Presentation
Abdominal cystic neoplasm incidentally found at US. No history of asbestos exposure.
Patient Data
CT demonstrates large multicystic peritoneal mass with minimally enhancing thin septums. Cysts have homogenous fluid density. There is no solid component or calcifications within the cystic walls. Peritoneal mass spreads along the internal surface of the abdominal wall, adjacent to the cecum, ascending colon, duodenum, right half of the transverse colon, small intestine, visceral surface of the liver, bladder apex and rectum.
At operation the huge multicystic mass was removed, the peritoneal mass adhered to the omentum, duodenum and rectum. Neither peritoneal carcinomatosis nor liver metastases were identified.
Case Discussion
There is no solid component inside the neoplasm structure. So different types of solid peritoneal masses were excluded in the imaging interpretation. At MRI, the peritoneal mass demonstrated high signal at T2 and a low signal at T1 (images not available). Peritoneal lymphangioma or peritoneal inclusion cyst (multicystic peritoneal mesothelioma) were suspected.
Histological findings were compatible with multicystic peritoneal mesothelioma. Neoplasm consists of thin-wall cavities of different calibers, lined with big round cells. Inside the cells, there were big round hyperchromic monomorphic nuclei.
My gratitude for surgeons Trushin A.A., Zaytsev D.A., Zakharenko A.A., Scuridin P.M. (First Saint-Petersburg Medical University by I.P. Pavlov, First Oncology Department).
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