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Early localized peritoneal mesothelioma as an incidental finding at laparoscopy
Author(s) -
Sugarbaker Paul H.,
Yan Hui,
Grazi Richard V.,
Shmookler Barry M.
Publication year - 2000
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(20000915)89:6<1279::aid-cncr12>3.0.co;2-8
Subject(s) - medicine , mesothelioma , peritoneal mesothelioma , asymptomatic , laparoscopy , endometriosis , abdominal cavity , carcinoembryonic antigen , pathology , cancer , radiology , surgery
BACKGROUND Peritoneal mesothelioma is regarded as a fatal disease that presents with progressive ascites in a relatively late stage of its natural history. To the authors' knowledge, prior published articles have not described the early manifestations of this cancer. METHODS A 30‐year‐old asymptomatic woman underwent laparoscopy for an infertility workup. Nodules noted in the pelvis were biopsied and determined to be mesothelioma. Standard immunohistochemical studies were performed. Cytoreductive surgery and heated intraoperative intraperitoneal chemotherapy were used for treatment. RESULTS Multiple (approximately 30) tumor nodules up to 2 mm in dimension and limited to the pelvis were observed and resected. No primary tumor focus was evident. These tumor nodules stained positive for Calretinin and negative for carcinoembryonic antigen immunohistochemically. CONCLUSIONS In this patient, no incidence for transcoelomic dissemination of mesothelioma from a single primary site was observed. Rather, this patient's clinical presentation suggested that mesothelioma may be multifocal in origin within a limited region of the peritoneal cavity. This hypothesis may support a rationale for aggressive local‐regional management of selected patients in whom peritoneal mesothelioma is of limited distribution and mass. Cancer 2000;89:1279–84. © 2000 American Cancer Society.