A case of malignant peritoneal mesothelioma diagnosed by diagnostic laparoscopic surgery

Abstract

Synopsis: Peritoneal mesothelioma accounts for approximately 15%of all mesotheliomas and has a poor prognosis with a 5-year survival rate of approximately 20%. Confirming the diagnosis takes time because of clinical symptom nonspecificity and disease rarity. Herein, we reported a case of peritoneal mesothelioma diagnosed after laparoscopic surgery for suspected peritoneal cancer. A 65-year-old female patient with no menstrual expectancies had previously undergone surgery for lung adenocarcinoma. Two years postoperatively, computed tomography revealed ascites effusion and suspected peritoneal seeding, and the patient was referred to our department. The uterus and bilateral adnexa were normal in size, and tumor markers were negative. Fluorodeoxyglucose-positron emission tomography revealed no accumulation, and laparoscopic surgery was performed for diagnosis. The intraoperative results demonstrated a large intraabdominal meshwork mass and numerous nodules in the peritoneum, and rapid intraoperative diagnosis indicated mesothelial hyperplasia. Permanent histopathology revealed epithelial-type peritoneal mesothelioma. The patient was scheduled to be transferred to the oncology department of another hospital to start chemotherapy but is currently under observation at her request. Tissue diagnosis is crucial for the diagnosis of peritoneal mesothelioma, but we confirmed the diagnosis by performing laparoscopic surgery.Key words: peritoneum, laparoscopic surgery, peritoneal mesothelioma