Excision of benign multicystic peritoneal mesothelioma and deep infiltrating endometriosis with bowel involvement – A case report
Benign multicystic peritoneal mesothelioma (BMPM) is a rare peritoneal tumour. Treatment involves complete surgical resection, although recurrence rates are high. Notably, there are 7 documented cases of BMPM coexisting with endometriosis on histology and in the case reported here it was associated...
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Elsevier
2024-12-01
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| Series: | Case Reports in Women's Health |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214911224000791 |
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| author | Zahra Azeem Jyoti Sharma Robert Johnson Natalia Price Miquel Zilvetti Yabar Donna Ghosh |
| author_facet | Zahra Azeem Jyoti Sharma Robert Johnson Natalia Price Miquel Zilvetti Yabar Donna Ghosh |
| author_sort | Zahra Azeem |
| collection | DOAJ |
| description | Benign multicystic peritoneal mesothelioma (BMPM) is a rare peritoneal tumour. Treatment involves complete surgical resection, although recurrence rates are high. Notably, there are 7 documented cases of BMPM coexisting with endometriosis on histology and in the case reported here it was associated with deep infiltrating endometriosis. Examination of the 26-year-old nulliparous woman with deep dyspareunia, dyschezia and occasional rectal bleeding revealed restricted uterine mobility and a rectovaginal nodule.Magnetic resonance imaging (MRI) showed multiple clear cystic structures in the pelvis of unknown aetiology. Following discussion by a multidisciplinary team, a diagnostic laparoscopy was performed. Intraoperatively, bilateral endometriomas were identified, along with multiple fluid-filled cystic structures in the pelvis and on the anterior abdominal wall. An adhesiolysis and drainage of endometriomas was performed and the cystic structures were sent for histology.Histopathology confirmed BMPM, positive for AE1/3 and calretinin. The patient was referred to a mesothelioma malignancy institute and advised to undergo definitive surgery by the local endometriosis team. A joint surgical procedure with a colorectal team involved laparoscopic excision of peritoneal cysts, cystectomy for bilateral endometriomas, and excision of deep infiltrating endometriosis with bowel shaving. Histopathology revealed benign mesothelial cysts with foci of endometriosis.The patient had an uncomplicated recovery and is planned for long-term follow-up with the mesothelioma malignancy institute due to the high recurrence rate (up to 50 %). This case report suggests a definitive role of this two-stage procedure in patients with this diagnostic complexity and emphasises the role of multidisciplinary management. |
| format | Article |
| id | doaj-art-e28859a583be477c856a7dd7ff36d1ff |
| institution | DOAJ |
| issn | 2214-9112 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Case Reports in Women's Health |
| spelling | doaj-art-e28859a583be477c856a7dd7ff36d1ff2025-08-20T02:49:25ZengElsevierCase Reports in Women's Health2214-91122024-12-0144e0065810.1016/j.crwh.2024.e00658Excision of benign multicystic peritoneal mesothelioma and deep infiltrating endometriosis with bowel involvement – A case reportZahra Azeem0Jyoti Sharma1Robert Johnson2Natalia Price3Miquel Zilvetti Yabar4Donna Ghosh5Corresponding author.; Worcestershire Acute Hospitals NHS Trust, United KingdomWorcestershire Acute Hospitals NHS Trust, United KingdomWorcestershire Acute Hospitals NHS Trust, United KingdomWorcestershire Acute Hospitals NHS Trust, United KingdomWorcestershire Acute Hospitals NHS Trust, United KingdomWorcestershire Acute Hospitals NHS Trust, United KingdomBenign multicystic peritoneal mesothelioma (BMPM) is a rare peritoneal tumour. Treatment involves complete surgical resection, although recurrence rates are high. Notably, there are 7 documented cases of BMPM coexisting with endometriosis on histology and in the case reported here it was associated with deep infiltrating endometriosis. Examination of the 26-year-old nulliparous woman with deep dyspareunia, dyschezia and occasional rectal bleeding revealed restricted uterine mobility and a rectovaginal nodule.Magnetic resonance imaging (MRI) showed multiple clear cystic structures in the pelvis of unknown aetiology. Following discussion by a multidisciplinary team, a diagnostic laparoscopy was performed. Intraoperatively, bilateral endometriomas were identified, along with multiple fluid-filled cystic structures in the pelvis and on the anterior abdominal wall. An adhesiolysis and drainage of endometriomas was performed and the cystic structures were sent for histology.Histopathology confirmed BMPM, positive for AE1/3 and calretinin. The patient was referred to a mesothelioma malignancy institute and advised to undergo definitive surgery by the local endometriosis team. A joint surgical procedure with a colorectal team involved laparoscopic excision of peritoneal cysts, cystectomy for bilateral endometriomas, and excision of deep infiltrating endometriosis with bowel shaving. Histopathology revealed benign mesothelial cysts with foci of endometriosis.The patient had an uncomplicated recovery and is planned for long-term follow-up with the mesothelioma malignancy institute due to the high recurrence rate (up to 50 %). This case report suggests a definitive role of this two-stage procedure in patients with this diagnostic complexity and emphasises the role of multidisciplinary management.http://www.sciencedirect.com/science/article/pii/S2214911224000791Benign multicystic peritoneal mesotheliomaDeep infiltrating endometriosisEndometriosisBowel endometriosisEndometriomasMultidisciplinary team |
| spellingShingle | Zahra Azeem Jyoti Sharma Robert Johnson Natalia Price Miquel Zilvetti Yabar Donna Ghosh Excision of benign multicystic peritoneal mesothelioma and deep infiltrating endometriosis with bowel involvement – A case report Case Reports in Women's Health Benign multicystic peritoneal mesothelioma Deep infiltrating endometriosis Endometriosis Bowel endometriosis Endometriomas Multidisciplinary team |
| title | Excision of benign multicystic peritoneal mesothelioma and deep infiltrating endometriosis with bowel involvement – A case report |
| title_full | Excision of benign multicystic peritoneal mesothelioma and deep infiltrating endometriosis with bowel involvement – A case report |
| title_fullStr | Excision of benign multicystic peritoneal mesothelioma and deep infiltrating endometriosis with bowel involvement – A case report |
| title_full_unstemmed | Excision of benign multicystic peritoneal mesothelioma and deep infiltrating endometriosis with bowel involvement – A case report |
| title_short | Excision of benign multicystic peritoneal mesothelioma and deep infiltrating endometriosis with bowel involvement – A case report |
| title_sort | excision of benign multicystic peritoneal mesothelioma and deep infiltrating endometriosis with bowel involvement a case report |
| topic | Benign multicystic peritoneal mesothelioma Deep infiltrating endometriosis Endometriosis Bowel endometriosis Endometriomas Multidisciplinary team |
| url | http://www.sciencedirect.com/science/article/pii/S2214911224000791 |
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