Unraveling Peritoneal Mesothelioma: A Case-Based Discussion on Diagnosis and Management

TL;DR

This paper discusses the diagnosis and treatment of a rare and aggressive cancer called peritoneal mesothelioma in a patient with no known risk factors.

Contribution

The paper presents a case-based discussion to highlight the diagnostic and therapeutic challenges of peritoneal mesothelioma.

Findings

A laparoscopic biopsy confirmed malignant epithelioid mesothelioma with specific immunohistochemical markers.

Systemic chemotherapy with platinum and pemetrexed showed initial response but long-term efficacy remains uncertain.

The case emphasizes the need for multidisciplinary management due to the lack of standardized treatment protocols.

Abstract

Peritoneal mesothelioma is a rare and aggressive tumor, and its management remains poorly standardized in the literature. This case highlights the diagnostic and therapeutic challenges through a 56-year-old woman with no significant medical history or known asbestos exposure, who presented with progressive abdominal distension and postprandial vomiting. Imaging revealed diffuse nodular peritoneal thickening and large-volume ascites. A laparoscopic biopsy confirmed malignant epithelioid mesothelioma, supported by immunohistochemical positivity for cytokeratin 7 (CK7), calretinin, and Wilms tumor 1 (WT1). Treatment was based on systemic chemotherapy with platinum (cisplatin/carboplatin) and pemetrexed, which elicited a rapid initial response. However, the long-term efficacy remains uncertain due to the aggressive nature of the disease. The absence of standardized treatment underscores the necessity for multidisciplinary management.

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