multicystic mesothelioma
Multicystic mesotheliomas are a rare benign subtype of mesothelioma.
Terminology
The nomenclature for this condition can be confusing due to the use of multiple interchangeable different synonyms that put it together with the peritoneal inclusion cysts. Although there is still some debate on this matter, this article will refer to multicystic mesotheliomas as true neoplasms, distinguishing it from peritoneal inclusion cysts, a term reserved for those cysts secondary to intra-abdominal inflammation and with its fluid content originated from the ovarian stroma.
Epidemiology
Different from malignant peritoneal mesothelioma, there is no association with asbestos exposure .
Clinical presentation
Patients generally present with non-specific symptoms such as abdominal or pelvic pain, or distension. A palpable abdominal or pelvic mass may eventually be felt on clinical examination.
Pathology
Typically comprises multiple grape-like clusters of cysts which are lined with mesothelium and separated by fibrous tissue components.
Location
Primarily occurs in the pelvic peritoneum, but can be multicompartmental .
Radiographic features
Ultrasound
May appear as a multicystic pelvic mass .
CT
- typically seen as a well-defined low attenuating (cystic) pelvic mass
- calcification is generally not a feature
MRI
Can better delineate the pelvic cystic mass. Reported signal characteristics include:
- T1: fluid components show low signal
- T2: fluid components show high signal
- C+ (Gd): may show enhancement of septa
Treatment and prognosis
Surgery is the preferred option for localized lesions. The tumor tends to recur locally (25-50% of cases) . Not thought to be chemo- or radiosensitive . May respond to hormonal therapy .
Differential diagnosis
The general differential includes:
- peritoneal inclusion cysts
- abdominopelvic cystic lymphangioma: tends to affect younger patients
- ovarian cystadenoma
- ovarian cystadenocarcinoma
- endometriosis
- cystic teratoma
- pseudomyxoma peritonei
- cystic mucinous tumor of the pancreas
See also
- mesothelioma (general article and discussion of pleural disease):
- peritoneal inclusion cyst
- primary peritoneal neoplasms
Siehe auch:
- Pseudomyxoma peritonei
- Endometriose
- Zystadenom des Ovars
- Mesotheliom
- seröses Boderline-Zystadenom des Ovars
- peritoneales Mesotheliom
- primäre peritoneale Neoplasien
- peritoneale Pseudozysten
- primäres Mesotheliom des Perikards
und weiter:
Assoziationen und Differentialdiagnosen zu multizystisches Mesotheliom:
