Abstract: Mesotheliomas are a rare malignancy of the serosal membrane. Mainly it affects the pleural surfaces followed by the second most common location, “peritoneum.” The disease follows an aggressive pattern of spread, and by the time the diagnosis is established, the condition significantly spreads to distant locations. Diagnosis of malignant peritoneal mesothelioma is typically made by tissue biopsy. The standard treatment is radical resection; however, patients have benefited from several other modalities. The current case report describes a unique case of malignant mesothelioma, biphasic peritoneal mesothelioma (BPM), which comprises less than 25% of all peritoneal mesotheliomas. The diagnosis and treatment do not differ from other subtypes; however, the prognosis is poor, and if untreated, the survival is typically less than six months.
Introduction: Malignant mesotheliomas are rare and aggressive tumors arising from serous linings of the pleura (65%-70%), peritoneum (30%), tunica vaginalis testis, and pericardium (1%-2%). Peritoneal mesothelioma (PM) was first described by Miller and Wynn in 1908. Histologically, PM is classified into three subtypes: epithelioid, sarcomatoid, and biphasic. A biphasic tumor is defined as having both epithelioid and sarcomatoid components. The diagnosis of malignant peritoneal mesothelioma requires biopsy; however, diagnosis is often delayed due to the nonspecific clinical presentation, resulting in a more advanced form of this tumor.
The recommended treatment for patients with confirmed malignant peritoneal mesothelioma is radical resection. Other treatment modalities include intensive loco-regional therapeutic strategies: cytoreductive surgery (CRS), hyperthermic intraperitoneal chemotherapy (HIPEC), and immunotherapy. We present the case of a 70-year-old female patient with right upper quadrant (RUQ) abdominal pain, nausea, malaise, and unintentional weight loss secondary to biphasic peritoneal mesothelioma (BPM). [Footnotes omitted]
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