2010 Volume 26 Issue 2 Pages 575-579
Objective: To describe a well-differentiated papillary mesothelioma (WDPM) detected incidentally at laparoscopic myomectomy.
Design: Case series
Patient: A 36-year-old asymptomatic female with uterine myomas and WDPM of the peritoneum, but no history of asbestos exposure.
Intervention: Laparoscopic diagnosis, excision, and treatment of WDPM and uterine myomas.
Result: During laparoscopic surgery for uterine myomas, we discovered a scattering of papillary nodules, 2.0 cm or less in size, studding the abdominal cavity serosa. The ovary was of normal size. Laparoscopic myomectomy and cytoreduction were executed to the extent possible. Histopathology confirmed our gross diagnosis of leiomyoma and WDPM. WDPM is rare subtype of peritoneal mesothelioma, marked by indolent behavior and a potential for malignant transformation. We thus referred the patient for specialty evaluation.
Conclusion: Presurgical radiography of this WDPM was not helpful. Its presence was an unexpected finding during laparoscopic surgery, for which immediate cytoreduction was performed. Because WDPM usually carries a favorable prognosis after cytoreduction, without need of adjuvant therapy, distinguishing it from malignant peritoneal mesothelioma is critical.
