Mesothelioma of Peritoneum

Introduction of mesothelioma

The most common primary malignant peritoneal neoplasm is malignant mesothelioma. The median survival rate for patients with this rare tumor is 4 to 12 months. This poor prognosis is due to the very advanced stage of the disease at the time of presentation. Patients present with abdominal pain, ascites, and weight loss.Omentum may be thickened and present as an epigastric mass. Fifty to 70 percent of patients will have a history of asbestos exposure.

CT Scan Of Abdomen

CT will demonstrate mesenteric thickening, peritoneal studding, hemorrhage within the tumor, and ascites.

Laparoscopy/Laparotomy

At laparotomy the ascitic fluid ranges from a serous transudate to a viscous fluid rich in mucopolysaccharides. The neoplasm tends to involve all peritoneal surfaces producing large masses of tumor. In contrast to pseudomyxoma peritonei, local invasion of intra-abdominal organs, such as the liver, intestine, bladder, and abdominal wall, is the rule.

Differential Diagnosis

Secondary Carcinomatosis

Pseudomyxoma peritoneii

Treatment

Operative intervention is used to provide palliation for intestinal obstruction. Radiation therapy alone, whether using open field techniques, intraperitoneal instillation of radioactive agents, or external-beam radiation therapy, has had very limited success and significant associated morbidity. Intraperitoneal chemotherapy, including the use of cisplatin and mitomycin C, have been reported, but with very limited success.Even in those patients with complete response, relapse is generally rapid.

Median survival at best is 24-30 months

Q1. Mesothelioma of peritoneum is associated with exposure of which of the following

a) Beryllium

b) Asbestos

c) Zinc

d) Nickel

Q 2. The most common symptom of peritoneal mesothelioma is

a) Abdominal pain

b) Anorexia

c) Nausea

d) weight loss

Answers

1) b

Mesothelioma is a malignant neoplasm originating from pleural or peritoneal surfaces that is

usually associated with occupational exposure to asbestos. In the US: Annual incidence of

mesothelioma is 7-13 cases per million male patients with a history of asbestos exposure.

Most fatal is cancer of the lung. Lung cancer is the most common due to working in such an environment.

Most people are eligible for compensation as many law firms have come up to support the cause.

2) a

Abdominal pain is the commonest symptom seen in 70 % of cases.