診断的腹腔鏡下手術により悪性腹膜中皮腫と診断した１例

抄録

　Malignant peritoneal mesothelioma is a rare malignant tumor with poor prognosis that arises from mesothelial cells of the peritoneum. The diagnosis of this tumor is not always straightforward because of its resemblance to cancerous peritonitis, and histological examination is essential for a definitive diagnosis. A 75-year-old woman presented to her doctor with complaints of lower abdominal discomfort and weight loss. A contrast-enhanced thoracoabdominal CT scan showed pleural effusion, pleural dissemination, ascites, and peritoneal dissemination, and the patient was referred to our department. Since a contrast-enhanced pelvic MRI scan revealed no tumor in the uterus or bilateral adnexa, peritoneal cancer with cancerous pleuritis and peritonitis was suspected. Diagnostic laparoscopic surgery was performed and several peritoneal disseminated nodules were biopsied. Histopathological examination finally led to a diagnosis of biphasic malignant mesothelioma, and chemotherapy with pemetrexed and cisplatin was started on postoperative day 23. Regrettably, the tumor was refractory to chemotherapy and the patient died 6 months after the initial diagnosis.