A 51-year-old man was seen at the hospital because of abdominal distension due to ascites. Abdominal CT scan and ultrasonography revealed a large amount of ascites and diffuse thickness of the greater omentum and mesenterium. Hyaluronic acid level in the ascites was as high as 800, 000ng/ml. Malignant peritoneal mesothelioma was suspected. So, exploratory laparotomy and attachment of subcutaneous port with an infusion catheter were carried out. Histopathologically tumor cells positive for alcian-blue which is digested by hyaluronic acid were confirmed, and the definite diagnosis of malignant peritoneal mesothelioma was made. Hyperthermic chemotherapy and irradiation therapy with intraabdominal administration of cisplatin were performed. Ascites almost completely disappeared and he survived 1 year after the diagnosis.
This therapy might be useful for malignant peritoneal mesothelioma in controlling ascites and in prolonging the life span.