Work

Malignant Peritoneal Mesothelioma with Rhabdoid Features Masquerading as Idiopathic Necrotizing Pancreatitis with Mucinous Ascites: A Case Report and Literature Review

Year: 2021

Type: article

Abstract: Background: Malignant peritoneal mesothelioma (PeM) is a rare form of malignant mesothelioma that accounts for 10-15% of all cases of mesothelioma. Of these rare tumors, the rhabdoid subtype is exceptionally infrequent with only three cases reported in the current literature. PeM most commonly presents with non-specific symptoms such as abdominal distention, anorexia and weight loss that are difficult to diagnose until the disease is advanced. In this case report, we present a case of malignant peritoneal rhabdoid mesothelioma and review the literature. Case presentation: The patient is a 76-year-old woman who originally presented with necrotizing pancreatitis one year prior to diagnosis. The patient continued to complain of abdominal pain, nausea, vomiting, and weight loss. She experienced recurrent deep vein thrombosis (DVT), recurrent chylous, and mucinous ascites. Diagnostic work-up including MRI, repeat CT, EUS, and MRCP were inconclusive. Additionally, cytology from multiple paracenteses were negative for malignancy. Diagnostic laparoscopy revealed diffuse carcinomatosis, abdominal wall and peritoneal implants and a large epigastric mass. Biopsies of lesions taken during the procedure were identified as peritoneal mesothelioma. Conclusions: To our knowledge, we have presented the first case of PeM with rhabdoid features present in the peritoneum and in gastric polyps. The large amount of histopathogical variation of these tumors requires surgical biopsy, as cytology alone is non-diagnostic.

Source: Journal of Surgery

DOI: 10.11648/j.js.20210905.16