Benign multi-cystic peritoneal mesothelioma of the porta hepatis

Hassan Aziz; Michelle Hao; Alam Merchant; Daniel Alfson; Chris Foran; M. Raashid Sheikh

doi:10.1016/j.ijscr.2020.08.047

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Benign multi-cystic peritoneal mesothelioma of the porta hepatis

Journal article

Open access

Peer reviewed

Benign multi-cystic peritoneal mesothelioma of the porta hepatis

Hassan Aziz, Michelle Hao, Alam Merchant, Daniel Alfson, Chris Foran and M. Raashid Sheikh

International journal of surgery case reports, Vol.74, pp.218-221

01/01/2020

DOI: 10.1016/j.ijscr.2020.08.047

PMCID: PMC7481495

PMID: 32892123

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Abstract

INTRODUCTION: Our case report describes a patient where multiple laparoscopies five years from initial presentation of symptoms were performed prior to laparotomy for benign multi-cystic peritoneal mesothelioma (BMPM), which has not been documented. PRESENTATION: A 61-year-old woman presented with years of chronic abdominal pain. Computerized tomography (CT) demonstrated a multi-cystic mass near the porta hepatis, and ultrasound was concerning for contained gallbladder perforation. Fine needle aspiration (FNA) demonstrated benign ductal epithelial cells in a background of mucin and bile without the presence of malignant cells. During laparotomy, a cystic mass attached to the porta hepatis seen emanating from the small bowel mesentery, and additional small cystic lesions through the abdomen were removed. The specimen, measuring 26 x 18 x 8 cm, showed multi-loculated cysts filled with serous fluid. DISCUSSION: BMPM is a rare neoplasm of mesothelioma cells originating from serosa of viscous organs. BMPMs appear as cystic structures with thin walls containing mutinous/gelatinous fluid. Microscopic features include a lack of invasion and no increased cellularity in the stroma, with or without inflammation (Myers & Babiker, 2018). It is postulated to be either a reactive or neoplastic process. There is no gold-standard treatment for BMPM. Our case is unique in the sense that our patient required several surgical biopsies before final diagnosis could be made. CONCLUSION: This case highlights the difficulty of diagnosing BMPM and differentiating it from malignant diseases that can present similarly and can be associated with significantly worse prognosis. Defined management strategies have yet to be demonstrated. (C) 2020 The Authors. Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.

Life Sciences & Biomedicine

Science & Technology

Surgery

Details

Title: Subtitle: Benign multi-cystic peritoneal mesothelioma of the porta hepatis
Creators: Hassan Aziz - Los Angeles Medical Center
Michelle Hao - University of Southern California
Alam Merchant - Los Angeles Medical Center
Daniel Alfson - Los Angeles Medical Center
Chris Foran - Los Angeles Medical Center
M. Raashid Sheikh - Los Angeles Medical Center
Resource Type: Journal article
Publication Details: International journal of surgery case reports, Vol.74, pp.218-221
DOI: 10.1016/j.ijscr.2020.08.047
PMID: 32892123
PMCID: PMC7481495
NLM abbreviation: Int J Surg Case Rep
ISSN: 2210-2612
eISSN: 2210-2612
Publisher: Elsevier
Number of pages: 4
Language: English
Date published: 01/01/2020
Academic Unit: Surgery
Record Identifier: 9984701552302771

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