our hospital for additional examinations and treatment. Two patients underwent laparoscopic examination and were pathologically diagnosed with multicystic peritoneal mesothelioma. Open surgery was performed for all three cases, and hyperthermic intraperitoneal chemotherapy was performed for two cases. A complete resection was achieved in all cases, with long-term, recurrence-free periods. The clinical features of multicystic peritoneal mesothelioma remain unclear. Because of its rarity, there is no established treatment for multicystic peritoneal mesothelioma. Since its preoperative diagnosis is difficult, laparoscopic examination may be a useful option for intraperitoneal cysts. In our experience, complete cytoreduction using hyperthermic intraperitoneal chemotherapy and sufficient intraperitoneal lavage leads to no recurrence and long-term survival. To aim for radical resection, peritonectomy is recommended for cases that spread diffusely into the abdominal cavity.